.<>-% %• # ': -'^ V* - <-\ "> x* N / "'< V W* - ^*. *.A A v <£ < ^ i^ x ^ A 1 " &% *> t o. ^ , o > ^c A - - V' >o ,\ x ^ " 4 c < .. V I B h Q * 0° , - , V/ Pi**. '* VV " - % , ° * CLINICAL MATERIA MEDICA BEING A COURSE OF LECTURES DELIVERED AT THE HAHNEMANN MEDICAL COLLEGE, OF PHILADELPHIA BY THE EATE E. A. FARRINGTON, M. D. REPORTED PHONOGRAPHICAEEY BY CLARENCE BARTLETT, M. D. WITH A MEMORIAL SKETCH OF THE AUTHOR, BY AUG. KORNDCERFER, M. D. i FOURTH EDITION, REVISED AND ENLARGED BY HARVEY FARRINGTON, M. D. l PHILADELPHIA : BOERICKE & TAFEL 1908 LIBRARY of CONGRESS* I wo Copies tecewd? JUL 11 )^08 CLASS- P> XACi Nu, 2 o cu COPY Katered, according to Act of Congress, in the year 1896 BY MRS. ELIZ. A. FARRINGTON In the Office of the Librarian of Congress, at Washington, D. C. Copyrighted 1908, by ELTZ. A. FARRINGTON PREFACE TO THE FIRST EDITION. During the year following the death of Dr. Farrington, the editor of this volume published several of the lectures here presented, in the Hahnemannian Monthly, North American Journal of Homoeopathy ■, and Monthly Homoeopathic Review. These were well received by the pro- fession. Some of them were, moreover, translated and published in German, French, and Spanish journals. A number of physicians expressed the desire to have the lectures appear in book form. The consent of Mrs. Farrington to such publication was therefore obtained, the Doctor's manuscript was placed at our disposal, and Dr. S. Iyilien- thal kindly consented to revise the lectures after their completion in manuscript. In order that the work should be thoroughly representative of Dr. Farrington, those concerned in its preparation for the press decided that the author's style should be closely followed. These lectures are therefore presented exactly as delivered, excepting where a change was suggested by his manuscript or by his published writings. There have also been incorporated in the volume numerous abstracts from the comparisons in the " Studies in Materia Medica," published in the Hahneman?iia?i Monthly in the years 1880, 1881, and 1882. These will be found in the lectures on Lachesis, Apis, Cantharis, and Sepia. The lecture on Moschus is essentially a reprint of the study of that remedy in the Hahnemannian for January, 1882. The editor feels no necessity for apologizing for this addition of the above-men- tioned matter to the lectures proper, for, as Dr. Korndcerfer truly says in his memorial sketch of his deceased friend, they "belong to the classics of our school. ' ' The regret is that they cannot be incorporated in their entirety. The reader must remember that in a course consisting of seventy- two lectures, it would be utterly impossible to include a complete presentation of the homoeopathic materia medica. This fact was always kept in mind by Dr. Farrington. It was his aim, therefore, to present to his students, only such matter as would enable them to establish their knowledge of materia medica on such a firm foundation that 1 2 PREFACE. their post-graduate study of that science would be a comparatively easy task. How well he succeeded in his object can be attested by the many physicians whose fortune it was to receive instruction from his lips. It should be said of Dr. Farrington's manuscript, that it gave marked evidence of constant study. Interlineations and notes of refer- ence were frequently added. Erasures were few, for what he therein recorded was only placed there after having been thoroughly confirmed by the clinical experience of himself, or of some other competent observer. Fully did he realize the importance to homoeopathy of a materia medica which should be, in all respects, perfect. CLARENCE BARTl,F/rT, M. D. Philadelphia, October ist, 1887. PREFACE TO THE SECOND EDITION. When the first edition of this work was published, in the autumn of 1887, a large number of copies were printed, sufficient, it was thought, to satisfy the demand for some time to come. So flattering was the reception accorded it, this large edition has been exhausted, and a new one has been called for. In the preparation of this the editor has had, as before, the assistance of the author's manuscript lectures, together with notes of students whose privilege it was to receive instruction from Dr. Farrington in more recent years than was accorded the editor. The result of this revision has been the addition of a number of symptomatic indications for drugs. These additions have been pretty evenly divided over the whole work. In presenting the second edition of Farrington' s Clinical Materia Medica to the profession, the editor cannot refrain from expressing his admiration of the thoroughness of the work of its distinguished author. A review of the index shows that more than four hundred drugs were considered by him; many of these received but minor men- tion, while others he treated of in extenso, as their importance war- ranted. The therapeutic index shows, moreover, that hardly a class of ailments to which humanity is liable but what has received more or less attention. The therapeutics of diseases like scarlatina, diphtheria, and typhoid fever, as to be expected from their importance, were thoroughly considered. Others, but seldom met with in actual prac- tice, were given but a passing notice. In all his teachings Dr. Far- rington showed himself to be a practical physician, fully alive to the demands to be made upon the needs of the student on entering practice. October i, 1890. C. B. PREFACE TO THE THIRD EDITION. Owing to the continued favor of the profession, the second edition of my father's work is now exhausted, and it becomes necessary to issue a third, which is herewith presented in substantially the same form with the one preceding. I have gone over the whole work, carefully comparing the text with the original material and correcting one or two palpable errors, also pressing into service a large volume of notes on Materia Medica, chiefly comparisons, which was not made use of before. Harvey Farrington, M. D. Philadelphia, Pa., August 19, 1896. PREFACE TO THE FOURTH EDITION. Farrington's Clinical Materia Medica has made for itself a place among the classics of homoeopathic literature. It has become a standard text book in the colleges, and is consulted by practicians generally in this country and, in fact, wherever Homoeopathy has made its way. It has been translated and published in the German language, in Spanish (Mexican), and an edition in Bengalee (Indian) has been contemplated, if not already issued. Though lacking in the perfection that the author himself would have given it had he written it with his own hand, it nevertheless bears the charm and freedom of expression of the fluent lecturer who is well-versed in the materia medica and a past-master in its practical application. In editing this, the fourth edition of the work, these essential characteristics have been faithfully preserved. The revision has consisted chiefly in the elimination of a few inelegant expressions, due to a too literal transcription from the notes of the stenographer. Over forty pages of new matter have been added, including a full lecture on Natrum arsenicatum. But, with only a few minor excep- tions, these additions have been made from original manuscript notes and articles from current literature by the author himself. Much time has been expended in compiling the indexes, which will now be found to contain the names of some of the lesser remedies mentioned in comparisons, the alkaloids and other references previously omitted. To master the homoeopathic materia medica requires years of study and close application. Those who are conscientiously toiling to this end will find much in the following pages to lighten their labor. In conclusion, I wish to acknowledge my indebtedness to my brother, Dr. Ernest A. Farrington, for valuable assistance in preparing the work for the press. Harvey Farrington, M. D. Chicago, Iu,., January, 1908. CONTENTS. PAGB In Memoriam, 9 Lecture I. Introductory, 17 II. Animal Kingdom, 25 III. The Ophidia — Lachesis, 33 IV. The Ophidia — L,achesis {continued), . . . 49 V. The Ophidia — L,achesis {continued), 62 VI. Archnida — Mygale, Lycosa tarentula, Tarentula Cubensis, Aranea diadema and Theridion curassavicum, 73 VII. Cantharis, 84 VIII. Hymenoptera — Apis mellifica, 98 IX. Moschus, 115 X. Sepia, 122 XI. Sepia {continued), 133 XII. Nosodes — Psorinum and Ambra grisea, 147 XIII. Secale cornutum, .... 153 XIV. The Vegetable Kingdom — Apocynacese; Apocynum canna- binum, Oleander, Vinca minor and Alstonia scholaris, 161 XV. Gelsemium sempervirens, 169 XVI. Nux vomica, 177 XVII. Ignatia, 197 XVIII. Spigelia anthelmintica, Curare and the Juglandacese, . . 205 XIX. Aracese — Arum triphyllum, Caladium, Dracontium and Pothos fcetida, 208 XX. Anacardiacese — Anacardium orientale, 217 XXI. Rhus toxicodendron, 223 XXII. Compositae — Arnica montana, Artemisia vulgaris, Absin- thium, Millefolium, Taraxacum, Kupatorium perfolia- tum, Artemisia abrotanum, . ., 237 XXIII. Cina and Chamomilla, ... 246 XXIV. Melanthaceae — Colchicum, Veratrum album, Veratrum viride and Sabadilla, 251 XXV. Menispermaceae — Cocculuslndicus, 259 XXVI. Papaveraceae — Opium, . 264 XXVII. Sanguinaria and Chelidonium, 274 XXVIII. Cucurbitaceae— Colocynth, 284 XXIX. Bryonia alba, . . 289 XXX. Coniferae — Abies nigra, Sabina juniperis, Terebinthina, Pix liquida and Thuja occidentalis ; Euphorbiaceae — Croton tiglium, etc., 304 XXXI. Ranunculaceae — Aconitum napellus, 314 XXXII. Actea racemosa, Ranunculus bulbosus and Ranunculus sceleratus, . 326 XXXIII. Helleborus and Staphisagria, 334 8 CONTENTS. PAGE IyECTURE XXXIV. Pulsatilla, 343 XXXV. Rubiacese — Cinchona rubra, 363 XXXVI. Ipecacuanha and Coffea, 376 XXXVII. Scrophulariacese — Digitalis purpurea, L,inaria vulgaris, Verbascum, Gratiola, L,eptandra Virginica and Eu- phrasia, . . 387 XXXVIII. Baptisia tinctoria, 399 XXXIX. Solanacese — Belladonna, 404 Xly. Stramonium and Hyoscyamus, 423 XL/I. Tabacum, Dulcamara, Capsicum and Glonoin, 432 Xlyll. I/ycopodiuni clavatum, 439 XL,III. The Umbelliferse — Conium maculatum, Ammoniacum gummi, Asafoetida, ^Sthusa cynapium ; the Berberi- dacese — Berberis and Podophyllum, 447 XLIV. Mineral Kingdom — Selenium, 454 XLV. Sulphur, 463 XI/VI. The Carbon Group — Carbo vegetabilis, . . 479 XI/VTL Carbo animalis, Graphites and Petroleum, 488 XL, VIII. Halogens, Bromine and Iodine; and Spongia, 501 XLJX. The Acids— Fluoric and Muriatic acids, 515 Iv. Phosphoric and Sulphuric acids, ... 526 IvI. Nitric, Hydrocyanic and Picric acids, 533 LJI. Silicea, ... .542 LIU. Arsenicum album, 549 IylV. Phosphorus, 562 IvV. The Preparations of Antimony — Antimonium crudum and Antimonium tartaricum, ... . 576 LVI. The Preparations of Mercury 584 LVIL The Noble Metals— Aurum, ■ • 600 IvVIII. The Preparations of Silver — Argentum nitricum and Ar- gentum metallicum, 605 LJX. Platina, Palladium and Alumina, 612 L,X. Plumbum and Stannum, . . 621 IvXI. Cuprum and Zincum, 628 LXII. Ferrum and the Magnesia Salts — Magnesia carb. and Mag- nesia mur., 639 IvXIII. Baryta carb. , Strontiana carb. and Lithium carb. , . ... 649 LXIV. The Ammonium Preparations — Ammonium carb. , Ammon- ium mur. and Ammonium phos. , 657 LXV. Salts of Ivime — Calcarea ostrearum, 666 IyXVI. Calcarea phosphorica and Hepar, . ... 678 IyXVII. Preparations of Soda — Natrum carb. and Natrum sulph., . . 689 IyXVIII. Natrum muriaticum and Natrum arsenicatum, 696 IyXIX. Borax veneta, 706 L/XX. Salts of Potash — Kali bromatum and Kali hydriodicum, . . 712 L,XXI. Kali bichromicum, 720 LXXII. Causticum, 729 LXXIII. Kali carb., 736 Index of Remedies, . 743 Therapeutic Index, 777 Un flfeemorianv PROFESSOR E. A. FARRINGTON, M. D. BY AUG. KORNDCERFER, M. D., PHILADELPHIA, PA. The subject of this sketch, Dr. Ernest A. Farrington, was born January i, 1847, at Williamsburg, Long Island, N. Y., and died at Philadelphia, December 17, 1885. During his early years his family removed to Philadelphia, at which place he received his education, and rapidly rose to eminence in his profession. Having already, during his early childhood, given evidence of ex- ceptional intellectual ability, he passed through his school life with the highest commendation of his teachers. After his entrance to the High School he seemed to develop an in- tellectual capacity rarely witnessed in one so young. He grasped and utilized facts with such vigor that his teachers looked upon him as quite a phenomenal boy. Often have I heard his teachers, professors of the High School, remark upon his aptness, clearness of thought, and remarkable proficiency in the various studies embraced in the curriculum of the school. It may here be worthy of passing note, that, during his entire school and student life, he endeared himself to his teachers, not less by his genial manners, than by his remarkable intellectual qualities. Having completed the prescribed course at the High School, he made a most brilliant examination and was graduated, not only at the head of his class, but with the highest average to that time attained by any graduate of the institution. During the following summer he visited his birthplace, spending the summer there and in New York city. Early in the fall he returned to Philadelphia, there to resume his favorite occupation, study. *From the Hahnemannian Monthly, January, 1886. IO IN MKMORIAM. Under the preceptorship of his brother, H. W. Farrington, M. D., he in the fall of 1866, matriculated in the Homoeopathic Medical Col- lege of Pennsylvania. Here, again, the characteristics of his early life became the remark of his fellow-students, and it was not long before he was looked upon as one of the brightest students of his class. His quickness of percep- tion, his ready memory, his devotion to study, and conscientious esti- mate of the responsibilities of his calling, marked him as one of the most promising students of our school. Coupled with all this, was an un- usually strong religious bent of mind. His religious views were, how- ever, of that happy type which but illuminate life's way, never casting shadows of doubt or gloom. His highest aim was to do right because it was right; that he accomplished this, all who knew him will attest. When the Hahnemann Medical College of Philadelphia was char- tered, in 1867, it became a question of serious import to him as to whether he should continue in the College with which he was con- nected or join the new institution. After lengthened consideration, he decided to sever his relationship with the old College. He became the second matriculant of the Hahnemann Medical College of Philadelphia. Here, again, he won unstinted praise, and graduated March, 1868, having enforced the full conviction upon the minds of all, both Faculty and class, that he had no superior in the class of "68." To the honor of all, let it be said that envy never tainted the commendation of one; every graduate delighted to accord to him his full meed of praise. He entered practice immediately after his graduation, establishing himself at the residence of his father, 161 6 Mount Vernon Street. His arduous labors in the pursuit of knowledge, during the years of college life, followed by even greater efforts during his early practice, made preceptible inroads upon his otherwise strong constitution; this led him, during the summer of 1869, to take a short European trip, from which he returned much improved in health He reentered prac- tice with renewed vigor, and speedily succeeded in securing a large and appreciative clientele. On the 13th of September, 1871, he consummated in marriage an engagement which had for some time existed with Miss Elizabeth Aitkin, of Philadelphia, an event which brought more than usual joy, as in his wife he found a most congenial and helpful spirit, both as to his professional and religious life. Four children, three boys and one girl, have blessed this union. IN MEMORIAM. II Dr. Farrington was essentially a teacher among men. Already we find him, in the spring of 1869, filling a lecturer's appointment as teacher of Forensic Medicine in the spring course of the Hahnemann Medical College. These lectures proved to be so satisfactory that the Faculty, on the resignation of the Professor of Forensic Medicine, after the session of 1869-70, elected him to fill the vacancy. Within two years, the chair of Pathology and Diagnosis becoming vacant, he was appointed to fill the same, and in 1874, upon the resignation of Dr. Guernsey, then Professor of Materia Medica, he was called to fill that most important chair. His ambition was now about to realize the attainment of its highest aim. This had really been his true field of labor — here his .deepest studies were made; here was, indeed, his life work. Possessed of superior analytical powers, he never felt satisfied to ac- cept a view or theory save it were demonstrably true; he, therefore, made deep and thorough research and study upon every question involved in the subject of homoeopathy; the law, dosage and potency questions, all were subjects of much interest, but above all, his delight lay in the study of the Materia Medica. His daily association with Hering quickened this his natural desire, and he was soon recognized by that master spirit of our school as one well fitted to a place in the highest rank among the expounders of that most intricate science, Materia Medica. Hering delighted to say, " When I am gone, Farrington must finish my Materia Medica." His labors in this direction were not restricted to simply reviewing old provings, but were rounded out unto fulness by personally super- vising provings of both old and new drugs. While he certainly pos- sessed a wonderful memory for symptoms, the most prominent feature of his teaching may nevertheless be said to have been his ability to thoroughly analyze the specific drug action, showing not only the superficial but also the deeper relationship of symptoms. Family and class relationship of drugs he studied with deepest interest. In fact, his " Studies in Materia Medica," a few of which have been published in the Hahnemannian Monthly ', belong to the classics of our school. On his election to the chair of Materia Medica. he devoted much of his time to the development of a method which, while full and com- prehensive, would at the same time present a simplicity which would enable every student to intelligently study this most difficult subject. 12 IN MKMORIAM. He infused such new life into this usually prosy subject, that it soon became the favorite hour with many, and to all an hour of interest and profit. To the earnest student it became rather a recreation than a task. His analytical mind carried the students through labyrinths of symptoms and mazes of modalities, with such clear and concise direc- tions as to the way, that the thoughtful student might ever after feel able to traverse the same alone. His writings all bear the impress of a master mind. Already in 187 1, scarcely three years subsequent to his graduation, we find him dealing with the philosophical elucidation of drug prescribing, in lan- guage indicating depth of knowledge rarely found even among our oldest practitioners. In illustration, permit a short quotation from his report of a case published in the Hahnema?inian Monthly, April, 187 1. "It is a singular fact that all of the tribe of Senecionidecs, Ord. Composites which we have proved (Cina, Artem. vulg., Cham., Tana- cet., Arnic, Senecio grac.) have relief from some form of motion. "The Artemisia vulgaris resembles the Cina in nervous troubles, but, as it is in conjunctive relationship, it can not be used immediately before or after Cina. As a disjunctive relative and hence one that fol- lows well, Silicea corresponds to the somnambulistic state, and Silicea, Nux vom. and Causl., to the irritation of the solar plexus giving rise to spasm. " The Absinthium (wormwood), another member of the Artemisise, when drunk in brandy (a famous drink used to stimulate the brain by actors, etc.), I have seen produce the delirium embriosorum, which was only relieved by pacing the floor, showing again the general relief from motion." Thus we find him, as a beginner in years, treating the Materia Medica as by the hand of a master. The literature of our school has been greatly enriched by his pen; for though he did not strive to gratify ambition in giving to the profession massive volumes, he performed that which he felt duty to demand, i. e., gave of his 'time in work not only upon his lectures, but also to societies, and in our journal literature. The American Journal of Homoeopathic Materia Medica, the Hahnc- mannian Monthly, the No?th American Journal of Homoeopathy, and other journals, have each received valuable articles from his pen. His Studies in Materia Medica alone, published in the Hahnemannian Monthly, aggregate about two hundred pages, and his comparisons, published as an appendix to the American fournal of Homoeopathic Materia Medica, from 1873 to 1875, embrace over 150 pages more. His other articles were numerous and instructive. IN MEMORIAM. 13 Dr. Farrington was a homoeopathist by conviction. With him it was not a light thing to be a physician, and he could only practice that which he could see to be true. Expediencies, for the sake of gaining the eclat of those who, through want of knowledge, grant un- stinting praise to pleasant error, had no attraction for him. He pre- ferred to sacrifice and to sustain his own sense of doing right rather than gain financial success by pandering to the ignorance of wealth, where it demanded departure from the law of cure in an experimental treatment of disease. The influence which such a mind must exert upon a profession can- not be overestimated. Essentially scientific in its bent, progressive in its character, earnest in its labors, logical in its reasonings, and philo- sophical in its judgments, the results reached even most presistent op- ponents were compelled to receive with respect. While thus a true and most consistent homoeopath, he necessarily became identified with every movement which might tend toward the advancement of learn- ing. Especially did he desire to see medical education brought to a far higher level than has ever been attained in this country. Dr. Farrington was also an active participant in our County Society work. On the floor during debate, he was listened to with that atten- tion which ability only can command. In the Chair, which for three successive years he occupied, he presided with dignity and justive. He was also a member of the State Society and of the American Institute of Homoeopathy, which latter he joined in 1872. For many years he was a member of its " Committee on Drug Provings," during which time he was also identified with its Bureau of Materia Medica. At the time of his decease he was chairman of that bureau. In 1884 the Institute appointed him a member of its Editorial Consulting Com- mittee on the new " Cyclopaedia of Drug Pathogenesy," etc. In December, 1879, when the Hahnemannian Monthly was purchased by the Hahnemann Club of Philadelphia, he was selected by his col- leagues of the Club as the sole editor of the journal, but on account of impairment of health and multiplicity of duties he felt impelled to de- cline the charge; though later, at the earnest solicitation of the Club, supplemented by that of the General Editor, he accepted the position of Contributing Editor, which position he filled until the time of his death; in fact, his last article, a book review, was written but a few weeks prior to his decease. Thus we find him throughout his life striving to accomplish the 14 IN MEMORIAM. work which he valued so highly. No labor seemed too great, no effort too severe, so long as it tended to promote the advance toward that standard to which he felt the profession should aspire. An earnest advocate of higher education in general, he especially longed for the time when the professional standard should be placed at its highest. Dr. Farrington was not less esteemed for his generous friendship than for his professional ability. He was noticeably a man of strong convictions nevertheless, with such characteristic breadth of thought and liberality of mind that he never allowed the strongest antagonism in scientific views to chill a friendship once formed. His genial manners rendered him a most delightful companion, as all who ever had the opportunity to enjoy social intercourse with him will heartily attest. His last illness began about the 14th of December, 1884, prior to which time he had contracted a cold to which he gave slight heed. Subsequently, owing to necessary exposure in the performance of his professional duties, laryngitis set in; he, nevertheless, delivered several lectures after the throat symptoms had assumed decided severity. During a lecture prior to the Christmas holidays, aphonia took the place of the existing hoarseness, rendering further lecturing impos- sible. It became necessary for him to secure a substitute during the month of January, 1885, but feeling much improved, he insisted upon resum- ing lectures during the month of February. He continued his duties in the College until after the Spring examination. During this time the disease invaded the bronchia, developing into a severe bronchitis; this, however, yielded partially during the latter part of March and April. At this time the most careful physical examination did not reveal the slightest sign of lung involvement. He now felt convinced that a trip to Europe would materially advance his recovery. He therefore sailed for Europe, accompanied by his wife, on the 9th day of May. On the 31st of May he wrote from Paris: " I am about the same, as yet, but live in hope." Under the advice of Dr. Herrmann, of Paris, he concluded to "go to Baden- Weiler, a beautiful little town in the Black Forest, noted for its mild climate, mountainous scenery, and restful surroundings." Here again disappointment came to him in that a wet season set in, which continued until his departure, although he remained for several weeks hoping for a favorable change. A stay of several weeks at Brighton, England, highly recommended IN MEMORIAM. 15 by several English physicians, afforded no relief. Much discouraged he finally sailed for home. Disappointment and injury alone had re- sulted from his journey. He now began to feel that his race was nearly run; that the great work in which he had engaged must be laid aside, and hopes long entertained must be abandoned. The first realization brought a feeling of bitter disappointment, which, however, speedily gave place to a calm conviction that the Lord's way was best. His mind seemed at perfect ease, and though he made fruitless efforts to obtain relief, he maintained an unwavering confidence in the law of cure. Some of his lay friends, seeing that homoeopathy must fail, strongly urged him to seek the advice of a prominent allopathist. This he positively refused, after- wards remarking to the writer: " If I must die, I want to die a Chris- tian." His faith in the law was unbounded; he believed it divine in origin, and therefore wholly true. In religious faith he was a Swedenborgian, holding devoutly to the views of that great expounder of God's law. In his church life, as in his professional, he showed that zeal and learning which soon made him a light among his brethren. He was loved and esteemed by his church as but few laymen at his age are loved. Conscientious, zealous and learned, he seemed destined to be a leader among men. He was early called to his work on earth — that work he faithfully performed. Early the call came to his work on high — confidently he entered thereon. Seeking higher planes of usefulness here, he looked forward to his higher field of labor there in pleasurable anticipation. A good man has been called away. May his living example inspire many to emulation. A CLINICAL MATERIA MEDICA. LECTURE I. INTRODUCTORY. Today we are to begin our study of Materia Medica. At the out- set, it will be necessary to give a rambling review of the subject. Before you begin the study of the details of a science, you must understand the construction of that science or art. Were it not for these underlying laws which string together the Materia Medica into one consistent whole you would have no need for lectures on the sub- ject. The ten volumes of the Encyclopedia of Materia Medica, issued by Dr. Allen, of New York, contain over nine thousand pages. These do not include clinical symptoms, which would make several thousand more. Then recollect, each physician discovers something new each year, and so a great mass of knowledge is accumulated by a sort of compound multiplication. You can, therefore, well understand why the student might be startled at the idea of attempting to master such a conglomeration. Nor could he master it, were he to attempt to do so by memor} 7 alone. Man's mind is composed of more than memory. Memory is the impression made on the mind by a fact. Recollection is another qualification of the mind, which enables one to call up the facts which have been memorized. It is understood that nothing which we take into the memory is ever effaced. It remains there for- ever. It may be covered with figurative cobwebs and never brought to light, unless the mind is so drilled or so orderly arranged that it may be recalled when occasion requires. The mind should be so drilled and its various faculties so trained that when an external thing occurs similar to an internal fact, i. e., a fact memorized, at once that external thing awakens into recollection the fact or facts bearing on that subject. This is very apt to be so with our feelings, perhaps 2 1 8 A CLINICAL MATERIA MEDICA. more naturally than with our intellects, because the latter require more cultivation. Many of us are so strong emotionally that we may call up an emotion without any evident effort of the will or any direc- tion of the understanding. L,et me give you an example. A man, on one occasion, was driving along a country road, and ran over a dog and horribly mangled the poor animal. This made him feel very sick. The event was apparently forgotten. Several years later he was driv- ing along the same road, never thinking of the incident, until he came to the spot where the accident happened, when immediately the same sensation of sickness occurred. Then the impression which was made on his mind was recalled, and at once awakened the emotions. Thus must be the intellectual mind of the man who would master the science of medicine. He must see his patient, and when he sees his patient it awakens in his mind the picture of the remedy. This has been termed instinct, but it is not. To do this he must study persistently. You see a plrysician old in years come into a sick-room. At once he says, this patient needs Sulphur. How did he know that ? It was not sec- ond sight on his part; but through thirty or forty years' experience he had been studying Sulphur, had been forming in his mind images of Sulphur, and living ideas of Sulphur. The moment he sees these in his patient, that moment he recollects Sulphur. If he had not the idea of that remedy in his mind, he could not see it in his patient. Now, I ask of you not to try to jump over these years that must pass between the beginning and the ending of the art of medicine, and do not make yourselves prophets before your time. In order to bring some system out of this chaos of Materia Medica, it will be necessary to adopt some plan of study. What is that plan, is asked by every student; one teacher answers in one way, another in another. The method may not be correct, and yet its results may be good. It does well enough for a scaffolding by which you erect your building, after which the scaffolding is removed and the building re- mains. Some method must be adopted, and that retained to the end. In analyzing the method which I have chosen to adopt it may be well to begin at the beginning and to carry you on until you may see what plan I propose for your adoption. It may not be clear at once. An abstract thing is not at once grasped by the mind. It requires to come up time after time. What seems difficult at first, is plain enough after a while. In the first place, I will begin by suggesting an analysis of the drug. INTRODUCTORY. 1 9 We presume now that you have heard of some one substance which has been a popular remedy in 3^our part of the country for years. You think that it ought to be proved. You proceed to get the necessary material. First, you procure 3'our drug. You prepare its tincture and then you potentize it. Now, it is a principle of Homoeopathy, to which there is no exception, that you shall learn the action of a drug on the healthy organism before you use it in practice. That is a rule which you cannot neglect. You cannot be too careful, otherwise you throw 3'ourself into confusion, doubt and empiricism, and help to fill the Materia Medica with "bosh," of which there is enough already there. What you want to know, is exactly what this medicine will do. What would 3^011 think of a machinist who undertook to build a ma- chine when he did not know how the parts fitted together? What would you think of a physician who does not know the use of the tools he is about to emplo3 T ? You now intend to try the effects of this drug on some health j 7- person or persons. Will it produce alterations in the function or the nutrition of the body or of its organs? If so, a symptom or symptoms will be the result. Symptoms, then, are indi- cations of alterations in the functions or the nutrition of a part or of parts of the bod3 r . I have been accused of stepping down from the lofty heights of pure Homoeopathy and dressing n^self in physiologi- cal liver3'. The statement made against me is that we cannot know wdiat changes are taking place except through symptoms; therefore, if one begins to talk about altered tissue, he at once pollutes Homoe- opathy. This is true, and it is false. It is true if you take this altered tissue alone. It is not true if 3'ou regard this altered tissue as a mani- festation of the change in the vital force. I cannot see how there can be a symptom which is not at least the result of a change of function. I do not mean that 3^011 must give Bryonia because it acts on serous membranes. 1 do not mean that you must give Aconite because it pro- duces dry skin, heat, etc. I do not sa3' that you shall give Belladonna because it produces Iwpersemia of the brain and dilatation of the pupil; but I do say that these drugs produce these effects, and if these effects are not alterations in function, what are they? We can know changes in the vital force only by results, and these results are S3miptoms. Now you get S3 r mptoms in your provings. These symptoms 3'ou will find to be embraced under two grand classes, subjective and objective. The subjective S3 7 mptoms are those which the prover himself experi- 20 A CLINICAL, MATERIA MEDICA. ences, and which he has to express to you in certain language. The objective are those which apply directly to your senses. They are such as you may see, hear, touch, taste or smell. For instance, if you give the drug we are speaking of, and the prover says he feels a pain over the right eye, that is a subjective symptom. You cannot see it, touch it, taste it or feel it. It does not apply to your senses. You know what pain is; you have experienced it; you can appreciate it in your own mind. But if a boil is produced by this medicine; if there is a cloudy deposit in the urine, or if there are mucous rales or harsh sounds in the lungs; if the heart itself is altered in its action; if a wart appears on the skin, or if sweat breaks out, you have an objective symptom. Now, what will be the alteration in function which these objective and subjective symptoms express? They are decrease of function, increase of function and alteration of function. If this drug produces photophobia, there is increase of function; if, on the other hand, it causes blindness so great that the patient can gaze at the sun, there is decrease of function; whereas, if it produces cloudiness of the cornea or visions of bright stars, there is an alteration of function. The prover may have increased urination, decreased urination or brick- dust sediment in the urine, this last being an alteration of function. So, when we come to speak of a drug, and to tell you what its effect on the system is, we will have these three classes with which to deal, increase, alteration and decrease. You go on collecting these symp- toms, both subjective and objective. If you are skilled in the analysis of the excreta of the body, you should make use of your knowledge to determine the elimination of urates, phosphates, etc. These are facts, and, in their place, are invaluable. I would have you mind this ex- pression, in their place, valuable; out of place, valueless and even harmful. An increase in the elimination of urea would weigh nothing in the bal- ance against the mental state. All symptoms of the Materia Medica are not of the same value. They are relative in value. We include all the symptoms that we can observe. Then -what have we? A mass of symptoms seeming to have no connection at all. They come from a human organism that is all order and perfection, and all the parts of which work in perfect harmony. When even one of these parts is out of order, there must be a certain clue to string these effects together and picture a form of disease, and when you get this form of disease, what have you ? A pathological state. I hope that no diploma will be granted to any man in this class who does not study pathology. INTRODUCTORY. 21 When you have the changes in toto that this substance has made on the system, you have the pathology of the case. You have the totality of the effects on the system. This grand effect of the drug must be in the mind always, qualifying the individual symptoms of the drug. You may express this as you choose. Some Call it the genius of the drug; others speak of it as the general action of the drug. This you must have in your mind or the other symptoms are worthless. Did you not do this you would be a mere symptomist, certainly a term of reproach. You must know what the whole drug does or you are not able to appreciate any one part of the drug. You can find twenty drugs with precisely the same symptoms. How will you decide be- tween them? x\pparently they are all identical, but not in their gen- eral action. How is this general action found? By the study of the drug as a whole. But here is a place where physicians may go too precipitately and fall into pathology. They say that as Belladonna produces a picture of scarlatina and as Arsenicum produces a picture of cholera Asiatica, even unto the growths found in the excrement, therefore these substances must be the remedies for their respective diseases. Baptisia produces a perfect picture of typhoid fever, there- fore they say Baptisia must be the remedy in typhoid. As we carry out the view I expressed a few minutes ago, when we examine a patient for disease we proceed in exactly the same way as we do in the case of the proving. We note the changes we see and the sensations the patient feels; we look at his tongue, we examine his urine, we put all these together and we make a pathological picture of that man. Suppose you decide the case to be one of typhoid fever. That must not be valued except by comparison, showing how the present case differs from the general disease. If the genius of the case under treatment suits the genius of Baptisia, and, if you give that remedy, the patient will recover whether you call his disease typhoid fever or mumps. If the genius of Baptisia does not suit the genius of the case, then that remedy will do no good. If the patient has the Baptisia symptom, " thinks he is double, or all broken to pieces," that drug will not cure unless the genius of Baptisia is there, too. I may be permitted to recall a remark of Carroll Dunham. At a certain con- sultation there was chosen for a patient a drug which seemed to have many of his symptoms, but when Dr. Dunham was asked for his opinion as to whether that drug was the similimum, he replied, " No, I think not, for the general character of Ignatia does not correspond with the general character of the patient, which corresponds to Baryta. 2 2 A CLINICAL MATERIA MEDICA. You will find his most prominent symptoms under Baryta." One physician decided for one drug, the other for another. Bach went by his study of the drug; one understood Ignatia in part, the other by its totality. It is my duty to show you this winter the genius of each drug, and the relations which drugs bear to one another. I cannot hope to give you all that is characteristic of each, but I think that I can give you an idea of its genius, and show you how drugs are related so that you may fill up the interstices at leisure. You must acknowledge that Materia Medica is the most important of all branches, but you cannot understand it unless you have a thorough knowledge of the others. You must learn symptoms and not mere words, and you cannot put any idea into them until you know their meaning; and unless you can interpret symptoms you can never learn the genius of a drug. Blood and bloodvessels. Lymph and its vessels. Nerves, brain, cord and sympa- thetic; muscles, tendons, liga- ments Analvsis of a medicine. { Connective tissue. Bones, cartilages and joints. Serous and synovial membranes. Mucous membranes. Skin. v Organs. We now understand a drug as analyzed according to the schema on the board. We must see how it affects the blood and bloodvessels, the lymph and lymph vessels, the nervous system, including, of course, the brain, cord, and sympathetic nervous system. The first of these divisions tells us something of the nutrition of the body. The second, the lymph, likewise tells us of nutrition and how well repair is going on. The muscles, ligaments, etc., tell us how the human machine may move; and so we may go through the entire schema. You will note the deviations from the normal under each of these headings. Under the conditions of the blood you will note increase, as in plethora or hyperemia; decrease, as in anaemia or ischaemia, and alteration, as in chlorosis or pyaemia. The same is true of the lymph, which may exhibit plus, minus and change, and so on down the list. INTRODUCTORY. 23 When you study the drug by this analysis you quickly arrive at an idea of it as a whole, that is, you get the genius of the drug. But when you have done that you are not through with your difficulties. You must learn to tell one drug from another. You go into a field and you see two or three hundred cattle. They all look alike to you, yet the man in charge of them knows each one. How does he know them? He knows them by certain distinctions which he has learned by familiarity with them. So can you know one drug from another by studying their points of difference. Drugs impinge in their resemblances, and separate in their differences. Thus we have another form of study, comparison of drugs. That is just as necessary to successful practice as is the first, step, the analysis of the drug. Then again there are drugs which antidote each other. You may have made a mistake. Your patient may be too susceptible to the action of the remedy, and you require to modify its effects. It was only yesterday that I prescribed Nux vomica for a cold. It relieved the patient of his cold, but he became almost crazy with headache. He had had an excess of Nux vomica, so I gave him Coffea, and in ten minutes his head was better. This was done by simply modifying the effects of Nux vomica, not by suppressing the symptom. iVgain, there are some remedies which, although they bear a strong resemblance to each other, seem as though they ought to be concord- ant remedies, yet they T are inimical. So you study the Materia Medica, analyzing one drug after the other until you have analyzed all. Then you must arrange your remedies according to some system in your mind, and so be enabled to recall facts as you need them If you study only one remedy, every case you see fits that remedy. If you have studied Aconite, every case will suggest Aconite Thus you must have Aconite and its confreres side by side in your mind, before you can use them successfully in the sick room. This is done by systematizing your study. Now, then, you will find that drugs hold certain relations to each other. You will find five relations. The first I have called the family relation, derived from their similarity in origin. When drugs belong to the same family they must of necessity have a similar action. For instance, the halogens, Chlorine, Iodine, Bromine and Fluorine, have many similitudes, because they belong to one family. So, too, with remedies derived from the vegetable kingdom. Take, for instance, the family to which Arum triphyllum belongs. There you find drugs 24 A CLINICAL MATERIA MBDICA. which resemble each other from their family origin. Take the Ophid- ians, and you will be perplexed to tell the differences between Iyachesis, Elaps and Crotalus. This resemblance through relationship is some- times so nearly identity that these drugs do not follow each other well. Take, for example, Ignatia and Nux vomica. Both come from the same order of plants; they do not follow each other well, and they do not antidote each other. Then we may have drugs which present marked similarities in action though dissimilar in origin. These are said to be "concordant." Drugs which hold a concordant relation may follow each other well. There is another relation, that of complement, that is, one drug completes a cure which the other begins, but is unable to effect. Such a relation exists between Belladonna and Calcarea. Next we have the relation of antidote, of which I spoke a few moments ago. Lastly, we have the relation of enmity, one that I am unable to ex- plain to you. It is a fact that certain drugs, although resembling each other apparently, will not follow one another with any satisfaction. They seem to mix up the case. Such drugs are China and Psorinum, Apis and Rhus, Phosphorus and Causticum, and Silicea and Mercury. In carrying out these various ideas we must study Materia Medica as a natural science, for such it must be intrinsically, although it is as yet undeveloped and unworthy of that dignified name in our present understanding of it. Nature's laws in no way dispute the known rela- tions and actions of drugs. They rather harmonize with them. Bach order or class is to receive a separate examination, its resem- blances and differences noted and the individual members compared with related remedies. Thus is preserved a uniform progression from generals to particulars. We are now ready to begin our study of the various drugs compos- ing the Homoeopathic Materia Medica. For this purpose I have ar- ranged the remedies in three grand divisions, according to the king- dom of nature from which they are derived, viz.: i. Remedies derived from the animal kingdom. 2. Remedies derived from the vegetable kingdom. 3. Remedies derived from the mineral kingdom. There is also a fourth class of remedies, the nosodes or disease products. In our next lecture we will begin our study of drugs derived from the animal kingdom. LECTURE II. ANIMAL KINGDOM. Today we begin our study of the medicines obtained from the ani- mal kingdom. I desire to preface my lecture on these remedies with a few remarks relating to their properties in general Many of the animal poisons are distinguished by the violence and intensity of their action, and by the decided alterations which they produce in both structure and function. The blood is often changed in its composition and quality. The nervous system suffers and even the lower tissues are affected. The whole tendency of these remedies is to produce dis- eases, which are never of asthenic character and always of a destructive form, tending thus to local as well as to general death of the body. We therefore look upon these poisons as medicines which suit deep- seated diseases, such, for example, as are accompanied by changes in the quality of the blood; such as profoundly affect the nervous centres. Consequently they are indicated in typhoid fevers, erysipelatous in- flammations, tuberculosis of different organs and tissues of the body, and many of those dyscrasiae which underlie and qualify acute dis- eases. You will find, if you devote time to the study of this portion of the Materia Medica, more time than we can spare or than these lec- tures will permit, that they are often necessary to arouse vitality and direct the vital forces into a proper channel. You will find, too, that these animal poisons are apt to affect the mind, especially the emotions. They arouse the lowest qualities in human nature, and produce a condition which is truly shocking. Some of them arouse the filthiest lust, the most intense anger, and passions of a kindred nature. So we may find many of these drugs suitable for persons affected with insanity, whether it be the result of functional or organic cerebral changes; whether or not it be reflex from irregularities in bodily functions. You will see by the table which I have placed on the board that we have a number of remedies derived from the animal kingdom. 26 A CLINICAL MATERIA MEDICA. Vertebrata < Mammalia Ophidia Pisces Batrachia Moschus, Castoreum, Mephitis, Oleum animale, Hippomanes, Castor equi, Lac vaccinum, Lac defloratum, Lac caninum, Koumyss, Fel tauri, Fel (^ vulpi, Pulmo vulpis. f Lachesis, Crotaeus, Bothrops, Ag- ( kistrodon, Elaps, JVaJa, Vipera. j Oleum jeco7 is aselli. Bufo rana. Mollusca Radiata Corallium rubmim, Spongia, Medusa, Badiaga. Hemiptera Coccus cacti, Cimex. Hymenoptera \ Apis meeeieica, Vespa, Formica. Articulata .J Coleoptera \ Cantharis, Doryphora. Orthoptera Blatta. Arachnid a \ Tarentula, My gale, Theridion, Arauea. I have, for convenience of study, divided these animal substances according to their natural relations. We have first the Vertebrata. Within this grand division of the animal kingdom we note the first class, the Mammalia, below this the Ophidia or great variety of ser- pents, then the Pisces, or fishes, and, finally, the Batrachia. In the higher order of Mammalia we have a large list of remedies; but these members of the animal kingdom compose only a small por- tion of it. There are many animal drugs of which we know nothing but their names; they have been used by one individual without any special proving. This is a field which has not been thoroughly inves- tigated, and one, too, the investigation of which has encountered great opposition. Especially has the Cimex lectularius, the common bed-bug, been condemned; but this opposition has extended to other remedies of the class. Prejudice goes far. I do not wish to sanction these medicines any more than they deserve. Our notions, our preju- ANIMAL KINGDOM. 27 dices, and our appetites affect us all. Reviewing the Mammalia, we note first the Moschus, and here another and similar animal substance, the Castoreum. I mention these together that you may remember them as two substances which act on the nervous system somewhat similarly. The origin of Moschus you all know; Castoreum is a similar product taken from the beaver, and is a very useful medicine for pa- tients, especially women, who are nervous and do not react after ty- phoid fever. If, after the fever has spent its force, the patient remains irritable, with weak and exhausting sweat, Castoreum helps her at once. Next we have here the product from the animal which you all know as the skunk, Mephitis putorius. This Mephitis also acts powerfully on the nervous system. If taken in a low potency when one is exhausted, it tones up the nervous system and relieves the exhaustion. The main use of Mephitis, however, is in whooping-cough. It produces a well- described hard cough, with well-marked laryngeal spasm and a distinct whoop. I have found in using this medicine that it often apparently makes the patient worse, while it really tends to shorten the course of the disease. When the catarrhal symptoms are slight and the spas- modic whoop is marked Mephitis is to be selected. The cough is worse at night and after lying down. There is a suffocative feeling; the child cannot exhale; convulsions at times ensue. It vomits its food, some- times hours after eating. Drinks get into the larynx. In whooping- cough you should compare with Mephitis, Corallium rubrum, which has, however, smothering before the cough, and great exhaustion after- wards. The gasping progresses into repeated crowing inspirations until the child becomes black in the face. Drosera should also be thought of in this connection. This remedy has spells of barking cough, which come so frequently as not to give the patient an opportunity to recover the breath. They are especially worse after 12 p. m. The child holds each hypochondrium during the cough, and if sputum is not raised, vomiting and retching ensue. The patient ma)* have a diarrhoea with stools containing bloody mucus. Mephitis has also been recommended in the asthma of drunkards. It may also be used in the asthma of consumptives when Drosera fails. In the last-named condition you may think also of Rumex and Sticta. The former of these is to be given when there is aggravation at 2 A. m. The latter remedy has been recommended by Dr. K. T. Blake when the trouble is associated with splitting headache. The Mephitis pa- tient seems to have the power of withstanding extreme cold. He feels 28 A CLINICAL MATERIA MEDICA. less chill}- than usual in cold weather. Washing in ice-cold water causes a pleasant sensation. Other symptoms of the drug which are worthy of notice are the following: Wandering pains, with pressure to urinate; fine nervous vibrations reaching to the bones, causing anxiety; awakes at night with congestions to the legs (see Aurum)\ legs uneasy, as if they would become insensible; vivid fancies, unfit- ting him for mental labor; talkative, as if intoxicated; violent pain in the head after a fulness which was pressing upwards; head dull and numb; head feels enlarged; heaviness and pressure in the back of the head, as from a finger pressing; redness and injection of the conjunc- tiva; dimness of vision; letters blur and run together. Below we have the Oleum animate. This is similar in its origin to Castoreum and Moschus. It is the secretion of the mare, which tends to excite the passion of the opposite sex. Next we have the Castor eqni, which is the red substance growing on the inside of the legs of the horse. The principal use that has been made of this in medicine has been in sore nipples, when they are cracked and ragged, almost hanging in fact. Now we come to the milk preparations. I am not going to uphold these. You are to be the judges. No editor of a journal, or college professor, however brilliant he may be, should decide for' you. I have been making experiments with them and I believe that some at least will become very valuable remedies. Try them, that you may know them by your own experience. The first is Lac vacci?ium, or cow's milk; the next is Lac dcfloratum , or skimmed milk. The latter has gained such a foot-hold that less objection has been made to it than to any of the others. It has been used largely in the treatment of dia- betes. Patients are directed to drink a pint of milk morning, noon and night, while all food containing starch and sugar is prohibited. The quantity of milk just mentioned is gradually increased until the patient consumes four or five quarts daily. Provings of Lac defloratum have been made. It has cured intense headache, located principally in the fore-part of the head. The pains are of a throbbing character, and are associated with nausea, vomiting and the most obstinate con- stii ation and great chilliness. It is especially suitable in anaemic women. Remember these symptoms — anaemic women, throbbing frontal headache, nausea, vomiting and obstinate constipation. Next we come to the dog's milk, Lac caninum. It has been used chiefly in diphtheria by a New York physician. Koumyss, another of ANIMAL KINGDOM. 2Q the milk preparations, is certainly no humbug. It is prepared by fer- mentation from asses' milk, and used largely on the plains of Asia. Many claim that it is an excellent food for the weak and anaemic and especially for the consumptive. It is readily digested and is well tolerated by weak stomachs. Next we have two substances, Fel tauri and Fel vulpi, which have been used in constipation and in accumulation of flatus in the intes- tines. Pulmo vulpis was introduced by Grauvogl, who, acting according to the law of " Sigiiatura rerum" recommended Pulmo vulpis in asthma because foxes were long-winded. I give you this without indorsing it. We next come to the Ophidia. Here we have the large class of serpents, the consideration of which I will omit now, because we will take them up for study at our next meeting. Among the Pisces or fishes, I will mention only the cod-liver oil, or Oleum jecoris aselli. This is known as a great remedy in scrofulosis, tuberculosis and debility. It is used, as you know, hy physicians of both schools of practice. Many physicians claim that it acts physio- logically. This is a mistake. It is a medicine. It does not act by the oil contained as Dr. Hughes claims. If it does, why is it that other oils do not produce as good effects? It is a compound drug and con- tains Iodine, Phosphorus, and other substances. Dr. Neidhard of this city has made provings of it. He gave the drug in the lower poten- cies to provers, until he obtained a list of symptoms which he found to be characteristic. I will here give you an outline of the sj^mptoms. You may use it when there are chills running down the back, hoarse- ness, and soreness through the chest. How many times you will see these symptoms as the beginning of tuberculosis ! There may be sharp stitching pains here and there through the chest; the patient complains of burning pain in spots or in some one portion of the chest. Fever is particularly marked toward evening with burning of the palms of the hands. The cough is dry, with an expectoration of a somewhat slimy mucus such as we notice in the initial stages of tuber- culosis. These are symptoms which have been noticed in the prov- ings conducted b}^ a conscientious observer, Dr. Neidhard; they are sj'mptoms which, when occurring in the sick, have been cured by the drug. When they are present, you may give Oleum jecoris aselli Neither in potency or in the crude form, and give it, too, on a scientific basis. Next we come to Bufo rana, a variety of toad indigenous to South 30 A CLINICAL MATERIA MEDIC A. America. The surface of its body secretes an oily substance which has the reputation of being poisonous. The native women, when tired of the importunities of their husbands, mix this oily secretion into their husbands' drink for the purpose of producing impotency. Prov- ings have been made of Bufo, and it has been found to produce a very disgusting set of symptoms. It causes a sort of imbecility, in which the person loses all decency. He becomes a confirmed masturbator and seeks privacy to indulge his vicious habit. Masturbation and even sexual intercourse seem to cause convulsions which simulate those of epilepsy. The aura that begins the epileptic paroxysm starts from the genital organs. The patient may even be thrown into violent convulsions during coitus. That form of epilepsy for which Bafo has done the most is that which occurs from sexual over-excitement or else seems to start from the solar plexus. These symptoms are pre- ceded by a singular irritability of the mind during which the patient talks incoherent^, and is then vexed because his gibberish is not understood. The convulsions themselves are usually followed by pro- found sleep. Some years ago, Dr. Wm. Pa}me cured a case of peri- tonitis with this remedy in which there were repeated convulsions, finally followed by stupor, unconsciousness, cold limbs, copious sweat, etc. I have recently successfully treated a woman with this drug-, the indications being spasms, with suppurating blisters on the skin, in the throat, and in the vagina. The abdomen was exceedingly sensi- tive, feeling to her as if the same sort of sores were also in the bowels. Bufo also cures blisters on the skin, which rupture, leaving a raw sur- face from which there oozes an excoriating ichorous fluid. We may here institute comparisons between Bufo and its concordant remedies. Indigo is indicated in epileptiform spasms which seem to be reflex from the irritation of worms. It is often useful in children when they are aroused at night with this horrible itching at the anus. But it never does any good unless the patient is low-spirited or sad or timid. If he is vehement or excitable, recourse must be had to a vehement remedy like Nux vomica or Bufo. Artemisia vulgaris is an excellent remedy in epilepsy, especially when it has been caused by fright or some exciting mental emotion. The attacks are repeated one after the other, and are followed by pro- found sleep. From the Mollusca we obtain two remedies, Sepice succus and Murex. These I will leave for the present, as I shall have more to say of them by and by. ANIMAL KINGDOM. 3 1 From the Radiata we obtain four medicines, the first of which to be mentioned is the Corallium rubnim or red coral. It has several uses, but I shall mention only two. Corallium rubriwi is useful in a combination of syphilis and psora. There are smooth spots on the surface of the body, mostly on the palms of the hands. At first they are of a coral- red hue, but they finally become darker, and assume the well-known copper-color characteristic of syphilis. Corallium is also useful for chancres when they have this coral- red hue. The whooping-cough of Corallium rubrum has been styled the min- ute-gun cough, the paroxysms, as alread} r described, coming very close together. During the day the cough is short, quick and ring- ing in character; when night comes, decided paroxysms of whooping appear, worse towards morning. These seem to take the child's breath completely away, so that when they have ceased, he falls back completely exhausted. In this whooping-cough it is similar to Mephitis, which I have already described to you. Spongia we shall speak of along with the Halogens, Bromine, Iodine, etc. Medusa, or the jelly-fish, has effects which are nearly identical with those of Urtica urens. It produces a nettle-rash, and also has some slight action on the kidneys. Badiaga, the fresh-water sponge of Russia, has two principal points of attack, the first of which is on the tymphatic glands, causing en- largement with induration. It has been successfully used in indurated buboes, especially when they have been maltreated. Here it is similar to Carbo animalis. It also has an action on the heart. It is of service in palpitation of that organ caused hy any unpleasant ex- citement; thus it is similar to Coffea and Phosphorus. It is not indi- cated in organic heart diseases. Nitrite of amyt 'is likewise indicated in functional cardiac affections. It paralyses the vaso-motor nerves and is therefore useful in conges- tions to various parts of the body, especially to the head or to the chest. The face becomes flushed, and even puffed and red. Respira- tion is greatly oppressed. The heart beats more frequently, but loses in force. A constrictive sensation about the heart is experienced and the patient must sit up. The urine ordinarity contains a small quantity of albumen. So susceptible is the person, that the opening of a door causes flushing. Nitrite of amyl is indicated in flashes of heat at change of life. 32 A CLINICAL MATERIA MEDICA. Next we come to the Articulata, insects whose bodies are in seg- ments, the wasps, bees, etc. We have in this group a great many remedies, some of which have been placed on the board. To the Hejniptera belong the Coccus cacti and the Cimex. Coccus cacti is a little insect infesting the cacti of South America. The principal use of the drug is in whooping-cough with morning aggravation The child awakens in the morning and is immediately seized with a paroxj-sm of whooping-cough, ending in vomiting of clear ropy mucus, hanging in great long strings from the mouth. That is a symptom which you all should remember. I can assure you that it is a positive one, for with this condition present Coccus cacti, when administered in the beginning, has cut short the whole disease. Still further, Coccus cacti affects the chest. The apices of the lungs are sore, and the patient coughs up this ropy mucus. Kali bichromicum and Senega are concordant remedies of Coccus cacti in these conditions. Kali bichromicum has a dry, barking cough, worse in the morning. The expectoration is stringy, but it is yellow in color — not clear, as under Coccus cacti. Senega is useful in chubby children. It has tough expectoration, which is transparent like the white of an egg and difficult to raise, but the cough is worse towards evening. If the child is old enough, it will complain of a crushing weight on the chest. Cimex is a remedy that I have never used. It has been recom- mended in intermittent fever. From the Hymenoptera we obtain such important remedies as Apis mellifica, Vespa and Formica. This order we must leave for the present. The order Coleoptera gives us Cant/zaris, which will be considered in a future lecture. From this order we also obtain the Doryphora decem- lineata, or potato-bug. This is highly poisonous, and has been used successfully in inflammations of a low grade; for instance, in gonor- rheal inflammation when the parts are purple or dark red. Under the order Orthoptera we have one remedy mentioned, the Blatta, or cockroach. Journals have contained many accounts of cases of dropsy cured with it. lastly, we have the A rachnida, or spiders, the consideration of which we shall leave for a future lecture. LECTURE III. THE OPHIDIA. In considering the remedies derived from the animal kingdom, first I shall speak, in extenso, of the large family, formally called Ophidians, or snakes proper. Of those we use in medicine, we have first the Lach- esis trigonocephalies. This was proved by Dr. Hering, sixty years ago. Next we have the Crotalus horridus. There is also a South American species, proved by Dr. Muir, the Crotalus cascavella. This has a few symptoms which will not yield to the administration of the other spe- cies. Then there are the Naja tripadians, one variety of the cobra, and the Elaps coralli?ius, so called from the shape of the scales on the back, which have something the appearance of coral. Lastly, there is the Bothrops lanceolatus, a remedy which, for a year or more, I have vainly tried to procure. It causes symptoms similar to that peculiar condition known as aphasia. Of these poisons, the first four are com- monly used in medicine. The poison of the snake is generally held in a little sac behind the fangs. On the under surface of the fangs is a small groove, into which empties a little tube that conveys the poison from the gland. When they are not in use they lie back on the roof of the mouth. If the animal is excited, it opens its mouth, the fangs are pushed forward, and at the same time, by muscular action, a drop of the poison runs down the canal and into the punctured wound. Now, what follows? That depends on various causes. The poison is more potent at some times than at others. The more angry the serpent is, the more active is its venom. If, in inflicting the wound, the fang passes through the clothing, some of the poison may thus be absorbed. Again, the power of resistance of the individual has some effect. Thus, you may divide the effects of the snake-poison into three sorts: First, that which may be compared to the action of a stroke of light- ning or a dose of Prussic acid. Immediately after the bite the pa- tient starts up with a look of anguish on his face and then drops dead. This represents the full, unmodified, lightning rapidity of the poison. In the second form, commonly, the part bitten swells and 3 34 A CLINICAL MATERIA MEDICA. turns, not a bright red, but rapidly to a dark purplish color, the blood becomes fluid, and the patient exhibits symptoms like those character- istic of septicaemia. The heart-beat increases in rapidity, but lessens in tone and strength. The patient becomes prostrated and covered with a cold clammy sweat. Dark spots appear on the body where the blood settles into ecchymoses; the patient becomes depressed from weakness of the nervous system, and then sinks into a typhoid state and dies. Or there follow nervous phenomena. Vertigo; dark spots before the eyes; blindness; a peculiar tremor all over the body; face besotted; dyspnoea, or even stertor. Or the process may assume a slower form. After the vertigo or trembling the patient remains weak, and the wound turns dark or gangrenous. All the discharges, the sweat, the urine and the faeces, become offensive. Dysenteric symptoms of a typhoid character show themselves. The patient goes into a low state, and finally dies. These are all phases of the action of these powerful poisons on the blood and the nerves. The Ophidia, as a group, are characterized by their paralyzing ac- tion upon the nerves. They directly weaken the brain and heart action. Then follow decomposition of the blood, changes in the mus- cular tissue and local death from gangrene. At first there is developed a condition of anxiety, mental excitability and oversensitiveness of the brain, with hallucinations, anxious fear, etc. Afterward arises nerv- ous depression, varying from such a debility as is observed in severe or protracted disease and advancing old age to mental confusion, stupor, low delirium and paralysis. Constrictions are noticed, as in the throat, larynx and sphincters in general. Haemorrhages, which are usually dark, decomposed, oozing from every orifice of the body; thus, also, ecchymoses. They are most marked under Lachesis and Crotalus, less in Elaps, least in Naja. Face sickly, pale, anxious; bloated, dark red or bluish. Special senses altered; dim vision, excitability of brain and spinal cord, accounting for the mental restlessness and bodily sen- sitiveness. Predominant, even with the pains, are torpidity, numb- ness, twitchings, formication. You already see in what class of diseases you will find these poisons curative: Inflammations and fevers of low, destructive type, such as gangrene, malignant ulcerations, diphtheria, typhoid, pyaemia, car- buncles, etc. With all there are tendency to faint, muscular prostra- tion, trembling as in drunkards, irregularities in circulation, flushes of heat, apoplectic congestions, paralysis. THK OPHIDIA. 35 Nerves especially affected by the snake-poisons seem to be the pneu- mogastric and spinal accessory; consequently, you expect to find, as eminently characteristic, symptoms of the larynx, of the respiration and of the heart. All of the Ophidia cause choking, constrictive sen- sation coming from irritation of the pneumogastric. All of them have dyspnoea and heart symptoms. Moreover, the Ophidia produce a yellow staining of the skin. This is not jaundice, and must not be confused with that affection. It comes from the blood, and is due to the decomposition of that fluid, just as we find in yellow fever, typhus or pyaemia, and not to the staining of the skin with bile. This is most marked in the Crotalus. Again, you may find that the skin is dry and harsh, as if there was no vitality in it, or it may be clammy, more characteristic of Lachesis. The discharges are foetid, even the formed faecal stools of Lachesis are horribly offensive. As the heart is weakened by all, we find as char- acteristic, running through them all, weak heart, cold feet and trem- bling — not the trembling of mere nervousness, but the trembling of weakness from blood-poisoning. The cold feet are not indicative of congestion, as you find under Belladonna; they are attendant upon a weakened heart. The heart symptoms of Naja resemble greatly those of Lachesis, but its cardiac symptoms point more markedly to the remote effects of car- diac valvular lesions; those of Lachesis more to the incipiency of rheu- matic disease of the heart. In Naja there is a well-marked frontal and temporal headache with the cardiac symptoms; the heart beats tumult- uously. The patient awakes gasping for breath. Naja causes more nervous phenomena than any of the snake-poisons. Under Belladonna the head is hot and the feet are cold, because the blood surges toward the head. Under the snake-poisons the feet are cold, because the heart is too weak to force the blood to the periphery. All of the snake-poisons cause inflammation of the cellular tissue. Accordingly, we find them valuable when cellulitis arises in the course of typhoid fever, diphtheria, etc. The color of the affected part is dark red, purple or black, like gangrene. In diphtheria Crotalus has had more clinical confirmation in the per- sistent epistaxis. Elaps claims attention in cases of haemoptysis, when the blood dis- charged is dark in color, especially when the right lung is affected. Antidotes for these poisons are numerous. There is no doubt that 36 A CLINICAL MATERIA MEDICA. alcohol is a powerful antagonist to the snake-venom. It is remarkable how much alcohol can be swallowed by persons bitten by serpents, without the manifestation of the usual physiological effects. Dr. Hering recommends radiating heat as an antidote. The part bitten should be held close to a hot fire. Ammonia and permanganate of potash have been recommended as antidotes, and cures have been claimed for each. IvACHESIS. Now let us consider Lachesis. First of all, in order that you may comprehend the subject, I wish to refer to those symptoms which are universal. We notice that Lachesis is especially suitable to persons who have a peculiar sensitiveness of the surface of the body. Even if the patient is lying in a stupor and you touch him, as when you try to feel his pulse, he will show that he is disturbed thereby. Hard rub- bing or pressure may cause no trouble at all. Dr. Hering, who first proved Lachesis, could never tolerate tight clothing about his neck. He always wore his collars loose. He noticed that, during the prov- ing, this symptom annoyed him more than usual, so he faithfully made note of the occurrence, but did not place much value on it. Since then the symptom has been confirmed many times in practice, and has been found true, not only as a local symptom of the neck, but as a symptom of the body universally. The explanation seems to be that there is an irritation of the peripheral nerves; and because of this the patient cannot bear touch or slight pressure. It is no evidence of inflammation, and must not be confounded with the inflammatory soreness of Aconite, Arnica or Belladonna. The sensitiveness also dif- fers from that of Apis, which has a bruised, sore feeling more acute than that of Arnica. It also differs from the sensitiveness of Nux vomica and Lycopodium which have it about the waist only after a meal. Next we find that the drug is prone to affect the left side of the body. Homoeopaths have been criticised for attributing to drugs the power of acting upon one side of the body in preference to the other. The simple fact that disease chooses sides ought to be enough to lead one to believe that drugs may do the same. The left side of the body is more apt to be affected by drugs having a depressing action, because that side of the body is weaker. Another peculiarity of Lachesis, arising, probably, from its action on THE OPHIDIA. 37 the pneumogastric nerves, is its influence on sleep. This is a universal symptom, that the patient is worse from sleep; he sleeps into an aggra- vation. If it is true that Lachesis has an influence on the centres of respiration, and is a weakening drug, we can understand why sleep should aggravate. During our waking hours we have some control over respiration. During sleep this voluntary control is lost. It is when this change takes place that the weakening effect of Lachesis is asserted. Lachesis is a very valuable remedy at the climaxis, especially in the woman who has exhausted herself by frequent pregnancies and hard work. In this worn-out condition there occurs a sudden cessation of the menses. Suppression or non-appearance of discharges always makes the Lachesis patient worse. Perhaps previous to the climaxis she was worse before the flow than during it. The pulse is weak and tremulous. There are the peculiar headache, and the annoying symp- toms of the mind, hot flashes, and nervous symptoms characteristic of the drug. Now, let us consider some of the symptoms of Lachesis in detail. First, as to the mental symptoms. The patient is nervous, anxious, loquacious, jumping from subject to subject; sometimes with fear of be- ing poisoned, which causes him to refuse the medicines you offer. In- teresting stories excite immoderately and even intensify the bodily symptoms. Sometimes the anxiety assumes a peculiar type, and he imagines that he is dead, and preparations are being made for the funeral. The loquacity may be accompanied with sleepiness, and yet inability to sleep. Ideas chase each other so rapidly through the mind he cannot write them down. He sits up late at night, mental activity then being unusually increased. But this stage of excitement is commingled w r ith another, which soon entirely supercedes it. The mind is weakened. The patient is able to think only with difficulty. He has to stop to think how words are spelled, like Sulphur, Lycopodium and Medor- rhinuni. There is vertigo, w T orse on closing the eyes, or on sitting or lying down. Vertigo with deathly paleness; syncope. In this vertigo, fainting, etc.. you may compare Theridion, which has dizziness worse with the eyes closed; but, as a distinctive feature, you will find that under the latter remedy, vertigo, pains and nausea are intensely aggravated by noise. Both remedies are useful in sunstroke. Arsenic, Hydrocyanic acid, Digitalis, Veratrum album and Camphor, you should compare in vertigo and fainting from cardiac weakness. Laurocerasus or Hydrocyanic acid may be needed in long-lasting faints; 38 A CLINICAL MATERIA MEDICA. there seems to be no reactive power; the face is pale and blue, the surface cold. If fluids are forced down the throat, they roll audibly into the stomach. If the syncope is attendant upon some poison in the system, as scarlatina, the symptoms are similar, the eruption being livid, and, when pressed, regaining its color very slowly (cf. Ailanthus) . Digitalis also rivals the Ophidians in syncope, with the antecedent dim vision; the pulse is generally very slow, and the patient com- plains of nausea and deathly weakness in the epigastrium. Camphor and Veratrum album display coldness and cold sweaty skin; in the latter remedy, the forehead is cold and sweaty. The face may be red while lying, but if raised, it turns pale and the patient faints; the pulse is thready. Camphor has icy surface, sudden sinking, as in Laurocerasus , and al- though so cold, he throws off the clothing as soon as he is strong enough to move, even though he be still unconscious. Heaviness of the head on waking, with nausea and dizziness, as in sunstroke. In ill-effects of the heat of the sun, compare Glonoine, Bellado7ina y Natrum card, and Theriolion (see above). The first two, with bloated red face, paralytic weakness (Glon.), unconsciousness, etc., resemble Lachesis, but the latter displays the effects of heat upon one already exhausted. All the Ophidians are intolerant of warm, relaxing weather, and so we find many ailments returning in spring and sum- mer. In the Lachesis case, the patient may be an inebriate or one prostrated by mental fatigue. The sun's heat makes him languid, dizzy, faint, or, if congestions ensue, the face is dark red, and looks at the same time sunken and cadaverous; the extremities are cold. Here Camphor may be demanded if vitality is ebbing away, the fainting spells growing worse, and the body icy cold and bathed in cold sweat. Both Lachesis and Natrum carb. are useful when hot weather fatigues, in which case you should compare, also, Selenium and Natrum mur. Returning now, after this digression, to the mental symptoms of Lachesis, we find that the delirium is of a low, muttering type. At other times the patient seems to be going deeper and deeper into a tor- pid state, with coolness of the extremities and trembling of the hands and body. When asked to protrude the tongue, it comes out trem- blingly, or catches in the teeth, and is usually coated dark brown, sometimes with little blisters on the tip. The lips crack and ooze dark blood. Loquacity is commonly followed by depression, and by weak- ness which amounts to a typhoid state; then comes delirium, but not of the violent Bellado?ina type. THE OPHIDIA. 39 These symptoms show Lachesis to be an invaluable remedy in typhoid fever, and in fact in all diseases of a typhoid type. The loquacity just referred to is particularly characteristic. Another men- tal state which these typhoid patients may have is the delusion that they are under some superhuman power. Diarrhoea is usually pres- ent, and the stools are horribly offensive, a strong characteristic of Lachesis, which will also aid you in diphtheria, scarlatina and other dis- eases of this type. Even when the stools are formed, and in every way natural, they give forth this horrible odor. Lachesis may also be indicated late in the course of typhoid fever, when the patient lies in a stupor with dropping of the lower jaw, and other symptoms indicative of impending paralysis of the brain. Let me now speak of some of the concordant remedies of Lachesis in these conditions. In the loquacity just mentioned Lachesis should be compared with Stramonium, Agaricus, Mephitis, Actea racemosa and Paris quadrifolia. Stramonium you will distinguish from Lachesis by the red face and the other evidences of great sensorial excitement. Agaricus exhibits great loquacity associated with convulsive move- ments of facial and cervical muscles; merry, incoherent talk. In Mephitis it is as if one were drunk. Under Actea racemosa the loquacity is usually associated with men- strual suppression, with puerperal mania or as a part of delirium tre- mens, for which Lachesis also is a useful remedy. Actea cures wild imaginings of rats, etc., sleeplessness, wild crazed feeling about the head, incessant talking with continual change of subject; the patient must move about. Lachesis has more marked trembling of the hands, diarrhoea and greater exhaustion with the loquacity and hallucinations. Paris quadrifolia causes a garrulity which is much like that pro- duced by tea, a sort of vivacity with love of prattling. In these typhoid types of fever you may compare Lachesis with Opium, Hyoscyamus, Arnica, Lycopodium, Apis, Muriatic acid, Baptisia and Rhus toxicodendron . Opium is indicated in typhoid fever with this threatening paralysis of the brain, but the sj T mptoms under it refer to a very different condition from that of Lachesis. The symptoms which indicate Opium, in addition to this dropping of the lower jaw, are un- consciousness, stertorous breathing, and a dark or brownish-red hue of the face. The darker red the face the more is Opium indicated. With Lachesis the cerebral condition is due to the effect of the typhoid poi- 4-0 A CLINICAL MATERIA MEDIC A. son on the brain. With Opium it is a secondary effect of the intense congestion of that organ. Hyoscyamus is perhaps more like Lachesis than is Opium. Here we find the lower jaw dropped; the patient is weak and trembling, and there is twitching of the muscles. This last is a necessary symptom of Hyoscyamus. Here, too, there is snoring breathing, as in Opium, with involuntary stool and great prostration. Arnica is also indicated when there is great congestion of the brain. The patient lies in a stupor, with lower jaw dropped and eyes fixed, but, even in stupor, as if the bed was too hot and hard. The face is dark red, and stool and urine are passed involuntarily. In addition to these symptoms, we find under Arnica a symptom which differ- entiates it from the drugs just mentioned, namely, dark spots here and there on the body, irregular in outline and having a black and blue appearance — ecchymoses, as they are called. Lycopodium is the complement of Lachesis, and is, therefore, more apt to be indicated after it than any remedy I have mentioned. The symptoms which indicate Lycopodium are these: The patient lies in a stupor, with lower jaw dropped and rattling breathing. There is a rattling of phlegm in the throat during both inspiration and expira- tion, and the eyes are fixed and set, and are filled with mucus. Lyco- podium is the most important remedy we have in impending paralysis of the brain; by that I mean to say that it is the most frequently in- dicated. Apis has not so markedly the dropping of the lower jaw, but re- sembles Lachesis in muttering delirium, trembling tongue, etc. The bee-poison, however, causes a nervous fidgetiness with sleepiness and inability to sleep; later, muttering delirium; happy, strange expres- sion; abdomen swollen and extremely sensitive, hands and forearms cold, involuntary stools. This sensitiveness is a bruised feeling, dif- fering from the hyperesthesia of Lachesis. Muriatic acid displays a sunken face, tongue smooth as if deprived of papillae, or brown, shrunken and hard; sliding down in bed from muscular weakness. Baptisia has dark, besotted face, drowsiness and stupor, goes to sleep while answering questions; discharges from the bowels dark, fluid and very offensive. Rhus tox. may simulate Lachesis in one phase of its action, namely, when drowsiness appears and there are muttering; dry, cracked THE OPHIDIA. 41 tongue, sordes and involuntary stool. In degree the snake poison is undoubtedly lower than Rhus, and, therefore, other things being equal, comes in later. Rhus has a well-marked restlessness with re- lief from motion; loquacity is not prominent; the tongue has a red, triangular tip, and the discharges are never so offensive as those of the former remedy. You must bear in mind that Rhus is an erethistic rem- edy, and must be very similar to existing symptoms if it is to be con- tinued after torpidity sets in without erethism. Leaving the mental symptoms of Lachesis and the indications of it and its analogues in typhoid fever, we will next consider its head symptoms. We find that it produces a pulsating headache usually in the left temple and over the eyes, with mental confusion before the de- velopment of a coryza, relieved as soon as the coryza appears. This is a universal characteristic — as soon as a discharge is established the patient feels better. I have relieved dysmenorrhea with Lachesis when there was a headache preceding the dysmenorrhea, but relieved as soon as the flow was established. At the menopause there is burn- ing in the vertex. In catarrhal and rheumatic headaches you may compare Mercurius, Cinchona, Pulsatilla, Bryo?iia and Gelsemzum. Mercurius relieves headache from suppressed coryza when there is pulsating headache with pressure towards the nose, worse when warm in bed and from damp, windy weather. Cinchona, when the pain is worse from the least draught of air. Bryonia and Pulsatilla come into use when the checked catarrhal secretion is thick, and yellow and green, respectively. Gelsemium, when motility is lessened and the patient is drowsy, with neuralgic pains from occiput to forehead and face. The headache may also arise from disordered stomach or bowels, or may be an accompaniment of fevers and of diseases of zymotic origin. The patient has an upward tendency of the blood, with throbbing in the head, dark redness of the face, puffed face, confusion of the mind, all the way from simple confusion to absolute stupor, often accompa- nied, too, by partial blindness, palpitation of the heart, and fainting. The pains about the head are briefly as follows: Sharp sticking, which seems to concentrate at the root of the nose; at other times the pains go from the zygoma to the ear. This direction of the pains is charac- teristic. As a parallel of this shooting pain from the zygoma to the ear we have pains from the head going down through and into the eyes. 4 2 A CLINICAL MATERIA MEDICA. These are all characteristic pains of Lachesis. There is an additional one that I will now mention, which is probably of rheumatic origin; pains in the head, going down into the shoulders and neck of the af- fected side, and often accompanied by slight stiffness of the neck, either catarrhal or rheumatic. You may have Lachesis indicated in severer forms of the head trouble; for instance, in inflammation of the membranes of the brain; sharp pains in the head, making the patient scream out; tongue show- ing papillae; strawberry tongue; patient rolls the head from side to side, and bores it into the pillow. Particularly useful is Lachesis when an exanthem, like scarlatina or erysipelas, has not developed or has been repercussed. The patient is at first very drowsy, but unable to sleep; there is trembling or palpitation of the heart. Soon stupor en- sues, and he becomes heavy and sleepy, and you can rouse him only with difficulty. In intense head pains, as in meningitis, you should remember the relation between Belladonna and Lachesis, the difference between these drugs being rather one of degree. Both are suited to meningitis from erysipelas, to scarlatina, to apoplexy, etc. ; but the former represents the initial stage of these diseases, or the state in which, even though there be stupor, there are still evidences of irritation and not wholly of de- pression. Thus, under Belladonna, the patient often starts from his heavy sleep, cries out, grinds the teeth, awakens frightened, etc. His pulse is usually strong and the surface congestions are bright red, or if more intense, deep red and livid. If there is an eruption, as in scarla- tina, it is red, even if sparse, but vitality is not so low that the extrem- ities are cold or the rash bluish, and the cellular tissue infiltrated and threatening an unhealthy suppuration, as in the snake-poison. Often, however, after the use of Belladonna we find evidence of cerebral exhaus- tion, or blood-poisoning, or impending paralysis, in which case Lachesis may be required. The patient still cries out in sleep or awakens fright- ened, the tongue still shows elevated papillae, the head is hot, and the face is red; but the pulse is quicker, and more feeble, the feet are cold, the surface heat is irregularly distributed; the mind is more befogged and drowsiness is stealthily creeping on, the inflamed part or the pseudo- membrane or the eruption, as the case may be, is becoming more purplish — these indicate the change. Considering the action of Lachesis on the special senses, we find the eyes to be affected by the drug. Dim vision, worse on awaking; dark THE OPHIDIA. 43 spots appear before the eyes; sight suddenly seems to fade away; feeling of faintness and palpitation of the heart; with these, nervous trembling. Lachesis is one of the leading remedies for dim sight as an evidence of heart disease and vertigo. We may also use it with good effect for what we may term retinal apoplexy. There it acts very well in causing an absorption of the blood. The nearest remedies to Lachesis in this condition of the retina are Crotalus, Phosphorus, Arnica, Belladonna and Hamamelis. Scrofulous ophthalmia calls for Lachesis when the symptoms are de- cidedly worse after sleep. There are gr:at photophobia and pains of a burning, stitching, shooting character, extending to the temples, top of the head and occiput. There are also itching and stinging in the eyes and lids, worse from touch. Vision is misty, with black flicker- ing before the eyes. Crotalus may also be called for in keratitis when there are cutting pains around the eyes, lids swollen in the morning, ciliary neuralgia with these cuttings, worse during menses. In the diseases of the ear, Lachesis ma}' be remedial for roaring and singing in the ears, and other sorts of tinnitus aurium, which are relieved by putting the finger in the ear and working it. This shows that the tinnitus is not congestive, but of catarrhal origin, especially from occlusion of the Eustachian tube. The wax is altered in quality and becomes pasty and offensive. There is swelling between the ear and the mastoid process, with throbbing pain and stiffness. You can here compare Nitric acid, Capsicum, Auruni, Hepar, and Silicea. Elaps and Crotalus also have an action on the ears. Elaps, like Lachesis, produces a catarrh with black cerumen, buzzing in the ears, and otorrhcea. In Elaps, the discharge is yellowish-green, liquid and bloody. Only Lachesis seems to have the Eustachian stop- page, better from shaking the finger in the external meatus. Crotalus causes a stuffed feeling in the ears, worse on the right side, associ- ated with a feeling as if hot ear-wax was trickling out. The face in the Lachesis patient varies, of course, with the condition that obtains in the system at the time. In many of the diseases in which the remedy is indicated the face has an earthy pallor. In ex- anthematic diseases it is apt to be bloated or puffed, and bluish-red; if the eruption comes out, it appears sparsely and is of a dark color. Anxious and painful expression with the stupor; face disfigured, puff y, hot, red and swollen, as after a debauch; blue circles around 44 A CLINICAL MATERIA MEDICA. the eyes. With abdominal troubles, as in ague, the face is earthy gray. Lachesis also has convulsions of the face; lockjaw; distortion of the face; stretching the body backward; screaming; feet cold and itch- ing. Sudden swelling of the face. For swollen face, you may compare: Apis, Belladonna, Arsenic, Lycopodium, Hyoscyamus, Rhus tox., Pulsatilla, Stramonium, Kali carb., and Phosphorus. For sickly, pale, or earthy complexion: Arsenic, Bufo, Lycopodium, Carbo veg., Rhus tox., Cinchona, Phosphorus, and Phosphoric acid. Blue around the eyes: Arsenic, Cuprum, Phosphorus, Secale cornutum , and Veratrum album. Debauched look: Baptisia, Hyoscyamus, Carbo veg., Nux vomica, Sulphur, Opium, Nux moschata. In facial convulsions compare: Nux vomica, Hyoscyamus, Bella- donna, Hydrocyanic acid, Lycopodhim, Cicuta, Camphor, Phytolacca, Arse?iic. Apis, Arse7iic, and Kali carb. agree in puffing of the face even with- out any redness. In the first, there are also smarting of the eyelids, and a sensation of stiffness. In the second, the swelling is noticed about the eyes, glabella and forehead (also Natrum ars.). Kali carb. has the well-known sacs of the upper lids, and also sudden swelling of the cheeks. The expression, complexion, etc., of Arsenic are very similar to those of the snake-poisons. The anxiety and pain are marked by more restlessness, irritability, fear of death, etc., and the sunken face is more completely Hippocratic, with pointed features, sunken eyes and cold sweat. When yellow or earthy, it is cachectic. If trismic symp- toms are present, the patient will be found lying pale, and as if dead, yet warm. Suddenly he arouses, and goes into severe con- vulsions, only again to relapse into this sort of cataleptic rigidity. The eyes are partly open, with gum on the conjunctiva. Lycopodhim has pale or yellow face, deeply furrowed, looking elon- gated. The convulsive movements are unique. All through the provings of this remedy you will note an alternation of contraction and expansion. And in the face you note the tongue pushed out and with- drawn, spasmodic trembling of the facial muscles, angles of the mouth alternately drawn up and relaxed, alse nasi alternately expanded and contracted. The eyes may be partly open and covered with mucus — a bad symptom, generally being indicative of brain exhaustion. THE OPHIDIA. 45 Phosphorus has a pale face, but it is distinguished by its ash}-, anaemic appearance. This should be remembered, since this remedy, like the Ophidia, has puffy face, sunken features, blueness around the eyes, and blue lips. Hyoscyamns is very similar to Lachesis in facial expression and in the convulsive phenomena. It has a marked stupid, drunken look; the face is distorted and blue, or swollen and brownish red; starting; twitchings of single groups of muscles are noted. Hunger appears before the attacks. Stramonium is readily distinguished by its swollen, turgid face, fright on awakening, renewal of spasms from light, and contracted gloomy expression, with wrinkles of the forehead. Hydrocyanic acid closely agrees in convulsive symptoms and in the color of the face. As in Llaps, fluids roll audibly into the stomach; but in the latter it is more as a spasmodic contraction of the sphincters, followed by sudden relaxation. In convulsions, the sur- face, in the acid, is pale blue, and the muscles of the face, jaw, and back are affected. Suddenly a shock is felt, which passes like light- ning from head to foot, and then comes the spasm. Here, the remedy is more like Cicuta and Helleborus than Lachesis. But Cicuta has, like the snake-poisons, great difficulty in breathing from spasm, and, more than any remedy, it produces staring; the spasm is followed by dispro- portionate^ severe weakness. Camphor is readily distinguished from Lachesis by the coldness and by the withdrawing of the lip, showing the teeth. Lachesis is indicated in erysipelas of the face. Characteristically, the disease will be most marked on the left side. The face at first may be bright red, but it soon takes on a dark bluish hue. There is considerable infiltration into the cellular tissue, so that we have puffi- ness of the eye of the affected side. Now the characteristic bluish face is due to the accompanying weakness. Kven in the beginning, while the skin is still red, the pulse, though accelerated, is weak, the feet are apt to be cool, and the head is affected sympathetically, so that the patient readify becomes drowsy, with muttering delirium; or the opposite con- dition of pseud o- excitement — the loquacity w T hich I have already men- tioned — obtains. You must now distinguish this erysipelas of Lachesis from that of the remedies which are akin to it; among these is Belladonna . In its early symptoms, Belladonna bears no resemblance to Lachesis. But in the 46 A CLINICAL MATERIA MKDICA. course of the disease, when the inflammation is so intense that the bloated face grows bluish red, threatening gangrene, or when the brain becomes affected, differentiation is necessary. Here, both have hot head and cold feet, delirium, dry tongue, etc. But Lachesis suits when the cerebral symptoms fail to yield to Belladomia, and the excitement gives way to muttering stupor. The pulse is weak and rapid, and the cool surface of the limbs is plainly due to failing vitality rather than to the upward tendency of the blood. Crotalus holds the same rela- tion to Belladon?ia. Apis mellifica is indicated in erysipelas when the affected parts ex- hibit a tendency to become cedematous. If the face is involved, the eye-lids protrude like sacs of water. The face is usually of a pinkish hue, or it may be dark purplish, but it never has the deep bluish-black hue of Lachesis. Although there may be a similar destructive tendency, the condition of nervous irritation produced by the bee-poison is very different from that of any of its congeners. It is a fidgety, nervous state, a fretted feeling, which deprives the patient of sleep, although he feels sleepy. Rhus toxicodendron is suited to the vesicular form of erysipelas. The patient is drowsy, as under Lachesis, little blisters form on and about the face, and the face is dingy red, not the bluish-black of Lachesis nor the purple of the intensified Apis case. If vesicles form in the Lachesis case, they quickly fill with pus. Speaking relatively, Rhus produces more vesiculation and burning, stinging and itching, with more aching of the limbs and restlessness; Lachesis, more bluish-red inflammation, with gangrenous tendency. Euphorbium, since it causes gangrene with erysipelas, anxiety as from poison, apprehensiveness, dim vision, etc., deserves your notice. The right cheek is of a livid or dark red hue, vesicles form as large as peas, and are filled with a yellow liquid. The pains are boring, gnaw- ing and digging in character, and extend from the gum into the ear, with itching and crawling when the pains are relieved. Lachesis may be indicated in prosopalgia when the pain is worse on the left side, and when there are tearing pains above the orbit and dig- ging and screwing pains around the malar bone. Delirium appears as soon as the eyes are closed. The teeth decay and crumble. The gums are swollen and bluish, with throbbing pains. Lachesis may be successfully used in perio- dontitis and abscess at the root of a filled tooth (compare Mercurius, Hepar, Silicea, Lluoric acid and Petroleum. THE OPHIDIA. 47 Of the allied remedies in toothache none is so similar as Mercurius, which, like Lachesis, relieves when the gum is inflamed and the tooth decayed, with abscess at the root. It is said to have a direct action on the dentine. The pains are tearing and pulsating, and shoot into the face and ears. In Lachesis the gum is swollen, and at the same time dark red and livid, or it is tense and hot and looks as if it would crack. Mercurius is markedly worse from the warmth of the bed. Lachesis often follows the latter, or is needed at once if the patient has been previously salivated. Only Mercurius has dirty gums, with white edges. In sore mouth, aphthae, etc., Lachesis should be compared with Bap- tisia, Nitric acid, Muriatic acid, Arsenic and Apis; while Mercurius com- pares more with Carbo veg., Staph isagria, Kali chlor., Iodine, Sulphuric acid, Nit} ic acid. Baptisia has blood oozing from the gums, which look dark red or purple, salivation, foetororis, offensive stools, and thus far is precisely like Lachesis. Both, too, are indicated in the stomacace attending the last stages of phthisis. Decide by general differences and also by the tongue, which, in the former, is yellow or brown down the centre, with red, shining edges. In the latter, it is red, dry and glistening, especially at the tip, and has its sides and tip covered with blisters. Nitric acid causes an acrid saliva ; the pains in the mouth are prick- ing in character, as from a splinter; the aphthae and gums are usually whitish; there are raw places, with shooting pains. Muriatic acid presents deep, bluish ulcers, with dark edges; the mu- cous membrane is denuded in places, the raw spots being dotted with aphthae. Arsenic looks very much like Lachesis, with livid, bleeding gums, edges of tongue blistered, or ulcerating diarrhoea. The burning is more intense, and is associated with restlessness, compelling motion in spite of the weakness. In gangrena ofis it causes more acute pain and heat in the mouth; both have bluish or black sloughing ulcers. Arsenic has more mental irritability. Apis has blisters marking the border of the tongue, or in clusters. The mouth is usually rosy-red, swollen, and there are marked stinging pains; the margin of the tongue feels scalded, as does the mouth gen- erally. Carbo veg. , Staphisagria and Sulphuric acid agree more with Mercurius; the gums are white, spongy, ulcerated, rather than livid. Staphisagria 48 A CUNICAL MATERIA MKDICA. may cause sores, which look bluish-red or yellow; especially is it needed after abuse of Mercury, or in syphilitic cases when the general debility is marked with sunken face, blue around the eyes, etc. Sul- phuric acid produces great debility, yellowish-white gums, yellow skin; the patient is nervous and hasty, and constantly complains of trem- bling, which, however, is not observed by others. Salicylic acid causes the common canker sores, with burning soreness and foetid breath. Lycopodium produces similar sores near the fraenum of the tongue, Lachesis at the tip, and Nitric acid, Phytolacca, Natrum hydrochlor. on the inner sides of the cheeks. Phytolacca has some systematic resemblance to Lachesis here as well as in the throat (see next lecture). Both cause great weakness, dim vision, sunken face, blueness around the eyes, sore mouth, tongue blist- ered along the edges, tip of tongue red, roof of mouth sore, profuse saliva. The poke-root may be distinguished by the great pain at the root of the tongue when swallowing. These pains are a part of the tired aching and soreness which are general over the body. Helleboi'us produces canker in the mouth, but the sores are yellowish, with raised edges. Returning to the subject of decayed teeth, it may be noted that Kreo- sote cures pains extending from teeth to left side of face; teeth decay rapidly, gums bleed, the blood being dark; but the accompanying facial pains are burning, and the patient is excitable, nervous, even, as in children, thrown into convulsions. Thuja causes a decay just at the border of the gums, leaving the crown apparently sound. Gums dark-red in streaks. Teeth turn yel- low and crumble. LECTURE IV. THE OPHIDIA Lachesis (conti?iucd) . Next we take up the action of Lachesis on the nose, throat, and chest, so far as catarrhs are concerned. Lachesis produces watery discharge from the nose, which is often preceded by throbbing headache, worse in the left temple and forehead, and relieved as the coryza estab- lishes itself. Accompanying this coryza sometimes are vesicles about the nose, redness, puffiness of the face and lids, creeping chills over the body, palpitation of the heart, and great relaxation of the whole system; hence it is suitable for a cold which occurs in relax- ing weather, consequently in the spring of the year. Lachesis may also be used in ozsena of mercurial or syphilitic origin. Here you may compare Kali bichromicum, which follows Lachesis well; and also Aurum, Nit) ic acid, Mercmius, and Lac caninum. The last-named drug cures syphilitic ozsena and angina when the corners of the mouth and alsenasi are cracked. The cold may extend to the throat, and then we will find that the tonsils are enlarged, particularly the left one, or the inflammation may tend to spread from the left to the right tonsil. The throat, when ex- amined, exhibits a red hue, not bright or rosy- red, but bluish. The patient complains of a sense of constriction, as though the throat were suddenly closing up, or a sensation as though there were a lump in the throat which he must constantly swallow, but which as often returns. Pains in the left side of the throat extending to the tongue, jaw, ear. Rawness and burning. The throat externally is exceedingly sensitive to touch. Unless the tonsils are going on to suppuration , there is relief from swallowing solids, while swallowing of liquids and empty swallowing increase the pains. I except suppurating tonsils because, when they are large and stop up the fauces, nothing can be swallowed; then the attempt to take anything is followed by a violent ejection of the food, through either the mouth or the nose. But with the ordinary catar- rhal sore throat, when the tonsils are not parenchymatously swollen, the swallowing of food often relieves the irritation for a time. 4 50 A CLINICAL MATERIA MKDICA. The cold may travel farther down and involve the bronchial tubes, when a different class of s3 r mptoms develops. The patient may suffer from tickling, irritating cough, which is especially apt to come on as he drops off to sleep, arousing him as if he were choking. He can bear nothing to touch the larynx or throat, so that he loosens his neckband. These, briefly, are the catarrhal symptoms of Lachesis. But suppose, while we are considering this locality, we look to more serious affections which may manifest themselves in these parts, diph- theria, for example. Lachesis may be indicated in diphtheria of one or all of these parts. Symptoms for which you will be called upon to prescribe it are mostly those that I have already given you, with these points in addition: The discharge from the nose is thin, sanious, and excoriating; a really dangerous objective symptom. The throat is, if anything, a darker red than in the catarrhal state. The membrane is more marked on the left tonsil, or has an inclination to go from the left to the right. It early develops that gangrenous state which obtains in diphtheria, with the attendant foetid breath, and the increased danger of systemic infection. The tissues surrounding the throat are often in- filtrated so that you have swelling of the glands about the neck, and also of the cellular tissue. The swelling may be so great that the neck becomes even with the chin and sternum. The lymphatic glands are swollen, too, and have a dark purplish hue, and threaten suppuration. When pus does form, it is not a laudable pus. The child is drowsy, even though feverish; the heart, though beating more rapidly than normal, is evidently greatly weakened, as is shown by the feebleness of the pulse and coolness of the extremities. This is the kind of diph- theria in which you can hope much from the use of Lachesis. The diphtheritic deposit may extend down into the larynx, and the remedy still be indicated. You must not infer from this that Lachesis is the remedy for laryngeal diphtheria; but when it has the character- istic symptoms which I mention, it may be needed; the patient arouses from sleep smothering, and has a diphtheritic, croupy cough. Crotalns and Naja, like Lachesis, have relieved in diphtheria. The former has been selected when the epistaxis is persistent; blood oozes from the mouth, not merely coming from the posterior nares but escap- ing from the mucous membranes of the buccal cavity. Naja has helped in cases just like Lachesis, when the larynx is in- vaded; the patient grasps at the throat, with a sensation of choking, the fauces are dark-red; there is foetid breath, and short, hoarse cough, with raw feeling in larynx and upper part of the trachea. THE OPHIDIA. 51 Lac caninum is very similar to Lachesis in diphtheria, but is readily distinguished by its peculiar habit of alternating sides. Starting on one side, frequently the left, the soreness and swelling, and even the membrane, suddenly shift to the opposite side, only to return, in a few hours, to the starting point. The membrane is grayish-yellow and curdy, and if ulcers form, they shine like silver-gloss. Lycopodium, which also resembles Lachesis, has aggravation of the symptoms from 4 to 8 p. m. The right side is mostly affected; the child awakes from sleep frightened or cross and angry. Apis is to be distinguished by the oedema of the throat, the stinging pains, the blisters on the border of the tongue, etc. Again, you may find Lachesis of great service in affections of the lungs. We ma)- use it in asthma when there are present one or more of these few symptoms. The patient arouses from sleep with the asth- matic paroxysm, and cannot bear the least pressure about the neck or chest; finally, he coughs up a quantity of water}- phlegm with great relief. This last is a neglected characteristic of Lachesis in asthma. I have succeeded with it in relieving an incurable asthmatic for months. In pneumonia Lachesis may be useful, but not in the early stages of the disease. There is nothing in the provings of Lachesis to suggest that it will be useful in pneumonia. It does not cause the engorge- ment of the lungs, the fever or the fibrinous deposit. But it ma)- be indicated in the later stages of the affection, when it assumes a typhoid form, especially when an abscess forms in the lungs. Brain symptoms, such as low muttering delirium and hallucinations, appear. The spu- tum is frothy, mixed with blood, and purulent, and the patient is bathed in a profuse sweat. Sulphur is, perhaps, the better remedy to prevent suppuration when there are no typhoid symptoms, but be careful how you give Sulphur if tuberculosis has been developed by pneumonia. To do so is almost like giving a person running down hill another push. It will only hasten the end. In chest affections Elaps is sometimes of great service. It affects the right more than the left lung, but both may be diseased. In the morning there is pain in the right side severe enough to prevent the patient's getting up. There is a feeling of coldness in the chest after drinking. The cough is accompanied by intense pains in the chest, worse in the right apex, as if it were torn out, and the sputum consists of black blood. 52 A CLINICAL MATERIA MEDICA. You may use Lachesis in phthisis, not necessarily to cure, but to re- lieve. Remember it when, in the course of typhoid fever or pneu- monia, tubercles have been deposited in one or the other lung. You may use it in the advanced stages of tuberculosis of the lungs when the patient has a retching cough, which arouses him from sleep, and which ends in expectoration of tough, greenish muco-purulent matter, which causes gagging, and is vomited rather than clearly expectorated; when the patient sweats during every nap, the sweat being most copious about the neck, shoulders and chest, and when the strength is greatly reduced and the pulse indicates extreme prostration. Next we turn our attention to the alimentary canal from the mouth down. I referred to the tongue in speaking of the typhoid condition. Lachesis is useful for weakness of digestion in patients who, from some vicious habits, from abuse of Mercury, or of Quinine, or of alcohol, have so exhausted their stomachs that even the plainest food causes indigestion. Acids especially disagree, aggravating the stomach symptoms and causing diarrhoea. Sometimes a gnawing pain is re- lieved by eating or improves immediately after a meal, but soon a heavy pressure, as from a weight in the stomach, and other symptoms of indigestion show themselves. There may be a craving for coffee and oysters, which may not disagree. The liver is affected by Lachesis. Like all the snake-poisons, it causes jaundice. Even when abscesses form it may be useful by rea- son of the tenderness on pressure, intolerance of clothing, and deep throbbing in the right hypochondrium. The bowel symptoms are not numerous, though they are important. We find diarrhoea caused by the drug, with watery, horribly offensive stools; diarrhoea during the climaxis; diarrhoea of drunkards. Espe- cially may Lachesis be used in chronic diarrhoea with great debility and aggravation in spring weather. The tongue is smooth, red and shining {Kali bi.). The abdomen is bloated; very sensitive to touch about the waist. Constant tormenting urging in the rectum, but not for stool. It is merely a spasmodic condition of the bowels with an unduly irritable sphincter. The rectum protrudes and is held b3^ the constricted sphincter; after stool there is often a sensation in the rec- tum as from the beating of little hammers. These symptoms are com- mon enough in dyspeptics, particularly in those who have, abused alcohol. They are not infrequently associated with large, protruding haemorrhoids, which are worse at the menopause, or with scanty THE OPHIDIA. 53 menses, with stitches upward at each cough or sneeze. They occur also in connection with constipation. The patient attempts to strain at stool, but must desist on account of pain in the sphincter. Unsuccessful urging; the anus feels closed. Stool hard, like sheep's dung, and excessively offensive. In dyspepsia Lachesis is very similar to Hepar. The latter remedy, however, has relief of the symptoms from the use of condiments. Under Hcpar the plainest food disagrees. The cravings are unique. As if knowing instinctively what will "tone up" the stomach, the pa- tient longs for condiments or wine. Eating relieves the relaxed feel- ing, but food annoys as soon as the digestive process begins its slow and imperfect work. The bowels move very sluggishly, even when the stools are soft. Cinchona, too, enfeebles digestion and induces great weakness and languor after meals. It also has a craving for coffee-beans. Fruits induce diarrhoea with intestinal fermentation. Both cause fulness after eating, but only in Cincho?ia is the fulness so severe as to cause pain, with little or no relief from belching. Bitter eructations and bitter taste be- long to each; the latter has the altered taste after swallowing, food retaining its normal taste while being masticated. The discharges from the bowels and the flatus are offensive; yellow watery stools, undigested. But the marked aggravation at night, after a meal, and the resulting prostration, are not at all like Lachesis. In dysentery, etc , when putrid or gangrenous changes occur, the choice is more difficult. Both have cadaverous smelling discharges of a chocolate color, with coldness and great debility. And, although Cinchona is far preferable if the disease is of malarial origin, such a complica- tion does not contra-indicate the snake-poison. The apparently close similarity is also enhanced by the nervous excitability in both. Light touch is distressing, the epigastrium is sensitive, and clothing annoys in each remedy. But this in Cinchona is an increased general sensi- bility, while in Lachesis there is general torpor, with hyperesthesia of the cutaneous nerves. The former is suitable when the offensive dis- charges follow a severe, rapidly exhausting inflammation, or when the frequency and quantity of the evacuations have greatly reduced the vitality, thus favoring retrogressive changes. If hectic symptoms are present, the choice is rendered more certain. In addition, we may also refer to the well-known anaemic symptoms of Cinchona, paleness, ringing in the ears, easy fainting, etc., which show at once how it affects the blood. 54 A CLINICAL MATERIA MEDIC A. Mercurius presents many points of similarity with Lachesis. The latter frequently follows the former, and also antidotes its abuse. There are loss of appetite, coated tongue, nausea with oppression, and epigastric tenderness. Pressure in the pit of the stomach produces a deadly faintness. The stomach hangs heavily, even after a light meal of food of ordinary digestibility. The sensitiveness of the stomach to the clothing is a part of a symptom which is completed by a similar tenderness over both hypochondria, with fulness and upward pressure from the abdomen. The patient cannot lie on the right side. If hy- pochondriacal, he is suspicious, anxious and restless at night, with vascular erethism and sweat. In fact, this erethism is directly con- trary to the torpid Lachesis. In abdominal inflammations with suppuration, as in typhlitis, both remedies are useful and follow each other well. Mercurius has its ever-present perspiration without relief; stools slimy, or much strain- ing, with or without stool. Lachesis follows when the symptoms threaten a typhoid condition. The patient can lie only on the back with the knees drawn up; if he turns to the left side, a ball seems to roll over in the abdomen. In the rectum and anus, Mercurius has more persistent tenesmus; protrusion of the rectum, which looks inflamed and blackish; Lachesis \ more spasmodic tenesmus, with constriction of the anus, which tightly constricts the prolapsed rectum. Both have chronic constipation. The former induces much straining, with tenacious or crumbling stools; chilliness during defecation. Arsenicum intensifies the gastric and systemic weakness to which we referred in the remedies just considered. While it is true that the pa- tient does not fully realize his want of strength, and hence does not care so much to lie quietly, nevertheless the actual amount of his vitality is seriously reduced. In a word, he is excessively weak without feeling so fatigued. Any exertion produces fainting. Taste is lost, or is bitter, sour, and putrid. The stomach feels swollen as if full of water. Craving for acids and for coffee; the latter, as in Lachesis, agrees with the patient. There are burning feelings, red rough tongue, and anx- iety and distress after eating, as in subacute gastritis, which no remedy pictures better. Nausea is frequent, and often periodical (12 p. m.) and is accompanied by great prostration. The vomiting is of many- kinds, but is distinguished from the bilious, slimy, or bloody emesis of Lachesis by its irregular convulsive character, indicative of gastric THE OPHIDIA. 55 irritability. Lachesis is adapted to the nervous weakness and trem- bling of drunkards; spasm of the stomach, spasmodic constrictions, relieved temporarily by eating; vomiting of bile or mucus; Arsenic is adapted to burning periodical pains, with sour acrid vomiting; vio- lent thirst, but vomits the water. Cadmium sulph. has nausea, } T ellowish or black vomit, saltish rancid belching, cold sweat of the face, burning, cutting in the stomach; cramps after beer, griping in the lower part of the bowels. Both this remedy and Lachesis induce marked sensitiveness to touch upon stomach or abdomen, spots of burning soreness here and there over the swollen abdomen (peritonitis); offensive, bloody, chocolate-colored discharges, as in dysentery, with constriction in the bowels; cutting pains in bowels. But in Arsenic there is more lamenting with ago- nized expression; restless moving despite the pains. The constriction of the intestines is torturing; the patient declares he cannot stand it, and rolls about in agony, despairing of his life. The extreme tender- ness of the pit of the stomach denotes a more positive state of acute inflammation than Lachesis causes. In the vomiting of yellow fever Lachesis has, in addition, brown coating on the teeth and abdominal tenderness. Arsenic has also spasmodic protrusion of the rectum; very painful tenesmus with burning; haemorrhoids, especially in drunkards; they protrude at stool with burning. Alvine discharges are offensive, dark, sometimes involuntary, with great weakness and coldness. But Lachesis has less tenesmus recti, the distress there being attributable to a con- striction of the anus not found in the other drug. Arsenic, moreover, causes more acridity of the stools, with rawness and excoriation of the anus. All that I have here stated regarding the difference between these two drugs might be tersely stated thus: One causes intense irritabil- ity and acnte inflammation of tissue, mental anguish, and extreme pros- tration; the other, torpidity, with loss of vitality, but associated with nervous excitability, constrictions, and cutaneous hyperesthesia. Still, some minds require more attention to detail; and every one re- tains general mental impressions more accurately if they are formed with due attention to particulars. When there is ulceration of the bowels, tendency to sloughing, with offensive, purulent, or bloody discharges, the two remedies are very nearly allied. Vitality is at a very low ebb; blood oozes from the 56 A CLINICAL MATERIA MEDICA. cracked lips and tongue, and the extremities are cold. But even here the best distinctions are the mental irritability of Arsenic, and the in- tolerance of pressure of Lachesis. Carbo vegetabilis resembles Lachesis in weak digestion, complaints of drunkards, flatulent asthma, constriction of the oesophagus, annoy- ance from clothing about the waist, offensive, bloody, decomposed, purulent stools, collapse, etc. There is craving for coffee, but it does not relieve. Milk dis- agrees in both remedies, but only the snake-poison has craving for it. Carbo veg. has aggravation from fats, tainted meats, fish, oysters, foods causing flatulency, ices, vinegar, and sour cabbage — the latter principally on account of the flatulency it causes. Eructations are sour, rancid. Both drugs have relief of flatulent distension from belching, but Lachesis has an ill feeling in addition, which is relieved. Both drugs experience freer breathing after belching. In Carbo veg. this is expressed as the lessening of a tension and upward drawing which marks the costal attachments of the diaphragm; in Lachesis there is a relief after eructations which seem to suffocate him. They come rapidly, and induce the ever-present Lachesis constriction of the throat. The latter remedy also has empty eructations, which in- tensify the pains. Carbo veg. has heaviness, fulness, sleepiness after eating, with ful- ness of the abdomen, almost to bursting. Burning in the stomach is also increased. This heaviness is very characteristic, and is noted likewise in the abdomen, which seems to hang heavily; also in the head, which feels as heavy as lead. The burning is attended with a creeping feeling up to the throat. In Lachesis, the fulness and press- ure is as from a load, and the sense of repletion induces lowness of spirits. There is, also, a feeling as if a lump were forming in the stomach and also in the bowels; burning, with hard abdominal disten- sion, and a feeling as if a stone was descending; he must stand still or step cautiously. This lump is presumably a part of the Lachesis constriction, which we have so often designated as highly character- istic. In Carbo veg. the flatus is more rancid, putrid, or, when passed per anum, burning, moist, offensive. Its incarceration with burning is a cause of many of the symptoms, and it is more in quantity than in the snake- poison. It also causes a bearing down upon the bladder and sacral region. Lachesis relieves a gnawing gastralgia, when eating lessens the pain; Carbo veg. cures when there is burning, with a con- THE OPHIDIA. 57 strictive cramp, bending him double; the pains are paroxysmal and take his breath. The burning spreads up to the chest and down into the abdomen, seemingly following the sympathetic. Tenesmus recti is most prominent in Carbo veg., anal constric- tion in Lachesis It is this latter symptom which explains, as we have before observed, the ineffectual urging to stool; while in Carbo veg. the urging is fruitless on account of the pressure of flatus. Both have bluish, protruding piles, as after debauchery. This constriction distinguishes them, as do also the headache and diarrhoea In each there is throbbing headache, but Carbo veg. has more of the heaviness, and the diarrhoea is thin. In typhoid conditions, whether the specific fever, or as a sequel to peritonitis, dysentery, etc., Carbo veg. causes the more perfect picture of collapse, while in Lachesis the cardiac debility, drowsiness, cool ex- tremities, etc., indicate failing vitality, but the patient is not so near death as in the former drug. Inthe collapse of Carbo veg. there are tympany; cold legs, especially to the knees; filiform pulse; cool breath; absence of discharges from the bowels; or involuntary, putrid, bloody, purulent diarrhoea. In hernia, Carbo veg. has anxiety, as in Arsenic, but with uneasi- ness rather than restless change of place; and it resembles Lachesis in the annoyance of the clothing, foulness of the parts, if strangulated, etc. There is, however, more meteorism and foetid flatus. Graphites has anxiety, melancholy; tip of the tongue blistered; feeling of a lump in the left side of the throat, over which the food seems to pass with difficulty; on empty deglutition, a constrictive retching from the oesophagus up to the larynx; must loosen the clothing after eat- ing; gastralgia, relieved by eating; chronic gastritis, especially after abuse of alcoholic drinks. Sensation of a lump in the stomach; flatulent distension of the abdomen, with congestion to the head; foetid flatus. Suffocative spells arousing from sleep, must jump out of bed; com- pelled to eat something to relieve the pain. Offensive stools. But this remedy causes more flatulence than Lachesis. The gastral- gic pains are burning and griping, and the feeling of a lump in the stomach is accompanied by a constant beating; the heartburn is rancid. The suffocative spells are usually worse after 12 p. m. instead of during or after a sleep at any time; and the constriction noticed on falling asleep is of the chest instead of the larynx. The offensive movements from the bowels are half-digested, dark and papp}^, 58 A CLINICAL MATERIA MEDICA. indicating the imperfect digestion which is so characteristic of this remedy. There is some resemblance in the constitutional symptoms of Graph- ites and Lachesis, since both are needed at times in phlegmatic patients; but the former is related to a distinguishing type; fat, cold and costive; skin herpetic, rough and disposed to crack and ooze a glutinous fluid. Aside, then, from a few resemblances to the snake- poison, Graphites belongs more with Arsenic, Nux vomica and Lycopodium. It resembles the first two in gastritis and gastralgia; the latter in flatulency. Sulphuric acid resembles the snake-poisons somewhat, especially in the ailments of drunkards. Its corrosive effects, however, are distinc- tively prominent, as shown in the violent inflammation of the alimen- tary canal. But the nervous system is so involved that several symp- toms look like those of Lachesis, as, for instance, epigastrium sensi- tive, constrictive feeling in the bowels, griping, cutting, twisting, with faint-like nausea; trembling, pale face, apprehensiveness; fluttering pulse; cramps in the pharynx; he cannot swallow; oesophageal stric- ture; great weakness, etc. Both, moreover, crave brandy. The acid acts well when the patient is weak, emaciated and com- plains of trembling, which, however, is more subjective than objective. He is anxious and restless; must do everything hurriedly. The face is pale, and sometimes presents dry, shrivelled spots, especially when the haemorrhoids are worse. Eructations are sour. The stomach feels relaxed and cold. Wine may palliate and distilled liquors aggravate, as in Lachesis; but the peculiarity of the acid is that the stomach re- jects cold water unless it is mixed with brandy. The abdominal mus- cles are spasmodically retracted. Stools are yellow, like Lachesis, but present a chopped appearance, and are stringy; they are watery, diar- rhoeic and very offensive. Piles are moist, burn, and may prevent defaecation. As the acid causes croupous formations, it should be remembered with Lachesis when the stools indicate such a condition in the intestine. The acid also resembles Elaps; drinks feel like ice in the stomach; but only the former has the relief from the admixture of spirit. The Elaps diarrhoea resembles that of the rest of the order, but this remedy is particularly called for when the stools consist of black, frothy blood with twisting pains in the bowels. Colchicum deserves mention here, especially since, like Lachesis, it causes coldness or cold feeling in the stomach {Elaps), intolerance of THE OPHIDIA. 59 pressure of the clothing, burning in the stomach, vomiting and purging, spasms of the sphincter ani ', urging to stool, offensive flatus, offensive diar- rhoea, sensitiveness to the least touch, very much exhausted, slow breathing, feeble pulse. But there is generally present nausea, worse from the smell of food; if the patient sits or lies very quietly, the vomit- ing is suppressed (like Veratrum) . Senses too acute; a bright light, touch or strong odors irritate him (like Nux vom.) . Vomiting and purg- ing as in cholera morbus; the sphincter ani contracts after each stool, with fruitless urging. The similarity, then, exists chiefly in the sen- sitiveness to touch and the constrictions of sphincters with weakness, other symptoms being so different as to render a choice easy. (See also below.) In cholera Lachesis has been employed when the vomiting was re- newed by the least motion and the nausea was attended with a great flow of saliva. As Colchicnm has precisely the same symptoms other indications must decide. In reflex irritation, as convulsions with variegated, slimy stools in teething children, and rolling of the head, Colchicum resembles Podo- phyllum. Belladonna, Lachesis, Rhus tox. and Baptisia constitute a group ser- viceable in peritonitis, enteritis, etc. Belladonna differs from all in the character of the inflammation. It is only when the affection becomes asthenic that the others are needed. Lachesis follows Belladonna when, especially in children with inflam- matory diarrhoea, constipation suddenlj 7 sets in with abdominal swell- ing and tenderness, particularly at one spot, or if suppuration ensues and Mercurius fails, or, again, if gangrene threatens. In peritonitis Lachesis is indicated late in the disease, when the fever still continues and is worse after i p. m. and at night. The slightest touch on the surface of the body is intolerable. Typhoid symptoms complicate the case. It may even be indicated when there is typhlitis after the formation of pus. It follows, particularly, Belladonna, Bry- onia or Mercurius corrosivus. It is also similar to Rhus tox., but, hav- ing more typhoid symptoms, comes in later in the case. Rhus tox. requires drowsiness, the fever remaining high or increas- ing; restlessness; tongue dry^, parched, brown, with red, triangular tip; diarrhoea slimy, watery or putrid, yellowish-brown and bloody, involuntary during sleep; generally it is accompanied by tearing down the thighs, while Lachesis has painful stiffness from the loins into 60 A CLINICAL MATERIA MEDICA. the thighs. In typhlitis, in which affection either may follow Bella- donna, Rhus tox. has relief from pressing the swelling gently from be- low upward; Lachesis, intolerance of touch. In periproctitis Rhus tox. may be needed if the inflammation is of traumatic origin; Lachesis, if an abscess forms and fails to point, the surrounding tissues presenting a purplish hue. Colchicum compares with Lachesis when the prostration is extreme, with coma, hot abdomen, cold extremities, and thready pulse; if raised, the head falls back and the jaw drops; the face is hippocratic, the tongue is protruded with difficulty, and the bowels move involuntarily. But the tympany is more marked in the former; and the stools contain white flakes or shreds; the tongue is either thickly coated brown or it is bright red, except at the root, where it is coated. According to provings and cases of poisoning, Colchicum does not cause sensitive ab- domen below the epigastrium. Aryiica develops a profound stupor, with blowing respiration, dry tongue, brown down the middle, distended abdomen, and involuntary faeces and urine. It may be distinguished by the ecchymoses and the bruised aching, inducing restlessness, which latter is relieved if the patient's clothing is smoothed down and his position changed. Among the remedies causing constriction of the anus, the following are worthy of notice: Bellad., Caustic, Nitric ac, Nat. mur., /gnat., Kalibi., Opium, Plumbum, Mezereum, Coccul. The first has pressing and urging toward the anus and genitals, alter- nating with contractions of the anus; spasmodic constriction of the anus, as in dysentery. The second, Causticum, causes fruitless urging to stool, with anxiety and red face. Nitric acid causes sticking in the rectum, as from a splinter; the constriction occurs during stool and lasts for hours afterward; the rectum feels as if torn. Natrum mur. has a sensation of contraction in the rectum during stool; the faeces tear the anus; frequent ineffectual urging; spasmodic constriction of the anus. fgnatia induces a proctalgia; contraction, with cutting, shooting pains; contraction of the anus worse after stool. Symptoms are incon- sistent, irregular, fitful, as in hysteria. Kali bi. has a sensation of a plug, similar to Lachesis; diarrhoea of a brown, frothy water, spurting out in the early morning and followed by tenesmus ani. THE OPHIDIA. 6 1 In Opium the anus is spasmodically closed during the colic, with ob- stinate constipation. Plumbum is very similar. But all these are readily distinguished from Lachesis by the charac- teristic symptoms of the latter: Tormenting urging in the rectum, but on account of constriction of the anus it becomes so painful he must desist; protruding piles, with constricted anus. Much nearer, and indeed almost identical here, is Mezereum; after the stool, the anus is constricted around the protruded rectum. In other respects, however, the two remedies are widely different. Kali bichromicum must also be remembered as a relative of Lachesis in dysentery. Both have red, cracked, smooth tongue; blackish stools; hence both are useful in severe or typhoidal cases, and here they fol- low each other well. The offensive odor of the discharges distin- guishes the latter; the jelly-like, sometimes stringy mucus, the for- mer. A peculiar feature of Cocculus is tenesmus recti after stool, with faintness, and yet peristalsis is lessened. (Compare Ignatia.~) LECTURE V. THE OPHIDIA. Lachesis {continued) . Lachesis causes in the male an increased lasciviousuess with dimi- nution of the physical powers. The mind is a prey to all sorts of allurements, but erections and emissions are imperfect. Upon the female organs, Lachesis acts very powerfully. It seems to have special affinity for the ovaries, particularly the left ovary; ovaritis, ovaralgia, and tumor, may be relieved when there are tenderness to pressure of the clothing and other characteristic symptoms of the drug. Menses scanty, feeble, blood lumpy, black, and very offensive; pains in the hips, bearing down in the region of the left ovary — all bet- ter when the flow is established. The uterus is also intolerant of the least pressure. Lachesis may be used in puerperal metritis, especially when the lochial discharge is foetid. The face is purple and the patient uncon- scious. It is indicated in ovarian tumors when the disease shows a tendency to extend from left to right, even when suppuration has taken place. It is especially called for after Hepar or Mercurius when there is great adynamia. In syphilis, Lachesis is called for as an antidote to mercury or when the chancre becomes gangrenous. Its characteristics are found in its peculiar sore throat, the blue surroundings of the ulcers, nightly bone- pains, violent headache, and the phagedenic chancre. The syphilitic ulcers on the legs are flat and have blue surround- ings; caries of the tibia; the parts are sensitive and livid; ulcers in the throat; bone-pains at night; all after abuse of mercury. The bluish ulcers ally it with: Hepar, Asafcetida, Lycopodium, Siticea, Arsenic; the pimples, blisters, or pustules surrounding the ulcers ally it with: Arsenic, Phosphorus, Lycopodium, Mercurius, Hepar, Siticea, etc.; the burning in the areola with: Arsenic, Lycopodium, Mercurius, Siticea; the offensive pus with: Arsenic, Asafcetida, Lyco- THE OPHIDIA. 63 podium, Silicea, Sulphur, Hepar; the ulcers, being flat, with: Arsenic, Asafcetida Lycopodium, Mercurius, Silicea, Phosphoric acid, etc.; if they become black or gangrenous, with: Arsenic, Secale. Silicea, Plumbum, Carbo veg., Euphorbium, Muriatic acid. But Lachesis has the burning most marked when the ulcer is touched. The surround- ing skin is mottled. Ulcers on the legs tend to spread superficially (rather than deeply, as, for example, in Kali bi.), the discharge is scanty and the strength is failing. Dark blisters encircle the ulcers and the surrounding skin is dead. Sometimes the discharge ceases, the patient is stupid, cold, the leg becomes cedematous, and a bluish- red swelling along the course of the veins shows that phlebitis exists. All this looks like Arsenic, Carbo veg., Bufo, Secale, Cinchona, etc. But Arsenic presents more vascular excitement and nervous irritability with the prostration. Carbo veg. induces still greater prostration than Lachesis, cold sweat, cool breath, collapse. The ulcer has a cadaver- ous odor. In mild cases there is no resemblance at all between the two, for Carbo veg. causes much burning, rawness in the folds of the skin; borders of the ulcer hard, but not oversensitive, as in Lachesis. Hepar should be remembered as a concordant of Lachesis, espe- cially because it is so useful after abuse of mercurials. The areola of the ulcer is very sensitive, but there is a sore, bruised feeling, together with hyperesthesia. And, although the suppurating part may turn bluish and the patient experience weakness, yet there are no evidences of loss of vitality and gangrene, such as suggest the later-indicated drug, Lachesis. Lycopodium is here again a complement of the snake-poison. If syphi- litic ulcers appear in the throat, they are dark grayish-yellow, worse on the right side. The forehead exhibits a coppery eruption and the face is sallow, often furrowed, but lacks the small red bloodvessels which shine through the yellow skin in Lachesis. Chancres are indo- lent. Condylomata are pediculated. Ulcers on the legs refuse to heal, with tearing burning, worse at night; they are made worse by poul- tices or by any attempt to dress them. The pus is often golden-yellow. There is flatulent dyspepsia. Nitric acid, should it seem similar in phagedenic chancre, ulcers on the tibia, etc., may easily be distinguished by the irregular edges of the ulcer, which also presents exuberant, easily-bleeding granulations; and its mouth and throat symptoms may be differentiated by the cracks 64 A CLINICAL MATERIA MEDICA. of the commissures of the lips, sensations of a splinter in the throat, etc. Kali iodatum exhibits a very different train o£ symptoms from La- chesis. Gnawing, boring bone-pains; throbbing and burning in nasal and frontal bones; greenish-yellow, excoriating ozaena; papules ulcer- ating and leaving scars; rupia; chancres with hard edges and curdy pus; ulcers deep- eating; violent headache, much more severe than in the snake-poison, and causing hard lumps on the head. Tendency to interstitial infiltration of soft tissues and also of bones, thus more ex- tended than with Lachesis, which infiltrates only the soft tissues. In the uterine and ovarian symptoms of Lachesis your attention is directed to the following comparisons. Platina has profuse, dark menses instead of scanty flow, and the hau- teur is much more pronounced. The nymphomania is accompanied by titillation and tingling of the genitals or with vaginismus. In ovarian affections this drug has relieved after Lachesis failed, as in suppuration of the ovary, the pus having been evacuated under the action of the latter. The pains are burning, with violent bearing down. Palladium has relieved induration and swelling of the right ovary, as has Lachesis. Mentally the two are widely different. The former develops an egotism which manifests itself in the patient's concern ior the good opinion of others, consequently her pride is often injured. Mental emotions aggravate the ovarian pains, as in the snake-poison, but in a different way. The Lachesis patient is ecstatic or at least ex- citable; the relating of stories moves her to tears. The Palladium pa- tient is easily agitated in society; a lively conversation or some evening entertainment increases her pains and tries her mentally and bodily. In ovarian affections Apis stands closely allied to Lachesis, but it acts more on the right ovary than on the left. There is a bruised, sore feeling, or a stinging, burning. At other times the pains are de- scribed as lancinating. In prolapsus uteri or during the menses the bearing down seems to be in the right ovary; pains followed by a scanty dark mucus. Both have pains from the left to the right ovary, but in Apis these are experienced while stretching. There is also a strained feeling in the ovarian region, very characteristic. The pains may ascend in either, but in Apis they are in the right ovaty, with pain also in the left pectoral region, and cough. Mentally there is considerable similarity (see Mind). Both have THE OPHIDIA. 65 jealousy, with talkativeness and increased sexual desire; restlessness, with bustling manners. Arsenic affects the ovaries and uterus, and has metrorrhagia of dark blood, and increased sexual desire. But this powerful agent affects more the right ovary, with marked burning, tensive pains and restlessness, which is somewhat relieved by constantly moving the feet; menstrual colic, better from warm applications. Lycopodium reverses the Lachesis direction of pains, shooting from right to left. Its gastro-enteric symptoms are also always present. Although Graphites more often affects the left ovary it will also relieve when pains in the right ovarian region are followed by a discharge from the vagina, but constitutionally- this drug and Lachesis differ. A marked symptom of Lachesis is the relief of pain when the blood flows. Compare Moschus, drawing, pulling at beginning of menses, ceasing with the menstrual flow; Ziricum, relief of boring in the left ovary (just like Lachesis). Platina and Ammonium carb. have pains which continue with the flow, the former even with a profuse discharge, the latter with flow between pains. In Actea racemosa the more profuse the flow is the greater is the pain. Now, the heart, circulation and fevers. Lachesis, as I have already intimated, affects the circulation markedly; it causes flushing of heat, as at the climaxis; rush of blood headward, with coldness of the feet; palpitation of the heart, with a feeling of constriction about the heart as if tightly held by cords. These latter symptoms, with the oppression of the chest, the dyspnoea on awaking, and the inability to lie down, have led to the use of Lachesis in hydrothorax and hydropericardium when dependent on organic disease of the heart. Lachesis is indicated in general dropsy when the urine is dark, al- most blackish, and contains albumen, and the skin over the cedematous parts is dark bluish-black. I remember a man, sixty years of age, who had just this sort of dropsy, and continued to live for six months under the action of Lachesis, and whose death, when it came, was painless. It is especially useful in the ascites following scarlatina and the ascites of drunkards, when the above symptoms are present. In renal and vesical affections Lachesis is to be selected more by the general than by the local symptoms. For instance, in albuminuria or morbus Brightii, the respiratory symptoms, aggravation after sleep, and blue surface are more characteristic than the urinary symptoms- 5 66 A CLINICAL MATERIA MEDICA. In cystitis the drug is indicated when the offensive mucus introduces the universal characteristic of tendency to putrescence. And the more this offensiveness of the urine is disproportionately intense, when com- pared with the time of the vesical retention of the mucus, the more likely is Lachesis to be the remedy. In haematuria the drug, like its powerful rival Crotalus, is called for when the symptoms occur as an evidence of blood degeneration, as in low fevers; hence there is the characteristic deposit of disintegrated blood-cells, of fibrin, etc., presenting the appearance of charred straw. In albuminuria after scarlatina there is dropsy from delayed desquam- ation, and the urine is black or contains black spots. This spotted appearance is precisely like Helleborus. Other remedies causing black urine are Colckicum, Natrum mur., Carbolic acid and Digitalis. Apis, Ammonium benz., Arsenicum, Benzoic acid, Arnica, Opium, Car bo veg., Kali car b. and Terebinthina produce dark turbid urine. Lachesis alone, however, has the foaming urine and the general characteristics already discussed. Helleborus is to be distinguished by the sensorial apathy, muscular weakness, pale puffed face and jelly-like, mucous diarrhoea which ac- company its dropsy. The patient may breathe better when lying down, which is the converse of Lachesis and Arsenicum. Digitalis, with blackish, scanty, turbid urine, faintness from weak heart, with bluish face, looks very much like Lachesis here. In the latter there is more laryngeal constriction, as well as oppression and constriction of the chest; in the former the suffocative constriction is as if the internal parts of the chest had grown together. Digitalis has also sinking or faintness at the stomach, as if life was becoming ex- tinct. Terebinthina, has smoky and turbid urine, depositing a sediment like coffee-grounds. It is often. indicated in dropsy after scarlatina. The sediment contains disintegrated blood-corpuscles; haematuria. Dysp- noea; the patient must be propped up in bed. There is great drowsi- ness. The tongue is dry and glossy. Clinically, Terebinthina has proved useful in the early stages of renal disease, when congestion predominates, that is, before renal casts appear in any great quantity. It causes more intense burning and pain in the back than Lachesis, and the urine may have a violet odor. In typhoid fever both renal and alvine discharges resemble those of Lachesis. Foetid stools, haem- orrhages from the bowels, caused by ulceration; the blood is dark, THE OPHIDIA. 67 sooty and looks like coffee- grounds. Foetid urine; disintegrated blood in the urine. In addition, Terebinthina causes stupor, dry, smooth, glossy tongue and great weakness. But it is distinguished by a pre- ponderance of tympanites, with burning, which is accompanied by a smooth tongue, as if it had lost its papillae. Apis simulates Lachesis in post-scarlatinal dropsy, for both remedies have albuminuria, scanty urine, which is dark from decomposed blood, and dyspnoea. But Apis usually requires thirstlessness, pale waxen skin and an eruption here or there resembling nettle-rash, red pimples or an erysipelatous rosy appearance of the anasarcous limbs. Arsenicum is needed in cases of renal disease when the urine is scanty and albuminous without blood, the remedy being required on account of its well-defined heart symptoms or its mental restlessness, etc. Thus far it needs no differentiation here. But if the urine is dark, turbid, blood-mixed, depositing a coffee-like sediment, if there is or- thopnea with cold legs, bronchial catarrh, great difficulty in breath- ing until phlegm is raised, spasmodic constriction of the larynx, the choice may demand further comparison. Arsenicum cures when the urine looks like dark dung- water, and renal casts are abundant. The dyspnoea is noticed more when the patient attempts to lie down in the evening, and again it arouses him after 12 p. m.; it is relieved by the expectoration of mucus. In Lachesis the dyspnoea is worse when, after lying down, he drops off to sleep, relief follows the hawking loose or coughing up of a small amount of thick adherent mucus, and there is far more annoyance from the contact of the clothing than there is with Arsenicum. In the latter the clothing is torn loose lest its pressure smother the patient; in the former there is added a cutaneous hyper- esthesia. Col chimin causes an intense congestion of the mucous membrane of the stomach and bowels, and also of the kidneys. The urine is dark, turbid, albuminous, bloody and as black as ink. There is dropsy. But Colchicum is readity distinguished from Lachesis by the prominence of irritation of the sphincter vesicae with tenesmus of the bladder after urination. It is especially indicated in gouty patients, who at the same time suffer from a nervous weakness, which is combined with hyper- sensitiveness. If this latter symptom seems to resemble Lachesis, we may readily distinguish by the general effects of Colchicum, namely, oversensitiveness to touch (except perhaps the tympanitic abdomen); senses too acute, especially over- affected by strong odors; gastric 68 A CLINICAL MATERIA MKDICA. symptoms are prominent; mental labor fatigues, causing inability to fix the thoughts or to think connectedly; headache, the skin of the scalp feels tense; coated tongue; nausea; great weakness, yet easily irri- tated by external impressions. A peculiarity of Colchicum is that if there are copious salivation and urinary secretion, the stools are scanty and attended with tenesmus, and vice versa. I need not dwell upon the fevers of Lackesis, because I mentioned them in speaking of the mental symptoms of the drug. I may, how- ever, speak of the intermittent fever which recurs in the spring-time in spite of the use of quinine in the fall. The chill comes on at one or two o'clock in the afternoon. During the chill — and here is a symp- tom which is characteristic — the patient feels that he -must have cloth- ing piled on him, not so much to keep him warm as to keep him still. He wants to be held down firmly to relieve the shaking and the pains in the chest and head. The fever is characterized by burning pun- gency, by the oppression of the chest and the heart, and by the asso- ciated drowsiness and loquacity. Desire to be held down during chill is also characteristic of Gelsemium. Carbo veg., like Lackesis, has annual return of the paroxysms, lo- quacity during the hot stage, thirstlessness during the fever, oppressed breathing. The patient is very weak from protracted disease and abuse of quinine. But the thirst is greatest during the chill, not be- fore it, and the chill is often accompanied by cold breath, coldness of the knees, even when wrapped up in bed. Flushes of burning heat in the evening attacks, without thirst. Flatulency. One-sided chills, left side generally. Collapse more marked. Capsicum agrees in thirst before chill, desire for warmth, chill begin- ning in the back; irregular, intermittent pulse. But with the red pep- per the chill commences in the back and spreads thence; the thirst continues into the chill, and drinking aggravates (see Elaps). The patient is relieved by hot applications, as by a hot water-bottle ap- plied to the back. Menyanthes is preferable when the disease manifests itself as a cold- ness of the tip of the nose, the ear-lobes, and the tips of the fingers and toes. Feet to knees icy cold. Hands and feet icy cold, rest of the body warm. When Lachesis is called for in such irregular cases, with cold nose, etc., the livid skin and great weakness, as shown by the filiform pulse, are sufficiently distinctive. Agreeing more accurately are the following remedies, all of which THE OPHIDIA. 69 produce weak or thready pulse, coldness orblueness of the skin, and, of course, great prostration: Carbo veg. (see above). Veratrum album, but in this drug the chill is associated with thirst, and (if internal) runs downward, not upward. Skin blue, cold, in- elastic; hands blue; face, mouth and tongue cold; breathing op- pressed and labored; heart weak; cold, clammy sweat, worse on the forehead. Heat has no palliative effect. Arsenic, external heat relieves; mouth and tongue cold; face blue; single parts of the surface blue. Anxious restlessness despite the great debility; cold, clammy sweat. Suffocative attacks of breathing. Camphor, icy-cold surface, but hot internally, so he throws off the clothing; face deathly pale; limbs blue; breath generally hot. Spasms, or, if conscious, voice altered. Sopor follows. Hydrocyanic acid, marble-like coldness of the whole body. Pulse feeble or imperceptible. Long-lasting faints. Drinks roll audibly down the oesophagus. Clutches at the heart as if in distress. Spasms; espe- cially muscles of back and jaw are stiff. Helleborus, muscles relaxed; suddenly he falls, with coldness, cold sweat on the forehead; slow pulse. Horrible convulsions, with ex- treme coldness. Rheumatic pains in the knees. Digitalis, like the snake-poison, weakens the heart. The skin is very cold. Copious sweat, but the heart symptoms are not relieved. Pulse intermits every third, fifth or seventh beat; very slow pulse. It will be remembered that Lachesis has oppression of the chest, with cold feet. As the latter become warmer the oppression lessens. Secale, cold surface; sunken, pale face and blue lips. Will not be covered. Tingling in the limbs; holds the hands with the fingers widely spread apart. Cold, clammy sweat. Speech feeble, stuttering. Hyoscyamus resembles Lachesis in the chill up the back, objective coldness of the body, convulsions, delirium. But the chill is worse at night, and spreads from the feet to the spine, and thence to the neck. The lowering of the temperature is accompanied hy slow arterial action, drowsiness, or by delirious and excited talk; picks at the bed-clothing, fears being poisoned, hallucinations, fibrillary twitchings, etc. Lachnanthes, like Lachesis, causes glistening eyes during the chill, icy coldness of the body, relieved by warmth. But only the former has brilliant eyes and circumscribed red cheeks with the fever and de- lirium. 70 A CLINICAL MATERIA MEDICA. Lycopodium follows Lachesis. It is needed in fevers when the pa- tient becomes drowsy or stupid; coldness, as if lying on ice. One foot warm, the other cold — an important symptom. Feels as if the blood ceased to circulate. In intermittent fever the chill begins in the back, as in Lachesis. It is worse from 4 to 8 p. m., or at 7 p. m. ; hands and feet numb and icy cold. Sour eructations or vomit are almost invariably present, es- pecially between chill and heat. Thirst mostly after the sweat. De- sires hot drinks only. Apis here, as in many other instances, favors the snake-poison. Both are suited to old or maltreated cases; afternoon chill, oppres- sion of the chest, nose cold, pulse fluttering, skin of hands and arms blue, and general appearance of collapse. But the bee- poison has ag- gravation from heat, Lachesis has not; the former has much more marked oppression of the chest, with consequent smothering. The tongue is red, raw, and covered on tip and borders with vesicles. Thirst during and not before the chill. Urticaria. Cuprum combines coldness with convulsive phenomena. Icy cold- ness of the whole body. Severe cramps in the extremities, with cold sweat, blue surface; also collapse. Urine suppressed. Employed suc- cessfully in the cold stage of cholera, after Camphor, but also useful in other forms of collapse. For instance, it has antidoted snake-bite, with cramps, delirium, and finally torpor. L^achesis may also be indicated in scarlet fever, but not in the Syden- ham variety of the disease, but in those forms which have a malignant tendency. The child is drowsy and falls readily into a heavy sleep. The rash comes out very imperfectly or very slowly, and has a dark purple hue. It may be interspersed with a miliary rash. It is apt to be complicated with a membranous deposit in the throat having the character I have already described to you when speaking of the rem- edy in diphtheria. The cellular tissue of the throat is inflamed and threatens suppuration. The cervical glands are swollen. On looking into the throat you find it to be dark red with a dirty white deposit on the tonsils, especially the left. The tongue is coated dirty yellow at the base, and the red papillae show prominently through this coating. The pulse is weak and the surface of the body cool. There is apt to be dark blood oozing from the mouth and nose. The majority of physicians make a mistake in beginning their treat- ment of scarlatina. A mistake in the beginning means one of two- THE OPHIDIA. 71 things, either a long, tedious illness, or a short one, ending with death. The mistake made is to give Belladonna in every case. Let us look for a moment at the differences between Belladonna and Lachesis. Both remedies have the strawberry tongue, the throbbing headache, the red face and the high fever. Belladonna is indicated only in the sthenic type when there is an active delirium, the throat is bright red in color, the pulse is full and bounding, the rash is bright red and smooth. Lachesis on the other hand, is suitable where asthenia predominates, with purplish, tardily-appearing rash, drowsiness, marked swelling of the cervical glands, and other symptoms of malignancy above enu- merated . In carbuncle and cancer we think of Lachesis when the surrounding area is swollen and purple or blackish, and pus forms very slowly. Lachesis given under these circumstances increases the quantity and improves the quality of the pus, and the patient's strength improves also. When giving Lachesis for malignant pustule you should accompany the remedy with brandy. That is an experience of Dr. Dunham. I will next say a few words respecting the modalities of Lachesis- Modalities, as you know, express the mode or manner by which symp- toms are qualified. They are therefore important in the study of drugs and especially in differentiating allied remedies. Two medi- cines, for instance, may induce supraorbital pains of a shooting char- acter. But if one has the pains modified by pressure, the other by sleep, we are thus enabled to distinguish them in practice. Modalities, then, qualify symptoms and are as essential as adjectives to nouns. Care must be exercised, however, that they be not substituted for the symptoms they modify. Too often we see cases reported, the only homoeopathic resemblance between which and the remed}^ selected is a mere modality, as, for instance, worse after sleep. The modalities of Lachesis, then, are as follows: Worse. — During sleep, especially the throat symptoms, choking, which arouses him; worse after sleep, especially in the morning. Time of Day. — Generally worse from noon until 12 p. m. ; still there are some prominent symptoms aggravated in the morning and fore- noon. This is partly owing to the bad effects of awaking, but, as some symptoms appear later in the morning, we may ascribe them to causes then at work. For instance, the patient has vertigo on awak- ing, yet this returns, on closing the eyes, at 11 a.m. Headache in 72 A CLINICAL MATERIA MEDICA. the left frontal eminence in the morning. Weakness in the morning on rising. Finger tips numb. On sitting up quickly in the morning, breathing becomes slow, difficult and whistling. In the evening and before 12 p. m., we find the following especial exacerbations: Throat sensitive; diarrhoea; dry, hacking cough. Chill beginning some time between noon and 2 p. m., but fever is marked in the evening and night; worse before 12 p. m. Temperature, Weather, etc. — Worse in the cold air, from change of temperature and from the warmth of the bed (see below under Motion, etc.); worse from getting wet, wet weather, windy weather; worse before a thunderstorm; worse from the sun; worse in the spring. Better often from warmth, wrapping up, near the stove, etc. Excessively cold or excessively warm weather causes debility. Motion, Rest, Position, etc. — Worse on and after rising from bed; worse while sitting and better after rising from a seat; better lying in bed on the painless side, but worse from the warmth of the bed (see above under Temperature) and from lying on the painful side. Some symptoms are better from moving, but not if continued long. Touch, Pressure, Injuries, etc.— Almost invariably worse from touch, however slight. Useful for the bad effects of injuries, as penetrating wounds, with much haemorrhage or gangrene. LECTURE VI. ARACHNIDA. Of the Arachnida or spider-poisons used in medicine I shall call your attention to the following: 1. Mygale lasiodora. 2. Lycosa tarentula. 3. Tarentula Cubensis. 4. Aranea diadema. 5. Aranea scinencia. 6. Theridion curassavicum. The action of the drugs in this group is a two-fold one; they all poison the blood, and they all act prominently on the nervous system, producing spasmodic diseases, as chorea and hysteria. Among other nervous symptoms produced by them are anxiety, trembling, great restlessness, oversensitiveness and nervous prostration; periodicity. The system is profoundly affected by spider-poisons; hence, they may be used in serious and chronic ailments. Taking up the study of these drugs seriatim, we come first to the Mygale lasiodora. Mygale lasiodora. The Mygale lasiodora is a large black spider, native to the island of Cuba. It was first proved by Dr. J. C. Houard, of this city. It is one of our best remedies for uncomplicated cases of chorea. The patient is apt to be low-spirited and depressed. She complains of dull pain in the forehead. She has constant twitchings of the muscles of the face. The head is often jerked to one side, usually to the right. There are also twitchings and jerkings of the muscles of one arm and leg, usu- ally the right. Control over the muscles is lost. On attempting to put the hand up to the head it is violently jerked backward. When an effort to talk is made the words are jerked out. I can recall one case of chorea in which, under the use of this rem- edy, the convulsive symptoms were speed \Xy removed, and the patient, 74 A CLINICAL MATERIA MEDICA. a little girl, remained well for years. Dr. Houard, to whom I just re- ferred as having proved this drug, has given me the following symp- toms indicating its use. The muscles of the face twitch, the mouth and eyes open and close in rapid succession; cannot put the hand to the face, it is arrested midway and jerked down. Gait unsteady; legs i.n motion while sitting and dragged while attempting to talk; constant motion of the whole body. The most similar remedy to My gale in chorea is Agaricus* which also has these angular choreic movements. But as a distinctive symp- tom we have itching of the eyelids or of different parts of the body, as if they had been frost-bitten. The eyelids are in constant motion. The spine is sensitive to touch. Actea racemosa is to be employed in chorea when the movements af- fect chiefly the left side, and when the disease is associated with my- algia or rheumatic ailments, or occurs reflexly as a result of uterine displacements. Tarenttda is indicated in chorea affecting the right arm and right leg. The movements persist even at night. Ignatia is called for in chorea of emotional origin. Zizia may be used in cases in which the choreic movements continue during sleep. The Stramonium chorea is characterized by the following symptoms. Features continually changing; now he laughs and now appears aston- ished; tongue protruded rapidly; head thrown alternately backward and forward; spasmodic twitching of the spine and whole body; the extremities are in constant motion, though not always jerked, for sometimes their motion is rotary, gyratory, even graceful. The mus- cles of the whole body are in constant motion. There may be stam- mering. If the mind is affected, the patient is easily frightened; he awakes from sleep terrified; or he often assumes an attitude of prayer, with fervent expression and clasped hands. He frequently lifts his head from the pillow. *By a very ingenious selection of Agaricushy Dr. Korndcerfer, in the case of a two-year old child, who had evident meningitis, and who was not relieved by Apis, Sulphur, etc., the rolling of the head ceased, alarming forewarning of imbecility happily vanished, and the patient fully recovered. I used the drug in a case of .typhoid, in which the child rolled her head and bit her nightgown. Some im- provement followed. Tarentula was then given, with slight aggravation, fol- lowed by lasting improvement. The two should be remembered in impending imbecility. — E. A. F. ARACHNID A. 75 Returning now to Mygale, I give you the following symptoms in addition to those already described: Delirious talk about business; restlessness all night; fear of death; despondency, with anxious ex- pression; nausea, with strong palpitation of the heart, dimness of sight, general weakness; tremulousness of the whole body in the even- ing; severe chill, thirty minutes, then fever, with trembling; pain in the head in the morning, worse in the eyes and from temple to temple. My gale, after having been given to a boy for some time, produced, during the spasmodic symptoms, violent erections of the penis. The penis, when erect, was curved, not straight, and consequently the pa- tient suffered great pain. Dr. Williamson, by whom this observation was made, was then led to a successful use of the remedy in chordee. He used it in a low potency, but it has since been used high w 7 ith equal success. IyYCOSA TARENTULA. In poisoning by the bite of the Tarentula, the symptoms are strik- ingly similar to those of the Ophidia. The bitten part becomes swollen and discolored, and the lymphatic glands are enlarged. By conveyance of the poison to the neck the cellular tissue there is af- fected, giving rise to swelling of a dark red or purplish hue. Chok- ing seems imminent, when epistaxis, with discharge of dark clots, ap- pears and relieves the symptoms. Evidence of cerebral congestion is given by the violently throbbing carotid arteries. But with all these symptoms there is a pale, earthy hue to the face. The fauces ap- pear swollen and purplish, and there is a difficulty of swallowing which is of paralytic origin. The patient has burning thirst for large draughts of water. The stools are dark and foetid, and the urine scant} 7 and voided with difficulty. Thus far, there is but little to aid us in distinguishing this condition from a Lachesis case. But there are other symptoms — nervous phenomena — which typify the drug. Nervous symptoms are present in all the spider-poisons, but Tarentula applies, more than other members of the group, to hysteria. There is marked spinal irritation, and what I have found to be very character- istic is great excitability of the terminations of the nerves. The pa- tient keeps the hands in constant motion, trying to work off this over- excitability. The playing of a lively piece of music excites her and starts her to acting like one crazy. When there are no observers she has no hysterical attacks. As soon as attention is directed to her she 76 A CLINICAL MATERIA MKDICA. begins to twitch, etc. When she has headache it is better from rub- bing the head against the pillow. Rubbing seems to relieve. Tarentala acts on the uterus and ovaries. It is palliative in enlarge- ment of these organs. There is pain in the uterine region associated with constrictive headache. There is also burning pain in the hypo- gastrium and hips, with sensation as of a great weight in the pelvis. The menses are profuse and are followed by pruritus vulvae. The pa- tient feels sore and bruised all over, particularly when moving about. She longs for sleep, but is so nervous that she cannot sleep. Now let us study for a moment the concordant remedies of Taren- tula, taking up first Kali bromatum. We have no remedy in the Ma- teria Medica which has so many reflex symptoms as Kali bromatum. Any little irritation, such, as dentition or indigestion in children, may bring on convulsions. The symptom, however, which I wish particu- larly to emphasize is peripheral irritation, with relief from motion or using the part affected. Crocus deserves mention because of the hysterical state it is capable of exciting, together with choreic symptoms. It causes jumping, dancing, laughing, desire to kiss everybody, contractions of single groups of muscles. She is angry, and then suddenly repents; or angry and talkative, laughing alternately. As in Tarentula, music affects her. Hearing one sing, she begins involuntarily to join in; but there is not the subsequent relief from music which is noticed in the spider-poison. Actea racemosa resembles the spiders in producing sleeplessness, rest- lessness, trembling and fear of death; and, too, these evidences of nervousness are often, in Actea as in Tarentula, reflex from uterine affections. The former has, after going to bed, jerking, commencing on the side on which she is lying, compelling change of position, nerv- ous shuddering and nervous chills. Mentally the two drugs differ. Actea causes nervousness; she feels as if the top of the head would fly off; delirium with jumping from subject to subject; sees strange ob- jects; great apprehensiveness, as a concomitant of uterine irritation; pains darting into the eye-ball, through to the occiput. Feels grieved, troubled, with sighing; next day, tremulous joy, mirth and playful- ness. This head symptom of Actea is not quite the same as that of The- ridion, under which remedy the patient's head feels as if she could lift it off. ARACHNIDA. 77 Hyoscyanius is useful in well-marked local jerkings and twitehings of groups of muscles. The patient is sleepless and nervous, or sobs and cries in sleep. The head falls from side to side. She laughs at everything in a silly manner. Stuttering. Mental excitement; talka- tiveness; she is nervous, suspicious, troublesome, but not maniacal. Causticum bears some resemblance in causing restless moving at night; she can find no quiet position. Intolerable uneasiness in the limbs in the evening. Anxiety and timidity in the evening. Trem- bling. Uneasy at night; she awakes from a short sleep with anxiety, which scarcely allows her to remain in one place ten minutes; she is obliged to turn her head involuntarily from one side to the other, until, exhausted, she falls asleep. During sleep frequent motions with her arms and legs. She jerks, mostly the right side of the body. Con- vulsive motions of mouth and eyes, with sleeplessness and restlessness, after repercussed eruptions. It is especially suited to rheumatic pa- tients, or to those who suffer from paretic affections, especially of one side of the face or of the tongue; the mouth, in consequence, is dis- torted. Belladonna produces a bodily inquietude, as in chorea. The patient is obliged to move to and fro, especially to move the hands and feet; he cannot stay long in any position. The predominant jerking is back- wards, although this may alternate with a forward bending. There is a boring of the head into the pillow, not mere rubbing against the pil- low as in Tarentula. Bellado7ina also has constrictions, hyperaesthesia, mania, with laughing, dancing, wild crying, etc. But it is distin- guished by the intensity of its symptoms; there are violent conges- tions throbbing of the carotids, wild look, dilated pupils and injected eyes. In hysterical states Ignatia, though agreeing in many respects with Tarentula, has a w 7 ell-defined individuality of its own. The nervous system is over-impressionable, incoordinate in function and contradic- tory in action. The patient is extremely susceptible to emotional in- fluences. Fear and grief affect her seriously; the least contradiction offends; she is readily chagrined, and is thus often reduced to grief and tears by the slightest causes. Her mental states, however, are not usually exhibited in violence and rage. On the contrary, she nurses her troubles in seclusion and silence, and broods over them until they prey upon her whole system. She thus grows more and more nerv- ous, and, at the same time, more and more weakened. The heart 78 A CLINICAL MATERIA MEDICA. beats nervously, with variable pulse; she frequently sighs heavily and deeply; suffers from goneness at the stomach, with qualmishness and flat taste in the mouth; feeling of a lump in the throat, swelling sym- pathetically with the intensity of her mental disturbances. Sleepless- ness or violent startings of the limbs. Grief, fright, disappointed love or some other similar cause may develop hysterical or choreic parox- ysms. The moods change with wonderful rapidity; now she laughs and jokes, then, quickly, she bursts into tears. Her manner becomes hurried, so that everything is performed hastily, and hence imper- fectly and awkwardly. She is afflicted with intense headaches. These are characterized by the predominance of a sensation of pressure; the pain goes to the eye, which feels as if pressed out, or to the root of the nose, or, again, it is confined to one small spot, like a nail press- ing; hence the name, clavus hystericus. At the height of the parox- ysm she becomes restless and chilly, and often describes a peculiar per- version of vision; she sees fiery zigzags when looking out of the line of vision (see Theridio?i} . Finally, a profuse flow of colorless urine ter- minates the attack. While, then, both remedies induce sadness, indifference, profound melancholy and hysterical states, only Ignatia has the introverted state of mind; only Tarentula, the cunning attempts to feign paroxysms and wild dancing. Platina should not be confounded with the spider-poisons here, be- cause ii develops a different form of hysteria. True, there are present deranged coordination of functions, anxiety, trembling, fear of death, which seems to the patient to be imminent; also alternation of depres- sion with gayety and laughter; sexual excitement and convulsions. But the patient assumes a hauteur, a self-exaltation, which is foreign to the other drugs considered. Her mental disturbances develop into a condition of self-esteem, during which she looks disdainfully down on all around her. Her paroxysms of laughter are not only loud and boisterous, but ill-timed, occurring even under circumstances of a sad nature. The headaches are of constrictive character, as in Tare?itula y but there is, in addition, a squeezing, cramplike pain, with numbness, and the pains gradually increase and as gradually decrease. Indurated uterus belongs to the symptoms of both remedies. Palladium is readily distinguished by its unique mental phenomena. The patient is not haughty, but she is irritable, and is, unfortunately, given to strong and violent language. Music, society or animated ARACHNIDA. 79 conversation excites her and produces pains in the right ovary; the following day she feels correspondingly exhausted. Her egotism is displayed in a fondness for the good opinion of others, hence she is continually being "slighted." The uterine symptoms are character- ized by a weakness, as if the womb were sinking; an empty feeling in the groins, as if eviscerated. Moschus repeats the scolding of Palladium, but the patient keeps it up until her lips turn blue, her eyes stare and she falls to the floor in a swoon. She suffers from sudden suffocation from closure of the glottis or cramp of the chest. She also has faint spells: palpitation; tremulousness of the whole body; coldness of the body; hysterical headache, with fainting spells; copious pale urine; fear of death, like Platina and Tarentula, but with pale face and fainting; she talks only of approaching death. Vertigo, nausea, dim vision. Vertigo, objects turn in a circle. (Musk relieves when Theridion produces vertigo; worse when the eyes are closed.) Headache, as from a weight press- ing here or there on the head. An oft-observed symptom with the nervous is fidgetiness of the legs, at times preventing sleep. In addi- tion to Tarentula the following remedies may be studied in this relation: Zincum induces moving of the feet for hours after retiring; even continuing in sleep. Asafcetida has several times relieved restlessness, as has also Ammon- ium carb.; Adea racemosa has already been mentioned. Arsenicum, so useful in stubborn cases of chorea, has the following: Uneasiness in the legs, must change the position of his feet all the time or walk about for relief. Mephitis has relieved uneasiness in the legs, as if they would become insensible. Sticta pulmonaria has produced a sensation as though the legs were floating in the air. One prover became so lively that she lay down on a lounge and began to kick, exclaiming that she felt as if she wanted to fly away. This excitability reminds us of the desire to jump which Tarentula causes. (Compare Stramonium, Agaricus, Cicuta, Hyoscy- amus, Crocus and Natrum mur., which latter has jumping high up, regardless of near objects.) Asaruvi induces a feeling as if the body were hovering in the air; it also causes shivering and coldness from any emotion. But it offers no essential similarities to Tarentula, though it has some slight resem- blance to Theridion, in that noises become intolerable. The distinction 80 A CLINICAL MATERIA MEDICA. is evident. Asarum is so sensitive that a thrill runs through the pa- tient on merely thinking of the scratching of silk, which she is contin- ually impelled to do. Although I have tabulated several drugs as bearing symptomatic resemblance to the Spiders, only the following hold any intimate rela- tionship: Ignatia, Mosckus, Actea racemosa, Agaricus, Stramonium, Bella- donna, Magnesia mur. (the latter in uterine cramps). Tarentula Cubensis. Tarentula Cubensis, the hairy spider, causes a perfect picture of car- buncle, even to the sloughing, and claims place as a rival to Arsenicum and Carbo veg. It may be used effectually when there are great pros- tration and diarrhoea, with intermitting fever of evening exacerbation. In relieving the atrocious pains accompanying this condition it acts almost like magic. It should, therefore, be compared with Arsenicum, and no less with Lachesis, Anthracinum and Silicea. Aranea Diadema. Aranea was suggested by Grauvogl as one of the remedies for what he called the hydrogenoid constitution, this being a constitution which could not tolerate moisture. Under Aranea all the symptoms are worse during damp weather or from dwelling in damp localities. Es- pecially is this true with what we may call chronic intermittent fever, for which Aranea is the remedy when the symptoms are aggravated during every spell of damp weather. The patient may feel very com- fortable on a sunny day, but as soon as it becomes damp he gets sick. During this aggravation he complains of chilliness, as if the bones were made of ice, bone-pains, followed by little or no fever. The chill is apt to be typical, occurring at the same hour every other day, every week, or at some regular period. You find also that the spleen is en- larged and the patient is subject to haemorrhages. He may or may not have been previously treated with quinine. Cinchona and Chininum sulphuricum are both very similar to Ara7iea diadema in the periodical return of symptoms, and both are indicated in cases of swollen spleen, and of ague from living in damp places. Cedron, of which it has been asserted that it will relieve the bite of the rattlesnake and modify hydrophobia, may also be regarded as an ARACHNIDA. 8 1 analogue of Aranea diadema and of the spider-poisons generally. It is said to act best in nervous, excitable and even voluptuous patients, especially females. The febrile and neuralgic symptoms return with clock-like regularity. It is used in ague contracted in warm countries or in low, marshy lands, in which latter respect it offers some similarity to Aranea. But the former remedy has won favor mainly in hot cli- mates, while the latter works well in chills contracted in cold and wet localities. The chill predominates, heat being slight or wanting. In Cedron, on the contrary, there is congestion of the head, flying heat in the face alternating with chill, and dry heat with full, quick pulse. So far as proved, Aranea does not develop the extreme excitation of the other three spiders mentioned above. Still there is evidence that it affects the nervous system. Confusion of the head and headaches lafter eating, relieved by smoking; headache ceases in the open air; sudden, violent pains in the upper and lower jaws at night immedi- ately after lying down; restless sleep with frequent waking, always with sensation as if the hands and forearms were greatly swollen, as if they were twice as strong and large as natural, a symptom common to remedies that affect the cerebro-spinal nervous system. Aranea also cures diarrhoea, and these patients are often troubled with this disorder. The stools are watery, and are associated with great rumbling in the bowels, as if considerable fermentation were go- ing on within. The toothache is especially worse in damp weather, and also as soon as the patient gets into bed. Here it reminds you of Mercnrius. There is a symptom of Aranea which I have not had the opportunity of observing in practice, and that is numbness of the parts supplied by the ulnar nerve. Arayiea also attacks the bones. It is especially indicated in disease of the os calcis when the patient complains of violent, dull, boring pain in that bone. This ma} 7 be due to a simple periostitis, or it may be associated with caries. Sometimes there is a sensation as if the bones felt like ice. This is purely subjective. Theridion Curassavicum. Theridion compares with Tare?itula in headache, nervousness and hysteria. According to the provings, there is a similar restless, busy state; he desires to occupy himself, though he finds pleasure in noth- 6 82 A CLINIC AL MATERIA MEDICA. ing. But there is a strong distinctive characteristic in the sensitive- ness to noise. This qualifies the vertigo, headache, and even the gas- tric ailments. Vertigo and nausea, worse when the eyes are closed, from motion and from noise.* Every sound penetrates the teeth. Every penetrating sound and reverberation extends through the whole body. Headache worse if others walk over the floor. I have re- lieved most intense headache with Theridion when this hypersensitive- ness was present, as well as nausea and aggravation from motion. The general accompaniments are true spider-effects: Weakness, trembling, coldness and anxiety. Hysteria, too, has yielded to Theridion. Time passes too quickly; hilarity; talkativeness; feels as if her head did not belong to her, as if she could lift it off. Luminous vibrations before the eyes. Sensitive to light; if she looks into the light, dark vibra- tions are produced; double vision. Faints after every exertion. An- % xiety about the heart, with sharp pains through the left chest, or to the left shoulder. Bites the point of the tongue during sleep — all with weakness, chilliness, or easily excited cold sweat. Nausea and van- ishing of thoughts, greatly intensified by closing the eyes. Theridion is very similar to Spigelia, which has sharp neuralgic pains over the left eye. Under Spigelia, however, the pain comes up from the nape of the neck and over the head, settling above 4:he left eye. The Spigelia sick headache is very apt to follow the sun, beginning in the morning, reaching its acme at noon, and gradually subsiding at sunset. The antidote to Theridion when it causes, this headache is Moschus. Bryonia is at times very similar in headache. I once treated a lady suffering from intense headache and nausea that were worse from the least motion. Bryonia was given, but failed. However, when the pa- tient added the fact that noises made both headache and nausea worse, I found the similimum in Theridion. In headaches worse from jarring the floor compare Belladomia and Sanguinaria. Another use you may make of Theridion is in the sea-sickness of nervous women. They shut their eyes to get rid of the motion of the vessel, and they grow deathly sick. The spine is very irritable. We have what is known as spinal irri- tation. Examination reveals great sensitiveness between the vertebrae. *In vertigo worse closing the eyes compare Lachesis, Apis, Arnica, Piper methysticum, Arsenicum, Thuja, Petroleum, Chelidonium, Sepia. ARACHNIDA. 83 So great is this hyperesthesia that the patient sits sideways in a chair in order to avoid pressure of the back of the chair against the spine. A rather peculiar employment of Theridion, but one which I have had occasion to confirm, is its use in phthisis florida. It is claimed that the drug tends to stay, and in some cases stop, the rapid prog- ress of this fatal affection. One symptom I know is good, violent stitches high up in the left chest through to the back. Dr. Baruch succeeded in removing this symptom with Theridion after other physi- cians had utterly failed. Myrtus communis and Pix liquida vie with Theridion in pains in the upper left chest. The first has pain through to the shoulder-blade, a symptom which it often relieves, even in consumptives. Pix selects a spot at the third left costal cartilage, where it joins with the rib. (If it fails, consult Anisum stellatum, which affects either side at the third rib.) Rales through the lungs and muco-purulent sputum are further symptoms of the tar. Dr. Baruch has also made use of Theridion in scrofulous diseases of bones, particularly after Snlpimr, Calcarea, Lycopodium and the ordi- nary remedies have failed. I think that it may even cure ozsena with caries, since it attacks the bones and so often removes the j^ellowish or yellowish-green, thick and offensive discharge from the nose. LECTURE VII. CANTHARIS. The remedy which I propose to bring before you for study today is Cantharis, the so-called Spanish fly. It is my purpose to speak of the more important symptoms produced by the drug, comparing it super- ficially with a number of others having effects similar to it. First of all, for the sake of completeness, let me give you notes on two other drugs, the Lytta vittata and the Ca?itharis strygosa. The first of these is the potato-fly, not the potato-bug, the pharmacopceial name of which is Doryphora. The potato-fly acts much like Caiitharis when applied to the skin. It produces first a dermatitis, which is soon fol- lowed by the formation of vesicles. The affected parts become red, almost erysipelatous in appearance. The vesicles finally rupture, leav- ing an ulcerated surface. Finally, death of the part may ensue. The Cantharis strygosa is a species of Cantharis, which infests the cotton plant. This, too, has vesication for its characteristic. There are other varieties of this Cantharis among which are the C. cinerea, C. marginata, C. atrata, C. nutalli and Mycabis cichorii et Phalateria, these last two being imported from China. Cantharis, or Spanish fly, has long been used by allopaths as a counter-irritant; when applied to any part of the surface of the body it excites a violent inflammation. This inflammation begins, of course, with erythema, rapidly advancing to vesication. The blisters thus formed are filled with a yellowish-white serum. As the inflammation progresses they enlarge, and their contents assume a purulent char- acter. Finally, death of the part ensues, presuming, of course, that the application is continued long enough. At other times 4arge blisters, termed bullae, may form.. These are sometimes as large as a silver half-dollar. They are raised above the surface, and are filled with a fluid which is excoriating. This irritating property of Cantharis is the founalatio?i- stone of the whole provi?ig . The pains incident to this kind of inflammation are, of course, very severe. They are of a burn- ing character. At times, when the nerves seem to be implicated in the inflammatory process, there will be sharp lancinating pains along their course. CANTHARIS. 85 But Cantharis is not the only drug that has these highly irritating effects when applied to the skin or taken internally. Thus, from external use the following will, sooner or later, cause vesicles to develop on the skin: Varieties of Ca?itharis, Formica; vari- eties of Rhus, Anacardium orientate et occidentale; Ranunculous plants, as Clematis, Ranunculus bulb., Ranunculus sceleratus , Pulsatilla, Aconite, Caltha, Helleborus, Actea spic ; Araceae, especially Arum mac, Arum tri., Palladium, Pix, Terebinthina, Thuja, Nux juglans, Chininum sulph.; several species of Plumbago, Allium sat.; Buphorbious plants, particularly Croton tig., Hura, Euphorbia corol., Euphorbium offic, Ma?ici?iella, Sinapis, Piper nigrum , Capsicum, Mezereum, Thapsia gar- ganica, Chloral, Cotura matura, Drosera, Podophyllum, Chimaphila, Oleander, Chelidonium, Cochlear ia arm., Veratrum album, Camphor, Picric acid, Ammonium causticum, Calcarea caustica, Sulphur, Sulphuric acid, Kali hydro sulphuricum , Nitric acid; Arsenic preparations, Car- bolic acid, Mercury, Cuprum arsenicosum, Antimo?iiu?n tart., etc. Rhus tox. and Anacardium cause vesication, with much redness of the skin and infiltration. The latter adds loss of appetite and other gastric symptoms as essential concomitants. The former causes red skin and numerous vesicles, surrounded with a red rim from infiltra- tion. A well-defined advance-line of inflammation marks the progress of the disease. The predominant sensations are itching or tingling, while in Caiitharis burning and smarting, as from salt, are leading sensations. The latter, in some cases, when topically employed, in- duces an eczematous eruption around the plaster, and in others the vesicated surface assumes a soft, pultaceous, almost gangrenous ap- pearance; but the skin is not the reddish-brown of Rhus. Croton tiglium gives rise to myriads of small, terribly-itching vesicles on a red base. When the genitals are attacked there is pain on uri- nating, and some of the blisters become large, others break, leaving a red, moist surface. The vesicles may develop into pustules, which finally break and form grayish crusts. Hura Brasiliensis, a near relative of the former, also produces red vesicles. Both of these remedies cause a tension of the skin, a hide- bound feeling, which is best confirmed in Croto?i; but Hura carries this feature into its vesication, for the blisters become so tense that, on opening, their serous contents fairly burst forth. A characteristic of this remedy is a sensation as of a splinter under the thumb-nails. The eruption prefers projecting portions of bone, as the skin over the malar bones. 86 A CLINICAL MATERIA MEDICA. Formica, locally applied, sets up inflammatory redness, with itching and burning, slight exudation and desquamation. The urine is albu- minous and bloody, and there is much urging to urinate. Clematis crispa is food for the Spanish fly. The Clematis ereda we know irritates the skin to the production of burning vesicles, which pustulate and discharge a yellowish corrosive ichor. The urine is discharged in drops, or intermittingly, from a narrowed urethra. Ranunculus bulbosus and Ranunculus sceleraius act similarly. In the former the vesicles may become blue-black, or they may discharge a secretion which becomes horny. The latter raises blisters, which leave a raw surface with acrid discharge, and resembles Cantharis in pem- phigus. In blueness Ranunculus bulbosus rather resembles Lachesis; the latter causes deep-seated bluish blisters (which appear after scratching). In horny crusts it resembles Antimonium crudum. The several species of Spurge have caused vesication, and the variety called Euphorbium officinarum has been employed in vesicular erysip- elas; red cheeks, covered with yellow vesicles as large as peas (from an application of the juice); violent fever. Like Hura, this plant and the Euphorbium cyparissias have an affinity for the malar region. Cantharis attacks the surface of the nose (like Graphites). Euphorbia peplus also attacks the nose, as well as the cheeks. Ma?icinella is so irritating that even the water dropping on the skin from the leaves may raise blisters, but the accompanying erythema far exceeds that of Cantharis. It resembles the blush of scarlatina, and has been used in that disease. Thapsia garganica, an umbelliferous plant, closely resembles Croton* It causes more pustules, however, and these fill rapidly with pus. Mezereum develops numerous small vesicles, with intolerable itching; but the secretion quickly forms into thick, high scabs, from beneath which an acrid pus oozes. Capsicum, Camphor, Terebi?ithina, Fix and Piper nigriim vesicate very slowly. Several of them are used rather as rubefacients. The first may be distinguished by the fact that the blisters appear on sur- faces which have been wet with sweat, and the sensation is a pungent burning, while in the fly it is a smarting burning, as from salt. Camphor, topically, causes an erysipelatous dermatitis, with bright redness, and, eventually, blisters (from concentrated solution). We generally think of it when there has been a retrocession of skin dis- ease, with its well-known symptoms of collapse and convulsions. CANTHARIS. 87 Pix and Terebinthiyia cause violent itching, especially the former. The skin becomes cracked under Pix, with sleeplessness and bleeding when scratched. Potash preparations favor more a papular than a vesicular eruption, the latter form being intermediate between the papule and the pustule- Kali hydro sulphur icum and Kali nitricum develop papular vesicles when locally applied. Kali bromatum causes vesicles about the hair follicles (from internal use). Kali bichromicum induces an eruption, which presents vesicles with a depressed centre; they suppurate, and on healing leave a cicatrix. Kali hydriodicum causes papular vesicles (from internal use), the resulting vesico-pustules contain minute quan- tities of Iodine. None of these, therefore, resemble the superficial blister of the fly. Chloral is capable of producing several forms of eruption. Its vesi- cles are surrounded with a marked capillary hyperaemia. Chininum sulphuricum has caused an erythematous appearance strongly resembling scarlet fever, but it also forms confluent vesicles, which ulcerate or dry into crusts. Pemphigus, also, may appear. In pemphigus Cantharis compares with Causticum, Rhus tox. , Ranun- culus sceleratus , etc. The following have induced this form of eruption, and deserve a trial: Caltha, Nitric acid, Copaiva, Sulphuric acid, Chin- inum sulphuricum, Carboneum oxygenisatum. In Caltha the bullae are surrounded by a ring and itch a great deal. On the third day they are transformed into crusts. Copaiva affects mucous membranes, then the stomach and bowels, and later the skin. A red, miliary rash forms on a red base; urticaria, pemphigus, with excessive offensive discharge. Carboneum oxyge?i. is prone to excite vesication along the course of nerves (sciatic, trigeminus, etc.), and hence resembles herpes zoster, a disease which Cantharis has occasionally cured. It also causes "large and small vesicles of pemphigus." Cantharis has a most remarkable affinity for the urinary organs; in fact, experience has. demonstrated that nearly always when it is indi- cated C3^stic or renal symptoms are present. Marked symptoms of the kidneys and bladder may result even from the use of the drug exter- nally. The same is true when the drug is taken internally. Let us now look at some of its symptoms. We find dull pressive pains in the region of the kidneys. At other times violent cutting, burning pains extend from the kidneys down either ureter to the bladder. The parts 88 A CLINICAL MATERIA MEDICA. extern ally over the region of the kidneys are very sensitive to touch. There is persistent and violent urging to urinate. Often, too, these cutting pains extend along the spermatic cords to the testicles and down the penis, attended by drawing up of the testicles. At other times there is pain in the glans penis, exhibited in children by frequent pull- ing at the organ. This pain in the glans penis may not be of an acute nature, but may be simply an uneasy, uncomfortable sensation. When in children you notice this symptom Cantharis is generally indicated; at other times you may think also of Mercurius solubilis; of course, the symptom may be a habit which the child has been allowed to practice. That, of course, does not call for these remedies. Coming to the bladder itself, we find here, too, extreme superficial sensitiveness over the hypogastrium (especially when the bladder is distended with urine), and almost unbearable tenesmus vesicae. Some- times the patient will have the desire to urinate every two or three minutes. The urine does not pass freely or copiously, but dribbles away in hot, scalding, sometimes bloody, drops, with burning, cutting pains which could not be worse if the urine were molten lead. This burning and urging continue after urination, so that the poor sufferer is really in constant torture. Exacerbations come on every few min- utes as calls to urinate become too urgent to resist. The urine itself shows changes in its composition. Blood is more or less thor- oughly mixed with it, according to the part of the urinary tract from which the haemorrhage proceeds. The urine, however, is of a deep red color, independently of its containing blood, and deposits a sedi- ment of mucus. Fibrinous casts, epithelial cells, small rolled-up mem- branous pieces of the lining of the parts through which it passes — the tubules of the kidney, the ureters and the bladder — are observed under the microscope. This is the picture of the effects of Cantharis as they attain their maximum. From these extreme symptoms you have all grades of severity down to the slightest irritation at the neck of the bladder, with aggravation after micturition. Now these symptoms characterize Cantharis, and indicate it in a variety of affections. You would expect it to be of use in inflamma- tion of the kidneys, particularly in acute inflammation of one or the other of these organs rather than in chronic Bright' s disease. We find, too, that Cantharis is a valuable remedy in the passage of renal calculi, especially when the pains are very violent. It has been CANTHARIS. 89 stated in controversy that it was nonsense to talk about relieving the pains from the passage of renal calculi b}^ homoeopathic medication. The ureter is a narrow tube and the stone is frequently large, and it is said that this cannot be passed without pain. This is a mistake. The indicated remedy maj r so lessen local irritabilit} 7 that the pain attend- ant on the passage of the renal calculi may be greatly modified. Often you find Cantharis indicated in gravel in children when they have this irritation extending down the penis, with almost constant pulling at that organ. Cantharis you will find indicated in acute cystitis more frequently than all other remedies put together. It is also indicated in hematuria of inflammatory origin. It also has a secondary action in producing retention of urine, an effect due to the severity of the preexisting symptoms. In gonorrhoea Cantharis is indicated when there is most intense irrita- tion; not a simple discharge with the necessary burning and smarting, but with violent and painful chordee, marked sexual erethism and dis- charge that is purulent or bloody. It is also indicated in cases in which the disorder has been suppressed by the use of injections and the disease involves the neck of the bladder. Now, a word as to related remedies. Cannabis sativa is very similar to Cantharis in its urethral phenom- ena. It has the same yellow, purulent discharge from the urethra, but is more important when the discharge is thin, and there is smart- ing and burning on urination. There seems to be more burning and smarting under Cannabis, while there is more tenesmus and cutting under Cantharis. The glans penis is dark red and swollen. Chordee may be present Cannabis sativa may be indicated in simple acute nephritis, but it is not likely to be of much use in Bright' s disease of the kidneys. It has, however, drawing pain in the region of the kid- neys, extending into the inguinal glands, with anxious nauseous sen- sation in the epigastrium. Cannabis Indica is much used in Asiatic countries. It produces the most wonderful mental phenomena, far exceeding Opium in its effects. The two central points of the mental phenomena of this Cannabis Indica are delusions as to distance and as to time. Time and space seem to be greatly extended. For example, the patient tells you that he is hungry, that he has eaten nothing for six months, when the dishes from which he has just partaken are yet by his bedside; or, on 90 A CLINICAL MATERIA MEDICA. looking out of the window he tells you that objects but a few feet off are maii}^ yards distant. But it is the urinary symptoms of Cannabis Indica that concern us more particularly just now. It is very similar to Cantharis, and is said to be even superior to that drug for gonor- rhoea when the chordee is well marked. In renal disease Cannabis is indicated by burning, stitches, aching in the kidneys, pains when laughing; also when uraemia sets in attended by severe headache, with a sensation as if the vertex were opening and shutting. If delir- ium appears, it is associated with the delusions respecting time and space just mentioned. Equisetum hyemale is a plant growing in water. It contains a large quantity of silicic acid. It acts very similarly to Cantharis on the kid- neys and bladder. There are, however, less escape of blood and less tenesmus vesicae than may be found under Cantharis. The urine is less scalding and does not contain so many fibrinous flakes. Cantharis is not called for so often as Equisetum when there is an excess of mucus in the urine. The bladder is tender and sore, with severe dull pain, which is worse after urination. There is constant desire to uri- nate, sometimes with a feeling of distension in the bladder and with profuse urination. During urination a burning pain is felt in the ure- thra. Equisetum has won most favor in enuresis. It has proved cur- ative in these cases even when vesical irritation is marked, especially in women, and the urine contains blood and albumen. Linaria is another drug which has produced and cured enuresis with frequent painful urging to urinate, causing the patient to rise at night. Eupatorium purpureum is similar to Equisetu?n in vesical irritability of women, for which condition it was used by Dr. Richard Hughes, of England. It causes frequent and painful urging with either excessive or scanty flow of high-colored urine containing mucus. Petroselinum, one variety of the parsley, is indicated by frequent sudden and irresistible urging to urinate. In the case of a child, he will be suddenly seized with the desire to urinate; if he cannot be gratified immediately, he will jump up and down with pain. You will find Petroselinum useful in gonorrhoea with this sudden urging and strangury. Camiabis, Cantharis and Mercurius all have the sudden urging to urinate, but it is strongest under Petroselinum. Clematis erecta is to be selected when there is mucus in the urine, but not pus; when the urine flows by fits and starts, or the patient has to wait a long time for the urine to come, and then passes only a few CANTHARIS. 91 drops, with intense biting and burning along the urethra, followed by a full, painless stream. Clematis is to be thought of in "first cases'' of gonorrhoea when the inflammation develops stricture. Co7iium is useful in urethral and bladder diseases when there is pus in the urine; otherwise it is like Clematis. It has "passage of the urine by fits and starts," cutting in the urethra after micturition, urine flows more readily while standing ( Sarsaparilla) . Doryphora is indicated in urethritis in children under ten years of age when the trouble has been provoked b}' local irritation. In these cases think also of Hyoscyamus. Capsicum is sometimes useful in gonorrhoea, especially in fat persons of lax fibre and of rather indolent disposition. The discharge is of a thick yellow character. The patient complains of fine stinging pains in the meatus urinarius and of stitches in the urethra between the acts of micturition. Copaiva and Cubeba have been so abused by allopaths that I think we are too apt to neglect them. Copaiva causes a urethritis with burn- ing at the neck of the bladder and in the urethra. The discharge is of a milky color and of corrosive character. The meatus urinarius is tumid and inflamed and sore as if wounded. Cubeba causes cutting and constriction after micturition. The dis- charge is of a mucous nature. Both Copaiva and Cubeba are useful in the irritation attending thickening of the lining membrane of the blad- der. Neither remedy has so violent. an action as has Cantharis. Thuja gives us symptoms of continued or oft-repeated gonorrhoea. The patient has continued desire to urinate. The urging is violent, 3 r et he passes only a few drops of bloody urine at a time; or, if these do not pass, there is intense itching. The urethral discharge is thin and green. Warty excrescences appear on the genitals and about the anus. At night there are painful erections which drive away sleep. In Cantharis the erections prevent urination; this is not the case in Thuja. Argentum nitricum follows Cannabis in gonorrhoea when the dis- charge becomes purulent and the urethra feels sore and swollen. Mercurius sol u bills and corrosivus follow when the discharge becomes worse at night and is green and purulent. The corrosive mercur} T causes the more violent tenesmus, burning and swelling, hence it is very similar to Cantharis. The meatus urinarius is very red. Mer- curius solubilis has more burning between micturition than has Can- tharis. 92 A CLINICAL MATERIA MEDICA. Chimaphila has been found useful in catarrh of the bladder caused by stones. It produces frequent urination at night with increased de- bility and smarting pain extending from the neck of the bladder to the end of the urethra. In irritation of the neck of the bladder you may use a number of remedies, some of which I shall mention: Erigeron, with or without bloody urine. Pulsatilla is indicated when micturition is followed by cutting pains and there are pressure and soreness over the pubes. Under Ferrum phos. the symptoms are worse the longer the patient stands, and better after urination. Epigea, Apis and Copaiva should also be studied in this connection, the latter especially in old women. Capsicum has spasmodic contracting and cutting in the neck of the bladder; Mercurius aceliacs, cutting just at the close of urination, like Natrum mur. The Digitalis patient finds relief on lying down, as that position relieves much of the pressure upon the neck of the bladder. Sulphur comes in to remove the remnants of a gonorrhoea. Ipomea nil^ which is one variety of the morning-glory, was a remedy used by the late Dr. Jacob Jeanes for the passage of stone from the kidney to the bladder when he had the following symptoms present: Severe cutting pain in either renal region, extending down the ureter on the corresponding side. The distinctive feature which separates it from other remedies is that these pains excite nausea. Hydrangea has also been used for the intense pain attending gravel and calculus. Sarsaparilla is useful for gravel in children when they scream or cry with pain after passing urine; then there is found a grayish sand in the diaper. Ocimum may be employed in renal colic when there is considerable haemorrhage; when the urine not only has a brick-red sediment, as under Pareira brava, but contains considerable blood. It favors the right side. Terebinthina , like Cantkaris, has marked action on the kidneys, but it differs from the latter remedy in that the urine is always dark, cloudy and smoky, from admixture of blood. This is due to conges- tion of the kidneys. Cochlearia armor acea, or the horse-radish, is a valuable drug. It CANTHARIS. 93 produces burning and cutting in the glans penis during and after uri- nation, with a great deal of strangury. The urine becomes thick like jelly on standing. Then we have the Uva ursi. This remedy finds no equal when cys- tic and urethral symptoms are referable to stone in the bladder. You have, as symptomatic of the drug, burning, scalding urination: the flow of urine stops suddenly as if a stone had rolled in front of the in- ternal orifice of the urethra. When the urine passes it is ropy from the admixture of mucus and blood. The drug seems to diminish in- flammatory thickening of the cystic walls, and relieves suffering until the stone can be removed by operation. Similar to this is Pareira brava, which is an excellent drug in gravel and in cystic calculus, w T hen the patient has to get down on all fours to urinate. The tenesmus is great; the urine passes in drops; pains shoot from the kidneys down the thighs, and even into the feet; the urine deposits a copious uric acid sediment and also blood. This brings to mind Berbe?'is vulgaris. This remedy suits when there is kidney affection, with sharp stitching pains radiating from the renal region in all directions, particularly downward and forward, filling the whole pelvis with pain. There are pains in the loins and in the hips. The urine when passed is more slimy than is the Pareira brava urine, and deposits copiously a loamy sediment having a yellow- ish turbid appearance. Berberis is an excellent remed3 T in case of stone in the pelvis of the kidney or in the ureter. Now, you see the differ- ence between the two remedies. Pareira has pain going down the thighs, Berberis only in the hips and loins. You may expect to be called upon to use Camphor when strangury, retention of urine, etc. , have resulted from the abuse of Cantharis. In some cases Kali nitricum may be substituted for Camphor when renal symptoms have been produced by Ca?itharis. Apis, too, is said to have relieved the c}^stitis caused by the Spanish fly. Aconite frequently suits the incipienc}^ of renal and cystic affections, which, unmodified, progress into a Cantharis condition. The urging to urinate, the dysuria and hematuria are accompanied by an anxious restlessness and high fever altogether different from the expression of Cantharis. Just as Ca?itharis acts on the tissues, producing inflammation, so does it excite the brain. Thus we find the patient violent at times, 94 A CLINICAL MATERIA MEDIC A. with paroxysms of rage, tearing his clothing and biting at anyone who approaches him. He barks like a dog. The slightest touch ag- gravates the symptoms, as does also any dazzling object, as a looking- glass or glass of water. These symptoms greatly resemble those of hydrophobia. They also point to Cantharis as a remedy useful in puerperal convul- sions and in inflammation of the brain. The eyes are bright, the pupils widely dilated, and the face is pale or yellowish, and bears an expres- sion of deep-seated suffering. These symptoms, indicative of inflammatory action in and about the brain and meninges, find their nearest concordant in Belladonna, which has the majority of the symptoms above mentioned, if not all of them. Even the intolerance of water is present under Belladonna. The dif- ference between the two remedies is found in the expression of the face, Belladonna having a bright-red face with throbbing carotids; Cantharis usually exhibiting a face that is pale, yellow and wrinkled, with a constant frown and an expression of extreme suffering. When Cantharis is the remedy dysuria is almost always present. Camphor and Arsenicum are also nearly related to Cantharis. In all three of these drugs the anxiety, the restlessness and the expres- sion of suffering on the face indicate the severity of the disease and be- token a sinking of the vital forces. Arsenicum closely resembles Cantharis in violent inflammations, with intense burning, agony, thirst and subsequent collapse. The two drugs may also meet in uraemia. Arsenicum, however, lacks the sex- ual erethism, and its delirium is associated with a tendency to self- mutilation or to suicide. The patient exhibits fear of death, and rest- lessness often alternates with the stupor. Camphor, like Canthaiis, causes delirium, convulsions, sexual mania, priapism, strangury, internal burning with external coldness, hyper- emia or inflammation of internal parts, as brain, stomach, bladder, etc. The coldness and the sinking of the vital forces in Camphor are usually regarded as its most characteristic effects, the symptoms of ex- citement being reactionary. In Cantharis, on the contrary, the prin- cipal effects are those of excitement, coldness expressing the result of its prolonged or continued action. Practical^, you may decide upon Camphor when delirium, mania or convulsions exist with coldness and extreme prostration, especially if caused by a suppressed eruption. On the mucous surfaces we find that Cantharis causes just as violent CANTHARIS. 95 an inflammation as it does on the skin. It is indicated in inflammation of the throat of a diphtheritic character, accompanied by severe burn- ing and raw feeling in the throat, great constriction of the throat and larynx, amounting almost to suffocation, on any attempt to swallow water. Even the bladder symptoms are aggravated b}' water. It seems as if the sight or sound of water brings about a constriction of the sphincter muscles. Cantharis has been used very successfully in diphtheria when these throat symptoms and the dysuria were present, and when the debility was very marked. While Belladoyma has constriction of the throat, worse from swallow- ing liquids, and intense inflammation of the throat, it lacks the burning, vesication, etc., so characteristic of the Spanish fly. Much more nearly related to Cantharis in its throat symptoms are Mercui'ius co?'rosivus, Arsenicum, Arum triphyllum, Diffenbachia and Capsicum. The first is all but identical in symptoms; the distinctive mercurial features must decide, although Mercurius cor. causes more swelling, especially of the tongue. Deep ulcers form, rather than the extensive vesication of Cantharis. Arum triphyllum is distinguished by the sore, cracked corners of the mouth and tongue, the acrid coryza and the excoriating saliva. Diffenbachia has caused an intense stomatitis with blisters and burning. Capsicum relieves burning vesicles; mouth and throat swollen and dark, constriction of the throat, flat ulcers; worse between the acts of swallowing. Cinnabar is also used in scarlatina, but the mucus from the posterior nares is dirty yellow, ropy, and there is dryness of the throat, waking the patient at night. Apis bears some resemblance to Cantharis in erysipelatous states of the mouth and throat, and in diphtheria; but the debility in the latter condition is early in Apis, while it is the sequel only in Cantharis. In the alimentary tract we find Cantharis producing inflammation of the stomach, of the same character as the symptoms already men- tioned, rawness, great thirst with aversion to drinks, and vomiting. It is of use in dysentery. The discharges are bloody and slimy, and are mixed with flakes that look like scrapings of the intestines. These, I believe, are not really portions of the bowel or pieces of the mucous lining, but are fibrinous formations, resulting from the Q6 A CLINICAL MATERIA MEDICA. inflammation. Tenesmus is marked and is almost always associated with dysuria. The pains in the abdomen are colic-like, doubling the pa- tient up; they are of a cutting, burning, griping, wandering character. In dysentery Cantharis has several concordant remedies. One of these is Colocynth, which has colicky pains, doubling the patient up. The stools are bloody and slimy, and are made worse by any attempt to eat or drink. They also contain the so-called scrapings of the in- testines. Colocynth differs from Cantharis in that the colicky pains cease after stool, and the patient is relieved by bending double and by pressing firmly against the abdomen. Looking at the two remedies from a pathological standpoint, Cantharis has more inflammation and Colocynth more nervous symptoms. Another remedy very similar to Cantharis is Colchicum. This rem- edy has tympanitic distension of the abdomen. The discharges from the bowels are composed of white jelly-like lumps, and are followed by violent tenesmus and constriction of the anus, tormenting the patient more than the urging during stool. Another concordant remedy is Capsicum, which is good for dysen- tery occurring in moist weather. It is best indicated in stout flabby persons. The pains and other symptoms are increased by the slight- est draft of either warm or cold air. The drinking of water causes^ shuddering and increases the pains. Sulphur you will find best adapted to chronic or persistent cases, es- pecially when the tenesmus continues from one evacuation to another, like Nux vom., or when the bleeding and tenesmus have abated but the stools are still slimy with frequent sudden urging. Zincum sidphuricum has several times cured subacute cases of dysen- tery. The pains are referred to the sides of the abdomen, probably in the colon. Kali bichromicum follows Cantharis when, though the "scrapings" continue, the discharges become more jelly-like. We have yet to speak of the action of Cantharis on the sexual organs. Cantharis inflames the sexual appetite, producing a violent, almost insatiable, desire for coitus, with erections so violent and so persistent as to amount to priapism; even sexual intercourse does not always reduce the erections. These symptoms call for the drug in chordee during the course of gonorrhoea. They also point to its use for uncontrollable passion, whether the result of mental disease or not. This priapism of Cantharis should not be confounded with that of CANTHARIS. 97 Picric acid. Under this remedy the priapism is associated with some spinal disease, such as myelitis, meningitis or locomotor ataxia. Erec- tions are violent and the penis is distended almost to bursting. Cantharis also acts on the female genital organs, producing nympho- mania, for which condition it may be a useful remedy. We may also make use of Cantharis in labor. The drug has the property of expelling moles and other foreign materials from the uterus. We may make use of this effect in cases of retained placenta, either after labor at full term or after a miscarriage. Cantharis is a useful remedy in erysipelas, especially of the vesicular form. The erysipelatous inflammation begins on the nose, either with or without vesicles. It then spreads to one or the other cheek, with the formation of vesicles which break and discharge an excoriating fluid. Graphites also has erysipelas commencing on the nose, but it is bet- ter adapted to chronic cases. Cantharis should be remembered as of use in burns. It is remark- able what this remedy will do in allaying the painful symptoms and accelerating the repair of affected surfaces. It may be given internally in potency and applied locally at the same time. If administered early enough in slight burns, the formation of blisters may sometimes be prevented. In burns you ma}^ compare Cantharis lotion with Sapo soda, Soda bicarb., Arsenicum and Carbolic acid — the last named when the affected parts ulcerate. LECTURE VIII. HYMENOPTERA. From the order Hymenoptera we derive Apis mellifica, Vespa crabro, Formica rufa and Bombus. The local effects of the poisons from these insects are well known. The skin becomes red and swollen, with burn- ing pain; finally, even sloughing may ensue. In susceptible persons, or after the injection of considerable quantities of the poison, general symptoms may develop, such as fainting, prostration, chills and cold- ness; great restlessness, or insensibility, and even death may result. The stings of certain ants {Formica, not Termites, which are neurop- terous) contain a poison, the chief ingredient of which is called Formic acid. This highly irritating acid is also found in the glands attached to the hairs of stinging nettles, in some caterpillars and in old oil of turpentine. Apis mellifica. For this remedy we have two names, according to the manner in which the preparation is made. It is either Apis mellifica, the honey- bearing bee, or Apium virus, the poison of bees. The original prepar- ations of the remedy were made in the following manner: A large white dish was placed under a bell jar, in which there was a perfora- tion through which a stick was inserted. Several hundred bees were then placed beneath the jar. The stick was then moved about, and, irritating the bees, caused them to sting the jar and the dish. After a while the bees were allowed to escape, and on the bell jar and plate were seen numerous specks. Alcohol was poured over these, and thus was obtained a powerful extract of the poison of the bee. This is Apium virus. Subsequently the whole bee was used. Triturations were made of the entire insect. Thus we obtain Apis -mellifica. The symptoms of the two preparations have not been separated. Apis mellifica is an invaluable acquisition to our Materia Medica. In order to understand its symptomatology let us look at its toxi- cology. Take, if you choose, a sting on the hand or finger as an illustration. Just after the sting, which causes a sharp sticking or HYMENOPTERA. 99 burning pain, there commences, very promptly, swelling of the part, with extreme soreness. The part feels as if it had been bruised or pounded. The swelling is at first of a rosy pinkish hue. It spreads very rapidly; the pains become intense. They are of a burning, sting- ing or shooting character, seldom throbbing. Heat of the part in- creases with the burning and stinging pains. This may end very speedily in resolution or it may go on. If it pursues the latter course, you will notice that this ros> r appearance becomes more intense, in fact, assumes an erysipelatous appearance. Still later, it changes its color and takes on a pale but bluish hue, and the swelling pits on pressure, showing that the parts are cedematous. After a while, if the condition of the system is such as to permit it, gangrene of the part takes place. Experience teaches us that some such dermal or cellular symptoms are usually present in ever}' case for which Apis is the remedy. They, therefore, deserve to be emphasized. The soreness is as important as the more frequently described burning, stinging pains, and varies from a bruised, sore feeling to an exquisite sensitiveness to contact. The swelling is the result of a rapid serous effusion into the cellular tissues. It is a universal symptom. The inflammation produced by Apis is, therefore, not of a sthenic type. It is not, for instance, such as would be cured by Aconite, w T ith sudden swelling of the part coming on rapidly and ending in resolu- tion; nor is it such as would be cured by Belladonna, with bright red swelling accompanied by throbbing pains and ending either in resolu- tion or suppuration. The Apis inflammation is distinctly asthenic, with whitish discoloration and a tendency to gangrene and destruction of tissue. In one case, where the sting was on the hand, the patient suffered also from a carbuncle on the back of the neck. The vitality is speedily and sometimes alarmingly reduced by the action of Apis. This is shown in the severe prostration, desire to lie down, deathly faint feeling, premonition of approaching death, nerv- ous trembling, coldness and loss of consciousness, especially in erup- tive diseases. The heart is weak, beats slowly or almost impercep- tibly, with pulselessness at the wrists. In the majority of cases calling for Apis the nervous system is irri- tated notwithstanding the accompanying prostration. The patient is excitable and dances with excessive joyousness; she laughs at the greatest misfortune as she would at a comedy; she is always changing her occupation, and will not keep steadily at anything. IOO A CUNICAL MATERIA MEDICA. As will be inferred from the symptoms mentioned, Apis may be em- ployed in states of mind resembling hysteria. The fidgetiness, rest- lessness, excitability and ill-timed laughter, together with fickleness at work, have led to its successful use for nervous girls. In addition, it has been observed that they are awkward, dropping things and then laughing in a silly way at their clumsiness. The sexual passion is too active, and they are prone to jealousy. The confusion of mind and unconsciousness just noted indicate the remedy in severe adynamic forms of disease, such as malignant scar- latina, diphtheria, typhoid fever, etc. A complete stupor after apo- plexy is said to have yielded to Apis when Opium failed. In scarlatina the fever runs high, and the attending restlessness is one of nervous agitation. The mouth and throat are very red, with blisters on the borders of the tongue, and swollen puffy fauces; there are burning, stinging pains and a scalded, raw feeling in the mouth and throat. The skin pricks as from needles, the rash being inter- spersed with a miliary eruption. There is always puffiness of some part of the surface. Prostration comes on early, with scanty or sup- pressed urine, high fever and drowsiness. In meningitis or in meningeal irritation Apis holds a prominent posi- tion as a curative agent. It is often the remedy, no matter what the^ ailment, when shrill outcries in sleep lead to the suspicion of cerebral irritation. Such cases frequently begin with the nervous fidgetiness so characteristic of the bee poison, and advance to more serious condi- tions. In tubercular meningitis, or in acute cerebral effusions, a sup- pressed or undeveloped eruption is a good guide to the choice of Apis. We may profitably compare Apis here with Bellado?ina, Helleboius, Arsenicum, Bryonia, Zincum, Sulphur, Cuprum, Glonoine, Lachesis, Rhus tox., Hyoscyamus, Natrum mur., Bovista, etc. Belladonna is doubtless frequently employed when Apis would suit better. A little care, however, will enable the practitioner to distin- guish the fidgety nervousness of the latter from the more intense cere- bral irritation of the former. The congestions of Belladonna are more violent, with throbbing of the carotids, injected red eyes, and drowsi- ness broken by starts and frightened outcries. The adynamia is much less than in Apis. If the disease is scarlatina, the rash is smooth and bright red, but not miliary. The skin is hot and the face red, or, in some cases, pale; but not pale and cedematous as in Apis. The cer- vical glands may be swollen, but there is not the cellular infiltration, with an erysipelatous blush, as in the bee-poison. HYMENOPTERA. IOI If there is meningeal irritation, Belladonna is needed when the con- gestive symptoms are intense; Apis, when the nervous agitation pre- dominates, with the shrill cry, which betokens stabbing, piercing pains or excitement. In meningitis Belladonna is decreasing^ indicated as the symptoms of effusion increase, while Apis is increasingly indicated as long as symptoms of irritation obtain and the cephalic c^ is marked. Helleborus claims precedence when the irritation of Apis gives place to mental torpor, with want of reaction. The forehead is wrinkled, the pupils dilated, and the lower jaw tends to drop; the sopor is com- plete. There are automatic motions of one arm and one leg; the fore- head is bathed in cold sweat. In such cases Helleborus may bring about reaction so that another remedy will cure. In typhoid fever they differ widely. Apis, although it has great weakness, apathy and stupor, has a dry, blistered tongue and exquisite soreness of the abdo- men. Helleborus has complete sensorial apathy, dark, sooty nostrils, slow pulse, and no response to touch or pressure. Bryonia bears some slight resemblance to Apis, especially as it may be needed, like the latter, for cerebral effusions following suppressed exanthemata. The sensorium is benumbed, but the senses are not so perverted as in either Apis or Helleborus. There is a constant chewing motion; the face is dark red, the lips parched; when offered a drink it is taken hastily and impatiently. If the child is moved, it screams with pain. Later, when the sensorial depression amounts to sopor, Helleborus follows well, even if the chewing motion and hasty drinking continue. Apis follows if the sopor is accompanied by a more shrill cephalic cry than in either of the other remedies. Cuprum compares with Apis when meningitis results from a sup- pressed exanthem, but the symptoms are very diverse. Cuprum causes loud screaming, followed by violent convulsions; the thumbs are clenched, and the face is pale with blue lips; the eyeballs are con- stantly rotating. If convulsions occur in the Apis case, they are less violent, consisting of restlessness and twitching of one-half of the body; the other half is lame and trembles. Much more closely related in suppressed eruptions is Sulphur. The two follow each other well. Glonoine, like Apis, has the cephalic cry; there is a sensation as if the head were enormously expanded. Spasmodic vomiting of cerebral origin is most prominent in the former, as is also intense congestion and throbbing. 102 A CLINICAL MATERIA MEDICA. Zincum produces cerebral irritation; the child awakes with fear, rolls the head ; cries out and starts in sleep. There is constant fidgety mo- tion of the feet. The drug is indicated in anaemic children who are too enervated to develop an exanthem. In typhoid states the prostra- tion is very great, with impending cerebral paralysis. Unconscious- ness develops, with blue hands and feet, coldness, weak pulse; lower jaw dropped. Here the Oxide has been successfully employed. Rhus tox. , though incompatible with Apis, has many similar symp- toms. In scarlatina, for instance, both suit in adynamia, swollen throat, erysipelatous inflammation of the skin of the neck, miliary rash, drowsiness and oedema. In Rhus, however, the eruption is darker, the erysipelas dusky red, and there is great bodily restlessness — not the fidgetiness of Apis. Arsenicum is similar to Apis in many respects. Both have anxious change of place, fear of death, restlessness, great weakness. (See also in several instances below.) Irritability of mind occurs in both, but it is more an anxiety and fear in Arsenicum; more a nervous restless- ness in Apis. If they meet in cerebral affections, as possibly they may, especially in hydrocephaloid, Arsenicum is to be selected by hot skin, pale and hot face. The child lies in a stupor; suddenly it twists its mouth and a jerk goes through the body; or the child lies as if dead, with half- open eyes, dried mucus on the conjunctivae, and no response to touch upon the eyelids. Hyoscyamus and Lachesis are similar in jealousy. Natrum mur., Bovista, Lachesis, ALthusa, Ignatia, Nux vom. have awkwardness; the first is most similar to Apis. I have already hinted that Apis may be of use in dropsies. The symptoms calling for it are briefly these. In general dropsies we find it indicated by the peculiar appearance of the surface of the body. The skin has a transparent, waxen look, with a whitish or perhaps slightly yellowish tinge. The urine is scanty, and there is almost always absence of thirst. The characteristic symptoms are the trans- parency of the skin and the thirstlessness. Now as to cause. Apis is especially useful in dropsies of renal origin, whether the result of scar- latina or not. The urine is scanty and highly albuminous, and con- tains casts of the uriniferous tubules. There is a swelling about the eyelids. The surface of the body feels sore and bruised; in some cases the pain is of a burning character. If the dropsy is of cardiac origin, HYMENOPTERA. 1 03 the feet are cedematous, especially after walking. This is attended with almost intolerable soreness and burning. Even when the dropsy has invaded the chest and we have hydro- thorax Apis may be the remedy, especially when the trouble is of car- diac origin. The patient is unable to lie down. He has the same constrictive feeling about the chest that we find under Lachesis. He has a dry cough, which seems to start from some place in the trachea or larynx, usually the trachea, the cough not ceasing until a small quantity of phlegm is loosened. Thus far the remedy is exactly like Lachesis. But Apis has, in addition to these symptoms, a mental symptom which conies from the chest, namely, a constant feeling as though he could not live. It is not a feeling of dyspnoea, but appears to be a sort of anguish of mind; the patient cannot understand how it would be possible for him to get another breath, so great is this suffo- cative feeling. Associated with these chest symptoms, the patient often has a strange feeling as though he were going to die, but there is not the intense fear and sthenic fever of Aconite, nor the great rest- lessness of Arsenicum, but more of a fidgety anxiety. In pleuritis with exudation Apis is one of the best remedies we have to bring about absorption of the fluid. Apis and Sulphur will cure the majority of these cases. Apis also acts on the synovial membranes, giving a perfect picture of synovitis, particularly when it affects the knee. It is indicated when there are sharp, lancinating, stinging pains shooting through the joint, with aggravation from the slightest motion. Bryonia affects the joints and their synovial membranes, but the pains are stitching in character, w 7 ith tension, and they are better from the warmth of the bed, while the Apis pains are better from cold ap- plications. Iodine is useful in dropsy of the knee, and has followed Apis well, especial^ in scrofulous children (compare also Kali iod.). We have still another form of dropsy in which Apis is a remedy, namely, dropsy of the brain, a condition which used to be called hy- drocephalus. It is not so often indicated in true hydrocephalus, that is, when from some mechanical cause there is inflammation set up in the membranes of the brain, followed by accumulation of serum; but it is in tubercular meningitis that this remedy is useful. Apis is here indicated in the first stage. The symptoms which call for it are these. The child bores its head backward into the pillow, and rolls it from 104 A CLINICAL MATERIA MEDIC A. side to side; every little while the child arouses from sleep with a shrill, piercing cry. This peculiar shriek is due to pain. One side of the body twitches and the other lies as if paralyzed. Strabismus is usually present. The pulse is rapid and weak, and the urine scanty. There is no remedy which can do any good in this stage if Apis does not. Apis has a peculiarity which I should mention, and that is slow- ness of action. Sometimes you will have to wait three or four days before you notice any effects from its administration. The favorable action of the remedy is first shown by increased flow of urine. In dropsies, Apis may be compared first of all with Arsenicum^ which has the same transparency of the skin, and is also of use in dropsies of renal, cardiac or hepatic origin. The differences between the two remedies are the.se. Arsenicum has intolerable thirst, but the patient usually drinks only a small quantity at a time, because water annoys the stomach. Eating and drinking both cause vomiting. I have seen cases in which even a single teaspoonful of medicine pro- voked vomiting. The patient exhibits marked restlessness. Another remed} T for comparison is Apocynum canabinum. This is much used in the West for general dropsies, swelling of any part of the body, ascites, hydrothorax, etc., usually without any organic dis- ease as a cause. The patient cannot tolerate any food. Food or water is immediately ejected. There is a sunken, gone, exhausted feeling at the pit of the stomach. The next remedy similar to Apis is Acetic acid. This is useful in dropsies when the face and also the limbs have this waxen or alabaster appearance. It is especially indicated when the lower parts of the body, that is, the abdomen and limbs, are swollen, hence it is useful in ascites. Thus far it is similar to Apis. But it has thirst, which Apis has not, and gastric disturbance is almost always present; sour belching, water-brash and diarrhoea. Acetic acid is an undeservedly neglected remedy in dropsy. You see how it stands between Apis and Arsenicum. It differs from both of these remedies in the preponder- ance of gastric symptoms. In hydrocephalus, the most similar remedy to Apis in the stage of exudation is Sulphur. Sulphur is indicated more on general principles than for its particular affinity for the meninges. Tubercular menin- gitis cannot occur in an otherwise healthy child. There must be a diathesis at the bottom of the trouble. Sulphur helps in the same stage as Apis when Apis fails to bring about a reaction, particularly HYMENOPTERA. IO5 when the child is scrofulous aud has other Sulphur symptoms The child lies in a stupor, with cold sweat on the forehead, with jerking of the limbs, particularly of the legs, with spasms of the big toes and sometimes of the thumbs also. The urine is suppressed. Sulphur is all the more indicated if there has been a retrocession of some erup- tion before the disease displayed itself. Helleborus is also similar to Apis in hydrocephalus. Apis is useful while there is still some irritation of the brain, as indicated by the cephalic cry. Helleborus comes in when torpor predominates and the child lies wholly unconscious. The eyes do not react to light. The urine is suppressed. There is automatic motion of one side of the body. You will notice, too, a peculiar corrugation of the muscles of the forehead, particular^ the occipito-frontalis. In milder cases, be- fore the stupor is profound, you will find Helleborus indicated by these symptoms. This corrugation of the muscles of the forehead is pres- ent, together with a constant chewing motion of the mouth. The child seems to have no wants. It asks for nothing; yet, when given water, it drinks with avidity. Now, a word respecting the difference between Belladonna and Apis. Belladonna is not usually indicated in tubercular meningitis. It is the remedy above all others for simple meningitis, but not for the tubercular form of the disease. Belladonna has the very essence of acuteness in its symptomatology. Every symptom appears suddenly and with great intensity. But tubercular meningitis is a slowly de- veloped disease. If the premonitory symptoms are violent, however, you may use Belladonna in tubercular meningitis in the stage of hyper- emia with acute pains, restless tossing about, crying out in sleep, and boring the head into the pillow; but it ceases to be a remed)^ when the exudation is established. The range of action of Belladonna is at an end when that of Apis begins. There is another remedy which sometimes comes in between Bella- donna and Apis, and that is Bryonia, which acts on serous mem- branes, causing copious exudation. It is indicated after Bcllado?ina. The child becomes more stupid from increased pressure on the brain. The face suddenly flushes and then pales, usually a bad symptom. The child cries out, particularly when moved, even the least bit; this is a characteristic symptom. The abdomen is distended and the tongue is usually coated white down the middle. So much for Apis and its concordant remedies in dropsies. 106 A CLINICAL MATERIA MBDICA. The next use we may make of Apis is in erysipelas. It is useful particularly in erysipelas of the face, when the eruption commences under or about the right eye, and spreads thence across the face to the left side, the parts quickly becoming cedematous, and at first assum- ing a pinkish rosy hue. The soreness soon becomes severe, and burn- ing stinging pains follow. There is high fever, with dry skin and usually no thirst. Now, if the disease is not checked, and the face assumes a purplish livid hue, as in phlegmonous cases, in which the inflammation involves the deeper structures, causing destruction of tissue, Apis may still be the remedy. There are several concordant remedies in erysipelas. First of all, Belladonna. The difference lies in this: Belladonna is required when the swelling of the face is smooth, bright red, streaked red, or, from intensity, deep dark red. There is not much tendency to oedema or to the formation of vesicles. The pains are always acute, with throb- bing in the affected parts. The brain almost always sympathizes markedly, causing throbbing in the head and visions as soon as the patient closes his eyes. The patient jerks in his sleep. The pulse is full and hard. Another remedy, more similar to Apis even than Belladonna, is Rhus tox. You should be particular in differentiating these two remedies, because they are inimical, and one cannot be given after the other. Under Rhus tox. the color of the face is dusky red and not the bright red of Belladomia, nor the rosy or purplish livid hue of Apis. There is almost always a formation of blisters, which burn and sting. They are distinguished from those of Apis by the preponderance of itching. Under Rhus tox. the disease usually travels from left to right when attacking the face. Apis stands between Rhus and Belladonna in nerv- ousness, partaking somewhat of the former's restlessness, with the latter' s cerebral excitement. Neither produces exactly the livid or blue-red hue noticed in some Apis cases. Here Lachesis is nearest. The other symptoms will enable you to decide. When the nose is mainly attacked Apis compares with Cautharis, but the latter has larger blisters and more burning. When the face, after a spell of erysipelas, is sensitive to cold, com- pare Rhus tox., Belladonna, Hepar, Silicea, Sulphur, etc. Apis may be of use in urticaria when there suddenly appear on the surface of the body long pinkish- white blotches raised above the skin. The itching, burning and stinging are almost intolerable. The HYMENOPTERA. 107 eruption may come as a result of cold or during the course of intermit- tent fever. Here Apis is similar to Arsenicum, which also produces hives, and to Urtica urens. This latter remedy is indicated in hives when the welts are smaller than in Apis. The itching and burning are intolerable. It is especially indicated when the disease has been produced by eating shellfish. Terebinthina and Copaiva are also useful in urticaria after eating shellfish. Kali bromatum is indicated when the hives occur with nervous dis- eases. Rhus tox. is to be thought of when they are an accompaniment of ague or rheumatism. Bovista is required when they are attended with diarrhoea, the stools being followed by tenesmus and burning. Pulsatilla comes in when the hives are of gastric or uterine origin. Calcarea ostrearum is especially suited to chronic cases, and Sepia and Rumex are indicated when the trouble is worse in the open air, the latter especially if worse while undressing. Apis may also be given in variola when there are intense itching and swelling. Apis may be used in rheumatism, whether of articular or muscular origin, but it is more frequently indicated in the articular type, com- monly called acute inflammatory rheumatism. The affected parts feel very stiff and exceedingly sensitive to pressure. There is often a sen- sation of numbness. The joint or joints affected are swollen and give the patient a kind of ' ' stretched-tight feeling. ' ' The swelling is rather pale red in color, and some fluctuation may be detected about the joint. There are burning, stinging pains, worse on any motion. Apis has often been successfully employed in paralysis following de- vitalizing affections, such as diphtheria or typhoid fever, and also when meningeal effusions remain after inflammations. In all such cases sup- pressed or preexisting exanthemata constitute a leading indication for the bee-poison, and the re-appearance of skin symptoms calls for its discontinuance as long as the improvement thus instituted lasts. Sul- phur is a great aid here. In these cases of prostration the patient is either nervous, restless and oversensitive, or hot and drowsy, whether thirsty or not. Apis produces an intermitting type of fever, and is therefore of 108 A CLINICAL MATERIA MEDIC A. service when this type is found in the sick. The chill occurs charac- teristically at 3 P.M., and is accompanied by thirst and an oppression of the chest as if it were too full, which may be actually the case on ac- count of congestion of the thoracic viscera. The chill is worse in the warmth. It is followed by burning heat of the whole body, with an increase of the oppressive feeling of the chest, drowsiness, but usually no thirst, and the warmth of the room becomes intolerable. Then comes the sweat, which may, however, be imperfect. There is never any thirst during the sweat. This is characteristic. During the apyrexia many characteristic symptoms are present. The patient often complains of pains under the ribs on either side. The feet are swollen and oedematous, the skin is sallow or waxen, the urine is scanty, and urticaria breaks out. Such symptoms are found in rather severe forms of this affection when excessive use of quinine has spoiled the case, and in chronic forms which have undermined the general health and produced disease of the liver, spleen, etc. The most similar concordant of Apis here is Natrum mur. This is indicated in exactly the same type of intermittent fever as Apis; the chief difference between the two remedies lies in the time of appear- ance of the chill; at ten o'clock in the morning in the case of Natrum mur t , and at three o'clock in the afternoon in the case of Apis. In typhoid types of fever Apis is to be selected primarily by the mental state. The delirium is not of an active type; the patient lies in a stupor, with muttering; the face is either flushed red, or, more frequently, pale and waxen, wearing a look of anxiety as from visceral disease or a happy expression. The skin in this type of fever is burn- ing hot in some places, while in others it is unnaturally cool; it is almost always dry; should there be sweat it is usually of a transient character; the prostration is so great that the patient slides down in bed; he cannot exercise sufficient muscular force to retain his position on the pillow. The tongue is dry, cracked and red, and, like that of Lachesis, it catches on the teeth when the attempt is made to protrude it, and it trembles; there is often a whitish or darker coating on the dorsum of the tongue, while the edges, especially about the tip, are red and covered with little blisters and vesicles. Very important is the bruised soreness of the swollen abdomen. In these cases Apis resembles Muriatic acid, which has this prostra- tion, but with the characteristic acid diathesis. In scarlatina most of the indications for Apis have already been HYMENOPTERA. IO9 given. Here, too, we find the same defective effort on the part of nature to produce a fever. The body is very hot in some places and cool in others. The rash is deep-red in color, very much like that of Belladonna, but differing from that remedy, you remember, in the presence of this miliary eruption which Belladonna does not have. The child is drowsy, sleeping most of the time, or he is drowsy but cannot sleep. This symptom you must remember because it is iden- tical thus far with one of Belladonna. Associated with this sleepy or wakeful state the patient is fidget}' and restless. You notice, too, that he is peevish, and manifests every symptom of being very irritable. This restless state of Apis must be distinguished from those of Rhus tox. and Belladonna. In Rhus tox. it is a general restless state of the whole body, and of the mind as well. The patient lies first on one side and then moves to the other, but is not affected with anxiety as in Arsenicum. In Apis the restlessness or desire to move comes from a general nervous feeling. The inabilit}' to go to sleep in Belladonna comes from inflammation or congestion of the brain. The hyperemia produces this drows}^ state, and the brain is so exhausted that the patient cannot go to sleep. In addition to the symptoms already mentioned for scarlatina, we have Apis further indicated when the condition advances to effusion of serum about the brain. The throat symptoms are unimportant. You often find patches on the tonsils. The throat inside is swollen and rosy-red, while externally it is engorged, with an erysipelatous blush to it. Apis may also be used late in the disease for the sequelae — that is, when the kidneys become affected and dropsy appears with albu- minuria. Again, we find Apis of service in diphtheria. The disease advances so insidiously that its presence is not suspected, or, from the very be- ginning the child is thoroughly prostrated, with high fever and drow- siness. The pulse is rapid, but not strong. At first the throat has a varnished appearance, as though the tonsils and fauces were coated with a glossy red varnish. The membrane forms on either tonsil, oftener on the right than on the left, and it is thick, looking like wash-leather. The tongue is often swollen, so that the child can scarcely swallow. If the child is old enough, he will complain of a feeling of fulness in the throat which necessitates swallowing, but makes it very difficult. The explanation of this is found in the next symptom, that is, the uvula hangs down like a sac of water, and IIO A CUNICAI, MATERIA MEDICA. consequently there is a feeling of fulness. If you examine the throat thoroughly, you will find the rim of the glottis swollen, red and oedematous, and breathing is labored owing to the narrowing of the entrance of the larynx. In some of these cases the breath is very foetid, while in others there is little or no foetor. In still other cases you will find as characteristic of Apis a red rash over the surface of the body, making the case appear like one of scarlatina. The exter- nal throat is swollen and erysipelatous. The above symptoms may in- dicate Apis in non-diphtheritic oedema of the glottis also. Now, there are several remedies similar to Apis in diphtheria. One of them is Arsenicum. Arsenicum is indicated, as you might expect, in rather severe cases of diphtheria when the throat is very much swollen inside and outside, the membrane has a dark hue, and there is great foetor. There is a thin, excoriating discharge from the nose. The throat is oedematous, just as it is in Apis; the patient is restless, especially after midnight; the urine is scanty, and the bowels are either constipated or else there is an offensive, watery diarrhoea. In still other cases, when, despite the dark purplish hue of the throat, and the marked swelling and great prostration, there is not much pain, Natrum arseiiicosum is the remedy. Here, also, the uvula is infiltrated with fluid. Still another remedy is Kali permanganatum. This remedy, which is seldom used in the high potencies, is indicated when the throat in- side and outside is swollen and oedematous, the breath is horribly offensive, and a thin discharge issues from the nose. The great char- acteristic is the extreme foetor. Apis causes an irritation of the mucous lining of the larynx and trachea, and also soreness in the chest-walls. It has been found most useful when laryngeal symptoms accompany erysipelas, oedema of the throat, glottis, or larynx, or suppression of eruptions; less often in simple laryngitis or laryngeal catarrh. Difficult breathing, and especially the unique symptom, " he does not see how he can get another breath, ' ' has led to the successful em- ployment of the drug in hydrothorax, hydropericardium, oedema pul- monum and asthma. The lancinating, darting pains, palpitation, orthopncea, etc., render Apis valuable in cardiac inflammations and dropsy. The essential symptoms seem to be oedema or sudden mucous swelling, dyspnoea, sudden, lancinating or stinging pains, restlessness and anxiety. HYMENOPTERA. Ill Compare: Lachesis, Arsenicum, Sulphur, Belladonna, Kali card., Spig- elia, Digitalis, Aspai'agus, Apocynuvi cannabinum . Arsenicum and Apis have many resemblances. So apparently alike are the restlessness, changing of place, and dyspnoea, that one remedy is often given when the other should be. The best distinction lies in the fidgety restlessness peculiar to Apis. If dropsy obtains, both may be needed in pale, tensely swollen limbs, but Apis often has redness, itching or an erysipelatous condition present, as well as thirstlessness. Belladonna is too often mistaken for Apis in laryngeal affections. The latter has more oedematous swelling, with consequent dyspnoea; the former more spasmodic constriction. In cardiac affections Arsenicum, Apocynum cannabinum, Digitalis , and Aspai'agus bear some similarity to Apis, especially in great debil- ity, and dropsy. Apocynum cannabinum is needed when the pulse is small and weak, the heart-beat irregular, now weak, now stronger; and there is sinking at the epigastrium. Asparagus suits in the aged, with weak pulse and pain about the left acromion. Digitalis causes a doughy appearance of the skin; the pulse is slow or weak, quickening with every bodily movement; a gone, deathly sick feeling develops in the epigastrium soon after eating. The cough of Apis is frequently encountered in cases where this remedy is needed. It resembles, more or less, Lachesis, Carbo veg., Rumex, Belladonna, Chamomilla, Crotalus horridus, Nux vomica, Bryonia, Ignatia, Arsenicum, Hyoscyamus. Lachesis, Nux vom., Bryonia and Hyoscyamus agree in adherent mucus. But Lachesis has intolerance of touch, even clothing, about the neck, a symptom not marked in Apis, except with the sense of suffocation. Rumex has a teasing, persistent cough, aggravated by cool air, or by anything which increases the volume or rapidity of the inspired air. Chamomilla differs mentally. Nux vo??iica cures cough from adherent mucus high up in the tra- chea; but there is a rough, scraped feeling in the throat. Bryo7iia adds epigastric irritation to the suprasternal, and the pains in the trachea and chest-walls are sharp, stitching, as well as bruised, aching. Ignatia induces a nervous cough, and the more the patient coughs, the more annoying is the irritation. Arsenicum causes more of a burning tickling, referred to the 112 A CLINICAL MATERIA MEDICA. suprasternal fossa; but since it so often concurs with Apis, it should be compared with the latter, especially when the cough accompanies dropsy, heart disease, etc. Belladonna may be misapplied for Apis, but can be distinguished by its greater constriction of the throat, and deeper inflammatory red- ness. Carbo veg. agrees in hoarseness, rawness, and tickling cough, but the irritation is as from vapor of sulphur. Now, the action of Apis on the genital organs. Apis is often indi- cated in diseases of the female organs. Nearly all the provers experi- enced symptoms referable to the uterus and ovaries. There is in- creased sexual desire with stinging in the ovaries. This is sometimes a symptom in widows, and Apis will often relieve it. Tendency to abort at or before the third month. Apis produces and will check abortion when the symptoms agree. Therefore it must be given cau- tiously during pregnancy, because if given in low potency and fre- quent dosage it may bring about a miscarriage, especially before or at the third month. We may use it in amenorrhcea when we have con- gestion of the head as a result of the suppression of the flow, bearing down in the uterine region, thirstlessness, and intolerance of heat. Particularly is it indicated in girls with this amenorrhcea at the age or puberty. They are nervous, hysterical, awkward and silly. It is not a natural awkwardness, but one that comes from incoordination of the muscles. With these s3'mptoms there is flushing of the face. We may also use Apis in affections of the ovaries, especially of the right side. It holds the same relation to the right ovary that Lachesis does to the left. It is indicated in ovaritis with extreme soreness in the right ovarian region, together with burning or stinging sensations, and some tumefaction, detectable either over the pelvis or, more char- acteristically, through the rectum or vagina. In ovarian cysts, Apis is an excellent remedy to control the growth, especially in the incipient stages. We have here, in addition to the burning and stinging pains, numbness down the thigh and over the right side of the body, and a feeling of tightness across the chest, with cough. This is not a symptom of lung disease, but is reflex from the uterus. Now there is a combination of honej^ with salt, known as Mel cum sale. This was for years a popular remedy in Germany for bladder troubles and for diseases peculiar to women. I have used this remedy HYMENOPTERA. 113 in prolapsus uteri and even in chronic metritis, especially when asso- ciated with subinvolution and inflammation of the cervix. The spe- cial symptom which leads to the selection of the remedy is a feeling of soreness across the hypogastrium from ilium to ilium. Apis may be of use in diseases of the eyes. I have seen several cases of asthenopia cured by this remedy, when reading caused smart- ing in the eyes, with lachrymation and itching of the eye-lids and some burning and stinging. Apis is also a remedy for staphyloma, whether of the cornea or sclerotic coat. In external diseases of the eye, it is not without value. The eyes are over-sensitive to light. The conjunctiva is reddened or puffy and chemotic. But this swell- ing of the palpebral conjunctiva under Apis is more from congestion than from a true chemosis, as under Rhus tox., which is very similar, especially in cedematous swelling of the lids, chemosis, hot, gushing lachrymation; erysipelas. But Apis has less tendency to the forma- tion of pus — a symptom highly characteristic of Rhus tox. In the former the pains are stinging, the time of exacerbation is the evening, and cold water relieves the inflamed lids. If erysipelatous, the lids are a bluish red, looking watery, as if semi-transparent. In the lat- ter, the pains are worse at night, particularly after midnight; warmth relieves; the erysipelatous lids are of a dusky red, and, together with the cheeks, are studded with small watery vesicles. The pains in Rhus tox. are usually of a drawing, tearing character, although in erysipelas they may be burning or stinging, but with more itching than in the bee-poison. The eyelids often feel heavy and stiff. Arsenicum compares with Apis in hot tears, violent pains and cede- matous lids. But the lachrymation is more acrid. The cedematous lids are pale, not bluish-red. The palpebral conjunctiva and the edges of the lids are very red. The restlessness is more pronounced. Relief is usually obtained from warm applications, though the scrofulous patient can open his eyes in the cool open air, but not in the room, even if dark. The symptoms are worse at and after 12 p. m. To return to the eye symptoms of Apis, the lids are swollen, red and cedematous. There is burning of the tarsi, with agglutination of the lids. Sudden and very severe pains shoot through the eyes, and these are relieved by the application of cold water. The eyes are generally worse in the first part of the night. Apis is often indicated in scrofulous ophthalmia, in which affection it is often followed by Kali bich rom icum . 114 A CLINICAL MATERIA MEDICA. It now only remains for me to speak of the intestinal symptoms of Apis. It may be of value in diarrhoea, such, for instance, as comes on during the course of typhoid fever or scarlatina, or as the result of the debilitating influence of continued heat. You will find it useful in the diarrhoea of children who are very much debilitated. Irritability of the brain is generally present with the condition known as hydrocephaloid. The symptoms are much like those indicating Apis in hydrocephalus. The child wakens with a scream. The stools are thin, watery, yellow in color, and usually worse in the morning. At every motion of the body the bowels move, as though the sphincter ani had no power. The stools may or may not be offensive. Apis differs from Bryonia, which has morning diarrhoea, worse from motion; in the diarrhoea of Apis the motion aggravates, not because of its general effects, but because the sphincter ani is so uncertain. In bad cases you will find the urine scanty. Apis may also be thought of in panaritium. The finger swells rapidly, with tense, glossy-red surface and violent burning, stinging pains. In this respect it is very similar to Stdphur, and may be followed by Sulphur when its action is imperfect. Modalities: Apis has general relief from cold applications. Many complaints are worse evenings and night, though diarrhoea increases in the morning. Motion generally aggravates, as does a w r arm room. Apis is antidoted by Plantago and Lachesis, and is complementary to Natrum mur. Ledum was proposed by Teste as an antidote for the stings of in- sects. Dr. Drysdale has cured nightly itching of the feet with it. In closing, let me ask you to remember the relation of Apis to Arsenicum, Acetic acid, Belladomia and Sulphur. Remember, also, its inimical relation to Rhus tox. LECTURE IX. MOSCHUS. The order of Ruminantia furnishes us with an article called Musk, which is obtained from the Moschus moschiferus ■, or musk-deer. It is found in a sac just behind the umbilicus, and probably consists of a secretion from the preputial follicles. The second word, " moschiferus," is a necessary qualification, since several species of the musk-deer, as the Tragulus Javanicus and the Meminna Indica, are unprovided with the musk-bearing pouch. So penetrating is the odor of this substance, that it is with great difficulty removed from a room, even after extensive cleansing and alterations. Moschus is of some value in nervous affections, and also in several grave forms of disease. Injected into the veins of animals, it has produced narcotism with muscular spasms, bloody stools and finally death. Wood regards its action on man as feeble and uncertain, though he admits its clinical worth when the nervous system is ex- hausted, with accompanying restlessness, etc. Ringer regards it as ill-adapted to medicine on account of its sickening odor. Bartholow, Flint, Hammond and Rosenthal do not use it in hysteria. German writers, Jolly, for instance, admit a temporary benefit from its use in hysteria. Like some American authorities, they employ it more con- fidently in pneumonia and in spasmus glottidis. Trousseau, with characteristic conservatism, rejects the overdrawn laudations of older writers, and proceeds, in his own unique fashion, to define its accurate application to diseases. In our own school, precise prescribing has had its influence in more clearly defining the power of Musk, and in thus limiting its action within reasonable bounds. The experiments of Joerg and Sunderlin, which Allen has seen fit to incorporate in the Encyclopaedia, are con- sidered by some to be contradictory. Still, they are not opposed to other provings obtained with potencies or by inhalation, and so are of value and deserve to be retained. Homceopathically employed, Moschus is of use in various affec- tions when the nervous symptoms predominate. The disease, in Il6 A CIvINICAIv MATERIA MKDICA. consequence, does not follow its normal course, but remains uncured or develops serious symptoms, indicating nervous exhaustion. It is also sometimes called for in hysteria and hypochondriasis. Moschus, then, produces numerous symptoms referable to the nervous system. The following are especially worthy of note: Excited as from alcohol; pulse full and frequent; temperature slightly elevated; congestion of the brain; raves, speaks rapidly and con- fusedly; scolds until her lips are blue, her face pale, and she falls uncon- scious; anxiety; starts at any noise; anxious about death. Anxiety, with fainting; faints, with coldness, pale face, complete unconscious- ness; hysteria; cries one moment and bursts into uncontrollable laughter the next; delirium; sleeplessness; muscular twitching; ataxia; the face wears an expression of surprise; convulsions, more tonic than clonic. Accompaniments: palpitation of the heart, as from anxious ex- pectation; nervous, busy, but weak; soon drops things; tremulous nervousness; fainting spells, with pale face and coldness; sleepy dur- ing the day; rush of blood to the head, with staring eyes; dizzy un- steadiness, as of something rapidly moving up and down; vertigo; headaches and pains in the back and limbs, which are described as a sensation of tension, stiffness, pressure or drawing; the muscles and skin are tightly drawn (tonic spasm). She frequently complains of nausea, and there is cramping about the navel, or a jerk-like clawing. Uneasiness in the legs, worse while she is sitting; great tympanitis, with fainting; copious watery urine; spasmus glottidis. The menses are too early and too profuse, preceded by the tense, drawing sensa- tions, and also a drawing and dragging towards the genitals. Sexual desire is increased, with local titillation. Sudden sensation in the upper part of the larynx, as if it closed upon the breath. A kind of "cramp" in the lung, beginning with an inclination to cough, gradually increasing* and making him perfect- ly desperate. Suffocative constriction in the chest. The most important hysterical symptoms of Musk are: attacks even to fainting or unconsciousness; coldness of the surface; pale face; suffocative paroxysms; scolding until she falls unconscious. Compare Castoreum, Nux moschata, Asafcetida, Gum ammo7iiac ) Valeriana, Ignatia, Magnesia muriatica. Camphor antidotes many of the symptoms of Musk, especially if unconsciousness and coldness are present. MOSCHUS. 117 Castoream is derived from the preputial sacs of the beaver. Like Musk it causes nervousness, twitching, and deranged menses. But it is more adapted to the nervous symptoms which precede fully de- veloped hysteria. It suits women who suffer from irritable weakness, abdominal symptoms predominating. Charge, for example, employs it for women who, during convales- cence from a prostrating disease, as typhoid fever, suffer from spas- modic affections, twitchings of muscles, with extreme exhaustion. The want of nervous reaction, therefore, tends to prolong convales- cence unduly, and Castoreum, by strengthening the nerves, hastens re- covery. Trousseau employs this remedy for nervous colic with pallor, cold sweat, and sudden loss of strength, caused by emotions, chilling the feet, etc. Also for amenorrhcea, with painful tympany; the menstrual blood, owing to uterine tenesmus, escapes only in drops. Teste agrees with him in the main. The provings develop a train of symptoms quite consistent with these clinical effects. The woman is nervous, apprehensive and sad, growing fitful during the menses. Tearing pains, better from press- ure or rubbing. Tearing pressure in different parts during menses. Abdomen distended with flatus; dragging in the groins, inclina- tion to stool during menses. Cutting about the navel. Stools of bloody mucus, or of wmitish water, with burning in the anus. Green mucous stools, which burn. Cutting colic before stool, better from pressure or bending double. A Spanish physician has confirmed the modality of Castoreum, re- lief of pains from pressure, and we may profit by French and Spanish authorities in their treatment of nervous affections, since from national peculiarities they have ample opportunities to treat such cases. The similarities between Musk and Castoreum are rather in the kind of affections in which they are indicated than in special symptoms. Still Trousseau places them together in nervous attacks, when the aura starts from the abdominal viscera. But only the Musk has clear- ly developed hysterical attacks, with pulmonary and laryngeal spasms and unconsciousness. And we may say, in passing, only Castoreum has cured watery or green mucous stools in delicate, nervous children, who weaken under summer heat or during dentition, and who will not rally under the usual remedies. Il8 A CLINICAL MATERIA MEDICA. Nux moschata exerts a very novel influence upon the mind. The state varies from a bewilderment, in which the surroundings are strange, dreamy, or fanciful, to a condition of absentmindedness, sleepiness, and finally deep stupor, with loss of motion and sensation. Mental states may alternate. At one time she laughs, as if everything partook of the ludicrous. She jests even about serious subjects. Suddenly her mood changes to sadness, with w 7 eeping and loud cry- ing; or her expression grows stupid, all ideas vanish, and she appears as if overwhelmed with sleep. There are, likewise, errors of percep- tion; a momentary unconsciousness she regards as having been of long duration. Her hands look too large. Objects gradually diminish in size as she looks at them steadily. The bodily functions come under the same influence; great weakness and bruised feeling of the small of the back and the legs; the knees feel weak, as after a long journey; pros- tration; tendency to faint; oppressed breathing, rush of blood to the heart, skin cold and dry. So relaxed that pulse and breath are scarce- ly discernible. Head drops forward, the chin resting on the breast. Head rolls about as if bulky. Bowels enormously distended with wind, as from weak digestion. Even soft stools are evacuated with difficulty. It is this mental and bodily atony which has led to the ex- cellent cures made with Nux moschata, not only in hysterical weakness, but in typhoid fever and cholera infantum. The hystero-spasmodic symptoms of the drug are intimately commingled with the above symptoms; head jerked forward; jaws clenched; heart as if grasped; sudden oppression of the heart, with choking sensation; tonic, fol- lowed by clonic spasms; unconsciousness or fainting. Accompaniments are: great dryness of the mouth and throat, which, on account of her tendency to magnify, she complains of ex- tremely. The least emotional excitement renews the symptoms, in- creases the distension of the abdomen, etc. Skin dry and cool, no disposition to sweat. Palpitation of the heart; heart-beat and pulse changeable. Valeriana is so much abused as an antispasmodic that Homceopathi- cians are too apt to neglect it. But it occupies its definite place in the treatment of hysteria, differing from Musk, Asafcetida, and all other "nervines." It is not so much adapted to hysterical spasms, with unconsciousness, like the drugs already considered, as it is to a general state of nervous and vascular excitement. Both mind and body are in a condition of irritation. The patient is livety, joyous, talking MOSCHUS. 119 rapidly, with rapid sequence of thoughts. Sometimes she imagines she is beset with dangers, or surrounding objects seem strange. She suffers from headache, giddiness and restlessness. Her muscular organism is so irritated that she cannot keep quiet; she must move. The same state influences her pains. The provings show twinging, drawing, cramp-like, stinging, or darting-tearing pains, all worse when she sits and better when she walks. The circulation, too, is ex- cited; her head feels full to bursting; constant heat and uneasiness; dry heat in the evening while sitting, flushes of heat. She is wide awake and restless all night, falling into a dreamy sleep toward morn- ing. Digestion is disturbed. Before dinner she has a taste as of foetid tallow, while early in the morning, on awaking, the taste is flat or slimy. Nausea, as if a thread w r ere hanging in the throat; nausea beginning in the region of the umbilicus, and gradually rising to the fauces. Bloated abdomen. From the order of Umbellifer Pulsatilla, Arsenicum, Ipecac, Veratrum album. < Selenium, Digitalis. 364 A CUNICAL MATERIA MEDICA. Iyoss of fluids. Anaemia. Ill-effects of sudden or acute diseases. Haemorrhage. Fevers: malarial, intermittent, hectic. Digestive organs. Rheumatism. Neuralgia. Cinchona. Cinchona is certainly a wonderful drug, wonderful in the many va- rieties of its species, wonderful in its composition and wonderful in its effects. It also has a historical value to homoeopathists as being the drug which led Hahnemann to the discovery of the law of cure and enabled him to establish Homoeopathy as a fixed science. It is not a little singular that the natives of Peru, especially in the early days, would not permit the Cinchona tree to be touched, as they believed it to be poisonous and under the charge of special gods. They were, therefore, greatly astonished when Europeans became engaged in the occupation of stripping the bark from the trees and exporting it to Europe. The Cinchona industry has now grown to such an enormous extent as to demand certain restrictions in its gathering and exporta- tion lest the species become extinct. New trees are being continually planted, so that there is no danger of extermination of the drug. There are several varieties of the Cinchona bark, of which, however, I can mention but three, namely, the pale bark, the Calisaya or yellow bark, and, lastly, the red bark, or Cinchona rubra. There are some thirty other species known. A physician in the West, the value of whose experiments I am in- clined to doubt, claims to have discovered in Cinchona rubra a certain specific against intemperance, or the thirst for liquor. He gives the bark in appreciable doses, and claims that in a time varying from one to four weeks it will cure the most confirmed inebriate of his per- nicious appetite. In publishing the accounts of his observations in the journals, he says that he was led to his discovery on treating an "old sot " who had never known a sober day until he had chills and fever, which was cured by red bark. Cinchona contains a number of alkaloids which are closely related chemically; in fact, many of them are isomeric. They are associated with various organic acids peculiar to the group. RUBIACE^. 365 The most important of the Cinchona alkaloids are given below: Quinine, C 20 H 24 N 2 O 2 . Quinidine, C 20 H 24 N 2 O 2 . Cinchonine, C 20 H 2i N 2 O. Cinchonidine, C 20 H 24 N 2 O. Quinamine, C 20 H 24 N 2 O 2 . Quinic acid, C t H 12 O e . Cincho-tannic acid. Ouinovic acid, C 24 H 38 4 . It now remains for us to study the general effects of Cinchona before we proceed with our consideration of its symptomatology. It has been determined that a solution of Quinine of one part to ten thousand acts destructively on bacteria and infusoria. Thus it will destroy the poisons that propagate many of the contagious diseases, as puerperal fever, scarlatina, etc. You may make use of this prop- ert}' when going from one case of puerperal disease to another, for if you bathe your hair and whiskers in a solution of Quinine \n bay-rum, this will destroy all danger of carrying the contagion and will not prove a source of annoyance to yourselves. On the contrary, it will aid the growth of the hair and beard. Qui?iine and its salts when topically applied to a denuded surface or to a mucous membrane, act as decided irritants. Quinine also has a toxic action upon all protoplasm. It is particu- larly active in preventing amoeboid movement, which, as you know, is possessed by the leucocytes. This is one reason why allopathic physicians have used it to prevent inflammation. Quinine also inhib- its enz3 T tne action, thus retarding tissue metabolism. That is one ex- planation of its tonic effect. You will see, however, that this prop- erty of retarding waste is still more marked in Coffea. Quinine also acts upon the heart substance, weakening that struc- ture. Thus there is impaired circulation. Another effect of Qui?iine is that large quantities injected subcuta- neously destroy the oxygenating power of the blood. Furthermore it has the ability to reduce hyperpyrexia. This appears to be accom- plished mainly by a direct action on the heat-producing foci. It also tends to act on the spleen, producing congestion, inflamma- tion and enlargement of that viscus. There is still one other property of Quinine which it may be well to 366 A CLINICAL MATERIA MEDIC A. remember, and that is its power of abolishing reflex action when taken in large quantities. Now let me give you the symptoms of cinchonism, that is, the symptoms which follow the excessive use of Cinchona bark or of Qui- nine. You will find prominent among these symptoms an increase of appetite from stimulation of digestion. Soon nausea and vomiting appear, and even diarrhoea may be added to the gastric disturbances. Then the head becomes affected. There is a peculiar sensitiveness to external impressions, to noises, to bright lights or to anything that is apt to render the patient irritable. There is experienced a peculiar form of headache, which is characterized by dull aching and at other times by throbbing in the head. There are well-marked ringing or roaring sounds in the ears, a very characteristic effect of Cinchona. Vertigo still further complicates the case. If the use of the drug is still persisted in, deafness follows. In other cases there appears a sort of Cinchona intoxication which is not unlike that produced by alcohol. This is followed by delirium, dilated pupils, then complete stupor with difficult respiration and finally convulsions, these convulsions arising from anaemia of the nerve centres and not from congestion, as is the case with Belladomia. In extreme cases collapse and death from paralysis of the heart end the patient's life. These, then, are the general effects of Cinchona, when that drug is given persistently in increasing doses and at short inter- vals. They may vary in severity from a simple ringing in the ears to all the symptoms of complete poisoning. Hahnemann has taught us that Cinchona is useful only when de- bility or anaemia comes from loss of fluids. In the allopathic school it is used in all forms of debility, given either alone or in combination with iron or sherry wine. But, as I have said before, we have learned from Hahnemann that it is useful only in the anaemia which results from loss of fluids. Hence, you may use it for the results of haemor- rhage, whether it be from the mouth, lungs or uterus. You may use it when long-lasting diarrhoea has exhausted the patient. It may even be used when the condition has proceeded further than a simple debility, and that horrible disease known as hydrocephaloid has de- veloped. In such cases, when Cinchona is the remedy, the child has these symptoms: after violent or long-lasting cholera infantum, it becomes drowsy; the pupils may be dilated, the breathing is very rapid and RUBIACE^. 367 •superficial; the diarrhoea may have ceased, or the movements may be involuntary; the surface of the body is rather cool, especially the prominent features about the face; thus, the ears, nose, and chin are cold. In just such cases as this, Cinchona will, if there is any vitality remaining, restore the patient to health. If it should fail, you may still fall back on Calcarea phosphorica, a similar but more deeply-acting drug. In applying Cinchona to the debility resulting from sexual excesses, remember that it is only curative for the debility resulting from the excessive loss of semen. If there are constitutional troubles it is worse than useless. Now let us pause and stud}^ the relation which Cinchona bears to other drugs applicable to debilitated and anaemic conditions. Ferrum is indicated in pure anaemia, with an appearance of plethora. Arsenicum is the remedy for debility resulting from overtaxing of the muscular tissues, such as follows prolonged exertion, climbing mountains, etc. Phosphorus is preferably indicated in prostration which is very sud- den in its onset, when the nervous system is exhausted. Hence, we may have to use this drug in a variety of diseases, in scarlatina, in measles, in diphtheria, and, in fact, in any disease in which the nerv- ous system seems to have sustained a sudden shock or blow. This is not a Cinchona case, remember. Phosphoric acid is somewhat different from Phosphorus . It is to be thought of in debility of nervous origin, when it is not connected with an} 7 pain except, perhaps, a simple burning in the spine or in the limbs. The mind is rather apathetic, and the patient is inclined to be drowsy and sleepy. The characteristic of this sleepiness is that he is easily aroused from it and is wide awake. Zincum is good when the brain becomes affected in the course of nervous diseases, scarlatina or summer complaint of infants. Espe- cially is it useful in scarlatina when the child has not sufficient strength to develop an eruption. You may use Cinchona for haemorrhages, and here you can scarcely do without the drug. The haemorrhage ma) 7 come from any orifice of the body; the blood is apt to be dark and clotted; the flow is so pro- fuse as to have almost produced exsanguination of the body; there is coldness of the face, of the whole body in fact; the features show the presence of collapse; there is gasping for breath; the patient demands 368 A CLINICAL MATERIA MEDICA. to-be fanned. Now, this fanning is desired, not for the purpose of cooling the patient, but is called for because of the instinctive demand for more oxygen, which the fanning produces by changing the strata of air about the patient's head. Cinchona is frequently called for in ante-partum and post-partum haemorrhages; in such cases you do not give it in a single dose, but repeatedly, at short intervals, until the consequences of the hsemorrhage have been removed. There is another condition in which I would recommend Cinchona, and that is, when retained placenta is attended with haemorrhage- Pulsatilla does no good. I know that it has been recommended in these cases to take away the after-birth by manual interference, but it has been my practice to administer Cinchona until the tonicity of the uterus is restored, and then remove the placenta. The nearest remedy to Cinchona in these symptoms is Ipecacuanha > which is useful when there is profuse bright red flow of blood, usually accompanied by nausea, and sometimes by very hard, labored breath- ing. Sometimes there is coldness of the surface of the skin, which is covered with cold sweat. It is one of our best remedies in the haemop- tysis of incipient phthisis. Belladonna is useful when the haemorrhage is of bright blood, coagu- lating rapidly, and feeling hot to the parts over which it flows. Trillium controls haemorrhage when the flow is either bright red or dark, and occurs in women who flood after every labor. Millefolium is suited for a profuse, bright red flow, unattended with pain; it is much like Aconite, but it lacks the restlessness, anxiety and fever of that remedy; it has, also, continuous flow after an injury. Sabina is to be used when the flow is bright red with clots, and is worse from any motion. The haemorrhage is attended with pain ex- tending from the pubes through to the sacrum, and with pains in the legs. Carbo vegetabilis is to be given when there is a continuous dark passive haemorrhage. The patient wants to be fanned. The skin is cool and bluish, and the pulse rapid and weak. Secale is said to be best adapted to thin scrawny women. The flow of blood is passive; it is attended with tingling in the limbs. Although the surface of the body is cold, the patient persistently expresses her desire to be uncovered. Erigeron is said to be useful in profuse haemorrhage similar to that of Sabina, but associated with irritation of the bladder and rectum. RUBIACKiE. 369 Hamamelis is suited to passive venous haemorrhages, especially when the part from which the flow of blood proceeds feels sore and bruised. Acalypha Indica is useful in haemoptysis after fits of dry coughing. Cinnamomum, profuse haemorrhage from a strain or misstep. Cyclamen, profuse haemorrhage, with dizziness and obscured vision, as from a fog. This is different from the natural syncope resulting from excessive or sudden bleeding. It may follow slight losses of blood in women of a delicate build, whose weakness is cerebro-spinal. You may also compare Ledum, Vinca minor and Phosphorus if the haemorrhage is caused by uterine polypi. When reaction has been established after haemorrhage, you may still give Cinchona if there is headache with violent throbbing of the caro- tid arteries. This is not a Belladonna symptom. It is here an indica- tion of anaemia, whereas under Bellado?ina, this symptom is indicative of hyperaemia. It is a general characteristic of Cinchona to produce a nervous ere- thism with its symptoms of debility, a fact which allies it more with Arsenicum than with the torpid Carbo veg. The mind is over-active, although lacking endurance. Ideas crowd on the mind in unwelcome profusion, preventing sleep. On closing the eyes he sees persons and figures. The surface of the body is sensitive to the touch. This susceptibility is more imaginary than real. If the patient has a slight pain he feels it unbearably, and he dreads the slightest attempt to ap- proach him lest you touch him, yet firm pressure or rubbing relieves. He exhibits a similar sensitiveness to a draught of air, which always makes him worse. These hints are appropriate to neuralgic and other pains. Arnica has this fear of being approached in gout; Spigelia has an actual sensitiveness of the whole surface, the least touch sends a sudden shock through the entire frame. You may have to use Cinchona to cure asthenopia, but only when it occurs as the result of haemorrhage or loss of fluids. An examination with the ophthalmoscope shows the disk to be pale and anaemic. The pupils are apt to be dilated; the eyes ache on attempting to use them, as in reading or writing, and objects appear blurred. We now come to the study of the action of Cinchona on the digestive organs. It is very useful for dyspepsia occurring especially after loss of fluids. Digestion is so weak that the stomach cannot tolerate any food at all. Should the patient's supper come to him later than usual 24 370 A CUNICAI, MATKRIA MKDICA. he is sure to suffer in consequence. The stomach is distended with flatus, but belching relieves only momentarily or not at all. The least food or drink taken increases this symptom, so that after taking but a small quantity, he feels full, as though he had eaten an enormous meal. He complains often after eating of a sensation as of a lump in the mid-sternum, as though food were lying there. This is situated higher up than is the "hard-boiled egg" sensation of Abies nigra. Pulsatilla also has the same sensation in the same locality. This state, when Cinchona is the remedy, is often the result of loss of fluids, drink- ing tea to excess, and beers, fruits, etc. The appetite is often vora- cious when not capricious; thirst for cold water; drinks little and often; longs for acids, brandy, sweetmeats; buzzing in the ears. Aconite has anxiety, relieved by very cold water or ice. Veratrum album desires ice-cold water. The following also crave cold water: Pulsatilla, Plumbum, Scilla. Cinchona is an excellent remedy in the gastric troubles of children who are continually asking for dainties, but who reject substantial kinds of food. On awaking in the morning they are cross and irrita- ble. They have a bad taste in the mouth and a white-coated tongue. Cinchojia is useful in some diseases of the bowels, especially when associated with marked tympany. The abdomen is enormously dis- tended; when you percuss it, it gives forth a sound almost like that caused by striking the tense head of a drum. It is particularly when this tympany occurs early in the disease that Cinchona does good; then this symptom shows early debility. I^ater in the course of the disease, when it results from decomposition, Cinchona is less valuable, and you must resort to such remedies as Terebinthina, Colchicum, etc. The diarrhoea of Cinchona is very characteristic. The stool is lien- teric in character. It is worse at night and after eating. This is attended with rapid exhaustion and emaciation. In appearance the stools may be yellow, watery or brown, and very offensive. Cinchona is one of our best remedies for diarrhoea occurring in hot weather after eating fruits. The nearest allies to the drug here are Ferrum metallicum, Arseni- cum album, Phosphoric acid, Oleander, Iris versicolor and Podophyllum. Arsenicum and Ferrum both have profuse lienteric diarrhoea, com- ing on during or after eating. Phosphoric acid differs from Cincho7ta in that, while the stools are frequent and copious, they are not attended with much debility. RUBIACE^. 371 Iris versicolor is indicated in summer diarrhoea. The stools, are co- pious and are associated with vomiting. The patient is worse at about two or three o'clock in the morning. It differs from Veratrum album in the absence of coldness. Podophyllum . is to be used for profuse gushing diarrhoea, coming on in the morning, or more during the day than at night. The stools ma}^ contain undigested food and often, in children, deposit a mealy sediment. The Oleander diarrhoea is also lienteric. The patient passes in his stool the food which he had eaten the day before. Cinchona, as you all know, is a valuable remedy in the treatment of chills and fever. It is useful either in fevers of the tertian or of the quartan type. The chill is unaccompanied by thirst, but there is thirst either before or after the chill. During the chill the patient sits as near as possible to the fire or wraps himself warmly in blankets; but the warmth thus obtained does him no good. The chill is followed by long-lasting heat, during which the patient desires to uncover. He is then usually without thirst. His face is fiery red, and he is often delirious. The sweat which follows is profuse and debilitating, with intense thirst. The apyrexia is by no means free from symptoms. The face is sallow, dingy yellow, from bilious complications, the spleen is enlarged, and there are aching sore feeling in the splenic region and either total loss of appetite, or canine hunger. The feet become oedematous, sometimes from disturbance in the composition of the blood, but mostly from interference with the hepatic and splenic circu- lations. Sleep is greatly disturbed, and the patient, as soon as he closes his eyes, sees figures, etc., before him. The Sulphate of Qui?ii?ie has these same symptoms, with this in ad- dition, the chills recur with clock-like regularity, usually at 3 A. m., with blue nails, and pain in the dorsal vertebrae. But both drugs may be indicated in an anteponing type of fever. The heat is accompanied by excessive thirst and red face. The tongue is yellow down the cen- tre, with pale edges. The heat gradually breaks into a sweat which relieves. The patient is very weak between the periods. Cinchona and its preparations have been so much abused in the treatment of in- termittent fever that it is necessary to differentiate them carefully from their concordant remedies. First of all may be mentioned Coryius florida . This drug has sleepi- ness long before the chill; the patient feels chilly, but is warm to the 372 A CUNICAI, MATERIA MEDICA. touch; the heat is associated with drowsiness, and is followed by pro- fuse sweat. Menyanthes is excellent when the chill predominates, with icy cold- ness of the tips of the fingers; in fact, all peripheral parts of the body get cold. In Capsicum the chill begins in the back, with thirst. The patient feels better from heat applied to the back and from wrapping up, just as under Ignatia. Eupatorium perfoliatum is useful when the chill comes in the morn- ing, or in the morning of one day and in the afternoon of the next; the usual time, however, is nine o'clock in the morning. The chill is often preceded by thirst and bitter vomiting. The drinking of water makes the patient chilly. The fever is usually followed by very slight sweat. Lachesis may be used after the abuse of Quini?ie, when the chills return in the spring. Canchalagua is indicated in spring ague, with severe chill; the hands are puckered up like a washerwoman's. Eucalyptus is a remedy which has been highly recommended in malarial fevers, but I must say to you that I know little or nothing about it. Ipecacuanha is useful in intermittent fever when the type has been spoiled by Quinine. You can obtain no clearly defined picture of the case. Everything is confused. Ipecacuanha seems to have the prop- erty of developing the symptoms and of curing the case, or it provides you with sufficient data to enable you to select the appropriate remedy. The characteristic symptom of Ipecacuanha during the paroxysm is short chill, followed by long fever. Usually we find gastric symptoms, with a preponderance of nausea. Sepia is also to be thought of in cases that have been spoiled by Quinine or by bungling administration of Homoeopathic remedies. Another remedy which may be utilized for the removal of the bad effects of Quinine is Arsenicum album. It is called for when the parox- ysms occur more or less periodically. Thirst is great. The spleen is swollen. Dropsical symptoms appear. Paroxysms of neuralgia ap- pear in the face, and recur regularly. Arsenicum may be indicated when almost any form of disease assumes the malarial type. In these cases you will find the ordinary remedies of no value whatever. Still another remedy in severe cases is Carbo veg. This is especially RUBIACE^S. 373 of service after the abuse of Qui?iine, when there is thirst during the chill; when the body is icy-cold, and especially is this coldness noticed from the knees down; and when there is lack of reaction. You will be surprised to see how nicely an apparently hopeless case will rally under one or the other of these remedies. There is a constitution developed by the marsh miasm for which it is necessary to use deep-acting remedies. Foremost among these stands Aranea diadema. This drug is suited to persons who may not have any distinct type of fever, but who suffer at every cold or damp change in the weather. The symptoms seem to be ill-defined. At one time they feel dyspeptic, at another they ache all over; but in all cases the constitutional taint is at the bottom of the whole trouble. Aranea diadema will so change the type of constitution that the pa- tient will escape any further injury when exposed to dampness. Malaria officinalis should be compared in this condition. In some cases you will have to use Ferrum metallicum as an antidote to Quinine, especially when we have the masked anaemia peculiar to this drug. The face is easily flushed, and the bloodvessels throb. The spleen is enlarged, and dropsical symptoms are manifested mostly about the feet. Cinchona — to return to that drug — is also of essential service in the treatment of hectic types of fever, such types of fever as indicate a long-lasting suppurative process. The surgeon is called upon to em- ploy this drug very frequently when, after emptying an abscess, symp- toms of hectic fever develop. The cheeks are red. The patient is excessively nervous, the nervous irritability being greatly dispropor- tionate to the patient's strength. He is so greatly prostrated by the fever that he can scarcely raise his head. Diarrhoea adds to his weak- ness. Copious night-sweats also exhaust him. Along with Cinchona in this connection you must place in your mind its analogues, which are chiefly Arsenicum album and Carbo veg. You will often meet with a severe case in which Cinchona runs its course, and no longer produces improvement. You will then have to select Arsenicum or Carbo veg., according to the symptoms of the case. Carbo veg., as well as Cinchona, is to be remembered as a remedy to prevent collapse following the opening of a cold abscess, such as occurs in spinal caries. The symptoms of the two remedies are almost identical, and your choice between them may be difficult unless you find other symptoms in the case pointing distinctly to one or the other drug. 374 A CLINICAL MATERIA MBDICA. Psorinum, like Cinchona, is useful in some cases of night-sweats. It is indicated when profuse sweats occur after acute illnesses, as typhoid fever, etc. The patient is very despondent, hopeless of re- covery; remains weak, with trembling of the hands and weak back and joints. Sulphur is very similar. Another form of suppurative trouble in which you may use Cinchona is in suppuration of the lungs, particularly in drunkards, when the trouble is associated with hectic fever. You may also be called upon to use Cinchona in disorganized states, either of the external tissues or of the lung substance. In the latter case the remedy is indicated by the hectic symptoms and by the foetid breath. Here Cinchona vies with Arsenicum, Secale, and Lachesis. Do not confound the foetid breath just mentioned with that arising from certain forms of bronchitis, in which the sputum is retained a long time and undergoes decomposition in the lungs. While the pa- tient is breathing quietly you can notice no extraordinary odor. As soon as he gives a deep cough the breath becomes horribly offensive. This kind of cough calls for Capsicum, and, perhaps next in import- ance, for Sanguinaria Canadensis. You will find Cinchona often indicated in inflammatory rheumatism, not in the beginning of the disease, but later when the fever has be-^ come intermittent in its character. The joints still remain swollen. The characteristic pains in these cases are jerking and pressing. The patient will not permit you to approach, crying out with pain if you touch the affected parts, so exquisitely sensitive is the surface. Qui- nine sulphate is also useful in a similar condition. Ci?tcho?ia is also a neuralgic remedy. It is especially suited to neu- ralgia of the infraorbital nerve on either side when the symptoms are typical in their return, and when the slightest touch or draught of cold air makes the patient worse. If the neuralgia is of malarial origin Cinchona is increasingly indicated. You may here compare Cedron, which is applicable to malarial neuralgia, usually supraorbital, when the attacks return with clock- like regularity. In jaundice you should use Cinchona when the surface of the body and the sclerotica are yellowish. The liver is swollen and sensitive to the touch, and there is a feeling in the right hypochondrium as of sub- cutaneous ulceration. The stools are whitish, and are accompanied by foetid flatus, or else there is diarrhoea. It is especially indicated in RUBIACE^. 375 jaundice arising from sexual excesses, from loss of animal fluids, from abuse of alcohol, and from gastro-duodenal catarrh. The antidotes to Cinchona are Arsenicum album, Ipecac, Carbo veg. y Lachesis, Pulsatilla, Ferrum metallicum and Verat7'um album. The in- dications for most of these have already been given you. Cinchona and Morphia are antagonistic in brain symptoms. Cinchona and Belladoiina are antagonistic in heart symptoms, tem- perature, etc. LECTURE XXXVI. IPECACUANHA AND COFFEA. Ipecacuanha. ' Bry. , Puis., Nux v., Cinch. Ant. crud., Tabacum. Ars., Ant. tart., Veratr. alb. Ipecacuanha. \ ^ obelia infiata - V Cuprum met. >Tabacum, Ars., Nux v. Ipecacuanha ckphaeus is a small shrub growing in Brazil. It is bitter, acrid and nauseous, and possesses a peculiar odor which, in some persons, excites sneezing and even asthma. In many cases the conjunctivae are injected, with puffiness under the eyes, profuse coryza and tension over the eyes. Ipecacuanha contains as its active principle a substance called Emetin, which gives to the drug its property of producing vomiting. It also contains an acid called Ipecacuanhic acid, and a small quantity of a foetid volatile oil. The latter constituent probably has something to do with the action of the drug on the pneumogastric nerve and its consequent use in the treatment of asthma. Ipecacuanha is easily studied. It acts upon the nerves (especially the pneumogastric) and mucous membranes. It has been employed by allopathic physicians as an anti-spasmodic in asthma and in pulmonary catarrhs. In the latter class of troubles it is used to provoke vomiting, and, of course, gives temporary relief. Ipecacuanha seems to have a special affinity for the mucous mem- branes lining the bronchial tubes and alimentary canal. One of the most prominent features of this drug is its property of producing nau- sea and subsequently vomiting. So prominent is this symptom that you will find it present in almost all the cases in which Ipecacua?iha is required. IPECACUANHA. 377 Studied more particularly, Ipecacuanha is found suitable for patients who are easily irritated, full of desires, but know not for what. If a child, the patient cries and screams almost continually. As an adult, he is irritable and morose, holding everything in contempt. Thus you will find Ipecacuanha indicated in headaches. These are of rheumatic origin. The characteristic sensation is a pain as if the head or bones of the head were bruised or crushed, this feeling seem- ing to go down into the root of the tongue. This headache is accom- panied by nausea and vomiting. Ipecacuanha may also be used in uni- lateral sick headaches with deathly nausea. In these cases the face is usually pale, blue rings surround the eyes, and the expression about the mouth betrays the intensity of the nausea. Now, these symptoms are not so necessarily present in the adult as they are in the child. You see the corners of the child's mouth drawn, and a line extending from the alse of the nose to the corners of the mouth, giving to the child an expression of nausea, and at once suggesting to your mind such remedies as Ipecacuanha, Antimo?iium tartaricum and especially SEthusa cynapium. In that bursting headache of Ipecacuanha compare Veratrum album, which has that bruised feeling here and there in the brain. There is still another drug which has this symptom, and that is Ptelea. The gastric symptoms of Ipecacuanha, in addition to those already mentioned, are such as would call for the exhibition of this drug after indulgence in rich food, such as pastry, pork, fruits, candy, ice-cream, etc. Nausea is constant with all complaints; vomiting of bile; vomits just after eating (like Arsenicum); vomits after eating rich or indi- gestible food; vomiting of mucus; morning sickness. The tongue is usually clean, a symptom which differentiates Ipecacuanha from Nux vomica, Antimonium crudum, etc. Distress in the stomach; it feels re- laxed as if hanging down (like Staphisagria, Theine, Lobelia, Tabacuni) . These gastric symptoms of Ipecacuanha should be compared with those of three other remedies, the most important of which is Pulsa- tilla. You will at once recognize the similarity of the two drugs. They are both useful for gastric disturbances caused by indulgence in mixed diet, pastry, ice-cream, pork, fatty food, etc. Pulsatilla may be considered the better remedy of the two early in the attack, when the stomach still contains the food which disagrees, while Ipecacu- a?iha is better when the stomach is empty and the effects only of the 37§ A CUNICAI, MATERIA MKDICA. indulgence remain. The best distinction between the two remedies, however, lies in the condition of the tongue. In Ipecacuanha, the tongue, as above stated, is clean or only slightly coated, whereas in Pulsatilla the tongue is almost always foul, white or yellow, with a very disagreeable taste in the mouth. Arsenicum album must follow or supplant Ipecacuanha, when an actual catarrh of the stomach has been produced by indigestible food, espe- cially after sudden chilling of the stomach with ice-cream or ice- water. There are vomiting, burning pains in the stomach, diarrhoea, restless- ness, etc. Antimonium crudum, like Ipecacuanha, is suitable for gastric catarrh, following a mixed diet of pastry, etc. The tongue is thickly coated white, as if it had been whitewashed. Ipecacuanha may be indicated when, in the case of children, indul- gence in rich food has produced convulsions. It may even be useful in the convulsions of teething children, or convulsions following sup- pressed eruptions, cold, etc. They are of the rigid tetanic form. Sometimes the rigidity alternates with flexing of the arms and jerking of the arms toward each other. Colic may occur, and this is of a griping character. Either the pain is situated about the umbilicus, as though a hand were tightly clutch- ing the intestines; or the colic consists of cutting pains which shoot across the abdomen from left to right. The stools are either green, as in diarrhoea of infants, or they are yellow and liquid, and covered with mucus and blood. Sometimes they have a fermented appearance and look like molasses. That is as good a comparison as I can give you; the stool looks just like molasses when it is frothy. At other times the stools are black from admixture of bile. Some of these diarrhoeas are associated with tenesmus, indicating catarrh of the lining mem- brane of the bowels. Ipecacuanha is frequently indicated in the commencement of cholera infantum. You find present pallor of the face, with blue rings around the eyes; the fontanelles are still open, showing defective nutrition; the child may have nose-bleed with the pale face; it is drowsy, with starting and jerking of the muscles during sleep. The child is sub- ject to frequent attacks of nose-bleed. The condition already simu- lates that of hydrocephaloid. You must not think because Ipecacuanha is associated so closely with stomach symptoms, that it cannot be indi- cated in this reflex cerebral state. You will find nausea and even IPECACUANHA. 379 vomiting usually present. The child eats or drinks and vomits what it has taken almost immediately afterward. Particularly is Ipecacuanha indicated in these cases as a remedy preceding the exhibition of Arsen- icum album. Arsenicum, as already indicated, is complementary to Ipecacuanha in these abdominal affections. In some of these cases of gastro-intestinal troubles in children Ipecac- uanha and the other remedies just mentioned will sometimes fail you. Then it will be well for you to bear in mind the following remedies, which, though infrequently indicated, may prove themselves to be of inestimable value. Oenothera biennis, the evening primrose, commonly seen in the fields and waste places, is an invaluable remedy in exhausting, watery diar- rhoea. It does not act, as has been suggested, as an astringent, by its tannic acid, but is a genuine homoeopathic remedy, producing and curing diarrhoea. The evacuations are without effort, and are accom- panied by nervous exhaustion, and even by incipient hydrocephaloid. Gnaphalium causes a watery, offensive morning diarrhoea, which recurs frequently during the day. The provers were children, and well have they portrayed a very common group of cholera infantum symptoms. They had rumbling in the bowels, colicky pains, and were, at the same time, cross and irritable. The urine was scanty, and the appetite and taste were lost. A writer in the Homceopath mentions having used this drug very successfully, and Dr. Hale refers to it in his Therapeutics. Geranium maculatum is also a successful baby's remedy. Dr. Hale devotes eight pages to Geranium and other astringents, dividing their action according to his rule of primary and secondary symptoms, and deducing thence two propositions for use in practice. The provings, brief though they are, help us in the choice of the drug; constant de- sire to go to stool, with inability for some time to pass any faecal mat- ter, then the bowels move without pain or effort; mouth dry; tip of the tongue burning. The Allopaths use Geranium as an astringent. Paullinia sorbilis has been suggested for diarrhoea, which is green and profuse, but odorless. Opuntia comes to us recommended by so careful an observer — Dr. Burdick — that, although I have not used it, I do not hesitate to pre- sent it anew. Nausea in stomach and bowels; feels as if the bowels were settled down into the lower abdomen (confined in adults). In infants we may, perhaps, look to this drug when the lower part of the 380 A CIvINICAI, MATERIA MKDICA. abdomen is the seat of disease, as this seems to be its characteristic seat of attack. Niiphar luteum causes a yellow diarrhoea, worse in the morning, either painless or with colic. It has been employed for diarrhoea dur- ing typhoid, and indeed seems to cause nervous weakness. Whether it will be of service for infants remains to be seen. We should look to it when Gamboge, Chelidonium , etc., fail, and when exhaustion is a prominent attendant. Kali bromatum has been given successfully several times in cholera infantum, when there were great prostration, cool surface and symp- toms of hydrocephaloid. Compare Cincho?ia (incipient hydrocepha- loid, following prolonged or oft-repeated diarrhceic discharge), Calca- reaphos., Carboveg., Veratnim album, Camphor, etc. Returning now to Ipecacuanha, we should note another effect of the drug which is just as characteristic as its action on the bowels, namely, its action on the mucous membrane of the respiratory tract. Thus it may be used in coryza. The nose feels as if stuffed up; there is often epistaxis, loss of smell, nausea and some catarrh of the bronchial mu- cous membrane. You may compare here Allium cepa, which is an excellent remedy for simple nasal catarrh when the nasal secretion is watery and acrid and the lachrymation mild. There are rough raw feeling in the throat and cough provoked by tickling in the larynx. I may say in qualify- ing these symptoms of Allium, that although it quickly stops the nasal catarrh, it frequently seems to drive the trouble to the chest. Phos- phorus appears to stop this action of Cepa. Euphrasia is very similar to Cepa in nasal catarrh. Here, however, we have excoriating lachrymation and bland nasal discharge. Arsenicum album follows Ipecacuanha, in the catarrhs of fat, chubby children. Affecting prominently, as Ipecacuanha does, the pneumogastric nerves, we should expect it to be useful in affections which involve these nerves, such as asthma, in which disease it is indicated when there is a sensation as of constriction of the chest, worse from the least motion. When the patient coughs you hear the rattling of mucus in the chest, yet none is expectorated. Especially will you find this kind of asthma calling for Ipecacua?iha in stout persons of lax fibre, either adult or child, who are particularly sensitive to a warm moist atmos- phere. IPECACUANHA. 381 Very similar to Ipecacuanha in asthma is Arsenicum album, which often follows it well either in catarrhal or nervous asthma. Cuprum metallicum is useful in asthma when the spasmodic element predominates. The face gets blue; there is constriction of the throat; the patient almost goes into convulsions. Another drug closely allied to Ipecacuanha is Lobelia inflata. This has, with the asthma, a weak sensation in the epigastrium, spreading Wp into the chest, nausea, profuse salivation and a feeling as of a lump in the stomach. Ipecacua?iha is one of the best remedies we have for capillary bron- chitis in infants, especially if caused by the kind of weather I have described. There is a great accumulation of mucus in the chest. The examining ear hears rales all through the chest, both anteriorly and posteriorly. The cough is spasmodic and usually attended with vom- iting of phlegm. There may be fever and Ipecacuanha still be indi- cated. The child may have difficulty in breathing from the marked accumulation of mucus in the chest. In such cases, I have used the remedy in all potencies; that is to say, from the third to the twenty thousandth, and I have been well satisfied with its action. When Ipecacuanha is indicated, the stage for giving Aconite has passed, be- cause exudation has begun. If you adhere to the principles of homoe- opathy, you will not give Aconite and Ipecacuanha in alternation. Af- ter giving Ipecacuanha, you will notice that the mucus does not adhere so firmly to the walls of the bronchial tubes, but it becomes less tena- cious and is raised more readily. Let me warn you that there are two or three changes of symptoms which will call for concordant remedies. One of these changes calls for Antimonium tartaricum, and that is when the cough grows less and less frequent, the quantity of mucus in the chest not diminishing in amount. The infrequency of the cough is not a good symptom, al- though the mother will think so. The chest is so filled with mucus that the child cannot cough. He grows more and more drowsy. In giving Antimonium tartaricum in these cases, give it in frequent doses until the cough increases. Another change calls for Phosphorus. This should be given when the inflammatory symptoms increase, the substance of the lungs be- comes involved and pneumonia supervenes. Then Ipecacuanha ceases to be the remedy. Any one who practices in the colder parts of the country will find these catarrhs frequent, and with Aconite, 382 A CUNICAI, MATERIA MEDICA. Ipecacuanha, Antimonium tartaricum and Phosphorus, he can manage the great majority of his cases. Still other remedies may be needed. In some cases Aiitimonium tartaricum, though apparently well indicated, fails to control the symp- toms. Then we may have recourse to Sitlphur, which produces in the healthy a catarrh of the bronchial mucous membrane with loud rales all through the chest, particularly in the left lung. Especially is it indicated when there is atelectasis. I have used Sulphur with great success in just such cases. Another remedy is Terebinthina , which I have used when the child was drowsy and the lungs seemed to be all clogged up. The urine is apt to be scanty and dark from the admixture of blood. Terebinthina must be given repeatedly. Still another remedy is Lycopodium, which affects more markedly the right lung. Loud rales are heard all through the affected part. The expectoration is yellowish and thick. We may be called upon to give Ipecacuanha frequently in whooping- cough, by virtue of the spasmodic character of the cough and the action of the drug on the pneumogastric nerve. You will find in addi- tion to the symptoms already mentioned, that spasmodic convulsive symptoms are present. During the cough the child stiffens and be- comes rigid from tonic spasm of the extensor muscles; loses its breath and turns pale or blue in the face. Finally it relaxes and vomits phlegm, which of course relieves. While Ipecacuanha is of excellent service here, you are reminded of two other drugs which are similar. One of these is Cina, which I must ask you to remember as being something more than a mere worm remedy. This remedy is useful in whooping-cough with the same kind of rigidity that I have described for Ipecacuanha, but there is in addition a clucking sound in the oesophagus as the child goes out of the paroxysm. If in addition to this symptom you also have grinding of the teeth, Cina is certainly a better remedy than Ipecacuanha. Cuprum metallicum is the complement of Ipecacuanha in spasmodic affections and in whooping-cough. It is especially indicated in con- vulsions from worms and during the course of whooping-cough. Spasms of the flexors predominate. In fevers we may use Ipecacuanha, especially in those of an inter- mittent type. It is one of the best drugs to give when your case is mixed up. It is particularly indicated when there is a short chill, COFFEA. 383 followed by long fever with nausea and vomiting, especially after the abuse of Quinine. Ipecacuanha is an excellent drug for hematuria, for haemorrhage from the kidneys when the trouble is attended with nausea, oppression of the chest, hard breathing, and cutting pains in the abdomen. In some cases those who work in Ipecacuanha are affected with a violent inflammation of the conjunctiva. Now this fact led Jousset to apply the drug in the treatment of ophthalmia, and he claims many cures with it in the intense conjunctivitis of scrofulous children. There are tearing pains in and about the eyes and copious lachryma- tion. Tears gush forth ever}' time the lids are separated. When, however, there is marked keratitis, he prefers Apis. In closing let me give you the Ipecacuanha temperament. Studied as a homoeopathic remedy, you will find it indicated in patients who are full of desires they know not for what. The child cries and screams continually. The adult is irritable and morose, holding every- thing in contempt. Bismuth seems to hinder the action of Ipecacuanha. Opium increases its action on the bronchial mucous membrane. COFFFA ARABICUM. Coffea is extensively used as a beverage. Its alkaloid, Caffeine, is identical chemically with several others, such as Theine, the active principle of tea, and is related chemically to the purin bodies, xanthin, uric acid, etc. Caffeine lessens the amount of urea excreted in the urine. It is use- ful when there is an extra drain on the system, particularly after hard work in hot weather, at which time the system is doubly exhausted by the fatigue and the heat combined. Then a cup of coffee is a very good thing. So, too, it may be used after loss of sleep, when fatigue is more marked than it is after labor. Other things being equal, coffee is not so useful for the young as for the old. A man in active business life or one who works hard all day, or an elderly man in whom waste is out of proportion to repair, finds great benefit from coffee. In fact, it is almost instinctive on the part of workmen to fall back on coffee as a beverage, because it gives them what their food will not, a certain amount of strength and an antidote to the wear and tear of labor. 384 A CUNICAI, MATERIA MKDICA. The effects of Caffeine on the system bear a certain resemblance to Strychnia. It seems to excite reflex action, and, if persistently given, tetanus as well. It produces sudden starting from the slightest touch of the surface of the body (like Strychnia), and increased suscepti- bility to all external impressions. This increased ' ' excito-motor " action explains many of its symptoms. Violent emotions, whether of pleasure or of pain produce symptoms. Patients experience sudden joy, and they are at once sick from the excitement. They awaken at night without any desire whatever to return to sleep. Coffea also produces an ecstatic state of mind. Here it finds a con- cordant remedy in Cypripedium. Especially is the latter remedy indi- cated in children who awaken at night from sleep, and are unnaturally bright and playful, and evince no desire to go to sleep again. Such symptoms are often preliminary to some brain affection, which the timely use of Cypripedium may avert. Apoplectic congestion may be cured by Coffea, particularly if an ex- cited state of the mind has been the cause of the excessive fulness of the cerebral blood-vessels. So, too, an animated conversation in which the party interested becomes greatly warmed up and has cerebral con- gestion will call for Coffea. This remedy is of value, however, only in the beginning of these cases; then it is all-sufficient. But if the. trouble goes on to effusion (not inflammatory effusion, but effusion of serum by oozing through the distended capillaries), you must have recourse to Belladonna, Bryonia or some remedy more adapted to effu- sion than is Coffea. Coffea is also a remedy in eruptive diseases, when the eruption keeps the patient awake on account of the excessive itching and burn- ing of the skin; the patient scratches even until the parts bleed. This symptom is due, in the Coffea case, to the hypersensitiveness of the skin. Moreover, Coffea has fear of death, thus allying it with Aconite; this fear usuallly being present with the severe pains. All pain in the Coffea patient is intolerable. Kven a slight pain causes great com- plaint and crying and whining. Coffea is often indicated in the toothache of children and of nervous people. Sometimes you will be led to give Chamomilla in these cases. You find the mental symptoms indicating that drug, yet it does no good, or it affords but partial relief. You may give Chamomilla when the face is red, when the child cannot bear the least pain and is cross COFFEA. 385 and irritable, and when cold water in the mouth relieves for an in- stant. But if cold water relieves permanently, Cofiea is the remedy. The senses are all too acute under Coffea, not only the sense of touch but that of sight and of hearing also. Under the stimulating influ- ence of this remedy the patient may see fine print with a degree of distinctness altogether unnatural. Distant noises seem to be mag- nified. Coffea has a condition almost the reverse of the hypersesthetic state. It results from the secondary or depressant action of the drug. In its effect upon the circulation, at first it seems to increase the frequency of the pulse, showing that there is increased action of the heart. This is followed later by cardiac depression, with palpitation and irregular pulse. It must be remembered that this increased fre- quency of the pulse is not attended with an increase of force, as under Aconite, Bryonia and Baptisia. So you see that the stimulation is not genuine. On the contrary, it weakens the heart muscle, so that after awhile, if this drug be given long enough, or if coffee be indulged in as a beverage to excess, the heart exhibits a tendency to dilate. We find Coffea also indicated in diarrhoea, particularly that occur- ring among housewives; those who have a great deal of care and trouble in the management of the household. Remember also the use of Coffea for fatigue arising from long jour- neys, especially during hot weather. I wish to mention two or three other drugs analogous to Cojfea, that have recently been proved. Piper methysticum, also called Kava- kava and Awa-samoa, is largely used in Polynesia as a beverage. It has also been proved as a medicine. Its effects seem to be something like those of coffee, for it produces at first a feeling of buoyancy or tension, as though every nerve were " strung-up " to its highest pitch. The prover feels that he can work hard without fatigue. If these effects reach their extremes, there is a feeling of mental tension as though the head were large, almost full to bursting. There is dizzi- ness also; dizziness on closing the eyes or on directing the attention to any object. The vessels of the brain, and particularly those about the base of the brain, feel full, as if ligated (that is the symptom given in the language of the prover). Thus far you see it is somewhat sim- ilar to Coffea. But the secondary action quickly follows the use of Piper, and this reverse effect is characterized by what we may call brain-fag. The brain feels tired on awakening, as one feels after 25 386 A CUNICAI, MATERIA MKDICA. being out late at night and losing considerable sleep, or after a hard night's study. There is heavy, dull aching in the head, which is worse from reading, thinking or any use of the mind. The mental symptoms, be they those of excitement or of depression, are relieved by diversion of the mind. Further than this, Piper seems to produce convulsions, and it has cured them. The spasms simulate those of catalepsy. The mind is tired and yields to the least pressure. There is over-sensitiveness to all external impressions. LECTURE XXXVII. SCROPHULARIACE^, Scrophulariacege f Myrica cerifera. | Spigelia. Kalmia. j Helleborus. ^ < China. Digitalis. Gratiola. Leptandra. Euphrasia. Verbascum. Linaria. From this order of plants we obtain Digitalis, Gratiola, Leptandra Virginica, Euphrasia, Verbascum and Linaria. These drugs are not all thoroughly proved, but those that are well known are sufficiently distinct to be easily remembered. The most important member of the group is the Digitalis Purpurea. Digitalis contains among other ingredients two substances, one known as Digitalin, the other as Digitoxin. The latter is found in larger quantity than the former. Digitalin has been proved separately from the Digitalis. Its symptomatology, however, is, like most other active principles, very nearly identical with that of the original drug. Digitalis produces, very early in the proving or in poisoning cases, among other symptoms, the most distressing nausea and vomiting. This emesis is often accompanied by a deathly faint, sinking sensation at the pit of the stomach. The surface of the body is often cold, and sometimes covered more or less with cold sweat. The pulse is irregu- lar. These early symptoms of Digitalis remind one of several other drugs, notably, Antimonium tartaricum, Tabacum and Lobelia. It is 388 A CUNICAI, MATERIA MKDICA. probable that these drugs and Digitalis all cause this nausea and vom- iting by affecting the base of the brain, acting there upon the pneu- mogastric nerves as they leave their origin. Such symptoms as this deathly nausea and vomiting might suggest the use of Digitalis in the vomiting attendant upon cerebral disease; in meningitis, for instance, whether the meninges of the cerebrum alone, or of the cerebrum and cord combined, were involved in the inflammation. The drug may even be used in the nausea and vomiting of preg- nancy, and in the incipiency of abortion. One of the provers, a preg- nant woman, took an overdose of Digitalis, and in consequence was seized with this same deathly nausea and a flow of blood from the vagina. We may also study Digitalis in its action on the heart. Through irritation of the pneumogastric nerves we have inhibition of the heart's action. As a consequence of this effect of the drug, the pulse becomes slow. Arterial tension is greatly increased, probably owing to the action of the drug on the vaso-motor centre, which is supposed to be at the base of the brain; the pulse is, therefore, primarily slow and strong. In addition to the effect of the drug on nervous structure, we must remember that it also affects muscular tissue, both of the striated and non-striated varieties. Thus it causes weakness of the cardiac tissues. This weakness varies in intensity from simple weakness to complete paralysis of the muscular fibre. Consequently, we may very soon have added to these other symptoms, weakness of the pulse. Every little extra exertion, such as that incurred while rising from a sitting to a standing posture, increases the rapidity of the pulse, but the force of the beat is diminished. This quick pulse may become irregular and even intermittent. With this view, then, of the physi- ological action of the drug, you may understand the following symp- toms of the heart and respiration connected therewith. But first let me here give you a word of caution respecting the use of Digitalis in heart affections. The tendency of this drug, like that of Lachesis and Arsenicum album, is downward. You must not use it, therefore, indiscriminately or carelessly, but only when you are guided to its selection by the symptoms of the case, or you will certainly make your patient worse. In organic diseases of the heart, Digitalis must be used with extreme caution, because it may hasten the period when nature is no longer able to compensate by hypertrophy of the heart- muscle for the interference in the circulation. Nature thus may be SCROPHULARIACE^. 389 compelled to give out. Then the heart yields to the pressure of the blood within its cavities and begins; and we shall have the train of symptoms which I intend to describe to you shortly, as belonging to Digitalis. This warning is particularly applicable to the use of the drug in large doses. Given thus it may relieve for a time, but it only hastens the fatal end. With this word of warning I now proceed to give you in detail the heart symptoms of Digitalis. The heart feels as though it stood still, and this sensation is attended with great anxiety. There is a sort of indescribable uneasiness in the cardiac region, which may be expressed as a sense of oppression or tightness about the heart, or as an uneasy feeling with weakness and numbness in the left arm. There is a feeling of goneness or sinking at the epigastrium. This is sometimes relieved by eating, but often comes on worse after eating, particularly after breakfast. There are sharp sticking pains in the region of the heart. Sometimes there is choking when trying to swallow, from reflex spasm of the glottis. The pulse is slow, often slower than the beating of the heart. In these cases the heart beats so imperfectly that some of its pulse waves are not transmitted appreciably to the radial artery at the wrist. Any movement such as rising from a chair, getting out of bed, or increas- ing the speed in walking, increases the rapidity of the pulse but causes no increase in the force of its beat. The irregular distribution of the blood caused by these alterations in the heart's functions is exhibited in a variety of sympjtoms. In extreme cases, for instance, we find even cyanosis, which suggests Digitalis as a possible remedy for cyano- sis neonatorum. The child turns blue and falls into a syncope on the slightest motion, or else it becomes deathly sick, as you see from the expression of the face and from the involuntar}^ gagging. If you can feel the pulse, you will find it irregular both in rhythm and volume; the surface of the body is cool. The borders of the lips are blue or purple. The child is blue around the eyes. The veins wherever they show through the skin are seen to be dark. Other and more common illustrations of the irregular distribution of the blood may be shown in the sleep. The patient's sleep is un- comfortable and restless. He dreams a great deal; he starts up from sleep dreaming that he is falling from a great height. Sometimes he awakens with an anxious or distressed feeling, which he may be unable to locate, but which results from the cardiac affection. Men- tally, the Digitalis patient, besides being anxious, has those gloomy 39° A CUNICAI, MATERIA MKDICA. forebodings incident to heart disease. He has an apprehensive feel- ing, ill-defined it is true, yet none the less terrible. He is apt to be sad and depressed, as well as anxious. The respiration is of course affected by this action of the heart. We frequently find the breathing deep, sighing and slower than normal. This symptom is almost pa- thognomonic of heart affection. There is often a desire to take a deep breath, but an attempt to do so seems to result in only half-filling the lungs, which do not expand to their full capacity. This is often at- tended with dry cough, which seems to be excited by deep inspiration. The deeper he attempts to breathe, the more likely is he to cough. This is altogether a bronchial symptom, and comes on from an over- filling of the blood-vessels there. Suffocative spells with painful con- striction of the chest, as if internal parts of the chest were grown together, are not uncommon. Sometimes these attacks force the patient to sit up in order that he may breathe. If these cardiac symp- toms are present you will find Digitalis indicated in several varieties of disease starting remotely from the heart, and yet depending for their existence either directly or indirectly upon the disease of that organ. In almost all the affections in which Digitalis may be used there is present either a slow pulse or a feeble pulse, becoming irregular or quick. For instance, dropsy may call for Digitalis. This dropsy is not of renal origin. You would hardly think of Digitalis in dropsy resulting primarily from a liver or kidney disease, but in that form occurring primarily from cardiac debility, it is at times an invaluable remedy. Digitalis may be used with profit in a number of forms of dropsy. You may give it in anasarca when the surface of the body is bluish, rather than of the alabaster-like appearance characteristic of renal dropsies. Local dropsies, too, are present. Thus you find Digitalis indicated in hydropericardium, and even in hydrothorax and ascites, if they are connected with heart disease. In dropsies of the chest there is a remedy that is often forgotten, and that is the Sulphate of Mercury or Mercurius sulphuricus. Especially is this remedy useful when the chest-dropsy occurs from heart or liver disease. When the drug acts well it produces a profuse watery diarrhoea, with great relief to the patient. A very common form of dropsy calling for Digitalis, is infiltration of the tissues of the scrotum and penis. We may even use Digitalis in hydrocele when the cardiac symptoms calling for the remedy are present. The urine is often suppressed or very scanty. SCROPHULARIACK^. 391 This deficiency in the renal secretion depends upon disordered circu- lation, and not upon primary disease of the kidneys. The urine may be dark red or albuminous. We find Digitalis causing some liver symptoms which are worthy of notice. I think, however, that Digitalis has no direct action on the hepatic cells; it does not appear to affect the bile secretion directly. But in jaundice, in which the primary trouble is a cardiac disease of the type already mentioned, with ashy white stools, Digitalis certainly acts admirably. The liver is enlarged and feels sore, as if bruised. Objectively examined, it is found to be somewhat indurated. With this symptom we have jaundice. The taste is bitter, or at other times, sweetish. The tongue may be perfectly clean, or it may be whitish- yellow. The pulse is slow, even slower than the beating of the heart. Drowsiness may supervene and even increase to stupor. The stools are of the character above mentioned. The urine is high-colored from admixture of bile pigment. The jaundice calling for Digitalis is not that which follows retention of bile or is caused by catarrh of the duo- denum or by some obstruction of the biliary ducts, but it is due to an actual functional imperfection of the liver, that organ not taking from the blood the elements which go to form the bile. A remedy which here compares favorably with Digitalis is Myrica cerifera, which has the following symptoms. First, despondency, which depends upon the disordered condition of the liver. The symp- toms of Myrica are similar to those of Digitalis because in each case the jaundice is due to the imperfect formation of bile in the liver, and not to obstruction of the flow. But the two remedies are ver}^ different in their absolute effects on the system. With Digitalis, the jaundice is traceable to the condition of the heart. With Myrica, the case seems to be functional rather than organic. For some reason the bile is not properly formed, and therefore its elements remain in the blood. The heart is affected secondarily, slowness of the pulse thus being pro- duced. The S3'mptoms calling for Myrica are these: Despondency, dull, heavy headache, worse in the morning; the eyes and sclerotic have a dirty, dingy, yellowish hue, the lids themselves being abnor- mally red; the tongue is coated a dirty yellow. Weak sinking feeling in the epigastrium after eating. The patient is weak and drowsy, and complains of muscular soreness and aching in the limbs. The pulse is slow but intensified. The stools are ash colored. The urine is dark and turbid. You recognize at once the resemblance to Digitalis; 392 A CLINICAL MATERIA MKDICA. but it is more superficial in its action than is that remedy, and would not be suitable for so violent a case as the latter. In heart affections you may compare Digitalis with a number of remedies, notably, with Kalmia, Arsenicum album, Helleborus and Conium. Kalmia latifolia is a drug which belongs to the order Ericacecs, with Rhododendron, Ledum palustre and other remedies. It is a valuable rem- edy in rheumatism when it affects the chest. The pains in the Kalmia affection of the heart are sharp, taking away the breath; the patient almost suffocates, so severe are they. The pains shoot down into the abdomen or stomach; the pulse is slow, almost as slow as that calling for Digitalis. Kalmia is especially useful when gout or rheumatism shifts from the joints to the heart, especially after external applica- tions to the joints. I refer here especially to the application to the joints of substances that are not homoeopathic to the case. If you were giving Arnica internally and applying it locally, and if it were the indicated remedy, there would be no danger of metastasis. But if some one were to apply the tincture of Aconite to the affected joint there would be danger of the inflammation travelling to some more vital part. The Kalmia rheumatism, unlike that of Ledum, usually travels downward, thus following the direction of its pains. Helleborus is similar to Digitalis in the slowness of the pulse. The respiration is also slow and the temperature of the body is greatly diminished, often being as low as 95 or 96 F. There is generally cerebral disease. Spigelia also must be compared with Digitalis. It has the follow- ing symptoms. Sharp pain shooting through the heart to the back, or radiating from the heart and down the arm or over the chest and down the spine; great oppression or anxiety about the heart; palpita- tion of the heart worse from any movement of the arm or body; thrill- ing or purring sensation felt over the cardiac region (this is just such a thrill as you feel when stroking a cat's back when the animal is purring); blowing sound over the heart. You will find Spigelia indi- cated when these heart symptoms accompany other affections, for in- stance, neuralgia, particularly if it affects the left side of the face, commencing in the occiput and settling over and in the left eye. That is the Spigelia headache. Its aggravation follows the course of the sun. It commences in the morning, reaches its acme at noon, and diminishes toward night. You may also use it in ciliary neuralgia SCROPHU^ARIACE^. 393 with these accompanying sympathetic symptoms of the heart. Sharp pain shoots through the eyeball and radiates in all directions, almost driving the patient mad. At other times there is a sensation as if the eye were being squeezed in a vise or as if it were enormously enlarged and were being pushed out of the head. It is one of the chief reme- dies to be thought of in iritis with excessive pain. I wish also to mention a symptom for Spigelia that the late Dr. Jacob Jeanes con- firmed many times, and that is intermittent pulse. He prescribed this remedy as an intercurrent, in many varieties of disease, when the pulse assumed this character. Convallaria majalis presents heart symptoms associated with uterine symptoms; soreness in the hypogastrium; pain in the sacro-iliac syn- chondrosis, extending down the leg. Itching of the meatus urinarius and vulva. Another remedy is Magnolia gra7ialiflora , which has sadness; nerv- ousness; weak heart, with sensation of constriction in the cardiac region; worse on walking fast; and at times the sensation as if the heart stopped beating. It will not be unprofitable for us next to study the action of Digitalis on the brain. It causes symptoms which are very much like those of meningitis, even meningitis with effusion, or of hydrocephalus, and also of cerebro-spinal meningitis. The symptoms from which you will have to decide are these: there is throbbing headache, which is re- ferred to the forepart of the head; delirium, which may be so violent as to simulate mania; decided errors in vision; bright balls of fire ap- pear in the field of vision, or, like Santonin, objects appear of various colors, as yellow or green. Still later, as the trouble progresses, men- tal confusion increases and amaurotic congestion of the retina takes place; the pupils become dilated and fail to respond to light, and finally coma appears. There is great general prostration with cold- ness of the body, which is covered with a cold sweat. Even in these forms of cerebral disease, when Digitalis is to be your remedy, the pulse comes in as your chief guide. If the symptom, buzzing in the ears, should suggest Cinchona, I entreat you not to give it after Digi- talis, for Hahnemann tells us that, although there is a similarity in the cerebral symptoms and in the weakness, yet the drugs are inimical. Lastly we shall speak of the action of Digitalis on the urethra and genital organs. Digitalis produces a catarrhal irritation of the blad- der, particularly about its neck. There are strangury and frequent 394 A CLINICAL MATERIA MEDICA. urging to urinate, especially when the patient is standing or sitting; pressure on bladder not relieved by urinating. The patient may also have frequent urging to urinate at night. The urethra is inflamed so that we have burning in the urethra with purulent discharge, thick in character and bright yellow in color. Now, if you combine these symptoms with another one, namely, that the glans penis becomes in- flamed with copious secretion of thick pus over its surface, you have a perfect picture of Digitalis in gonorrhoea. This form of the trouble, Digitalis will cure, whether the pulse be slow, fast, soft, weak, or what not. Often, too, when Digitalis is indicated in this trouble, you will find the prepuce puffed up and infiltrated with serum. Let me say, in passing, that if the prepuce becomes indurated, Digitalis will do no good, but Sulphur will. The nearest remedy to Digitalis in gonorrhoea is Mercurius. This is a good remedy for gonorrhoea associated with inflammation of the prepuce, but with less oedema and more dark purplish swelling of the parts with phimosis or paraphimosis. Mercurius corrosivus is good in these cases when the glans has a dark red or gangrenous appearance. In the beginning of these cases of paraphimosis, we may give Colo- cynth, which will sometimes relieve the spasm and enable the prepuce^ to be drawn forward over the glans. Petroselinum is to be thought of as an intercurrent remedy in gonor- rhoeal affections when the neck of the bladder is involved, and there is sudden urgent desire to urinate. It seems as if the patient can hardly retain his urine until he gets to a convenient place. Digitalis also produces violent erections, even chordee. It is one of our best remedies for involuntary seminal emissions during sleep, even without dreams. The emissions are followed by great weakness. Lin aria Vulgaris. This drug acts powerfully upon the sympathetic nerves. It may be serviceable in fainting of cardiac origin when the patient faints dead away without apparent cause. Linaria has repeatedly produced this symptom. It is true that there is some difficulty in confirming such a symptom as this, because, in most cases, the patient quickly returns to consciousness without recourse to any remedy. But if a patient who is subject to attacks of fainting of this kind is not only relieved SCROPHULARIACE^E. 395 but is cured by taking the drug, you know that this is the result of the remedy. It also has some action upon the bladder, causing and also curing enuresis with painful urging to urinate. Verbascum. Verbascum is to be thought of as a remedy for catarrhs or colds when they are associated with neuralgia of the left side of the face, which appears periodically, generally twice a day, the same hour in the morning and afternoon of each day. It is described as a dull pressure on the malar bone as from a finger, with tension of the cheek and numb feeling. It is worse from every change of temperature, especially a change from warm to cold. There is considerable coryza and lachrymation present. Verbascum has a peculiar cough which is characteristically laryngeal and tracheal. It could be produced only in a hard unyielding tube like the larynx or trachea. The cough is hollow, hoarse, barking or trumpet-like, and is asso- ciated with hoarseness, the voice itself being deep and hard, a sort of " basso prof undo " It bears some resemblance to Drosera, Spongia and Sulphur. Gratiola. Gratiola is useful in diarrhoea. It produces and cures a profuse yellowish, gushing, watery diarrhoea, comparable to water rushing from a hydrant. This diarrhoea is very common in summer, and seems to have as its exciting cause excessive drinking of water, whether it be cold or not. It is concordant with Croton tiglium, Ela- terium, Podophyllum and several other drugs. Leptandra Virginica. Leptandra Virginica is a drug which acts prominently on the liver. Locally, we find dull aching in the right hypochondrium, in the region of the gall-bladder, and also posteriorly in the posterior portion of the liver. This aching is often accompanied by soreness. At other times the congestion is great enough to produce burning distress in and 396 A CLINICAL MATERIA MBDICA. about the liver. This often spreads to the stomach and abdomen. As accompanying symptoms ; we find drowsiness and despondency, which belong to liver affections of this character, and also diarrhoea, in which the stools are black, almost as black as pitch. These stools are ac- companied by burning, distressing, colicky pain at the umbilicus. In other cases we have vomiting of bile with this burning distress, and occasionally clay-colored stools. The tongue is coated yellow or more frequently black, or dark-brown, and black down the middle. With these symptoms present, Leptandra may be indicated in bilious and typhoid fevers. Leptandra resembles Mercurius. The main distinction between them is that Mercurius almost always has, characteristically, tenesmus continuing after stool. Leptandra has not this symptom, although it may have griping colicky pains after stool. Iris versicolor should also be mentioned here. This drug irritates the whole alimentary tract, hence there are burning, serous diarrhoea, even rice-water discharges; cramps and vomiting. In cholera morbus coming at 2 or 3 A. m. it is superior to Veratrum. It also produces inflammation of the pancreas. Leptandra acts more on the liver; if the stools are not black, they are watery, muddy, and worse in the morning after beginning to move. Euphrasia Officinalis. Euphrasia is particularly of use to us as a medicine acting on mu- cous membranes, especially the conjunctiva and the nasal mucous membrane. It has long been known as a remedy in affections of the eyes. First it produces an inflammation of the eyelids, a blepharitis. The eyelids become reddened and injected, particularly on their inner surface. They become puffed, red or even dark red; ulceration takes place, giving us a discharge which is thick and excoriating. The tears themselves are profuse and excoriate the cheeks. There is marked photophobia; the patient cannot bear sunlight, but even more objec- tionable to him is artificial light. It has been urged by some physi- cians that it is "splitting hairs" in attempting to differentiate between aggravation from sunlight and that from artificial light. I cannot see where this objection has any force, for sunlight and artificial light are very different in their compositions. SCROPHULARIACE^. 397 Belladonna has aggravation from artificial light, and Aconite from sunlight. In conjunctivitis, Euphrasia is sometimes indicated in scrofulous cases. Little blisters or phlyctenulae form on or near the cornea; the discharges from the eyes are acrid and purulent and a film of mucus seems to collect over the cornea, causing a difficulty in vision. This blurred sight is relieved by wiping the eye or by winking. We find Euphrasia indicated also in conjunctivitis of traumatic origin, when the above symptoms are present. Arnica, which is more of a remedy for bruises, has no application to this acrid discharge or to the formation of these little blisters; so when these form after an injury, Euphrasia is the preferable drug. Although Euphrasia affects principally the superficial structures of the eye, we find it indicated in rheumatic iritis. If you examine the eye, you find that the iris reacts very tardily to light, and the aqueous humor is cloudy from the admixture of the products of inflammation. The pains are burning, stinging, shooting in character, are worse at night, and are attended with this acrid lachrymation. Euphrasia is indicated in coryza which is perfectly bland with lach- rymation which is excoriating. If we compare it with its concordant remedies we find, beginning with the eye symptoms, that it is a close ally of Mercurius solubilis. Both remedies have this well-marked blepharitis and conjunctivitis coming from cold. But under Mercurius the discharge is thinner than under Euphrasia; moreover Mercurius has marked aggravation from the heat of the fire, and in damp weather. Next we find Euphrasia similar to Arse?iicum album. Both have the acrid discharge and the formation of phtyctenulae on the cornea, and both are indicated in scrofulous cases. But Arsenicum has more marked burning — burning like fire, especially after midnight. This symptom is frequently though not always relieved by the application of hot water. Nor have we in Euphrasia the marked restlessness we have in Arsenicum. Another similar drug is Rhus toxicodendron, which has profuse gush- ing tears, excoriating the check; profuse purulent discharge from the eyes. But the pus is thinner under Rhus than it is under Euphrasia. Rhus more often attacks the right eye; Euphrasia attacks either eye. Rhus has pains in the rheumatic iritis, darting from the eye through to the occiput, with a great deal of restlessness, agony, tossing about at night, and relief from motion and applied heat. 398 A CUNICAI, MATERIA MBDICA. In studying the coryza we are accustomed to associate Euphrasia with Allium cepa. We make this differentiation between the two remedies: Cepa has excoriating coryza and bland lachrymation; Euphrasia, bland coryza and acrid lachrymation. There is still one other application we may make of Euphrasia, and that is in paralysis of the third pair of nerves, causing ptosis, espe- cially when caused by catching cold, in rheumatic patients. The allies here are Rhus toxicodendron and Causticum, both of which have exactly the same symptom. This gives you very nearly the pre- cise position of Euphrasia in the treatment of catarrh of the eyes and nose. We may also make use of the drug in the treatment of condylomata. It is useful in broad, flat condylomata of the anus, of course of sycotic origin. Usually there is some oozing of moisture about them. LECTURE XXXVIII. BAPTISIA TINCTORIA. Baptisia tinctoria. Gelseinium. Rhustox., Bryonia. Arnica, Muriatic acid, Lachesis, Arseni- cum album. Ailantlius. I have selected for our study to-day a member of the leguminous plants, namely, Baptisia tinctoria, or the wild indigo. Baptisia is a drug which has a short history, but an exceedingly interesting one. Our journals are replete with glowing accounts of cures of typhoid conditions made with it. Baptisia causes, in general, the changes in the blood, both quantitative and qualitative, w 7 hich are exhibited in typhoid fever. The offensive exhalations, the mental and nervous phenomena which it develops are characteristic of this disease. Bap- tisia is suitable to all stages of typhoid, early or late. Its symptoms I will divide into two classes: first, those which indicate the remedy early in typhoid affections, and, secondly, those which call for it late. The drug may of course be indicated even if all the following symp- toms are not present in any one case. But I shall give you the char- acteristic symptoms of the remedy, and unless several of these are present it would not be proper to give Baptisia. These symptoms are as follows: excitement of the brain, just such as precedes delirium; wild-, wandering feeling; the patient cannot confine his mind to any one subject; restlessness, constant desire to move from place to place; disturbed sleep. The patient awakens at two or three o'clock in the morning, and then is so restless that he tosses about, unable to sleep any longer. During sleep his dreams are of the most extravagant character. He dreams that he is chained to the bed, or that he is swimming a river, or undergoing some ordeal which makes a great demand on his strength. He may suffer from nightmare, from which he awakens with a sensation as though the room were insufferably hot, making breathing almost impossible. If he still has strength he 400 A CLINICAL MATERIA MEDICA. goes to the open window to get air. Now this is not a true asthma; it is not due to a spasmodic contraction of the bronchioles. There is a fulness of the chest, causing the oppressed feeling. One prover de- scribed the symptom, not as a true difficulty of breathing, but as a feeling as though he had not strength to lift his chest. The patient makes frequent errors as to his own person, supposing at times that he is double or that his body is scattered about, and that he must toss about the bed to collect the pieces. Now these evidences of nervous excitement are accompanied by excessive prostration; the back and limbs ache; the back feels stiff; the patient feels tired and bruised all over; he complains of the bed feeling too hard; this makes him restless, and he tosses about the bed to find a softer spot; weak- ness develops, progressing so far that he becomes unable to walk; he suffers from an indescribable weak or faint feeling, with or without vertigo. The face is hot and flushed and has a heavy, besotted look, as in the case of one intoxicated. The eyes, also, are heavy and stupid in appearance. The tongue is at first white or slightly yellowish; fre- quently, too, the papillae are raised and project through this whitish or yellow coating. The edges of the tongue are of a deep red color. There is a dull, heavy headache, with the sensation as if the head would be pressed in; sometimes the pressure in the forehead seems to go down into the root of the nose. Again, the patient complains of a sensation which he describes ' ' as though the skin of the forehead were being pulled back towards the occiput." This is evidently due to tonic contraction of the occipito-frontalis muscle. At other times the patient simply describes the sensation as though the skin of the forehead were tense, or tight, or drawn. These symptoms of the head are often accompanied by a numb, tingling feeling in the forehead or scalp. At other times the head feels enormously large. The typhoid type of fever is very characteristic of Baptisia, it being one of the few T remedies which actually produce this type of fever. There is always an increase of temperature. The pulse is usually ac- celerated in direct proportion to the intensity of the fever. Even in the early stages of typhoid fever, you may find Baptisia indicated by the abdominal symptoms, slight sensitiveness in the ilio-csecal region, and yellow putrescent stools. These, then, are the symptoms calling for the early exhibition of Baptisia in typhoid fever. I can say confidently that if you select the drug on its homoeopathic BAPTISIA TINCTORIA. 40I indications as just outlined, you will succeed in aborting a large per- centage of typhoid states. I say this despite the assertions of many other physicians who have argued to the contrary. The properly- selected drug will abort typhoid fever. The disease need not run its course, as prominent old-school authorities claim it must necessarily do. Later in the course of the disease, during the second or third week, you will find Baptisia indicated when the prostration is profound. The patient is in a stupor. He falls asleep while answering questions. His face is now dark-red in color and has, more marked than ever, this heavy, besotted look. The tongue has changed its yellow or white coating to one which has a brown streak down the centre, the edges of the organ still remaining red. All the exhalations and dis- charges from the patient are exceedingly offensive. The teeth are covered with sordes having an offensive odor. The breath is fcetid. The stools are yellowish or dark, and are horribly putrid. The urine and sweat are both offensive. So 3^011 see, Baptisia applies to cases in which there is an evident decomposition of vital fluids and rapid dis- integration of tissue. To give Baptisia its legitimate position among other typhoid reme- dies it will be necessary to compare it with those nearest like it in symptomatology. The first of these remedies to which I shall call your attention is Gclsemium. This usually precedes Baptisia when there are malaise and muscular soreness, and the patient suffers from chills and "crups," which go down the back. This is on the first day, remember. In the afternoon comes the fever with accelerated pulse, this being full and flowing, not tense and resisting as under Aconite. The fever is usually associated with drowsiness; the face is red in color, uniformly suffused; and even as early in the case as this there may be prostration. Gelsemium causes paratysis of the motor nerves, hence there must be weakness of the muscles. By the next afternoon, if the fever rises, despite Gelsemium, you may change to Baptisia, provided the above-mentioned symptoms develop. The rea- son I dwell on the relations of these two drugs is because of the great similarity of their symptoms. Both of them have this intense muscu- lar soreness and prostration; both have drowsiness and nervous ex- citement, with prostration; both have this feeling of expansion, as though the head or some part of the body were enormously enlarged; and both have the afternoon exacerbation of the fever. The relation between the two drugs is one of degree or intensity. Gelsemittm is the milder acting drug of the two. 26 4-02 A CLINICAL MATERIA MKDICA. Another remedy which is not unlike Baptisia is Rhus tox. Like Baptisia, Rhus has restlessness, brown tongue and soreness of the mus- cles. I must confess that the distinction between the two remedies is not always easy. Formerly, Rhus held undisputed sway in almost all diseases which threatened to assume a typhoid t}^pe, whether the dis- ease was diphtheria, scarlatina, peritonitis or pneumonia. Now this honor is shared with Baptisia. The main differences between the drugs, brief! y given, are these: Rhus has restlessness, caused more by rheumatoid pains than by muscular soreness alone. The tongue, un- der Rhus, has a red, triangular tip, which is not noticed under Bap- tisia, Delirium is of a muttering character under Rhus, unaccom- panied, so far as I know, by these delusions respecting personal iden- tity. Neither are the putrid discharges of Rhus tox. quite so offensive :as those of Baptisia. If diarrhoea progresses to a severe type under Rhus, the stools are watery, .sometimes bloody and involuntary. The pneumonic symptoms which often complicate typhoid fever are more prominent under Rhus. Arnica claims a relationship with Baptisia. It is similar to the lat- ter remedy in the stupor, in the intolerance of the bed (the patient complaining that it feels too hard), and in the falling asleep while answering questions. Arnica, I think, is more suitable when there is a tendency to apoplectic congestion and when the stupor is so profound that both stool and urine are passed involuntarily. The intensity of the involvement of the brain is shown by the loud, snoring respiration. Then, too, in Arnica we find suggillations, sometimes called ecchy- moses. Lachesis also comes forward as similar to Baptisia. You will recog- nize the resemblances between the remedies in the oflensiveness of the discharges, in the putridity of the exhalations and in the excessive prostration. I believe that I have seen apparently hopeless cases react under the benign influence of this remedy. As an animal poison, I think it penetrates more deeply than Baptida, and in consequence should be called for in worse cases. It may be distinguished by the following symptoms: trembling of the tongue when attempting to protrude it; the tongue catches on the teeth during the act. When he succeeds in getting it out, it hangs there tremblingly, and he may not even have sense enough to draw it in again. Haemorrhages are fre- quent in the Lachesis patient. Blood may escape from every orifice of the body. The lips crack and ooze a dark or blackish blood. Dark blood escapes from the bowels. This, after standing awhile, deposits BAPTISIA TINCTORIA. 403 a sediment which looks like charred straw. In severe cases there is marked intolerance to light pressure. Even when the sensorium ap- pears to be perfectly benumbed the patient resists the slightest touch about the neck. In still worse cases, 3'ou have to distinguish it from Baptisia when there are approaching cerebral paralysis, dropping of the lower jaw and involuntary discharges. Muriatic acid bears some resemblance to Baptisia in the great pros- tration, in the decomposition of fluids, and in the low form of delirium. But the general character of its sj^mptoms is not sufficiently similar to those of the other remed}' to make a distinction difficult. The Muriatic acid weakness is so great that the patient is unable to make the slight exertion required to maintain the head on the pillow; he therefore slides down to the foot of the bed. Now, a word about Baptisia in diseases other than typhoid fever. In such affections it is indicated by the symptoms already mentioned. In dysentery 3^ou will give it when the discharges are offensive, bloody and are attended by tenesmus, but with a significant absence of pain, showing an alarming depression of vitality. Baptisia comes into play in the treatment of phthisis. It is espe- cially useful during the later stages of the disease in relieving the fever, particularly when it increases in the afternoon with slight drowsiness, thick speech and bewilderment of mind. Baptisia has proved itself one of our best remedies in diphtheria when it has assumed a typhoid type. Some of the s} T mptoms already mentioned will be present. The mouth is excessively putrid. The membrane is dark and exhibits a gangrenous tendency. Sometimes, early in the disease, you will observe this characteristic: the patient can swallow only liquids. Give him milk and he will drink it. Give him solid food and he rejects it at once. Ailanthus is to be compared with Baptisia in typhoid conditions, in scarlatina and in diphtheria. It produces even more profound stupor than the latter remedy. There is a well-marked, excoriating, watery discharge from the nose, making the upper lip sore. The rash, if any exist, is of a livid purplish hue, thus denoting the poisoned state of the blood. I wish to impress upon you the need of correlating properly in 3^our mind Gelsemunn, Baptisia, Rhus tox. and Lachesis. These remedies present so inan}^ distinct clinical pictures, which, when recalled in time of necessity and used according to their symptomatic indications, form a quartette invaluable in the treatment of disease. LECTURE XXXIX. SOLANACEiE. f Belladonna. ] Hyoscyamus. > Mydriatic— Acro-narcotic. Stramonium. ) Solanaceae. *{ Solanum nigrum. Tabacum. Dulcamara. [ Capsicum — Acrid. The drugs composing this group of remedies present great symp- tomatic similarity. The first three remedies on the list are continually in use, even in an average practice. There is scarcely a symptom of one of them which cannot be found under one of the others. The resemblances are, in fact, perplexingly similar. I have arranged the remedies on the board, not botanically, but rather according to their medicinal relations. For instance, the first four on the list attack prominently the brain and have narcotic prop- erties; they are, therefore, placed in one group. Then we have Tabacum, which also has narcotic properties, but which acts also on other parts of the body besides the brain. Next comes Dulcamara, which contains a small quantity of Solanine, and is only slightly nar- cotic. A large quantity of this drug would be required to develop the soporific effects which can be obtained from Stramonium or Hyoscya- mus. Lastly, we have Capsicum, which is decidedly irritant or acrid. Placed on the skin, it acts as a blister or counter-irritant. It has pos- sibly some narcotic effects, but it differs almost entirely from the other members of the group. The resemblances between the first three members of the group are so. great, in fact the drugs are so nearly " idem,'" that it is not well to follow one with the other. There are some symptoms of Belladonna and Hyoscyamus which are opposite, not so much in the phraseology in which they are expressed, for they may read almost exactly alike, but SOLANACE^E. 405 in the fact that they are results acting in opposite directions; conse- quently, they sometimes serve to antidote each other. Especially is this true of the skin symptoms. Belladonna. Belladonna. < Nerves. Ailments. J Sphincters contract. Irritates the centres. Irritates, then paralyzes the peri- pheries. Disturbs the circulation; worse in the brain. _ Disturbs the circulation; fever, f Violent, sudden, j Usually with brain symptoms. Inflammation. Hypersemia with tendency upward. ^ Brain cells. Belladonna, or the deadly nightshade, was known to the medical world as early as 1500 A. D. The Venetians named the plant " herba Bella donna," from the circumstance that the ladies used it distilled in water as a cosmetic to brighten the eyes and flush the cheeks. The plant, especially the leaves, yields the well-known alkaloid Atropine. The root, too, contains Atropine , although in variable proportions. Belladonna is intensely poisonous to man, though herbivorous animals may eat it with impunity. Studied as a poison, Belladonna causes the following symptoms: eyes dry and injected; face red, turgid, and hot; skin scarlet or studded with papillae, all but identical with those in scarlatina ; violent congestions especially of the head; mouth and throat distressingly dry; this last sensation extends downward, compelling frequent swallow- ing, and suffocative spasms of the fauces and glottis. Thirst is violent, yet water aggravates; there are vertigo, confusion, hallucination, and finally stupor. The pupils are so markedly dilated that the iris is hardly visible.* There are jactitation of the muscles; convulsions- Such poisoning cases are not uncommon in Europe, where the plant is * Belladonna dilates the pupil by stimulating the sympathetic ; Physostigma contracts it by stimulating the third cranial nerve ; Gelsemium dilates it by paralyzing the third cranial nerve. 406 A CUNICAIv MATKRIA MKD1CA. native, and where its berries have been mistaken for cherries. In this country, too, it has been taken accidentally, and also employed in attempts at suicide. To antidote it, use the stomach pump, emetics of hot mustard water, and strong coffee without milk or sugar. Belladonna as a homoeopathic remedy is almost as old as the art itself. Our symptomatology from provings and poisoning cases en- ables us to employ the drug with mathematical certainty, so far as its selection is concerned. But like all polychrests, it is abused by hur- ried and careless practitioners, and so is often given when its resem- blance to the cases under treatment is only superficial and partial. Of all drugs, it has the power of producing opposite effects most markedly. Belladonna has been so often mentioned in the preceding lectures of this course in comparing it with other drugs that you are already somewhat familiar with it. For this reason many of the symptoms of the drug may be passed over in brief review. But first of all let me tell you something of the general character of Bellado7ina. It seems to be best suited to rather fleshy and phlegmatic persons of a plethoric habit who are subject to congestions, especially of the head. This is something like the constitution of Calcarea ostrearum, but Belladonna has not the pallor of that remedy. The Belladonna patients are pleas- - ant and jolly enough when well, but they become exceedingly irritable and overbearing when ill. This pleasant sociability which makes them so companionable, seems to be converted into the opposite con- dition when they are afflicted with disease. It is also suited to pre- cocious children, with big head and small body, who may be scrofu- lous, with a tendency to swelling of the lips and enlargement of glands. They learn things rapidly; sleep is unnatural; the head is hot and the cheeks red; they scream out during sleep. Belladonna, when it is to be used for children, demands the presence of some cer- ebral symptoms. There must be some irritation of the brain, as shown by jerking of the limbs, irritability and fretfulness, or even some absolute meningeal inflammation. A peculiarity of Belladonna is its faculty of exciting constriction of the circular fibres of blood-vessels, contraction of sphincters, etc. This universal quality of Belladonna is exemplified in the constriction of the throat, worse from liquids; constriction of the anus, which, with tenesmic urging and pressing in the rectum, suggests the drug in dys- entery; spasmodic constriction of the os uteri, retarding labor; and ineffectual or frequent urging to urinate, with scanty discharge. SOLANACE^. 407 The disease in which Belladonna is indicated is acute, sudden and violent. The very rapidity of the onset of the trouble should at once suggest Belladonna. For example, a child is perfectly well on going to bed. A few hours afterward it begins to scream out during sleep, and is soon aroused with violent symptoms, such as jerking of the limbs, irritation of the brain, restlessness, can't lie still; ceaseless mo- tion, especially of the arms. All these symptoms suggest Belladonna. Again if inflammations come suddenly, and are violent or almost overwhelming in their intensity, Belladonna is suggested. We may think of it in abscess, when pus develops with lightning-like rapidity, whether it be an abscess of the tonsil, a boil, or any other kind of abscess. Hence we find it indicated in phlegmonous erysipelas, which quickly goes on to suppuration. The affected parts become greatly swollen. Pus works its way through the tissues between the various muscles. The very suddenness of the attack suggests Belladon?ia. The pains are quite consistent with this character of the drug. They come suddenly and last a greater or less length of time, and then cease as suddenly as they began. So much for the general character of Belladonna. Belladonna acts on muscular tissue and on the joints. It is one of our best remedies in acute and chronic rheumatism. The pains are cutting and tearing, running along the limbs like lightning. The joints are swollen, red and shining; streaks of red radiate from the in- flamed joint; rheumatic fever, with pains attacking the nape of the neck, shoulders and upper arms. It is one of the best remedies in rheumatic stiff neck, caused by cutting the hair, getting the head wet, or sitting with the head and neck exposed to a draft. The action of Belladonna on the brain must be understood before we can proceed further. In reviewing the symptoms of the drug, it seems to me that it does not develop positive inflammation of the meninges, but rather the collateral symptoms of the inflammation only. Thus Aconite causes an absolute inflammation of the meninges with an in- crease of exudation; Bryonia causes inflammation, with an exudation of leucocytes and blood plasma, constituting complete inflammation. But Belladonna seems rather to provoke congestion only. The sur- charged blood-vessels seem to have ruptured, producing little reddish spots or ecchymoses in the tissues, thus exciting a congestive irrita- tion of the brain beneath the membrane. If exudation follows this congestive irritation the exudate is serous, and is just the kind that 408 A CUNICAL MATERIA MKDICA. results from venous congestion. It is not the inflammatory exuda- tion, rich in plasma, which is pictured under Bryonia, Apis and Sul- phur. Nevertheless, Belladonna produces so many collateral symptoms of cerebral irritation, that we find its use indispensable in this condition. In the first place, it causes congestion of the head. In its milder form, this may be simply a feeling of heat about the head, the feet being cold. At other times and in more violent forms we find the face red and the whites of the eyes somewhat injected. The patient complains of a severe throbbing headache. He may be either drowsy or very wakeful. Frequently these latter symptoms alternate, that is, at times the patient is drowsy and falls into a heavy slumber, awaking later with a start, and crying out, or giving some other evidence of cerebral irritation, such as jerking of the limbs and twitching of indi- vidual muscles. As this form of irritation advances, we find the eyes very red, the whites of the eyes looking almost like raw beef. The carotid arteries throb so violent^ that their pulsations are plainly vis- ible. This congestion proceeds to an inflammatory irritation. We find intense throbbing in the head, with sharp shooting pains, making the patient scream or cringe, so violent are they. These pains come almost like a flash, and disappear as suddenly as they came. At first the patient cannot sleep. He is in the unfortunate predicament of being sleepy, yet unable to sleep. As the symptoms advance, espe- cially in children, there is boring of the head into the pillow; the head is thrown backward and there is rolling of the head from side to side. Some squint is noticed. The pupils are dilated. There is grinding of the teeth. The face is now bright red or else the congestion is so violent as to make it almost purple. If the patient is a child whose anterior fontanelle has not yet closed, you can feel it, tense and bulg- ing, above the convexity of the skull, throbbing and thumping with each pulsation of the heart. Convulsions often ensue, particularly in children, and these convulsions are very violent, distorting the body in every conceivable manner, opisthotonos predominating. The urine is either scanty or suppressed. Now the various symptoms, subjective and objective, which belong to this condition are, first, jerking in sleep, or even when awake; on closing his eyes the patient is very apt to see abnormal visions. These usually disappear on opening the eyes. At other times he has a sensation as though he were falling; the patient, if a child, suddenly arouses from sleep, clutches at the air, and SOIvANACE^e. 409 trembles as if from fear. Sometimes this symptom is due to dreams; at other times it comes from severe pain in the head, which, by its in- tensity, wakens the child in great alarm. At still other times it re- sults from the sensation as if the child were falling. Sometimes we find the patients with this cerebral. irritation lying in a stupor. They can scarcely be aroused, and when aroused they are alwa} r s violent, tossing about, striking those near them and tearing their clothes. All these are evidences of excitement, which, if not due to actual inflammation, at least approach that condition. In inflammation of the brain or its membranes, Belladorina must give place to other drugs when exudation takes places, whether the meningitis be simple or tuberculous. There is very little relation be- tween Belladonna and tuberculous meningitis. Tuberculous menin- gitis is slow in its course. Thus we have suggested at once Sulphur, Calcarea ostrearum, Apis, and other remedies deeper and slower-acting than Belladomia. Then again, when exudation has taken place, as in- dicated by the persistence of the rolling of the head and sudden shriek- ing, we know that we must resort to other remedies, principally to Apis. Bryonia, too, often comes in after Belladonna, when the face is flushed red or is alternately red and pale. The slightest attempt to move the child makes it shriek with pain. The pupils do not react readily to light. The child moves the mouth as though it were chew- ing or sucking. The resemblances between the two remedies are so great as to make a selection often perplexing. Both remedies have haste in drinking water, both have crying out with pain, both have aggravation from motion, and both have constipation. At times you will find it very difficult to distinguish between the two. To separate Belladonna from Aconite is easier. The fevers caused by the two drugs are distinguished in the following manner: Bella- donna does not produce fever primarily from its action on the sym- pathetic nervous system; Aconite does do this. Belladonna acts sec- ondarily on the sympathetic and primarily on the cerebro-spinal nervous system, hence is of use only when that system is involved, which in children occurs very early in the case. In adults it is apt to commence as a fever, cerebral symptoms ensuing; thus Bellado?ina becomes the remedy. In the beginning of fever, Aconite is preferable when there is violent anguish of mind, with restlessness, tossing about, fear of death, dry, hot skin, full, bounding pulse, some hallucinations, some crying out in sleep, and some muttering or foolish talk which 4-IO A CUNICAI, MATERIA MEDICA. belongs to the fever. These cerebral symptoms result from the high temperature and not from direct inflammation of the brain. But sup- pose this case goes on until the brain becomes involved. The skin becomes so hot that it almost burns the examining hand, or, if you raise the bed-clothes, a hot steam seems to come forth from the patient. That is the kind of heat that belongs to Belladonna. At other times, hot sweat, particularly about the head and face, accompanies this heat. You see the sweat standing out in beads on the forehead, and if you feel it you will find that it is hot. This is not at all characteristic of Aconite. The two remedies may be, however, distinguished by the fact that Belladonna has jerking in sleep, hallucinations, visions, and courting of death rather than fear of it. This is often the case in rheumatic fever. The whole system seems to be involved, producing general fever with pain in the joints flying about from place to place. This fever is almost always associated with profuse sour sweat, which gives no relief whatever. The patient seems to soak everything about him with the sweat, and the more he sweats the less sign is there of improvement. Aconite does no good here, but Belladonna does. When the fever has subsided somewhat, and the sweat still con- tinues, Mercurius is the proper remedy to follow. In typhoid types of fever, Belladonna is indicated sometimes in the- beginning of the disease. It is indicated in the stage of excitement when the congestion of the brain predominates. We find furious de- lirium, with screaming out and violent efforts to escape from the bed or the house. The face is red, either a bright or deep red, bordering on purple; the pupils are dilated and the eyes injected. The patient is full of fear, imagining that all sorts of accidents are about to happen to him. The urine is scanty, and when passed it is usually a bright deep yellow, with or without sediment. The feet are apt to be cold. The patient now falls into a heavy snoring sleep; this is not a quiet sleep, for there is apt to be some evidence of cerebral irritation, such as jerking of muscles, twitching of limbs, and crying out. No matter how profound the sleep may be, it is never a perfectly quiet stupor; if it is, Belladonna is not the remedy. You will see from this that Bella- donna is indicated, not from any changes in the brain caused by the poi- soned blood, but from changes resulting from congestion or inflamma- tion. When the disease has gone so far as to cause alterations in the fluids of the body, Belladonna is decreasingly indicated as these changes advance. Then you should have recourse to such remedies as Hyoscyamus, Rhtis tox., Lachesis, and others. SOLANACE^. 411 Sometimes we have a condition differing from the one already de- scribed, in which Belladonna may be the remedy. The face is pale in- stead of red. Now this indication is just as characteristic of Bella- donna as is the red face. It is usually associated with irritation of the brain and starting in sleep. It occurs usually in summer complaint, during dentition, and in colic and in similar diseases. The pulse is either full and hard, as under Aconite, or it is slow. It is slow when the cerebral congestion is great enough to cause some pressure on the brain. Here, again, you find an illustration of the alternating effects of Belladonna. The pulse may be rapid for a while, and then it becomes slow, and so alternates. The headaches of Belladonna are nervous and congestive. The ver- tigo also is congestive; the patient feels as if he would pitch forward; or he suddenly falls backward unconscious. The nervous headaches are semi-lateral, right sided, worse from 4 p. m. to 3 A. m., worse from lying down; the brain feels as if it were swashing about. The head- ache is worse from light, noise or any jarring. Vomiting; can't keep quiet; fidgety. The congestive headaches are of a throbbing character, with aggravation from inclining the head toward the part of the brain most markedly congested. The pains are often of a stabbing, shoot- ing character, driving patient almost wild. When the whole head is affected, the patient sits up with the head supported so as to keep it from bending; accompanying the headache there is generally a red face, and violent throbbing of the carotid arteries. The mind is often affected; the patient becomes delirious, wild and excited, and has all sorts of hallucinations. We have already seen how Belladonna may be indicated in inflam- mation of the brain. It is also a valuable remedy in inflammation of other parts of the body. For instance, we find it to be the best, though by no means the only, remedy in otitis media, or inflammation of the middle ear. This disease will perplex you at times. The symp- toms are very severe. The child puts its hands to its head, and you may erroneously presume the trouble to be there. ' The pains are dig- ging, boring and tearing in character; they are necessarily so on account of the anatomical relations of the parts affected. They come suddenly, and are very violent. They seem to shoot into the other ear, or into the head, with buzzing and roaring in the ears. Now if you examine the ear you will find the membrana tympani bulging outward, its blood-vessels very much injected; in fact, it presents a highly 412 A CUNICAI, MATERIA MKDICA. inflamed appearance. There is rapid formation of pus, which seeks to escape either by bursting the membrane, by the Eustachian tube, or through some internal part. In case it takes the latter course, it produces alarming if not fatal symptoms. It is your duty to recog- nize this disease early, while there is still a chance of saving the ear. Belladonna is believed to be our best remedy for the disease in its early stages; later, we have other remedies indicated such as Hepar and Tellurium. Tellurium causes inflammation of the middle ear, with rupture of the membrana tympani and pouring out of pus, which may, at first, be bland, but soon becomes very offensive, having an odor like that of herring-brine. In inflammations of the eyes, as in conjunctivitis or sclerotitis, we find Belladonna indicated by the suddenness of the attack, by the severity of the pains, and by the violence of the symptoms. There is great intolerance of light. The eye feels as if enormousl} 7- swollen. The conjunctiva is bright red. These symptoms give you a perfect picture of Belladonna. It seems to attack the right eye more than the left. It is the intense congestion which guides us to the selection of Belladonna in eye-affections; the same remark applies equally to neu- ralgias in and about the eye. Spigelia has many eye-pains like those of Belladon?ia, but they are left-sided, and lack the intense congestion. Amy I nitrite is similar to Belladonna, being indicated when the eyes and face are red. Paris quadrifolia is excellent when there are pains as if the eyes were drawn back by strings; the eyeballs feel too large (like Spigelia). Prunus has a crushing pain, or sensation as if the eyes were pressed asunder, or sharp piercing pains through and around the eye. The parotid gland is inflamed by Belladomia, especially on the right side; there are stitches, extending into the ear; the gland is swollen, hot and red; the orifice of Steno's duct is painful, as if abraded; the saliva is thick, gluey, yellowish and tenacious; mucus coats the mouth and throat with a thick tenacious layer; the tongue is white and fissured. Belladonna produces inflammation of the throat. The Belladonna tongue is usually bright red, the papillae are enlarged or elevated, giving it a resemblance to the strawberry (and hence it has been called the strawberry tongue). At times you find the dorsum of the tongue SOLANACE^. 413 coated with a thin white layer, through which the enlarged red papil- lse show. But, as the case advances, this coating peels off, leaving a bright red, highly-inflamed tongue. The throat is a prominent point of attack in the Belladonna proving. The inflammation which it develops there is of a very common kind. Looking into the throat, you find the fauces inflamed and bright red, the tonsils, particularly the right one, enlarged, with a tendency of the disease to extend toward the left. All these S3 T mptoms have the same rapidity of progress that we noticed with the Belladonna symptoms elsewhere. There is great contraction of the fauces and glottis, so that any attempt to swallow is followed by sudden constric- tion of the throat and ejection of the food through the nose and mouth. The patient makes an attempt to drink, and the moment the water touches the fauces it is ejected, and escapes in any way it can. The patient seems to be worse from swallowing fluids, more so, in fact, than from either saliva or solids. The tonsils rapidly suppurate; the glands in the neck, externally, are commonly involved, and are to be felt as hard but very sensitive kernels in the neck. Sometimes you find a pearly-white exudate on the fauces, which is seen to be mucus and not fibrin. There is, therefore, strictly speak- ing, no resemblance between the Belladoiuia inflammation and that characteristic of diphtheria or membranous croup, so that when Bella- donna is administered in diphtheria it must be indicated on other symptoms than those belonging to the membrane. The general char- acter of diphtheria is that of blood-poisoning, while Belladomia does not poison the blood. When you give Belladonna in diphtheria, there- fore, be certain that it is the remedy or you will lose valuable time. It may, occasionally, be the remedy in the early stages when the vio- lence of the attack calls for it. Let me here remind you that Lycopodium affects the right tonsil, that it produces high temperature, crying out during sleep, and awak- ing from sleep cross and irritable. These symptoms we found under Belladonna also; so be sure when you give the latter remedy that Lycopodium is not the one that is indicated. Then, again, you should think of Apis. Apis is a magnificent rem- edy in diphtheria. The exudate is more on the right tonsil; the throat is bright red and rosy; the tongue is red and the fever very high; the skin is dry and hot, the pulse accelerated, and the patient very rest- less. 414 A CIJNICAI, MATERIA MEDICA. But, in tonsillitis or quinsy, Belladonna stands at the head of the list of remedies. Here it far exceeds Apis in therapeutic value, because it attacks the parenchyma of the organ. The inflammation caused by Apis is superficial, only involving the mucous surface. In throat diseases Belladonna forms an interesting little group with Hepar, Mercurius, Silicea and Sulphur. When, in spite of the exhi- bition of Belladonna, pus forms in the tonsil, as indicated by rigors and chills and by sharp, lancinating pains with throbbing, you should change from that remedy to Hepar. Bven then you may be able to prevent abscess- formation. You should change to Mercurius if pus has already formed; the tonsil is enlarged and encroaches on neighboring parts and the breath- ing is labored. When pus has thus shown itself, Mercurius, given low and repeatedly, will cause a quick breaking of the abscess, relieving all the symptoms. If you give Mercurius at first you will greatly lengthen the course of your case. Sometimes you must have recourse to Silicea when the abscess has discharged and refuses to heal. Pus keeps on forming and grows dark and foetid and disagreeable to the taste. In some of these cases Silicea fails; then you should interpolate a few doses of Sulphur, which generally has the desired effect. It may be necessary to have recourse to Fluoric acid. There is another remedy that has been used to some extent, namely, Amygdala amara. The drug causes a dark red injection of the fauces, uvula and tonsils, with sharp pains, causing considerable difficulty in swallowing; sometimes they are so severe as to make the patient cry out. If these symptoms are present the drug may be used in diph- theria. I have myself cured cases of this disease with Amygdala amara alone when there were present this dark red color of the throat, the sudden sharp pains, and marked general prostration. Amygdala develops the prostrated, tired feeling which is incident to the first days of diphtheria. Belladonna is of use in oesophagitis with sense of constriction; there are painful swallowing and breathing. Veratrum viride, Rhus tox. and Arsenicum are also remedies sometimes indicated in oesophagitis. In gastric symptoms, Belladonna is called for when there are cramp- like pains in the stomach, worse during a meal; stitching pains; must bend backward and hold the breath; burning. These gastralgic pains always go through to the spine. Pressure is a prominent gastric SOLANACE^. 415 symptom; it is worse after eating and comes also at times when walk- ing. Calcarea ostrearum has pressure as of a stone, relieved from motion. Chininum arsenicosum has caused pressure in the " solar plexus " with tender spine just behind it. Bismuth has gastralgia going from throat to the spine, relieved by bending backward. It thus closely simulates the Belladonna case, but lacks the extreme nervous and febrile excitement; Bismuth is inclined to be cold, with pale face, although the pain may be accompanied by anxiety and restlessness. In inflammation about the abdomen w 7 e sometimes find Belladonna the remedy ; for instance, in peritonitis, whether accompanied by metritis or not, and whether or not it is of puerperal origin. The symptoms which call for it are: commencing t3anpanites; the abdomen is swollen like a drum, and very sensitive to touch, so much so, in fact, that the patient wants all the bed-clothing removed. The least jarring in the room makes her worse. For instance, if you should un- expectedly kick your foot against the bed in walking near her, you cause her to wince and complain bitterly of pain. You will also notice the pungent heat of which I have already spoken. The abdomen feels extremely hot to your hand. On raising the bed-clothes there appears to issue forth the hot steam to which reference has already been made. There is marked cerebral irritation. The lochial discharge is apt to be scanty or suppressed. Tilia Europea is a drug that I feel certain has not received due credit from the profession. It is useful in puerperal metritis when there is intense sore feeling about the uterus; there is also marked bearing- down with hot sweat which gives no relief. A remedy very commonly used by allopaths is Terebinthina . Now, the symptoms which this drug has actually produced are: bearing down in the uterine region; burning like fire about the hypogastrium; burning on urinating; dark, cloudy, muddy urine. In these cases the tongue is apt to be dry and red. For this feeling of soreness in the uterus Dr. Jeanes used a prepara- tion of honey with salt, Mel cum sale. He used it in the third or sixth attenuation. His key-note for the selection of the drug was a feeling of soreness in the t^pogastric region extending from ilium to ilium - This is an important indication in uterine displacements and in the commencement of metritis. 41 6 A CLINICAL MATERIA MKDICA. Under Belladonna, the urine is yellow and clear; turbid with red sediment, or profuse. There may be involuntary urination in sleep. This latter suggests the use of the drug in children. It will not often disappoint you when the other symptoms concur. There is not a true atony present, but a relaxation of sphincters and an over action from the loss of balance of the longitudinal muscular fibres. There is a feeling in the bladder as of a ball rolling there (also Lachesis and per- haps Lycopodiurri) , tenesmus of the bladder; strangury; dark, turbid and fiery red urine; frequent desire to urinate with scanty discharge of urine. In enuresis with actual relaxation look to Plantago major, Causticum, etc. Belladonna may have to be followed in these cases by Calcarea ostrearum, Sulphur or Silicea. Kreosote is indicated in en- uresis especially when the patient urinates when dreaming of the act. Hyoscyamus should also be considered. We have next to speak of the action of Belladonna on the skin. It causes at first an erythema, a bright scarlet redness of the skin; the skin becomes exceedingly sensitive to the touch. Sometimes, this erythema consists in a uniform blush over the entire surface of the body such as we have in the Sydenham variety of scarlatina. At other times it has an erysipelatous appearance, coming, as it does, in streaks which start from some central point and radiate in all directions, the, color usually being very bright, the swelling rapid with early involve- ment of the cellular tissue beneath the skin, and in some cases rapid formation of pus, which burrows deeply into the cellular tissue. Thus you have a true picture of phlegmonous erysipelas. With these symp- toms you do not often find development of vesicles or pustules. In- stead of this you find the surface smooth, shining and tense. Pains are violent and sharp. They are of a lancinating and stinging char- acter and are usually associated with a great deal of throbbing, par- ticularly if the deeper parts are involved in the inflammation. If the erysipelas should attack the face, it almost always begins on the right side, with a tendency to extend toward the left. There is almost always a tendency manifested. Do not confound this cerebral irritation with metastasis of erysipelas to the brain. It is a simple irri- tation caused either by the amount of fever, by the severity of the pain, or by the poisoning of the blood, or possibly all three; but it is not a true metastasis. If metastasis should take place, Belladonna may still be called for. If, however, Belladonna fail in these cases, we have other remedies; for instance, Lachesis, when cerebral metastasis SOLANACE^. 4 : 7 fails to yield to Belladonna, the face is of a purplish or bluish hue rather than of the bright or deep red of Belladonna. The patient is weaker, the pulse more rapid and lacking in force, and there is more drowsiness than we find under Belladon?ia. Still another concordant remedy is Crotalus, which is very similar to Lackesis — -so similar, indeed, that I cannot give you any points of distinction between the two. Cuprum is to be thought of for this metastasis, if the patient is threatened with convulsions. There are vigorous contractions of the flexor muscles. Ailanlhus suits when there is profound stupor and the face is livid and mottled. Apis and Sulphur also come within this sphere. Returning now to the erythema of Belladonna, we learn that when the condition becomes general, it suggests the employment of the remedy in scarlet fever. In this disease, it is indicated, first of all, by this bright rosy hue of the whole body; secondly, by the irritation of the brain and this of an active kind, the symptoms ranging from a simple starting from sleep or twitchings of individual groups of mus- cles to the most violent delirium with shrieking and jumping out of bed. The rash itself must be of the smooth kind. Belladonna does not cause a miliary rash. Vomiting is violent. Belladomia produces vomiting just as severe as that of Ipecacuanha; particularly is it indi- cated in cerebral vomiting. Throat symptoms are prominent. There is bright red swelling of the throat, the tonsils are glistening, the tongue has the strawberry appearance, or if it is coated, the coating is thin and the elevated papillae show through. The pulse is full, strong and accelerated, and there is great restlessness, as you might expect. You ma}' have swelling of the glands, particularly of those about the neck. You may have suppression of urine or copious urination. Either of these conditions is incident to the Belladonna case. The drowsiness or sleep is not that of clearly marked coma. There is not the sleepi- ness or stupor that is developed by poisoned blood, in which condition the brain is so imperfectly supplied with oxygen that it loses its activ- ity. That is not the Belladonna condition. The Belladon?ia sleep may be profound; the patient may snore; he may sleep " as heavy as a log," but the sleep is not quiet and passive. He cries out in his sleep, the muscles twitch, the mouth is in constant motion as if chewing; there is grinding of the teeth. In fact there are almost always pres- ent symptoms showing that there is irritation of the brain of an active 27 41 8 A CLINICAL MATERIA MKDICA. character. When the patient is aroused -from sleep he is violent, look- ing around the room wildly, and striking at those about him. When, however, the disease from its very onset is of a malignant type, or when it becomes so despite Bellado?ina, you cannot change too soon to some other remedy. You must at once select another, such for ex- ample as Lachesis, Rhus tox., or Hyoscyamus. Lachesis has, in these cases, many symptoms similar to those calling for Belladonna. We find in both remedies, crying out during sleep, restlessness, irritability •on awaking, strawberry tongue, redness of the whole surface of the body, suppressed urine, sore throat and vomiting. But wherein do they differ ? They differ in the very essence of the disease. In the case of Lachesis, the disease is adynamic and the blood poisoning is profound. The cerebral symptoms do not develop to a Belladonna furore, but there is more stupor. The skin-eruption has not the bright erythematous hue of Belladonna, but it is either pale, purplish or bluish. It is apt to be irregular, coming out imperfectly. The throat shows you not only enlarged glands externally, but swelling of the connective tissue all around, in the tissue about the fauces as well as in them. The affected parts are rather of a purplish color. If there is a tendency to the formation of pus which is offensive Lachesis is even better indicated. Rhus tox. often precedes Lachesis, particularly when cellulitis is a complication and before it has assumed that purplish hue. The in- flammation is of a low type. The rash is of the miliary variety (also Hyoscyamus, Stramonium, Bryonia and Lachesis). Returning again to Belladonna, we find that it sometimes fails in cases of the Sydenham variety of scarlatina, although the symptoms seem to call for it. The remedies to be thought of in this case are these: Sulphur, which, just as strongly as Belladonna, produces a smooth erythema of the entire surface of the body, and may, in fact, sometimes be indicated in the beginning of the case. Calcarea ostrearum, which is complementary to Belladomia, often completes what that remedy only partially cures. So in scarlatina, we find it indicated when the rash comes out under Belladoyina but begins to pale off. The face becomes pale and bloated. The cervical glands are swollen. The urine is scant}' or even suppressed, and the brain symptoms suggestive of Belladonna may yet be present. And Lycopodium which comes in when the child grows stupid and yet still awakes screaming in affright, is cross and strikes its at- tendants. SOIvANACEiE. 419 Another action of Belladonna on the skin is the production of boils or abscesses. You may give it in mastitis or inflammation of the mammae. It is here indicated by the violence of the symptoms, by the radiating redness, by the throbbing and tendency towards suppur- ation. The same symptoms call for it in abscess of any kind and in any situation. Even a bubo which is specific in its character may call for Belladonna if the symptoms are of the violent character already mentioned, and it will here do good service for the time being. We also find it the remedy for boils that recur in the spring. Belladonna may be used successfully in the summer complaint of very young infants. We find it to be the remedy when there is cry- ing or screaming hour after hour without any assignable cause. We find it also indicated in indigestion of infants, associated with sharp pains, suddenly screaming out and bending backward, not forward as under Colocynth. Sometimes the transverse colon is so distended that it protrudes like a pad in the umbilical region. This symptom some- times occurs in lead colic. Then, too, we find Belladoima indicated in diarrhoea. It is particularly suited to a dysenteric diarrhoea, that is, a diarrhoea from cold with enteritis, the discharges being associated with considerable tenesmus (for you must remember that Bellado?ina has great affinity for sphincter muscles) , the discharges being slimy and bloody. In summer complaint the stools are yellowish or green, and contain lumps looking like chalk, consisting no doubt of fat and casein. You must remember Belladonna as complementary to Chamomilla in this colic and diarrhoea of infants. In neuralgia, Belladonna is indicated when the pains come on sud- denly, last a longer or shorter time, and then as suddenly disappear; the pains are lancinating, burning, tearing and shifting. They are worse from motion, light, noise, or the slightest jar, and from lying down; and are better when sitting up. In prosopalgia the right side is mostly attacked, especially the infraorbital nerves, and the face is hot and red. In sciatica the pain is worse in the hip-joint at night, compelling change of position. All these pains, as well as the fevers, are apt to show exacerbation at 2 or 3 p. m., and again at 11 p. m. The power of this drug to excite neuralgic pains in any of the spinal nerves has led to its recommendation in the atrocious pains which mark the beginning of locomotor ataxia. In neuralgia compare Aconite, Amyl nitrite, Cactus grand., Verbascum, 420 A CUNICAI, MATERIA M^DICA. Platina and Ferrum carbonicum. The last named has vascular excitement, red face, etc., which are very similar to Belladonna. Belladonna is very often called for in the treatment of convulsions. Epilepsy is readily modified by it, and at times cured. So is that dread disease, puerperal eclampsia. And spasms of children during dentition, from repelled eruptions, etc., keep the remedy in almost daily demand. In all these cases the cerebral symptoms are promi- nent. Hot head, flushed face, throbbing carotids, starting from sleep in terror, etc., foam at the mouth having an odor of rotten eggs. The convulsive movements may be a combination of emprosthotonos and opisthotonos; or the patient, usually a child, becomes suddenly rigid, stiffens out, with fixed, staring eyes. In puerperal cases the woman is unconscious, and each pain re-excites the spasm. Between them she tosses about, moaning and crying, or lies in a deep sleep. In teething children the gums are swollen and the mouth is hot and dry. In epilepsy we should remember Absinthium, which causes conges- tion of the cerebral meninges and the medulla and even produces a fibrinous exudate under dura mater. Hallucinations are terrible; brilliant eyes; epilepsy, followed by obtuse state of the mind, a dazed condition. Epileptic vertigo or momentary unconsciousness. Arte- misia vulgaris is botanically similar to Absinthium, and helps in epk lepsy occurring after fright, and when numerous attacks follow one another rapidly. Great restlessness is characteristic of Absinthium, Artemesia, Cina, Chamomilla and other members of the order com- posite. In ailments during dentition compare: Kreosote, child worries all night; must be patted and tossed all night; teeth decay rapidly. Colchicum, stools changeable; convulsions during teething, reflex from abdominal irritation. Cina, convulsions, face pale, child stiffens out; restless. Dolichos, gums intensely sensitive; seem to itch. Althusa, swollen red gums; vomiting of curdled milk, followed by stupor, etc. Glonoiti to Belladonna is similar in child-bed; Chamomilla in chil- dren, cross, face red, hot sweat. Opium, dark red face, sopor, espe- cially after fright. We come now to speak of the action of Belladonna on the female genital organs, upon which the drug has a decided action. It causes constant and violent bearing down, worse on lying down, and relieved by standing. Sei>ia is opposite to this, and Acoriite has bearing down, worse from rest and relieved by motion. SOLANACE^E. 421 Under Belladonna the menses are early and copious, bright red, and attended with cramp-like tearing pain in the back, arms, etc. ; throb- bing headache; most intensely painful congestive dysmenorrhoea; bearing down; cutting pain from behind forward or vice versa; men- strual flow, which, without any apparent cause, is offensive; lochia offensive without apparent cause. Uterine haemorrhages; blood pours out and feels hot; uterine haemorrhage with bearing down in the back; leucorrhcea with this bearing down; spasmodic contraction of the os uteri, which feels hot and very tender; pain in the back as if it would break. Labor-pains come and go suddenly; pains violent but inef- fective. Belladonna may be used during labor when the os does not dilate on account of a spasmodic condition of the cervix. The labor-pains are violent and cause great distress, and yet the child does not advance. The examining finger finds that the os remains rigid and spasmodic. A few doses of Belladonna will usually be sufficient to correct the trouble. Gelsemium should also be remembered in rigidity of the os uteri. On the respirator} 7 tract Belladonna has some action. It causes cough from tickling in the larynx, as from dust; face red, eyes spark- ling; cough dry, hacking, coming in very violent attacks; cough with dryness and tightness in the upper part of the chest, worse just after lying down in the evenings and at night. The mechanical concussion of this cough is more severe than the existing cause warrants, which is in keeping with the violence of the drug's action. The sputum is composed of blood-tinged mucus. Larynx sore and hot internally, worse from pressure. Burning in the chest; sticking pains from coughing and motion, but not affected by breathing. The pains are worse under the right clavicle. Pressing in the chest and between the scapulae, with dyspnoea, walking and sitting. Calcarea ostrearum also has cough just after lying down. Phosphorus differs from Belladoima in having the irritation lower down in the respiratory tract. It has more rawness, and the larynx is sore, worse from talking or pressure thereon. In Belladonna it is only sore from pressure. Under Causticum the cough is tickling; the voice is almost gone; there are soreness and rawness of the trachea, but not of the chest. Rumex has dry cough from tickling in the supra-sternal fossa, ag- gravated by the least cool air or by deep inspiration. 422 A CLINICAL MATERIA MEDICA. With Cepa the cough causes a feeling as if the larynx would split; it makes the patient cringe; coryza. Lachesis has cough from tickling lower down than in the Belladonna case, and is aggravated by the slightest pressure of the clothing. Belladonna acts in muscular tissue and also in the joints. It is one of our best remedies both in acute and chronic rheumatism. The affected joints are swollen, red, shining and often have red streaks radiating from them along the limbs.. It is one of our best remedies for stiff neck caused by cutting the hair, getting the head wet or sit- ting with the head and neck exposed to a draft. Bryonia, Nux vom- ica and Guaiacum are nearly related in this affection. Belladonna is complementary to Calcarea ostrearum. It is antidoted by Cojfea, Nux vomica and Opium. Hyoscyamus antidotes its abuse in skin affections and cough. LECTURE XL. STRAMONIUM AND HYOSCYAMUS. Datura Stramonium. Stramonium stands between Hyoscyamus and Belladomia. It ex- cites the sensorium and perverts its functions. The special senses are affected. Thus there is double vision. Objects appear double or oblique. The mental symptoms are as follows: the mania or delirium is of a wild character, the face being of a bright red; the eyes have a wild and suffused look, although they are not so thoroughly congested as under Belladomia. The hallucinations terrify the patient; he sees objects springing up from every corner; animals of every kind and grotesque creatures arise, and terrify him. The patient, if a child, cries for its mother even when she is near. The eyes are open and the pupils widely dilated. If an adult, he is decidedly loquacious in his delirium. At times he manifests a merry mood in his loquacity, and at others he has the "horrors." At one moment he will be laughing, singing and making faces, and at another praying, crying for help, etc. He often has photomania or desire for light. He seems to have great fear of the dark. Sometimes he insists upon it that he is conversing with spirits. Again the mania assumes a silly character. He talks in a foolish and nonsensical manner and laughs at his own attempts at wit. The loquacity differs from that of Lachesis. In Stramonium the loquacity consists of a simple garrulity, whereas in Lachesis it is a jumping from subject to subject. During the delirium of Stramonium, as under many narcotics, the patient frequently at- tempts to escape. Agaricus seems to stand between Stramonium and Lachesis, having some resemblance to both. A condition simulating that of hydrophobia sometimes calls for Stramonium. In this state any bright object causes furious delirium, spasm of the throat and horrible convulsions. The dilirium, especi- ally in typhoid conditions, is excessive and seems to exhaust the pa- tient completely. The spasmodic motions of Stramonium are characterized by grace- 424 A CLINICAL MATERIA MEDICA. fulness rather than angularity; they are more gyratory than jerking. Especially is this condition noted in young children when there is a non-appearance of the eruption during one of the exanthemata. Stra- monium acts better on children and young infants than does Belladonna. Take, for instance, a case of measles. The rash does not come out properly; the child is hot; its face is bright red; it tosses about, cry- ing out in a frightened manner as soon as it falls asleep; it knows no one; its movements, though convulsive, are not jerking and angular. This is a case for Stramonium. Similar to Stramonium in these cases is Cuprum metallicum, which has, like the former remedy, aggravation on arousing from sleep, and also this same terror. It is characterized by the violence of its symp- toms. The abnormal movements are decidedly angular. The face is apt to be of a bluish color. It is especially indicated when the rash has been repercussed and these violent cerebral symptoms appear. Another similar remedy to Stramonium is Zincum metallicum. This, too, has crying out in sleep and awaking from sleep terrified. There is considerable evidence of debility, the child being so weak that it has not sufficient strength to develop an eruption. Another nervous affection which yields to Stramonium, or is at least modified by it, is nervous asthma; the patient can scarcely draw in the breath on account of the spasm; there is aggravation from talking. Stramonium is also indicated in locomotor ataxia. The patient can- not walk in the dark or with his eyes closed. If he attempts to do so he reels and staggers. Mental abnormalities as to shape seem to be characteristic of the Stramonium patient. For instance, he imagines that he is very large, or that one arm is very large. Sometimes he feels as if he w T ere double, or that he had three legs instead of two. These errors as to shape and size in the Stramonium patient bring to mind several other remedies, particularly Baptisia, which, however, does not in the least resemble Stramonium in other symptoms. It is to be remembered that both of these remedies have these illusions as to shape. The Baptisia patient feels that he is double, or, what is more characteristic, that his body is scattered about, and he must try to get the pieces together. Other remedies have this symptom; we find it under Petroleum and Thuja. Under the latter remedy the patient imagines that he is made of glass, and he walks very carefully for fear that he will be broken. These symptoms may indicate the drug in typhoid fever. STRAMONIUM. 425 In erysipelas, with involvement of the brain, you may find Stra- monium indicated when the disease assumes an adynamic type. The symptoms are very much like those of Rhus tox., but you distinguish it from the latter by the violent cerebral symptoms, the delirium, the restlessness, and the screaming out as if terrified. And yet with all these symptoms there is little or no fever. Stramonium may also be called for in the incipiency of scarlatina when the rash fails to appear and the brain suffers, but it has less fever and throat symptoms than has Belladonna. There may be sup- pression of urine, which is especially characteristic of this drug if it is free from pain or other discomfort. As in all remedies that irritate the brain, we find grinding of the teeth. We may also find stuttering, which, by the way, has been compared to the spasmodic urination of children, when the least ex- citement will cause them to pass urine in little jets; in a similar way are the words jerked out. Particularly does the patient find it diffi- cult to combine vowels with consonants. Another remedy for stuttering or stammering is Bovista. The tongue of the Stramonium patient is red or whitish, and covered with fine red dots, and is dry and parched. In some cases it is swollen and hangs out of the mouth. Stramonium may excite a decided nymphomania, during which the woman, though very chaste when in her normal condition, becomes exceedingly lewd in her songs and speech. She may become verjr violent in her manner. Often these symptoms occur in women before menstruation, in which case Stramonium acts most admirably. The menstrual flow is apt to be very profuse, showing that it is the high degree of congestion that produces the nymphomania. There is a strong odor about these women, reminding one of the odor of animals in the rutting season. I would also like to call your attention to the diarrhoea which Stra- monium cures. The stools are very offensive, smelling almost like carrion. They are apt to be 3 r ellow T ish. They may or may not be dark, but the offensiveness is the most important symptom. Absence of pain is characteristic of Stramonium excepting in ab- scess, particularly when it affects the left hip-joint, in which case it may be so intense as to throw the patient into convulsions. The antidote for Stramonium poisoning is lemon juice. 426 A CLINICAL MATERIA MKDICA. Hyoscyamus Nigkr. Botanically and, in a measure, therapeutically, Hyoscyamus is simi- lar to Belladonna. This interesting drug, though innocuous to some animals, is poisonous to fowls, and has received the name of henbane. Hyoscyamus seems to be especially adapted to acute mania, to mania without any evidence of absolute inflammation, to mania which has for its key-note extreme excitation of the sensorium. The patient, under such circumstances, has many strange notions, all arising from these abnormal impulses. He imagines, for instance, that he is about to be poisoned. Possibly he will refuse your medicine, declaring in angry tones that it will poison him. Or he imagines that he is pur- sued by some demon, or that somebody is trying to take his life. This makes him exceedingly restless. He springs out of bed to get away from his imaginary foe. The senses, too, are disturbed. Objects look too large or else are of a blood-red color. Sometimes objects ap- pear as if they were too distinct; that is, they have an unnatural sharpness of outline. The patient talks of subjects connected with everyday life, jumping from one subject to another pretty much as in Lachesis; all this time the face is not remarkably red, possibly it is. only slightly flushed. The pupils are usually dilated, sleep is greatly disturbed, the patient lies awake for hours. As the mania advances he seems to lie in a sort of stupor, and yet it is not a real stupor, be- cause the slightest noise rouses him into all these forms of violent mania. Every little impression causes excitement of the sensorium. Accompanying these symptoms we find characteristic debility, this debility showing itself in the great prostration on every attempt to move or walk about, and in paralysis of one or more muscles following the maniacal attacks. As the sensorium becomes more and more de- pressed he answers questions slowly or else gives irrelevant answers. Sometimes he will be in a stupor from which he can be readily aroused and will answer your questions quite correctly, but he will relapse into the stupid state immediately. With this there is a sort of adynamic condition of the brain resulting from this prolonged over-excitement, and in this condition we still find delirium, but the patient is greatly prostrated, stool and urine pass involuntarily, the pulse is no longer full and accelerated, but it is quick, rapid and without volume, and irregular. Stupor is now complete, sordes appear on the tongue and HYOSCYAMUS NIGER. 427 around the teeth, the lungs are engorged, not from a pneumonic pro- cess, but because of hypostatic congestion. Associated with this we have snoring-rattling during breathing. The mouth is opened, the lower jaw dropped, and the patient lies quietly with occasional twitch- ing of groups of muscles. This condition will soon be followed by death unless relief can be obtained. At other times we find the de- lirium returning anew and the symptoms take another form. The patients are silly and laugh in a flippant manner. Sometimes, for hours at a time, they will have a silly, idiotic expression of the face. Again they become exceedingly lascivious, throw the covers off and attempt to uncover the genital region. The abnormal movements ac- companying these symptoms are rather angular; they are not all of the gyratory character significant of Stramonium. Still another form in which the cerebral symptoms of Hyoscyamus may appear, particularly in women, is jealousy, and also the effects of powerful emotions, as disappointed love, fright and other emotions that are more or less exciting and at the same time depressing. Coming now to inflammation of the brain or meninges, we find Hyoscyamus sometimes indicated when we have present some of the symptoms already enumerated and in addition to these symptoms relief from shaking the head or sitting with the head bent forward. Here it is exactly opposite to Belladonna. The patient complains of pulsat- ing waves through the head. We have a cough quite characteristic of Hyoscyamus. This cough comes from elongation of the uvula, the result of relaxation or inflam- mation. The uvula hangs down and rests on the root of the tongue, causing irritation and the consequent cough. This cough is worse when lying down, the patient having almost complete relief wmen sit- ting up. It is usually worse at night and also after eating and drink- ing and from talking, There are two or three remedies to be compared with Hyoscyamus here. One of them is Rumex crispus. This is a splendid remedy for tickling cough from an annoying tickling in the supra-sternal fossa. The patient wants to breathe warm air. Anything which disturbs the temperature of the respired air excites the tickling, and hence the cough. The tickling may extend down into the chest and still Rumex be indicated. Natrum muriaticum also has a dry cough from elongated uvula. There is another remedy which has the same symptom, and one 428 A CLINICAL MATERIA MEDICA. which has been confirmed, too. It is Ment 'ha piperita. It is inferior to Rumex, however. I have heard it said that eating apples will re- lieve this kind of cough. Hyoscyamus is also to be considered as a remedy for sleeplessness. It is useful in the sleeplessness of children when they twitch in sleep, cry out and tremble, and awaken frightened. It is also a valuable drug in convulsions. It is one of the most re- liable remedies we have for epileptic convulsions, that is, if there is no other remedy indicated. In the Hyoscyamus convulsion we find the patient twitching and jerking. These angular motions that I have described seem to be provoked by eating. Especially is this to be noted in children; the child will wake up from sleep hungry; the face is apt to be of a deep red color, almost on the purple during the par- oxysm. There are also frothing at the mouth and biting of the tongue. These symptoms are almost always followed by profound sleep. Convulsions that are puerperal in origin also call for Hyoscya- mus, which may readily be separated from Belladonna and Stramonium by the prominence of nervous agitation, reflex excitability, etc. In epilepsy compare Cicuta mrosa, which has shocks from the head down, staring eyes, screaming, red face, limbs greatly distorted, respi- ration greatly impeded. Trembling before and after the spasm and great weakness afterwards. See also CEnanthe crocata. We have Hyoscyamus indicated also in chorea. The patients are very weak with tottering gait. They seem to have abnormal impres- sions of distances. They reach for something that seems to be just within their grasp, when, in reality, it is on the other side of the room. Stramoniu?n is also a remedy to be thought of in chorea, particularly if the brain is affected. The child awakens from sleep with a scream. It sings and laughs without reason. Still another remedy is Veratrum viride, which is particularly indi- cated when there is great congestion in the nervous centres, and the pulse is much over-excited. Now let me speak of the fevers of Hyoscyamus. I have already given you the symptoms which would indicate the drug in typhoid fever. We have to see how we may apply it in the treatment of fevers with skin symptoms, as scarlatina. Hyoscyamus is indicated in scarla- tina, although not very frequently; yet it may be called for in cases that have been spoiled by Belladonna. The rash is of a miliary type HYOSCYAMUS NIGER. 429 and is dark or dark red in color. It is rather scanty, too, from par- tial repercussion. There are also picking at the bed-clothes, crying out in sleep and stupor, all denoting the alarming progress made by the disease. Stramonium is indicated in scarlatina when the symptoms are vio- lent, something like those we have seen in Belladonna. The face is very red, the rash seems to be scattered over the surface, the prostra- tion is excessive, the skin is apt to be very dry and hot without as much of the hot sweat as we have found under Belladonna. If sweat does come it does not relieve. Now let us compare the three remedies, Belladonna, Stramo?iium and Hyoscyamus, one with the other. In general, we find that Bella- donna causes more congestion or inflammation of the brain, Stramo- nium congestion with more sensorial excitement, and Hyoscyamus more nervous irritation and less of congestion and inflammation than either of the others. The type of the delirium in Belladonna is wild; there is a desire to escape; the patient bites and strikes; the face is red and the eyes suf- fused with violent throbbing of the carotids. He either complains of these hallucinations on closing the eyes or he stares at one point with eyes wide open. Then, too, there is sleepiness with inability to sleep. If there is stupor, it is rather the result of the congestion and inflam- mation of the brain, and is attended with some symptoms of irritation so that the patient, when aroused, is violent or he alternates between delirium and stupor, there being no evidence of serious blood changes. Hyoscyamus has a similar desire to escape; the patient attempts to bite and strike those about him; he has the same desire to uncover, but he lacks the violent throbbing of the carotids and intensity of the redness of the face and suffusion of the eyes. The Hyoscyamus patient has a particular aversion to light and has especially marked the fear of being poisoned or of being betrayed. Lying quietly in the bed, he suddenly sits up and stares around as if looking for some one whom he expected to see in the room. At a word from the nurse he lies down again and goes off into a sleep. He may expose his sexual organs. His wakefulness is very different from that calling for Bella- donna. He is nervous, whining, crying and twitching. Phosphorus stands nearest to Hyoscyamus in this desire to uncover the person. But Veratrum album is also closely allied in nympho- mania. 430 A CLINICAL MATERIA MKDICA. Hyoscyamus is used very extensively in insane asylums for acute non-inflammatory mania. You will always find these patients weak; the pulse often lacks volume; they either have no appetite whatever or else an enormous appetite. Eating is at once followed by an aggra- vation of the symptoms. Allopathic physicians use very largely the alkaloid Hyoscyamia. This is very similar to Kali bromatum, having the power of exciting the sensorium without inflaming the brain. Thus we find Kali bromatum indicated in the acute mania of children when they arouse from sleep with screams and imagine that some one is going to hurt them. The patient may also have the insane impres- sion that he is to be murdered or that his honor is at stake, or that those in his house dislike him and intend to do him harm. Hyoscyamus is indicated in these cases particularly if they are puer- peral in their origin. We also find these symptoms of Hyoscyamus in typhoid fevers. The tendency, you will see, is to run into a low t}^pe of disease; it is more of an adynamic remedy than Belladonna. In typhoid fever you should compare Phosphoric acid, Rhus, Lycopodium and Lachesis. But all of these, excepting perhaps Phosphoric acid, act more powerfully than Hyoscyamus and hence follow Hyoscyamus well, the latter being insufficient. Belladonna may be indicated in the beginning of the disease when there is the wild and furious delirium. Hyoscyamus comes in later when the stupor becomes more marked; when the patient picks at the bed-clothes or at his fingers in a somnolent sort of way and occasion- ally reaches out as if grasping for something in the air. You will find the tongue, in such cases, dry and red; speech, of course, is diffi- cult; and, as the case progresses, we have the sordes on the teeth with involuntary stool and urine and dropping of the lower jaw. I would like to say here, by way of caution, that in some instances, although a case for Hyoscyamus is clearly made out by these symptoms, yet it does not always act. I cannot tell you why. I can see no cause ex- cept that the drug does not act deeply enough. In such cases, I usu- ally look up Lachesis, Lycopodium, Muriatic acid and Arsenicum. In fevers of this type Stramonium differs from Bdlado?ina and Hyoscyamus. The patient sees objects which seem to rise in every corner of the room and move towards him. He has a mania for light and company, which is just the opposite of Belladonna, is excessively loquacious and laughs, sings, swears and prays almost in the same breath. The desire to escape is present; there is sudden spasmodic HYOSCYAMUS NIGER. 43 1 lifting of the head from the pillow and then dropping it back again; he awakens from sleep in fright and terror, not knowing those around him; the motions that he makes are quite graceful and easy, although they may be violent. At times, the body is bathed in a hot sweat which does not give any relief to the patient. The desire to uncover is similar to that of Hyoscyamus, but it is more an uncovering of the whole body rather than of the sexual organs. The tongue is often soft, taking the imprint of the teeth; screaming in sleep, often with hiccough; the face is usually bright red, but not as deeply congested as in Belladonna. LECTURE XLI. TABACUM, DULCAMARA, CAPSICUM AND GLONOIN. Tabacum. Tabacum contains several active ingredients, the most important of which is Nicotine. Ever since smoking was an " art," attempts have been made to get rid of this Nicotine. Every one acknowledges that it has a serious effect on the body. There are three groups of symp- toms which may follow the use of tobacco. The primary symptoms are the well-known gastric symptoms, deathly nausea and vomiting. The patient is deathly pale, does not care whether he lives or dies. Sometimes cold sweat breaks out on the body. The secondary effects are more remote, coming months or even years after using the weed, and these are dyspepsia, amblyopia and also some symptoms of the heart. These symptoms of the heart I would have you remember. If they are not caused by tobacco, Tabacum will be a very valuable remedy in their cure. I refer especially to dilated heart when these symptoms are present: there are frequent pallor, with lividity of the face; diar- rhoea, alternating with constipation; palpitation when lying on the left side; muscse volitantes, tinnitus aurium and dry cough, which is cardiac in its origin; paroxysms of suffocation, with tightness across the upper part of the chest; feeble and irregular pulse; pains like those of angina pectoris shoot from the heart down the left arm or up into the neck, and involve different plexuses of nerves; the extremi- ties are cold and covered with a clammy sweat. Another symptom that may come as a secondary symptom of tobacco is neuralgia of the face. This symptom, when thus caused, is curable by Sepia, as is also the dyspepsia. Impotence also follows tobacco, and often yields to Lycopodhmi. The tertiary effects of tobacco include apoplexy. Tobacco, in its effect on the gastric organs, very much resembles Hydrocyanic acid, Veratrum and Camphor. For instance, we find it indicated in cholera, when the nausea and cold sweat persist after Veratrum, Secale or Camphor has stopped the diarrhoea. This nausea is accompanied by burning heat about the abdomen, the rest of the DULCAMARA. 433 body being cold. The patient persists in uncovering the ab- domen. I would remark here that this kind of sickness suggests Tabacum in renal colic or in strangulated hernia. There are this deathly nausea and sickness, with slimy stool, from irritation of the bowels. The resemblance to Hydrocyanic acid is found in asphyxia. The latter drug acts upon the medulla, and, hence, upon the heart through the pneumogastric nerves. Consequently, the symptoms you would expect it to produce are those of the heart and lungs. We find it pro- ducing convulsions, with drawing at the nape of the neck from irrita- tion at the base of the brain. Along with this, respiration is irregu- lar or gasping, and there is great distress about the heart, with re- peated weak ' ' spells ' ' and coldness and blueness of the surface of the body. It is well to remember this fact in ursemic convulsions when the medula is affected. Hydrocyanic acid is then our only hope. Tabacum is used as an antidote to the bad effects of Cicuta virosa. The primary effects of tobacco are generally relieved by Ipecac. Nux vomica is indicated for the bad taste in the mouth and the head- ache worse in the morning from excessive smoking. It is said that Plantago major produces a distaste for tobacco. I have seen one or two patients who, after taking it, supposed they had contracted a dislike to tobacco. Dulcamara. Dulcamara, or the "bitter-sweet," contains a small quantity of Sola- nine, a much smaller quantity, in fact, than an} 7 other member of the group. The tender leaves and twigs have been used for the prepara- tion of the tincture. Several accounts of poisoning from the berries of the Dulcamara have been recorded. The symptoms thus produced are hard griping pains in the bowels, followed by unconsciousness and spasms which are tetanic, and are accompanied by hot, dry skin, tris- mus, loud rattling breathing, and, in one case, death. The ordinary symptoms produced by the drug are not so severe. We find as the very central point around which all the other symp- toms of the drug group, this one: aggravation from cold, damp weather or from changes from hot to cold weather, especially if these changes are sudden. Thus we find Dulcamara useful in rheumatism made worse by sudden changes in the weather; twitching of the mus- cles of the eyelids or mouth whenever the weather becomes damp; dry 28 434 A CUNICAL MATERIA MEDICA. coryza, sore throat, with stiffness of the neck; colic from cold, especially with diarrhoea at night; earache, when it returns with every such change in weather. Dulcamara has a marked influence on the nervous system; but here again its use in practice is often based on the above aggravation. We have the tongue paralyzed in damp weather, with impaired speech; hyperemia of the spinal cord with the paretic state belonging to that disease when caused by lying on damp, cold ground, and intensified by every return of damp weather. It is also indicated in paralysis of the bladder aggravated by damp weather. It is also of use in incipient paralysis of the lungs in old people, es- pecially if the symptoms are aggravated by change in the weather. Dulcamara has a specific influence on the lining membrane of the bladder, causing catarrh of that organ. The urine is very offensive, and is loaded with mucus. It also exerts a marked action on the skin. Thus, it develops a bright red eruption on the surface of the body. Here and there will be large wheals, which may be white or red, and along with these there is usually burning and itching. It is indicated in urticaria traceable to gastric disorder when there is relief from cold air. The complement of Dulcamara is Baryta carb., which also has aggra- vation in cold weather, especially in scrofulous children. Capsicum Annuum. Capsicum possesses few, if any, of the narcotic properties of the Solanaceae, but it has, highly marked, the irritating properties of the group in high degree; but little of the drug is required to produce this irritation. It is eliminated from the body through the kidneys, producing strangury with burning when passing water. This drug acts best in persons of lax fibre, rather stout in build, who do not re- spond readily to medicine because they are of lax fibre, and also be- cause of impaired digestion. The Capsicum patient has weak digestion or weak stomach, hence the whole man is weak. Such patients are irritable and easily an- gered. This is true of either adults or children. They are worse from the least draft of air, even though this air be warm. They are clumsy in their motions. glonoin. 435 They are subject to chills and fever. The chill commences in the back. Although the patient is thirsty, yet drinking causes shivering. The Capsicum patient is subject to catarrhal asthma with red face and well-marked sibilant rales. He coughs, and a successful cough raises phlegm, which relieves the asthma. Capsicum has a symptom of the chest not often met with in practice, and that is very offensive breath during the cough. It also has a well-marked action on the ear, especially on the middle ear. It is of use in rupture of the membrana tympani from disease when there is soreness or inflammation of the mastoid process of the temporal bone. For abscess of the mastoid process the preferable remedies are Aurum and Nit?ic acid. For chronic suppuration of the middle ear you may think of Silicea. Capsicum is of importance in diseases of the throat. It is indicated in diphtheria or in gangrene of the throat when there are burning blisters in the roof of the mouth and when there is an odor from the mouth like that of carrion. The throat feels constricted as if spas- modically closed. The patient is worse when not swallowing and in extreme cases greatly prostrated. The most similar remedy here is Cantharis. Capsicum is also indicated in elongation of the uvula. In dysentery it is indicated when the stools are frequent but small and attended with violent tenesmus and burning in both rectum and bladder. The stools are bloody and slimy and contain shaggy pieces. There is thirst, and yet drinking causes shuddering. Glonoin. Blood. Glonoin. \ Trauma. (^ Convulsions. Glonoin or nitro-glycerine is considered in this part of the course of lectures on account of its symptomatic resemblance to Belladonna. It is a ver)' easy drug to study. Though its main point of attack is the blood, it does not affect the quality of that fluid so much as it does its circulation. It acts very quickly and very violently. The key-note to the whole symptomatology of the drug is expressed in this one sen- tence : "A tendency to sudden and violent irregula? ities of the circulation . ' ' 43^ A CUNICAIv MATERIA MEDICA. With that for our foundation we can easily work out the other symp- toms. The symptoms which are traceable to the irregularities in the circulation are these : very characteristic, indeed, is a throbbing head- ache. The pain may be in the whole head, or it may be in the fore- head, vertex, occiput or any one part of the head. This throbbing is not a mere sensation; it is an actual fact. It really seems as though the blood-vessels would burst, so violent is the congestive action of the drug. The throbbing is synchronous with every impulse of the heart. The blood seems to surge in one great current up the spine and into the head. The bloodvessels externally become distended. The ex- ternal jugulars look like two tortuous cords, the carotids throb vio- lently and are hard, tense and unyielding to pressure. The face is >deep red. This throbbing is either associated with dull, distressing ..aching or with sharp, violent pains. We find Glo?ioi?i applicable to sunstroke, indicated either by the :symptoms already mentioned, or by symptoms which show that the prolonged congestion has produced depressing effects upon the brain. The face becomes rather pale, the pulse, which was at first full, grows soft and feeble, and the respiration labored. There is not as much pressure about the chest as about the medulla oblongata, thus inter- fering with the nerves of respiration. The eyes are often fixed. The patient may even be unconscious. Glonoin, then, we find to be our best remedy for the effects of heat, whether the trouble arises from the direct rays of the sun, from hot weather or from working in the intense heat of a furnace, as in the case of foundrymen and machinists. These effects of the sun or heat are not confined to the head alone, but may involve the whole body. Thus we note oppression of breath- ing, with palpitation of the heart and nausea and vomiting, with white coated tongue. This nausea is not gastric in origin, but cerebral, as under Rhus tox., Belladonna and Apomorphine. The appetite is gone; there is no desire for food; there is a horrible sunken feeling in the epigastrium, and often, too, diarrhoea. All these symptoms call for Glonoin. Still other effects of this congestion are found in the eye. The eyes feel as if too large and protrude as though bursting out of the head. Glo?win is indicated in eye diseases arising from exposure to very bright light, as in the case of one obliged to work at a desk beneath a hot, bright light, as a bright Argand burner. If you should examine such an eye with the ophthalmoscope, you will find the bloodvessels of the retina distended or, in extreme cases, apoplexy of the retina. GLONOIN. 437 Again the effects of the increased blood pressure under Glonoin may be noticed in the symptoms of the mouth. For instance, there is diffi- culty in conversation from diminished power of the tongue, this due to pressure on the cerebral centres. Wine aggravates all these symp- toms. Sometimes the congestion is so great as to make the patient frantic ; he tries to escape, to jump out of the window. Another effect of the cerebral congestion is convulsions. Glonoin is an admirable remedy for the convulsions coming on during labor, puerperal convulsions. The face is bright red and puffed, the pulse full and hard and the urine albuminous. The patient froths at the mouth ; she is unconscious. The hands are clenched, the thumbs be- ing in the palms of the hands. At other times the hands are stretched out as under Secale, and the patient is unconscious. I think that Glonoin is one of the best remedies we have for the congestive form of puerperal convulsions, that form which is announced by rush of blood to the head, especially if there is albuminuria. It is also invaluable in congestion to the head from suppressed menses. The mental symptoms traceable to this congestion are syncope or sudden fainting, the face being pale or often livid, black spots before the eyes, sudden onset of unconsciousness, well-known streets seem strange to the patient. This last s} 7 mptom is one decidedly dangerous. It may be the forerunner of an actual attack. A person who is sub- ject to apoplectic congestion is suddenly seized in the streets with one of these attacks and does not know where he is. Glonoi?iis the remedy for him. Another remedy for this loss of location is Petroleum. Glonoin is also useful for the bad effects of fear. I mentioned that briefly when speaking of Opium. There is horrible apprehension and also sometimes the fear of being poisoned. 1ms last symptom places it alongside of Hyoscyamus, Lachesis, Rhus fox. , Bromide of Potassium and Baptisia. Another use of Glonoin is its application to trauma. It has been found an excellent remedy for pains and other abnormal sensations, following some time after local injuries. Long after the reception of an injury, the part pains or feels sore, or an old scar breaks out again; then Glonoin seems to relieve. Natrum sulphuricum should be compared, especially after head in- juries. 438 A CUNICAL MATERIA MEDICA. It is necessary for you to remember the distinctions between Bella- donna and Glonoin, because they meet in the congestions and inflam- mations of the brain in children and old persons. They divide the honors in these diseases, because each has a number of confirmed cures. We have the cri encephalique in Glonoin which is not so marked under Belladon?ia y so it would seem that the Glonoin case is more severe than that of Belladonna. The symptoms which would help you to differen- tiate the two drugs are these: First, Glonoin; the head symptoms are worse by bending the head backward; worse in damp weather; worse from the application of cold water, which may even cause spasms; better from uncovering; better in the open air; sometimes the patient is obliged to get up and walk about despite the soreness that jarring causes. A very marked symptom which anticipates puerperal con- vulsions, and which is an early symptom in congestion of the brain from suppressed menses, and a prominent symptom in the bad effects of the heat of the sun, is a feeling as if the head were enormously large. The head seems as if it were expanding. Although that symptom is found under Belladonna, it is not so characteristic of that drug as of Glonoin. Now Belladonna has relief from bending backward, from sitting up with the head quiet Belladonna usually has relief from covering the head, while Glonoin has relief from uncovering, although the latter symptom is of less importance than the others. The best antidote to Glonoiji, that I know of, is Aconite. LECTURE XLIL LYCOPODIUM CLAVATUM Lycopodium clavatum. < I. Constitution. 2. Blood. a. Fevers. b. Ebullitions; pulse c. Varices. d. Typhoid. e. Scarlatina. f. Diphtheria. 3- Liver. 4- Dropsy. 5- Catarrhs. 6. Kidneys. Lycopodium or club moss is a member of the Lycopodiaceae, so called from their resemblance to a wolf's foot. It has long been used in pyrotechnic displays, for the production of artificial lightning and in legerdemain. In legerdemain it is used as a coating to the hand, after which that member may be dipped into water and removed from thence perfectly dry. As a medicine, it was considered wholly inert by members of the allopathic school of practice, and was used only as a drying powder by nurses. Nevertheless in the experience of some it was found quite severe symptoms followed the use of this powder. Others, on the contran', used it for months, and years, and declared it to be posi- tively inert. Now why was this? The Cryptogamia, unlike other plants, instead of seeds, have spores, which are sometimes arranged under the leaves, as in the case of Lycopodium. Now these spores have a hard, shell-like covering, within which we find a small quan- tity of oily substance, which is the active part of the spore. As long as the Lycopodium used consisted of unbroken spores it was inert; when, however, these were ruptured, it became active and symptoms followed its local application. In the preparation of Lycopodium, great care should be taken to see 44° A CLINICAL MATERIA MEDICA. that all the spores are broken. When thus prepared, we have in it a truly valuable medicine which Hahnemann proved for us, and one, too, which we need in practice almost every day. I love to extol the virtues of this remarkable drug, for Hahnemann, with his infallable Law, rescued it from its ignominious use as an infant powder, and ele- vated it to the highest rank among the antipsorics. In order that you may understand the symptomatology of the drug, I have arranged the schema which you see before you on the board. First of all, we will study the general character of the drug. Lyco- podium affects profoundly the vital forces, causing a series of symp- toms that indicate it as invaluable in brain fag, typhus, scarlatina, etc., when the brain symptoms point to an alarming paralytic state. We find it indicated most frequently in emaciated persons who are muscularly weak; the mind, however, is well developed. Particularly is this noticeable in children. They are precocious and unusually ob- stinate. The emaciation is noticed particularly about the upper part of the body and neck. There is a predisposition to liver troubles, and also to affections of the lungs; the face is often pale and sallow; the eyes being sunken and surrounded with dark bluish circles. Often, too, the face is furrowed with creases and wrinkles, indicating deep- seated disease. The face readily flushes, the cheeks become red. This is often so in the evening and after eating. As to temperament, the Lycopodium patient is rather impatient and irritable, and easily made angry. At other times, sadness or tearfulness is marked. When sick, such patients are apt to become domineering and rather imperious in manner; or to consider themselves of great importance and those about them of no importance, so they order others about with an angry vehement manner. As to the intellectual part of the mind, we find the memory always weak. Thus we find the drug often indicated when there are frequent mistakes in speech. The patient forgets words or syllables. He cannot read, for the meaning of certain words is confused; he cannot find the right word while speaking, but if the subject is very important, so as to call forth his utmost energy, words flow with ease. Compare Sulphur, Lache sis, Fluoric acid, Silicea. All the symptoms are aggravated from 4 to 8 p. m. Lycopodium is not the only remedy that has this. It is also found under Sabadilla, Nux moschata and Helleborus. Helleborus bears some relation to Lyco- t>odium, not only because of its aggravation from 4 to 8 p. m., but also because of the arousing effect of directing the will to the work. LYCOPODIUM CLAVATUM. 44 1 The changes made in the blood by Lycopodium are not numerous. In febrile states we sometimes find it indicated by chill coming at three or four o'clock every or every other afternoon; this chill being fol- lowed by sweat without intervening heat; or the case may be charac- terized by chill coining at this hour and sour vomiting, with or with- out heat. The pulse in Lycopodium is not very characteristic. In the provings the pulse is changed very little, except that it is slightly increased in frequency towards evening. The arms feel numb, heavy and weak, relieved by using them. Next, I have to notice varicose veins. Lycopodium, by reason of its action on the liver, tends to produce swelling or enlargement of the veins, particularly those which are more or less imperfectly supplied with valves; so we have varices characteristic of Lycopodium; varices in the legs, particularly the right; varices of the genital organs; the labia are swollen by varicose veins; this latter condition occurring during pregnancy, being a symptom which calls for Lycopodhim; also Carbo vegetabilis. So, too, we often find naevi modified by Lycopodium. Now, do not suppose that every nsevus is curable by medicine, for such is not the case. It is, however, your duty to cure them by medicine when you can. For this purpose, Lycopodium is one of the remedies. Still another remedy, and one, too, which is better than any other, and has also produced naevi, is Fluoric acid. So, too, carrying out a similar line of symptoms, you will find Lyco- podium indicated in bleeding piles, piles which contain a far greater quantity of blood than the size of the vein involved would warrant; also in piles which do not mature, but which, from partial absorption of their contents, remain as hard bluish lumps. Then, again, in erectile tumors which have now an increase and then a decrease of the amount of blood in them, Lycopodiu?n may be useful. Lycopodium must have some effect on the blood and on the nervous system because of its general use in typhoid states. It is not the remedy in the beginning of typhoid fever, but when the disease has gone on, despite your treatment, to a state which is very alarming. The patient becomes stupid, lies with dropped jaw, half open eyes, the conjunctivae being coated with a glazing of mucus and directed into vacancy. Passes urine involuntarily. Again, about the fourteenth day 44 2 A CLINICAL MATERIA MKDICA. of the fully- developed fever, when the rash belonging to the disease does not appear and the patient sinks into an unconscious state, with muttering delirium, picking at the bed-clothes or grasping at flocks, distended abdomen, great rumbling of flatus, constipation, sudden jerking of the limbs here and there, breathing, snoring and rattling, pulse rapid, intermitting; involuntary urination or retention of urine; if the urine is passed in bed it leaves a reddish sandy deposit in the clothing. Here is a condition of non-reaction which must end fatally unless quickly remedied; Lycopodium often does it. These indications are very similar to those calling for Calcarea ostre- arum. Calcarea ostrearum has been found to be the remedy in thi s stage of typhoid fever when the rash does not appear. But Calcare a may have either constipation or diarrhoea. Lycopodium always requires constipation. Calcarea has more hallucinations. The patient sees visions when he closes his eyes; he cannot sleep; although he may be fully conscious, yet he is continually frightened by some imaginary object. In such cases Calcarea develops the rash and brings the patient out of this precarious state. In Hyoscyamus the urine leaves streaks of red sand on the sheet. The distinction between this remedy and Lycopodium in impending cerebral paralysis is chiefly one of degree — the Lycopodium being the. deeper acting of the two. Further it has this more pronounced after- noon aggravation and less nervous irritability, etc. In these typhoid conditions we have an indication for Lycopodium in the tongue. The tongue seems swollen and the patient cannot protrude it, or when the patient does put it out it rolls from side to side like a pendulum. Almost always, too, the tongue is dry and has blisters on it. These are symptoms enough to warrant you in the choice of Lycopodium. In scarlatina, Lycopodium is not indicated by its power to produce an eruption and fever similar to those of scarlatina ; it is called for, rather, in those cases which do not take a normal course, but which go on to a fatal issue by reason of the constitution. You are guided here by the typhoid symptoms just mentioned, and also by another symptom which anticipates these and leads you to Lycopodium long before such serious symptoms appear. I refer to the condition of the child after sleep. The child wakens cross and irritable, kicking the clothes off and striking every one about it, or it raises up terrified and clings to its mother as if for protection against some object of alarm. LYCOPODIUM CLAVATUM. 443 Although this symptom may seem insignificant, it is not so by any means. It is the beginning of mischief, and if not checked, stupor and impending cerebral paralysis will follow. Here it resembles Cu- prum, Belladonna, Stramonium and Zincum, all of which remedies have arousing from sleep as if frightened. The element of irritability and the absence of symptoms characteristic of the other drugs lead you to Lycopodium. Related remedies having more of the element of irritability are Chamomilla, Arsenicum, Kali carbonicum. Lycopodium is often needed when the child becomes suddenly obsti- nate; breathes rapidly in sleep; worries, cries; muscles become flabby; it is unable to walk any more. We may make another use of this symptom. Sometimes children have a disease called " gravel," in which lithic acid is passed in suffi- ciently large quantity in the urine as to cause pain on passing water. They awake from sleep screaming out with pain and kicking at all around them. Here Lycopodium is indicated by both the subjective and the objective symptoms; it is related to Sarsaparilla. Zingiber, Pul- satilla, Arnica, Prunus spinosa, etc., should be compared in ischuria. Often, too, when Lycopodium is indicated in scarlatina, you will find that one or the other parotid gland is inflamed and discharging puru- lent matter. Probably the very best remedy in the materia medica for parotitis accompanying scarlatina is Rhus tox. The next best is Calcarea ostre- arum, and next to that Lycopodium. Lachesis is only indicated when the swelling is purplish and the pus is not laudable but thin, excoriat- ing and ichorous. Lycopodium is often overlooked in diseases of the e3 T e, when, never- theless, it is here a very useful remedy, although indicated principally in cases that have become chronic. You may use it in granular lids, which are dry and smarting, in retinitis pigmentosa and even in cata- ract. It will also cure styes, especially occurring near the inner canthus. In diphtheria, Lycopodium is to be thought of when the diphtheritic deposit is most copious on the right side of the throat, with a tendency to spread toward the left. There is a constant desire to swallow, amounting almost to spasm of the throat, with violent stinging pains. The patient is worse from swallowing drinks, especially cold drinks. You often find the symptoms aggravated from four to eight p. m. 444 A CLINICAL MATERIA MEDICA. The cervical glands are swollen. Generally, when Lycopodium is the remedy in either scarlatina or diphtheria, the nose is invaded by the disease. The patient cannot breathe through his nose. The tonsils are very much swollen, as is also the tongue, so that he is obliged to open the mouth and protrude the tongue in order to get breath. Some- times, after you have given Lachesis, the membrane goes to the right side. Then Lycopodium comes in as a substitute. Arum triphyllum and Nitric acid are very similar in diphtheria of the nose. Phytolacca, dark red throat, worse on the right side, but there is inability to swallow hot drinks. Next we come to the action of Lycopodium on the liver. Lycopodium acts very strongly on this organ, producing quite a number of symp- toms. First, beginning with the mouth, we find the tongue coated, sour or, exceptionally, putrid taste in the mouth on arising; violent hunger, almost amounting to canine hunger; yet a few mouthfuls of food seem to produce fulsomeness, as though the patient were " full up to the throat," quickly followed by hunger again; distress in the stomach immediately after eating, ?iot some little time after, like Nux vomica; cannot bear the pressure of the clothing about the waist, here being somewhat like Lachesis; but it is distinguished from Lachesis in that the latter has the sensitiveness all the time, but Lycopodium only after a meal. The region of the liver is very sensitive to touch. Some- times there is a feeling of tension there, and this feeling of tension is a subjective symptom which leads you to the choice of Lycopodium in chronic hepatitis when abscesses have formed. The diaphragm is very apt to be affected in this state. There is a feeling as though a cord were tied around the waist. There is marked collection of flatus. Possibly that is the reason why a small quantity of food fills the patient up. This flatulence tends upwards rather than downwards; rumbling of wind in the splenic flexure of the colon, with distention of that portion of the intestinal tract. There is great fermentation in the intestines, this being followed by discharge of flatus, and even by diarrhoea. The bowels are usually constipated, however, with in- effectual urging to stool. After stool there is a feeling as of a great quantity remaining unpassed. Now these symptoms, especially if associated with ascites, will lead you to the choice of Lycopodium in that disease known as cirrhosis of the liver. Lycopodium, in these gastric and hepatic symptoms, has many LYCOPODIUM CLAVATUM. 445 analogues, one of which is Nux vo??iica. Nux may be distinguished from it by the following: Although Nux vomica has sour taste in the mouth, aggravation in the morning and fulness after eating, yet the im- mediate distress is more prominent under Lycopodium. In the accumula- tion of flatus, of the two remedies Nux has more pressure downwards, giving frequent urging to stool and pressure on the bladder. Both remedies have prominently constipation, with ineffectual urging to stool. The difference between the two remedies is this: Nux vomica has this ineffectual urging from its fitful action; under Lycopodium it arises from contraction o*f the sphincter ani. Sulphur is also similar in the accumulation of flatus and in the sour and bitter taste; but the characteristic place for the accumulation of flatus in Sulphur is in the sigmoid flexure, and is referred by the pa- tient to the left groin. Momordica balsamica is another remedy that has incarcerated flatus in the splenic flexure. Cepa has pain in the region probably due to the same cause. Raphauus is also to be thought of in cases with accumulation and retention of flatus. Dr. James B. Bell, of Mass., one of our most emi- nent surgeons, performed an operation on the abdomen. The patient was decidedly tympanitic, and yet he passed no flatus whatever, although the bowels moved. That s3^mptom is under Raphauus. Dr. Bell gave that remedy, and the patient recovered. Next we come to the dropsies curable by Lycopodium. We find the remedy indicated in dropsies, particularly in the lower half of the body. The upper part of the body is emaciated, the muscles of the arms and chest are shrunken, the abdomen is distended, and the legs swollen and covered with ulcers, from which serum continually oozes. Now, there are three remedies which may be given when ulcers form on the legs in dropsy. They are Rhus lox., Lycopodiuin and Arse?iic. The cause of the dropsy indicating Lycopodium is liver disease. It has also been used successfully for hydropericardium in heart disease after the failure of Arsenic. We next come to the catarrhs of Lycopodium. Lycopodium may be thought of in catarrh affecting the nasal mucous surface, particularly when the nose is "stuffed up" and the child cannot breathe. The child starts up from sleep rubbing its nose. Yeu may also think of it in bronchial catarrh, whether the larger or smaller tubes are involved, when there is accumulation of mucus, as 446 A CLINICAL MATERIA MEDIC A. indicated by rales, rattling breathing, cough and dyspnoea and waving of the alse nasi. It may also be given in hectic fever with suppuration of the lungs, particularly when the right lung is worse than the left. It is also useful in pneumonia when the hepatization is so extensive that the patient has great difficulty in breathing, and there is alternate contraction and dilatation of the alse nasi. It may also be employed in typhoid pneumonia, the symptoms agreeing, and also for the bad effects of maltreated pneumonia, particularly if suppuration of the lungs impends. I come now to the action of Lycopodium in the muscular and fibrous tissues. It weakens the muscles and so becomes of use in delicate persons whose muscles are poorly developed. The arms feel weak and heavy, but that this weakness is mainly functional is shown by the fact that the patient when he tries to use them, finds that he can work quite well with them. The limbs easily go to sleep, with numbness and formications. These sensations accompany rheumatism, neural- gia, etc. Lycopodium is found effective in chronic rheumatism and gout w T hen the pains are worse from damp weather and relieved by slow motion and warmth, and the characteristic gastric and urinary symptoms are present. The right side is principally the seat of trouble. In diseases of the kidneys we find Lycopodium indicated for a trou- ble to which I have already referred, the presence of lithic acid in the urine, and also in renal colic affecting the right side. There is one symptom for Lycopodium that I would yet like to add, a symptom not uncommon in typhoid fever, pneumonia, and scarla- tina, and that is coldness of one foot while the other is warm or even hot. This symptom may appear insignificant on paper, but I can assure you that it is of inestimable value in practice. Sulphur has coldness of one foot, but it is usually the left foot that is affected. Lycopodium is complementary to Lachesis. LECTURE XLIII. THE UMBELLIFERiE, THE BERBERIDACEiS AND SPIGELIA. The Umbeeeifer^e. The Umbelliferse are an order of plants which have a marked action on the nervous system, developing in some cases symptoms akin to hysteria. They also affect the glandular system, producing either en- gorgement or atrophy of glands. They all act on the mucous mem- branes, producing catarrh, and some of them act upon the skin, de- veloping pustular eruptions. The remedies obtained from this order are as follows: Conium maculatum, Cicuta virosa, CEnanthe crocata, Phellandrium aquaticum, Petroselinum, Asafoetida, Ammoniacum gummi. We will now proceed to consider the one first mentioned on this list. Conium Macueatum. Conium maculatum acts as a depressor of the cerebro-spinal system. It develops a paretic state which spreads from below upwards, the lower part of the body giving out before the upper. When the drug is taken in poisonous doses we find at first a difficulty in walking, as though the legs could not be moved. As the action of the poison in- creases, other and more vital organs are involved. The lungs are attacked; there is dyspnoea; the pulse is irregular, showing the fitful action of the heart muscle. Up to this time the mind is perfectly clear. Finally unconsciousness ensues, and the patient dies from pa- ralysis of respiration. We may utilize Conium in those exhausted states of the system re- sulting from old age. It may also be used after severe diseases, as 44-8 A CLINICAL MATERIA MKDICA. diphtheria and typhoid fever, and for the sequelae of that vice of vices, masturbation. In the paralyses of Conium, sensation is but little in- volved. Its analogues here are Gelsemium and Cocculus, which pro- duce functional motor paralysis and are prominent remedies in post- diphtheritic paralysis. In the treatment of the effects of sexual excess, we find Conium of great utility by reason of its mental symptoms. It produces a perfect picture of hypochondriasis. The patient is melancholy, averse to society, yet fears to be alone. Conium may also be given when this mental condition arises from celibacy. Zinc oxide is here very similar to Conium. The latter is a depress- ing remedy, while the former is irritating as well as weakening. You may use Conium in vertigo, when it is the result of cerebral anaemia and when it is characterized by exacerbations on turning over in bed. It is often associated with a numb feeling in the brain, as if that organ were stupefied. Acting as Conium does upon the glandular system, we would ex- pect it to be a scrofulous remedy. It is indicated in scrofulous oph- thalmia; a characteristic symptom calling for it in this trouble being intense photophobia disproportionately severe to the degree of inflam- mation present. In addition to this there are ciliary neuralgia and prosopalgia, usually on one side, and worse from cold, under the in- fluence of which the cheek becomes of a dark red color and swells. Conium affects the wax in the ears, increasing it in quantity and making it a dark color, something like chewed-up paper. The proper treatment in these cases is to remove the accumulation of wax by careful syringing, and then give Conium to prevent its for- mation anew. Conium does not act very prominently on the chest. However, we find it useful in consumptives when they find it impossible to expec- torate the sputum; they must swallow it again. It is especially use- ful for tormenting night cough, from tickling as from a dry spot in the larynx, which is relieved as soon as the patient sits up in bed. There is scarcely any cough during the day. Conium weakens the heart, causing the pulse to be one moment full and regular and the next soft, weak, and irregular. This symptom is not an uncommon indication for Conium in aged people. The use of Conium in glandular diseases and in malignant forms of tumors comes from its power of producing enlargement of the glands, UMBEIvLIFER^. 449 adenomata. The glands affected are of a stony hardness. These in- durations are quite common in the mammae, in the testicles, and in the uterus. Usually, there is little or no pain; although, sometimes, there may be darting pains. Conium is indicated in the beginning of scir- rhus. It is also indicated after contusions or bruises when induration is the result. There is an inflammation of Conium which closely simulates that of malignant disease. In the mouth it gives us a picture of noma; the tongue and mucous surfaces are swollen, with offensive discharge; the parts have an ashy, grayish hue, and may even be gangrenous. There is great difficulty in swallowing, with spasm of the throat. In cancer of the stomach, there is vomiting of blood, and of a gray- ish-black substance which is made up of decomposed blood and broken- down gangrenous tissue. Conium is complementary to Nux vomica in constipation, especially when there is faint feeling after stool. Ammoniacum Gum mi. Ammoniacum gummi is a gum obtained from a very large tree grow- ing in Arabia. It has gained quite a reputation as a cure for diseases of the eye. I have used it successfully in asthenopia, when the eyes smart and burn, especially if used at night by artificial light. The eyes become injected, and often throb, especially in the inner canthus of each eye. It thus stands between Belladonna, which is used for affections of the eyes from overwork when there is great congestion, and Ruta, which is indicated for irritability of every tissue of the eye from overwork or from using the eyes on fine work. Asafcetida. Asafostida is a gum having a decided alliaceous odor. It is espe- cially useful in two classes of disease: First, in nervous diseases de- veloping a perfect type of hysteria; it acts upon the muscular fibres, producing a reverse peristaltic action in the oesophagus and intestines. Thus, it causes a sensation as though a ball started in the stomach and rose into the throat; this being provoked by over-eating, by mo- tion, or by anything that can excite the nerves. It produces a burst- ing feeling, upwards, as though everything in the abdomen were com- ing out at the mouth. This is common in colic from hysteria, after 29 45° A CUNICAI, matkria medica. belching of wind of a strong rancid taste, and is associated with an empty gone feeling in the stomach at n a. m. like Sulphur. The second action of Asafoetida is upon the bones. It produces periosteal inflammations, resulting in ulcers, especially upon the shin bones. A characteristic of these ulcers is an intolerance of all dress- ings. The parts around are exceedingly sensitive to the application .of even charpie. We find Asafoetida curing hysteria arising from the sudden suppres- sion of discharges. Asafoetida produces inflammations of the eye. Thus it may be in- dicated in iritis after the abuse of mercury, especially when it is of syphilitic origin, with burning, throbbing pains, and soreness of the bones around the eyes. The nearest remedy here is Aurum, which has relief by warmth. Asafoetida has relief from pressure on the eye- ball itself, which Aurum has not. Phellandrium aquaticum we find to be indicated in headache which involves the nerves going to the eye. There is a crushing feeling on the top of the head, with burning of the eyes and lachrymation. Phellandrium also causes sharp pains in the course of the lactifer- ous tubes when the child nurses. Petroselinum comes into use in urethral disease, especially in gonor- rhoea, when the inflammation has travelled back, and the patient com- plains of pain at the root of the penis. There is a sudden irresistible desire to urinate, and itching deep in the perineum. Coniiun causes chronic cystitis, with intermittent urination. The urine flows and stops. That symptom of the drug I have utilized in the treatment of enlargement of the prostate in old people. iETHUSA CYNAPIUM. sEtkusa cynapium is a frightful poison, having narcotic properties as well as paralyzing effects. The principal use we make of the drug arises from its action on the stomach. It produces a deathly nausea and sickness, with vomiting. In the case of a child the vomit con- sists of curdled milk, which is often green. After vomiting, the child falls back exhausted and goes to sleep. It awakens hungry, eats and vomits again. The face is pale, and there are dark rings about the eyes. The analogue here is Antimonium crudum, which differs from sEthusa in having a white-coated tongue. Calcarea oslrearum or Cal- carea acetica, has vomiting of curdled milk, and the child is apt to have diarrhoea with sour-smelling stools. THE BERBERIDACE^E. 451 Cicuta virosa, another member of the order, when taken in any quantity produces congestion at the base of the brain and in the me- dulla oblongata. At first, the patient is rigid, with fixed staring eyes, bluish face and frothing at the mouth and unconsciousness. Next, there passes a shock, or series of shocks, from the head through the body. The jaws are locked, the patient bites the tongue. These spas- modic symptoms are followed by profound exhaustion. These symp- toms indicate Cicuta in epilepsy, spasms from worms, and also in some forms of puerperal spasms. We notice, too, that Cicuta, in addition to these symptoms, develops phenomena which resemble the remote effects of concussion of the brain. The pupils are dilated; there are vertigo and headache, and sometimes epileptiform convulsions. Cicuta also attacks the skin, producing a pustular eruption, with yellowish honey-colored scabs, particularly about the mouth, and matting the whiskers. It has even cured two cases of epithelioma when the cancerous growth was covered by these honey-colored scabs. Next, we will study the BERBERIDACE^E. Of this order we have time to study but two drugs, namely, Berberis vulgaris and Podophyllum peltatum. Berberis Vulgaris. Berberis vulgaris belongs to this order along with Caulophyllum and Podophyllum. It contains an alkaloid called Berberina, which is also found in Hydrastis Ca?iadensis, Zanthorriza, Menispeimum Cana- dense, Coptis root, etc. Some chemists have even asserted that what is sold as Muriate of Hydrastine is not Hydrastine at all, but Muriate of Berber ine. This Berberiue, when given in large doses to animals, produces restlessness, convulsive trembling, thirst, diarrhoea and, finally, paralysis of the posterior extremities. Man is far less readily poisoned by it than are the lower animals. In the old school it is used as an antiperiodic and also as a bitter tonic. Berberis vulgaris acts more on the kidneys and bladder than on any other parts of the body; next to these the liver, and, lastly, the mucous membranes. It also affects the vital powers and damages nu- trition, as shown by the sunken face and excessive prostration. First of all we will consider the kidney symptoms as the most 45 2 A CUNICAI, MATERIA MEDICA. important. Just as I would recommend Digitalis for several diseases when the heart symptoms decide for it, so would I recommend Ber- beris in certain affections, as peritonitis, metritis, etc., when marked by the Berberis kidney symptoms. We find in the renal regions stick- ing, digging, tearing pains, worse from deep pressure, for they are evidently in the kidneys themselves. These tearing pains extend down the back and into the pelvis along the course of the ureters. There is a sort of tensive, pressive pain across the small of the back, which feels stiff and numb; pains of a sticking or tearing character radiate from the kidneys down into the small of the back. Another symptom which seems to be peculiar to Berberis is a bubbling feeling as if water were coming up through the skin. It is a peculiar symp- tom, and one that may point very strongly to Berberis as the remedy. doming next to the bladder, we find here very marked cutting which extends down the urethra, and burning pain even after urinat- ing. The urine itself presents marked characteristics. We find it yellow, turbid and flocculent. Sometimes there is whitish sediment, later becoming red and mealy. With these urinary symptoms are the tearing pains just mentioned. Now, whenever you have these renal and vesical symptoms, you must think of Berberis, whether the trouble be inflammation of the uterus, of the bowels, of the peritoneum, or of any other part of the body. The face is usually expressive of deep- seated disease, being sunken and worn looking. General prostration is great. Sometimes the same condition obtains in liver affections. You find very characteristically sticking pain under the border of the false ribs on the right side. These pains seem to shoot from the hepatic region down through the abdomen. These symptoms may well be indicative of gall stone colic. The stools of Berberis are accompanied by violent burning in the anus, as if the surrounding parts were sore; frequent or constant de- sire for stool. These symptoms have suggested the use of Berberis in fistula of the anus. In fistula compare Silica, Sulphur, Ignatia and Calcarea p/ws., the latter when lung symptoms are present as the result of an operation for removal. You may also use Berberis in complaints of females, when the leu- corrhcea or menstrual difficulty is associated with the peculiar urinary symptoms of the drug. Berberis is to be studied alongside of Pareira brava. The difference THE BERBERIDACE.E. 453 between the two drugs is this: in the latter drug the pains go tearing down the thighs, while in the former they seldom go further than the hips, and the patient is unable to urinate unless he gets down on his hands and knees. Urine ammoniacal. We may also use Berberis in disease of the joints, when accompanied by the tearing and burning pains and the bubbling sensation just mentioned. It is also a very useful drug in rheumatism or gout, when characteristic urinary symptoms are present. This places it by the side of Lithium carb. , Benzoic acid, Calcarea ostrearum and Lycopo- dium. Benzoic acid is useful in gout and in rheumatism with urinary symptoms, when the urine smells strong, like that of the horse. Calcarea ostrearum has very offensive urine, with a white instead of a turbid deposit. Lycopodium is useful in rheumatism or gout when the urine contains a lithic acid deposit. Podophyllum Peltatum. Podophyllum peltatum is the mandrake or May-apple, a plant that grows to the height of some two or three feet, with leaves spread out like an open hand. It is found mostly on the borders of woods. The parts used in medicine are the roots and fruit of the plant. When applied externally, Podophyllum produces a rawness of the skin, re- sembling intertrigo. If the powdered plant gets into the eyes it pro- duces a severe inflammation and even a perforating ulcer of the cornea. The central point of attack of the drug, however, is in the abdomen. Shortly after it is taken there follow diarrhoea, colicky pains, the well- known morning stool pouring out like water from a hydrant, preceded by retching and vomiting and spasmodic contraction of the stomach, making the child scream out; a diarrhoea such as would make us think of Sulphur, Dioscorea, Bryonia, Natrum sulph., and a few other remedies. The stools are renewed immediately by eating, like Croton tig Hum, etc. In addition to its intestinal action we find it acting on the liver, and here is the main use that is made of the remedy. It is indicated in the torpid or chronically congested liver. The liver is swollen and sensitive, and friction over the right hypochondrium relieves this sen- sation. The face and sclerotica become tinged yellow. There is bad taste in the mouth, evidently arising from the degeneration of food in the intestinal tract. The tongue is coated yellow or white, and takes 454 A CLINICAL MATERIA MEDICA. the imprint of the teeth. The bile may become inspissated in the gall bladder, forming gall-stone; thus we find Podophyllum indicated in that tormenting disease, bilious colic. The stools are of the nature already mentioned; or they are constipated and clay-colored, showing the absense of bile. These symptoms of Podophyllum much resemble those of Mercurius. They have won for the drug the name of vege- table mercury. It is much less injurious, however, than is Mercury. In constipation of bottle-fed babies Podophyllum will sometimes relieve. The stools are dry and crumbling. Of the remedies having the symptom, the tongue takes the imprint of the teeth, Mercurius stands at the head of the list. Next to that we have Podophyllum, and then Yucca jilamentosa, and, finally, Rhus, Stramonium and Arsenicum metallicum. Podophyllum also produces prolapsus recti with the diarrhoea. The rectum protrudes before stool (JVzcx vom. after), especially in the morn- ing. Podophyllum also seems to have the power of producing and cur- ing prolapsus of the uterus with attendant symptoms of bearing down in the hypogastric and sacral regions worse from motion, and neural- gia in the right ovary, extending down the anterior crural nerve, backache, retarded menses, thick transparent leucorrhcea and often coexisting with these, prolapsus recti. As concordant remedies to Podophyllum in this prolapsus we have Nux vomica and Sepia, the indications for which I have already given you in a former lecture. Very few would think of Podophyllum as a remedy for tonsillitis and yet it has some very clear cut indications in this affection. The trouble is apt to start in the right side and extend to the left, like Lycopodium. There is great dryness of the throat, aggravation from swallowing liquids and in the morning and pain going into the ear. Podophyllum is a valuable remedy during dentition. It does not seem to act on the brain, yet it causes reflex cerebral irritation, whether this be from the abdominal symptoms alone or from the teeth. The symptoms which indicate it in addition to those already given are moaning and whining during sleep, not crying out with a sharp, sudden noise, as under Belladonna, but a sick cry; the child grates its teeth; the head is thrown back and rolled from side to side. Next we find Podophyllum indicated in fevers, usually of a remittent type, particularly in bilious remittent fever. The drug does not pro- duce many characteristic symptoms during the chill, but during the fever the patient is sleepy and sometimes delirious. LECTURE XLIV. MINERAL KINGDOM. I propose now to begin the study of the drugs obtained from the mineral kingdom. I have placed on the board {see next page) for your study the elements, arranged in order according to some of their relations, just as we find them in chemistry. I wish to explain here the general idea of the relation of drugs, and especially of those be- longing to the mineral kingdom. If you consult chemistry you will find that the elements hold to each other an electrical relation. They hold to each other a relation of polarity as positive electric and neg- ative electric. Certain of these elements are emphatically negative, and others are just as positively positive. Some of the elements, as gold, silver, etc., hold a middle relation, being rather neutral. These I have placed at the neutral point of the magnet. The advantage of this method of study will be seen as we proceed. The negative elec- trics are known to be conductors of light, the positive conductors of heat. The extreme effects in this respect are noticed at either pole, diminishing as we approach the curve of the magnet. Another fact which is well worth knowing is this general statement: the electro- negatives act on the bowels in the morning, and the chest in the after- noon: that is, they act upward on the body during the day. Exactly the opposite holds true with the electro-positive. These act on the chest in the morning, and on the bowels in the latter part of the day. Most of you are acquainted with the morning diarrhoea of Sulphur, which hurries the patient out of bed. You know how the asthma of that remedy increases in the afternoon. Taking the remedies at the other extreme, we have the Kali salts as examples; you know that they have aggravation of their chest symptoms in the forenoon, and of their bowel symptoms in the afternoon. This is, of course, a very general statement, but it may be of great use to you in enabling you to differentiate between drugs. Let me illustrate. You have a case of scrofula and you are obliged to decide between Sulphur and some salt of lime. You will be astonished to see how similar are many of the symptoms of these two drugs. The very fact of the diarrhoea 456 A CIvINICAL MATERIA MKDICA. Elect?'o- Electro+. Oxygen. Ozone. Nitric ac. Amyl nitr. Sulphur. Selenium. Sulph. ac. Carboneum sulph. Fluoric ac. Iodine. Spongia. Bromine. Chlorine. Muriatic ac. Cyanogen. Carbo veg. Carbo an. Graphites. Petroleum. Cosmoline. Silicea. Phosphorus. Phosphoric ac. Arsenicum alb. Arsenicum iod. Tellurium. Antimon. crud. Antimon. tart. Aurum. Argent urn. Mercury. Thallium. Cuprum. Antozone. Hydrogen. Ammonium. Kalium. Natrum. Lithium. Calcarea. Baryta carb. Strontia carb. Zincum. Magnesium. Cadmium. Alumina. Plumbum. Stannum. Ferrum. Manganum. Niccolum. Kobaltum. MINERAL KINGDOM. 457 coming in the morning or afternoon, insignificant as it may appear under other circumstances, serves as a differentiation between these two drugs. Now in making this statement I do not mean that be- cause Sulphur produces a morning diarrhoea, that it must always be the remedy when that symptom is presented; but I do mean that when you are compelled to decide between two remedies having opposite directions in action, this relation becomes of great importance. As you approach the remedies or chemicals at the neutral point of the magnet, you find these effects less marked, until, finally, they are un- noticeable. There is another fact which we may learn from this arrangement of drugs. You notice that here we have oxygen and sulphur. They are chemical elements, which are placed near together in chemistry, and are similar not only as chemicals but also as medicines. Next on the list we have nitrogen, which is used in medicine in the form of Nitric acid. Below this we have a list of remedies which constitute a group in chemistry known as the halogens; they consist of Fluorine, Fluojic add, Iodine, Bromine, and Spongia. The latter drug is placed here not as a chemical substance, but as a drug which owes its medic- inal properties to the iodine and bromine which it contains. It is of practical value to remember these drugs in this connection, because they are not only chemically similar, but they are also similar as medicines. Moreover, this grouping of remedies enables you to keep in mind a group of remedies from which you may choose one to suit your case. I have introduced cyanogen here because it holds import- ant chemical and medicinal relations to the halogens. Below we have the carbon group, Carbo veg., Carbo animalis, Anthrakokali , the dia- mond, and Graphites. I have also placed in this group Petroleum and Cosmoline or petroleum jelly, two oily substances, rich in carbon, and having many resemblances to the pure carbons. In a future lecture I shall give you the characteristics which belong to all the carbons, so that you can say here is a patient who needs some preparation of carbon, which shall it be? This you de- termine in the same way as you selected one of the halogens. Next we have a group composed of Phosphorus and its acid and Arsenicum. Below, we have Tellurium, Antimonium crudum and Antimoniu7n tariaricum, which is similar enough to the sulphide to be placed along side of it. This group of drugs possesses many similarities. Phos- phorus and Arsenic are continually placed in contrast in the physician's mind, and it is often difficult for him to decide which he shall give. 45§ A CUNICAI, MATERIA MEDICA. The Antimony preparations are similar in form and isomorphous with Sulphur and Selenium. There is another fact which we may borrow from chemistry, and that is that substances of similar crystal- line structure have similar medicinal effects. These substances often replace each other in chemistry. I give you these facts so that you may have a rational conception of drugs, not as mere individuals, but as consistent with nature and with themselves. Here below we have the noble metals, gold and silver. Then we may go up on this side tracing the drugs through the same relation we did on the other. Every one knows how closely related, chemically and medicinally, are Barium and Strontium. This relation is very much like that of simi- larity in origin. They are not apt to follow one another well. Here are Sulphur and Sulphiiric acid; suppose you are going to decide be- tween them and suppose it to be a perplexing case. You say ' ' I will give Sulphur, and if he is not better to-morrow I will give Sulphuric acid.''' That is bad practice. It would be much better to say that I will give Sulphur to-day and Calcarea to-morrow. Why ? They are similar drugs, but entirely foreign in their family relations and origin. Why do I dwell on these two relations ? Because I want you to dis- tinguish between that which is the same and that which is similar. Ignatia and Nux vomica are too much as though they were the same thing. Ignatia and Zinc are concordant remedies which are similar but which are not identical. You note that I have placed hydrogen above all the potash salts. You notice that here is placed antozone. Ozone is negative oxygen, and antozone is positive oxygen. Ozone exists in the sea-air and how many times do you send your patients to the sea-shore for relief. We may derive a hygienic fact from this statement; if I have a patient who is something of a Sulphur patient, I would think that sea-air would do him good because sea-air is rich in ozone, and ozone in a general way suits his condition. On the other hand, if he belongs more to the " salt" class of drugs I would not send him to the sea-shore. I would send him where antozone exists, as in fogs. We will now proceed to study the drugs derived from the min- eral kingdom. The remainder of the hour I will devote to the consid- eration of Selenium. To-morrow we will study the king of remedies, Sulphur. MINERAL KINGDOM. 459 Selenium. f Arum tri. < Cinch. Selenium. \ Caust., Carbo v., Phos., Spong. ^J^' ! Sulphur. Nux, Puis. Sulphur is an element with which you are all familiar. You must be careful, if }^ou prepare the medicine yourself, that you obtain it perfectly pure. The sublimed Sulphur that you buy in the shops is very impure. It contains some of the ox} T gen acids of Sulphur, some Selenium, and often, too, Arsenic. When chemical substances are associated in this way in nature, it is a fact that they must be related medicinally. There is also a relation between the plant and the soil in which it grows. Thus, Belladonna, which grows in lime earths, is related medicinally to Calcarea. The Agaricus will never grow where there is coal. You will find no relation between Agaricus and the carbons. Cistus Canadensis grows where there is mica, consequently you may expect some relation between that drug and Magnesium. Sulphur may be said to be the central remedy of our materia medica. It has well-defined relations with nearly every drug we use. The great utility of Sulphur arises from this peculiarity, it is our mainstay in defective reaction. When the system refuses to respond to the well selected remedy, it matters not what the disease may be, whether it is a disease which corresponds characteristically with the symptomato- logy of Sulphur or not, it will often be the remedy to clear up the case and bring about reaction, and either itself cure the case or pave the way for another drug which will cure. This qualit} T of Sulphur arises from its relation to what Hahnemann called psora. Hahnemann taught what is practically true, that when a disease is suppressed (and 464 A CUNICAI, MATERIA MEDIC A. a disease is suppressed when it is driven from the surface to the in- terior of the body), there is formed a constitution or dyscrasia which will afterwards modify every abnormality from which the patient may suffer. For instance, an eruption on the skin is dried up or is driven in by some external application. Afterwards (it may be some time), another disease appears, not necessarily as a skin affection, however. Pathologically, it may be entirely different from it. For instance, as the result of exposure to cold, the patient contracts pneumonia. This condition due to the suppression of the eruption so modifies the disease that it is not curable until that same eruption is reestablished on the skin. Then you will be amazed to see how promptly the remedy that before refused to act now cures the case. Many times has Sulphur restored such suppressed diseases, and in this fact lies its wide applica- tion in practice. Particularly is it applicable after the suppression of itch. Sulphur is especially adapted to persons of rather light complexion who are easily angered, although dark-complexioned persons may also yield to its influence if they exhibit Sulphur symptoms. It is one of our mainstays in the treatment of the negro. Whether this is owing to the rapid growth of scrofula in that race or not, I caraiot say. It is also suited to persons who are subject to skin affections, particularly to those who have harsh, rough skin, which very readily breaks out with eruptions of various descriptions, varying from a simple erythema to a positive eczema. There is apt to be also an offensive odor from the body. This odor may arise partly from uncleanness, for the typi- cal Sulphur patient is not very fond of water. Bathing aggravates his complaints. There is, moreover, a positive distaste or dislike for water. This peculiar disagreeable odor or exhalation from the skin is not removed by washing; hence, you must consider it to be for the most part an abnormality arising from impure excretions from the skin. The patient is rather of coarse fibre. His hair is harsh and coarse. There is craving for alcoholic drinks, especially those of the coarser type, as beer, ale, whiskey, etc. The patient walks rather stooped from weakness of the spine. Then, too, as I have already said, he fails to react to the apparently indicated remedy. In defective reaction, Sulphur does not stand alone. I have already spoken of the value of Psorimim in this connection. Cuprum should also be thought of. We also have Laurocerasus in chest affections, SULPHUR. 465 particularly in diseases of the lungs which do not respond to treat- ment; Valerian and Anibra grisea in nervous diseases; and Carboveg., particularly in abdominal affections and in the collapse which is marked by cold breath, cold knees, etc. Now, let me speak of the action of Sulphur on the circulation. In almost every instance in which it is the remedy you will find deranged circulation. It seems to act more prominently on the venous circula- tion, producing a sort of plethora. But this is not a true plethora. It is the result of irregularities in the distribution of the blood, by which certain parts of the body become congested. These conges- tions, generally speaking, are such as occur particularly from abdom- inal troubles, especially fulness of the portal system, a very common trouble nowadays. Especially is Sulphur indicated in plethora that has arisen from sudden cessation of an accustomed discharge, particu- larly a hemorrhoidal flow. For example, piles have suddenly stopped bleeding, and fulness of the head, with distended blood-vessels, fulness of the liver, etc., show that congestion of these parts has resulted. Sulphur will, in these instances, ease the congestion and restore the accustomed discharge. Then you may proceed with Sulphur or with some other remedy, according to the indications of the case, to cure this abnormal discharge in the proper way. The congestion of the head, for which Sulphur is indicated, is ac- companied by roaring in the ears indicating that there is congestion about the auditory nerves — redness of the face, worse in the open air and better in the warm room, and heaviness and fullness almost to bursting. The patient feels worse when he stoops. Sulphur is frequently indicated in congestion of the chest with or without haemoptysis. There is great difficulty in breathing. The pa- tient feels oppressed and wants all the doors and windows opened. These symptoms are accompanied with violent palpitation of the heart, resulting from the endeavor of that organ to compensate for the in- creased supply of blood to the thoracic cavity. If I may be allowed to use the expression, there is too much blood in the heart. The blood rushes into that organ and is not removed by its contraction rapidly enough. This is a very common symptom in- dicating Sulphur, and especially calls for it when the patient is dis- turbed at night with sudden rush of blood to the heart, with violent palpitation, gasping for breath, feeling as if the patient would suffocate if fresh air is not obtained. These symptoms may also be experienced 30 466 A CLINICAL MATERIA MEDICA. during the day from ascending a height or from exercise where the heart is called upon to do extra work. Often the patient feels as if the heart were too large for the thoracic cavity, a symptom also belong- ing to Glonoin, Eupatorium perfoliatum and Grindelia ivbusta. As further evidence of the irregular distribution of the blood in Sul- phur, we have redness of the various orifices of the body, a very strong characteristic of the remedy. The lips are of a rich red color. This symptom often indicates Sulphur in pneumonia, scarlatina, dysentery and anaemia. Redness of the ears may be noticed even when the rest -of the body is not abnormal in color. With this last indication, Sul- phur has often prevented earache in children. With this indication it lias often prevented erysipelas. We also find this redness along the borders of the eyelids, giving them an appearance as if they had been painted. We find redness at the anus, with soreness of the part, a symptom which is particularly useful in the diarrhoea of children. The child screams with pain when the bowels are moved. That symp- tom alone may frequently lead you to decide that Sulphur is the rem- edy. The same is also true of the vulva, which is found to be red. Another and very common expression of the irregularity in the cir- culation is flushes of heat, not only the flushes of heat that occur at the climacteric for which Sulphur is so frequently indicated, but the. flushes of heat which may occur in any disease and do occur during convalescence. The "flush" is followed by more or less moisture, which gives relief. To be purely characteristic of Sulphur, this must be associated with other symptoms, such, for instance, as sensation of heat on the top of the head. The feet, in such cases, are apt to be cold and the patient complains of weak feeling in the epigastrium, especially in the forenoon from ten to twelve. While you often cure flushes of heat with Sulphur when this symptom is absent, you never fail if you have the heat on the top of the head, cold feet and sinking feeling in the epigastrium. In the flushes of heat at climaxis you may also think of Lachesis, Sulphuric acid, Nitrite of Amyl and Kali bichro- micum ; in the weak faint feeling at n A. m., Phosphorus, Hydrastis, Asafoetida, and Zinc. Another illustration of the action of Sulphur on the circulation is shown in the fever of the remedy. Sulphur is not particularly indi- cated in typhoid or septic conditions. There is no indication that Sul- phur makes changes in the structure of the blood such as belong to scarlatina, typhoid fevers and the septic conditions generally, so that SULPHUR. 467 from this fact we could not give Sulphur. There are other reasons than the septic changes that enable us to prescribe Sulphur with suc- cess. It is indicated when the fever is of a remittent or continued type. It may be used after Aconite for the pure synochal fever when, despite the use of that remedy, the dry, hot skin remains and there is no reaction or no critical sweat, which will give the necessary relief. Hour after hour, day after day, this fever continues ; hence its name, continuous. Or it may be what has been termed a ' ' continuous remit- tent ; " that is, there is an exacerbation each evening and a slight fall towards morning, the fever never going away entirely. You may give Sulphur when this fever approaches the typhoid condition, led by these indications : the patient begins to be drowsy with his fever. His tongue is dry and red at the edges and tip, and he responds to your questions very sluggishly and slowly. He is literally burning up with fever. The consumption of oxygen of the system is producing these symptoms. Sulphur acts marvellously in these cases. Sulphur may also be indicated in intermittent types of fever. It is not a specific for intermittent or malarial fever, and yet it has periodi- city in its symptoms. Here you must select it from the well-known symptoms, torpor with slowness in answering questions, chills that will not stop despite your well-selected remedy, particularly if the in- termittent assumes the remittent type, or, more frequently, if the re- mittent type commences and runs into the intermittent. It may also be called for in malarial neuralgia occurring mostly in the face and re- curring quite periodically and resisting other remedies. Here, too, you must remember Cinchona, Arsenicum and Chininum sulph. In these fevers I would have you place Sulphur alongside of two other remedies, which usually follow that remedy because in their symptomatology they suit a more advanced case. These two remedies are Baptisia and Arsenicum. Baptisia typifies a fever which is de- cidedly typhoid in its tendency. The torpor does not stop with this sluggishness in responding to questions, but it goes on to stupor, so that the patient even falls asleep while answering you. The tongue becomes of a brown or blackish hue down its centre and sordes form on the teeth. The discharges from the mouth and from the bowels have an offensive odor; the face has a besotted look; the blood is actually decomposed from septic poisoning or from the prolonged high temperature. Arsenicum suits inflammatory fever further advanced than that 468 A CIvINICAI, MATERIA MKDICA. calling for either Sulphur or Aconite. It has some symptoms which remind you of the latter remedy, notably, restlessness; full, bounding pulse; hot, dry skin; anxiety and fear of death; yet beneath all these symptoms, there is evidence of prolonged tissue-changes. The inflam- mation is going on to destruction of the parts involved, whether the disease be typhoid fever or a simple inflammatory affection from cold as in gastric catarrh. The symptoms are aggravated after midnight; there is burning thirst with tendency to drink little and often, or burn- ing thirst with refusal to drink water because it aggravates these symptoms, especially the burning like coals of fire in the part affected. With all these symptoms the brain may remain perfectly clear. Next, we come to the consideration of the action of Sulphur on the lymphatic system, including under this head the glands and the ves- sels themselves. Sulphur is our mainstay in scrofula, which is, as you know, an affection involving this lymphatic system. It is the prince of remedies here. It is especially useful in the very commencement of the disease, when its first evidences are presented, particularly in patients having the temperament which I have already described to you as characteristic of the Sulphur patient. The patient sweats about the head, particularly during sleep. There is a marked tendency to eruptions such as crusta-lactea, boils, and, in older children, acne. In the case of children, the head is large in comparison with the rest of the body. The fontanelles, particularly the anterior, remain open too long from defective osseous growth. There is tendency to bone affec- tions, to caries, and, particularly in early childhood, to rickets and to curvatures of the spine. The child has a voracious appetite. This it expresses by greedily clutching at all that is offered it, whether edible or not, as if it were starved to death. There is defective assimilation. Glands are so diseased that, while sufficient food is taken into the sys- tem, it is not appropriated to the nourishment of the body, so that the child is always hungry and yet emaciated. The child looks shrivelled and dried up, like a little old man; the skin hangs in folds and is rather yellowish, wrinkled and flabby. All these are precious symp- toms for the exhibition of Sulphur. You may occasionally have to use Sulphur in the beginning in a sort of negative condition. You are certain from a majority of symptoms that you have a case of scrof- ula, and yet no particular remedy appears to be indicated. Then you should give Stdphur, which develops the symptoms and shows you what you have to contend with. SULPHUR. 469 In marasmus of children you may give Sulphur when many of the symptoms already mentioned are present. The child is ravenously hungry, especially at 11 A. m. Now, in regard to this eleven-o'clock hunger, I would say that if you want to use Sulphur successfully in these cases, you must also have these symptoms present: hunger at 11 A. m., heat on top of the head and cold feet. If you have these three symptoms present, Sulphur never fails you. If there is heat on the top of the head alone, you must think of Calcarea or Phosphorus. Another affection of which I wish to speak under the head of the lymphatic system is tuberculosis, not that I wish to say that scrofula and tuberculosis are identical, but that the lymphatic vessels have con- siderable to do with the spread of tubercle. Sulphur is a valuable drug in tuberculosis, no matter what part of the body it may invade. It is especially useful in tubercular hydrocephalus. Here it has done good work, not in the third stage, when the case is nearly hopeless, but in the commencement of the pathological process, when there are violent convulsions, sudden flushing of the face; the child cannot hold its head up from weakness of the cervical muscles. The child wants to lie with its head low. That symptom expresses a great deal, because, when the head is low, there is less effort of the neck required to hold the head up. The child cries out in its sleep. Often, on falling off to sleep, there is sudden jerking of one or both legs. It cries out in sleep as if frightened. The face is red and the pupils are dilated. This is not a case of Bellado?ina. Belladonna ca?i?iot, never did, and never will cure tubercular meningitis. The symptoms tend to appear more or less periodically. Associated with these few cerebral symptoms you will have very many general symptoms, some of which I have already men- tioned, and some of which will be spoken of before the end of the lec- ture. When I give you these symptoms in different groups, I do not wish to convey the idea that these symptoms indicate the drug only when they occur in their respective groups. In tuberculosis affecting the lungs, Sulphiir is indicated only in the beginning. I would here caution you as to how you use the drug. If carelessly or wrongly given, it may precipitate the disease which it was your desire to cure. You must not repeat your doses too frequently, and you must never give it unless you are certain that it is the remedy, for the tendency of Sulphur is to arouse whatever lies dormant in the system. The particular indications for Sulphura.ro. these: the body feels too hot. The patient wants the windows open, no matter how 470 A CUNICAIv MATERIA MEDICA. cold the weather may be. There are frequent flushes of heat, empty feeling in the stomach, heat on top of head, cold feet, etc., palpita- tion of the heart on ascending, pain through the left chest from the nipple to the back. Now you may, in this condition, give Sulphur as high as you choose, one, two, or three doses and await results. Watch your patient carefully, and in many instances a cure will result, but not in all. In tuberculosis affecting the mesenteric glands Sulphur is indicated by the symptoms that I have already mentioned under emaciation and scrofula. You may also find Sulphur indicated in hip-joint disease, and in white swelling, both of which are probably of tubercular origin. You will be aided in your selection of the drug by the general symptoms. In these tubercular troubles you may compare with Sulphur, Calcarea ostrearum and Phosphorus. Both of these remedies are suited to scrofu- lous children, generally after Sulphur. They are indicated more by the general character of the patient than by the brain symptoms alone. All three remedies, as you know, have the same imperfect growth of tissue. The Sulphur patient is apt to be thinner than the one of Cal- carea ostrearum, but Calcarea especially suits a fat, flabby, apparently well-nourished child ; the paleness and the softness of flesh show you^ that the growth of fat has been obtained at the expense of other tissues. The sweat of the Sulphur patient has an offensive odor ; with Calcarea the sweat is on the scalp, and is cool. Calcarea phosphorica gives you these symptoms : There is a tendency to emaciation rather than obesity ; the abdomen may be large, but is more apt to be flabby ; the fontanelles, especially the posterior, remain open too long. Still another remedy is Apis. You know that Apis is one of the best remedies in tubercular meningitis. It is very similar to Sulphur. Both remedies are indicated in cerebral symptoms arising from the repercussion of some eruption — Sulphur, if it is a chronic eruption, and Apis, if it is an acute one. Even here they collide. The best distinction to make is this : Apis is indicated when there is well-marked effusion on the brain ; the patient cries with a piercing shriek. Then, again, the restlessness of the two remedies ought to be compared. With Sulphur, the patient does not sleep at all, or starts up from sleep suddenly, or sleeps in cat-naps. In Apis, we have this picture : the child is sleepy ; it suddenly awakes from sleep with a shrill cry ; it may be wholly or partly conscious ; it is sleepy, but cannot sleep. SULPHUR. 471 Sulphur acts as powerfully on the nervous system as it does on the circulation. It affects the brain, producing first some alterations in the functions of that organ. For instance, it may be useful in hys- terical states, when the general symptoms of Sulphur are present ; when the patient has the insane idea that she is very wealthy ; she tears up her clothes regardless of the consequences ; she plays with and examines old soiled rags with pleasure, evidently regarding them as objects of beauty. At other times there is profound melancholy, with disposition to do nothing at all ; she is perfectly listless. This is not the indiffer- ence of Phosphoric acid, but listlessness or torpidity that is ver}^ com- mon in hypochondriasis. At other times the patient is affected with a religious mania ; even this mania is remarkably egotistic, the patient fears that she will not be saved ; she is anxious about her own soul, but perfectly indifferent concerning the salvation of others. At other times the patient is intolerably irritable and peevish ; this is particu- larly true with children. • Again, Sulphur may be indicated in hydrocephaloid. I have tested it fully in this condition, and know it to be invaluable. For instance, hydrocephaloid comes on during the course of cholera infantum. The little patient lies almost in a stupor. The face is pale, and bathed in a cold sweat, particularly the forehead. Do not mix the case up with Veratrum ; that drug is not indicated. The eyes are half open, and you find the pupil reacting very sluggishly to light, the urine is sup- pressed (a very alarming symptom); the child occasional^ twitches or jerks one or the other limb, and may now and then start up from sleep with a cry. This is a condition in which you will find Sulphur to act like a charm, and that, whether the diarrhoea continues or not. There is no remedy which can take its place. The violent rolling of the head, the suffused face, or the crying out of Belladonna are not present, nor is there the cri encephalique belonging to Apis, but there is a group of symptoms peculiar to Sulphur. Sulphur acts on the spine, producing several conditions there ; first of all, it is useful in spinal irritation. On pressing between the ver- tebrae you notice that the patient winces. Sulphur may also be used in spinal congestion, when the trouble results from suppression of the menses, or, still more characteristically, from the suppression of a hemorrhoidal flow. The back is so sensitive that any sudden jarring of the body causes sharp pains along the spine ; there is dry heat, par- ticularly in the small of the back, and this is often associated with cold feet. 472 A CLINICAL MATERIA MEDICA. We also find it indicated in paraplegia, or paralysis of both legs. Sulphur has produced this, and it can cure it. I do not think that Sulphur is well indicated in far advanced cases resulting from either sclerosis or softening of the cord, or from chronic inflammation of its meninges ; but it has done good work in paralysis of both legs, with total retention of urine, and numbness extending up to the umbilicus. When the urine is drawn by the catheter it is found to be turbid and highly offensive. Now Sulphur must be given persistently in these cases. I must say that it will not always cure, for many cases are in- curable, but it will cure some cases in which the central cause of the trouble is not so chronic, and in which the alterations in the structure of the cord are not so profound but that they can be removed. General weakness of the spine, not classed under any particular name, has been sometimes cured by Sulphur. The patient has the characteristic stoop-shouldered appearance. The chest feels empty and weak; it tires him to talk; there is weakness in the epigastrium during the forenoon. We may also use Sulphur when these symptom's occur during convalescence from various acute diseases. We next have to speak of the action of Sulphur on the muscles, ligaments, tendons and joints. Sulphur is indicated in acute and chronic rheumatism, particularly the latter, when the inflammatory swellings seem to ascend; that is, they begin in the feet and extend up the body. The pains are worse in bed, and at night. The patient uncovers on account of burning heat of the feet. Especially do we find Sulphur useful during the course of acute inflammatory rheuma- tism for that annoying symptom, jerking of the limbs on falling asleep, We may also use it in synovitis, particularly after exudation has taken place. Sulphur here produces absorption, and very rapidly, too, particularly in the knee. We come next to study the action of Sulphur on the serous mem- branes. I have already spoken of its use in tubercular meningitis, so I now speak of its action on the pleura. We find Sulphur indicated in pleurisy, particularly when you have that sharp stitching pain through the left lung to the back, worse lying on the back, and worse from the least motion. It is also useful in cases that refuse to respond to the well-chosen remedy, particularly when there is well-marked pleuritic effusion. Apis is also to be thought of in this condition. In peritonitis Sulphur is indicated more by the general symptoms than by those directly referable to the affected part itself. sulphur. 473 We next come to the action of Sulphur on the mucous membranes. Here we will consider its use in catarrhs and pneumonia. We find Sulphur indicated first of all in conjunctivitis. It is especially useful when the trouble has resulted from a foreign body in the eye, particu- larly after Aconite fails. It is also useful in scrofulous inflammations of the eye, especially with the characteristic tendency of this remedy to congestion. The eyes are red and injected, and there is a feeling as of a splinter of glass in the eye. The inflammation is worse in hot weather. During the winter the child is comparatively free from trouble. This symptom then is due to the relaxing influence of heat. The child is worse when near a hot stove. With the above symptoms to guide us, we may also use Sulphur in keratitis. Also when the condition results from the injury or irritation of some foreign body as a grain of sand or a cinder, and Aconite has failed to cure. In nasal catarrh or coryza we find Sulphur indicated in those who are subject to catarrhs, especially chronic catarrh, when scabs form in the nasal cavity, the nose bleeds readily, and is swollen, the alse especially are red and scabby, this redness at the outlet of the nose being quite consistent with the Sulphur condition. The nose is "stuffed up" while in doors, but when the patient is out in the open air, breathing is unobstructed. Coming next to the throat and lungs, we find Sulphur indicated in laryngitis and also in bronchial catarrh. Hoarseness is present, and this makes the voice very deep, a sort of basso profundo. In other cases there is aphonia, which is worse in the morning. The more chronic the case is the more is Sulphur indicated. In bronchitis, especially chronic bronchitis, Sulphur is indicated when there seems to be an enormous and persistent accumulation of thick muco-pus. The patient suffers from spells of suffocation, with palpitation of the heart. He must have the windows open. The cough is worse when he is lying in a horizontal position, and may then be so violent as to cause nausea and vomiting. Sulphur may some- times prevent pneumonia by relieving the lungs of that hyperemia which necessarily precedes the deposit of plastic matter. If in the very beginning you give Sulphur you will prevent the disease, provid- ing, of course, that remedy is indicated. If you are too late to prevent it you may still use Sulphur when exudation has commenced — that is, in the beginning of the stage of solidification. Even then it will modify the course of the disease. Again you may give it in torpid 474 A CLINICAL MATERIA MEDICA. cases to bring about a reaction when resolution will not take place rapidly enough, and you fear the formation of tubercles. You may also use it in pneumonia with typhoid tendency, with slowness of speech, dry tongue, etc., and also at the later stage of pneumonia when the lungs refuse to return to their normal condition and you fear the breaking down of lung tissue. All sorts of rales may be heard in the chest. Expectoration is muco-purulent, the patient has hectic type of fever, loses flesh, etc. Sulphur will save the patient. But you should not give it after tubercles have formed. The proper remedy then is Lachesis. Sulphur is indicated only in the early stages of phthisis. It is seldom indicated in the advanced stages. But in the very incipiency, when you have an increase of blood in the chest, beginning dulness on percussion in the apex of either lung, diminished respiratory movement in the upper portion of the chest, Sulphur will, by equalizing the circulation, cure the case. In affections of the bowels we find Sulphur a very useful remedy. You may give it in diarrhoea when these characteristic symptoms are present: the stool changes frequently in color, at one time it is yellow, at another slimy, and at another watery. It may contain undigested food, especially in the case of scrofulous children. It is particularly worse in the morning, driving the patient out of bed. You may also use it in dysentery, particularly after the tenesmus has ceased, and mucus and blood are still being discharged. It is necessary that you distinguish several other remedies from Sulphur in moving diarrhoea. In the first place, Bryonia, which is useful for early morning diar- rhoea, which comes on as soon as the patient begins to move about. Natrum sulphuricum is similar to Sulphur, and is oftener required in scrofulous cases. It also has diarrhoea in the morning after getting up and moving about, but the stool is associated with a great deal of flatus. Another remedy is Rumex crispus, which has exactly the same symp- tom as Sulphur — early morning diarrhoea, hurrying the patient out of bed. But it is indicated after catarrhs, with the characteristic cough of Rumex. Still another remedy that is not infrequently confused with Sulphur is Podophyllum. This has early morning diarrhoea, hurrying the patient out of bed. Like Sulphur, the stools are of a changeable color. It differs from Sulphur in that the diarrhoea continues through the sulphur. 475 whole day, although worse at noon. Then, too, with Sulphur you will almost always find the tendency to soreness and rawness of the anus. Phosphorus has morning diarrhoea, with green, painless stool. Dioscorea also has morning diarrhoea, but it is associated with grip- ing, colicky pains, pretty much of the same character as those calling for Colocynth, but they are apt to fly off to other parts of the body, and contrary to Colocynth the patient must bend backwards. I wish now to say a few words about the skin symptoms of Sulphur. I have referred to them already in brief, so that I am only supple- menting what has already been given to you. You will remember that the skin is apt to be harsh, rough, coarse, and measly in the genuine Sulphur patient. There is very little tendency to perspira- tion, or if there is perspiration, it is only partial, and offensive, sour, or musty. There is tendency to the formation of acne, principally on the face. Pustules form here and there over the body, which heal very slowly, indeed. Freckles are spread plentifully over the face, hands, and arms. There is also a tendency to intertrigo; soreness and rawness appear wherever there is a fold of skin, in the groin, mammae, or axillae, or in the folds of the neck. We find Sulphur indicated in that affection known as itch. Now, Hahnemann was the author of the theory that the suppression of itch by external salves, as by sulphur ointment, is responsible for the ap- pearance of many other diseases. He cited hundreds of cases to prove his assertions. Some years after this announcement a Corsican found the little sarcoptis homines burrowing beneath the skin and laying its eggs in these burrows. He showed this to be the cause of the itch, and then thought he had effected the complete destruction of the psora theory. But there is another side of the story. A man who is a victim of the "itch" goes along the street and meets two friends, A. and B., with both of whom he shakes hands, and A. contracts the disease while B. escapes. Now, there must be a difference in the constitutions of these individuals, or they would both have taken the itch or both escaped it, for they were both exposed to the same extraneous influ- ences. A.'s system must have been unsound or he could not have taken it, for the itch insect cannot find a suitable dwelling-place in a healthy organization. So, after all, the Corsican's discovery did not overthrow Hahnemann's psoric theory. The term psora is an unfortunate one, but it serves to indicate the constitution which favors the growth of the sarcoptis. 476 A CLINICAL MATERIA MEDICA. Sulphur is a valuable remedy in this affection, because it conforms so closely to the symptoms of the disease. It has itching in the bends of the joints and between the fingers as soon as the patient gets warm in bed. The skin becomes rough and scaly, and little vesicles form. As the disease progresses, you find occasional pustules appearing here and there over the eruption. Now, in order to rid your patient of this sarcoptis, wash the parts thoroughly in warm water with soap, and then have him rub the skin thoroughly with a common crash towel. Then apply the oil of lavender, which will kill both the eggs and the fully-developed insect without suppressing the disease. Then you may give Sulphur or some other indicated remedy internally. If Sulphur has been used externally and the itch suppressed, you may have other remedies to choose from. Give Mercurius when pustulous and eczematous eruptions complicate the case. Give Sepia particularly when constitutional symptoms appear. There are occasional large and well-formed pustules, which develop into an impetigo. Causticum is especially useful when itch has been suppressed by oint- ments of either mercury or sulphur. I next wish to say a few words about the action of Sulphur on the digestive apparatus. Sulphur is useful in disorders of the stomach, liver and intestinal canal. It may be indicated in dyspepsias of many varieties. The particular indications of the drug may be set down as these : first, in a general way, you find it indicated in patients who suffer from abdominal plethora or passive congestion of the portal system, as indicated by a sensation of tightness or fulness in the abdo- men, with feeling of repletion after partaking of but a small quantity of food. The liver is congested, enlarged and sore on pressure. The bowels are constipated, with frequent ineffectual urging to stool, and with haemorrhoids which are the direct results of this abdominal ple- thora. Constipation frequently alternates with the diarrhoea. In these cases the diarrhoea is not apt to be the early morning diarrhoea of Sulphur. This remedy may also be the remedy for gastric ailments arising from the suppression of an eruption, whether that be erysipelas, eczema, itch or the like. Dyspepsia of drunkards, after excessive use of brandy and beer rather than wines, sometimes calls for Sulphur. Here, too, you often find the enlarged or congested liver. sulphur. 477 Sulphur is also indicated in dyspepsia from farinaceous food. It seems as if in every case of disease of the liver in which Sulphur is in- dicated, the patient cannot digest farinaceous food, which calls upon the pancreatic juice and bile as well as upon the gastric juice itself. The patient vomits a great deal. He cannot take any milk. If he attempts to do so he vomits it at once. That, as you know, is a common symp- tom in drunkards. The vomited matters are apt to be sour and mixed with undigested food. In addition to these symptoms you find all sorts of abnormalities of appetite. The patient is hungry at ten or eleven o'clock in the forenoon, even after eating a moderate breakfast. He has goneness, faintness or gnawing feeling in the epigastrium, as if he must have food or sink. When he gets the food and relieves his hunger, he begins to feel puffed up. He feels heavy and sluggish, and so low-spirited that he scarcely cares to live. It will be well to remem- ber that Stilphur is indicated not so much in the beginning of these affections as after Nux vomica. You find almost exactly the same symptoms under Nux. When that remedy only partially relieves, Sulphur comes in to complete the cure. Lachesis should be used in the enlarged liver of drunkards when the case has gone on to a low grade of symptoms, especially if inflamma- tion ensues and abscess forms in the liver. If the liver wastes away, secondarily to the congestion, we must de- pend upon the other remedies, the most important of which are Phos- phorus and Laurocerasus, the former especially if there is fatty degen- eration of the liver substance. Next, a word or two in regard to Sulphur in diseases of the sexual organs. There is a trio of medicines, Nux vomica, Sulphur and Cal- carea, which are useful in cases of masturbation and excessive venery. Beginning with Nux you note some improvement in the patient; by and by you will find symptoms of Sulphur presenting themselves. If Sulphur fails after producing partial relief, Calcarea completes the cure. The symptoms calling for Sulphur are these: you will find the patient weak and debilitated, having many of the gastric ailments that I have mentioned, particularly faintness, flushes of heat, cold feet and heat on the top of the head. There is frequent involuntary emission of semen at night, exhausting him the next morning. The seminal flow is thin and watery, and almost inodorous, and has lost all its characteristic properties, being nothing more than a shadow of the normal seminal secretion. The genital organs are relaxed; the 478 A CWNICAI, MATERIA MKDICA. scrotum and testicles hang flabbily; the penis is cold, and erections are few and far between. If coitus is attempted, semen escapes too soon, almost at the first contact. The patient suffers from backache and weakness of the limbs, so that he can scarcely walk. He is, of course, low-spirited and hypochondriacal. You may find Sulphur indicated in gonorrhoea, whether the dis- charge be thick and purulent, or thin and watery, when there are burning and smarting during urination, and when there is this bright redness of the lips of the meatus urinarius. Sulphur may also be used when phimosis occurs, especially when there is inflammation and in- duration of the prepuce. Sulphur also acts on the female genital organs. The main symptoms it produces are those which come from congestion of these organs. They are associated with flushes of heat and abdominal plethora; there are bearing down and weight in the uterine region, a feeling of fulness and heaviness there, standing is a very annoying position to her, and there is burning in the vagina, often in association with pruritus and appearance of papules on the mons veneris. The nearest remedy to Sulphur here is Aloes, which produces pre- cisely the same symptoms, the same bearing down, the same fulness of the abdomen from abdominal plethora. Sulphur has, in addition to the above symptoms, aversion to washing. Aloes acts more on the rectum than on any other portion of the alimentary tract. There is a constant desire for stool. When stool is expelled it is accompanied by a great deal of flatus. The haemorrhoids of Aloes protrude like bunches of grapes, and are always relieved by cold water. In closing my remarks on Sulphur, I want to mention two or three uses you can make of the crude article. Sulphur has in its totality of symptoms a perfect picture of cholera Asiatica. It suits the incip- ient symptoms. It bears a resemblance to the course of the disease, and also to the subsequent symptoms. We have, then, in Sulphur a true prophylactic of that dreaded epidemic. It may be used by plac- ing a little flowers of sulphur inside of the stockings, as recommended by Dr. Hering several years ago. This sulphur is absorbed, as shown by the exhalation of sulphuretted hydrogen with the sweat. Flowers of sulphur burnt in a closed room may be used as a disin- fectant. LECTURE XLVI. THE CARBON GROUP. Carbo animalis (contains phosphate of lime). Carbo vegetabilis (contains carbonate of potash) Graphites (contains iron). Aniline sulphate. Carboneum (Lampblack). Coal gas. Bisulphide of Carbon. I invite your attention this morning to the medicines obtained from the carbon group. Carbon in its purity is found only in the diamond. We have it comparatively pure, however, in lampblack, or Carboneum. Carbon will necessarily be somewhat different in its action, according to the source from which we obtained it. Hahnemann used princi- pally three carbons, Carbo animalis, Carbo vegetabilis and Graphites. The first he derived from the animal kingdom, the second from the vegetable, while the last was an artificial product found principal^ lining the interior of large iron retorts. Carbo animalis is obtained principally from bones. It contains some phosphate of lime. Carbo veg. contains some carbonate of potash. It is obtained principally from a variety of the beech- tree. Graphites is always contaminated with more or less iron. Hence you see that these are not pure carbons. I have also placed on the board the Sulphate of Aniline, which behaves like a carbon and is a carbonaceous compound. Then, too, we have Carboneum and Carbonic oxide. Carbo?iic acid gas does not seem to possess active medicinal properties. It is not very poisonous. Its main deleterious effects are due to deprivation of oxj^gen. Carbonic oxide is much more poisonous, producing death, not only by suffoca- tion, by displacing the needed oxygen, but by another remarkable peculiarity. It has the property or peculiarity of displacing oxygen from the blood and taking its place there. You know that oxygen is carried along in the blood by the red corpuscles. Carbo?iic oxide has the power of supplanting the oxygen in these structures. For a time, 480 A CUNICAI, MATERIA MKDICA. it seems to act like oyxgen, but soon its poisonous properties are mani- fested with all the inevitable results of asphyxia. Coal gas, which we obtain by slow combustion of coal, and the illuminating gas used in our large cities, are of this character. They produce serious effects when taken in large quantities, especially when the subject is deprived of the ordinary atmosphere. It is said that this coal gas is beneficial in the treatment of whooping-cough. I have known of but one case thus treated, and that one died. Bisulphide of Carbon, which has also been proved, has some valuable symptoms. Now, all of the carbonaceous substances have some properties in common. For instance, they all have a tendency to relieve putrescence or putrid discharges or putrid exhalations from the body and offensive sores. You all know the mechanical properties of charcoal, what an absorbent it is, and how it can purify the atmosphere or substances that are undergoing decomposition. The animal charcoal, which is more porous, is here more effectual than the vegetable. If you bury a dead rat or mouse in charcoal for several months, you will not find any odor from decomposed tissue at the end of that time, but only a clean white skeleton. But this property, I would have you know, is not entirely mechanical. In the potencies, it may .be exemplified in the human system. Now I do not mean that potentized charcoal will remove the odor from a decomposing animal, but I do say, that in a potentized state it exerts similar effects on the human system. All the carbons act also on the skin, producing excoriations and inter- trigo. They affect the glands also, causing enlargement and indura- tion of the axillary and other lymphatic glands, even as in the case of Carbo veg. and Carbo animalis, simulating cancerous enlargement and infiltration. They all affect the mucous membranes, producing catarrhs of the nose, throat and lungs, and also of the bowels. They all tend to produce asphyxia. We find this prominently in Carbo veg., less so in the Carbo animalis, and very marked in Aniline and Carboneum. Carbojieum may produce asphyxia with convulsions simulating those of epilepsy. Coal gas and Carbonic oxide, too, are calculated to pro- duce dyspnoea from deprivation of oxygen. We find, also, that all the carbons act on the veins, producing varicose veins. We find, too, that all the carbons tend to produce flatulence This is one of the reasons why I object to toast as an article of diet for the sick. Toast, when the bread is nicely dried through by gentle and continuous heat, is very beneficial, but when it is charred, it tends to produce flatulence. The flatus is offensive and has an odor like that of rotten eggs. THE CARBON GROUP. 481 Carbo veg. V Kali c. V Phos. Carbo Vegetabilis. Ars., China, Phos., Phos. ac. In collapse, Camph., Veratr. alb. Caust., Kalic, Sulph. I Ant. tart., Amnion, c. <{ Baryt. c, Mosch., Nitr. Paralysis of lunsrs ac. ( Lauroc, Lach., Opium. Bry., Nux v., Puis., etc. As I have already intimated to you, Carbo veg. contains some car- bonate of potash. It is also a fact worthy of note that Kali carb. is complementary to Carbo veg. , especially in lung and throat affections and also in dyspepsia. Carbo veg. is also complementary to Phos- bhorus, here, too, in chest affections, in the throat more than anywhere else and, in excessive debility, particularly in the threatened paralysis of the whole system as a sequel to severe disease. The drug is anti- doted by Arsenicum and Camphor, and holds an inimical relation with Causticicm. The inimical relation between Carbo veg. and Causticum is not so marked as that between the latter remedy and Phosphorus. Carbo veg. is especially indicated in patients who are advanced in life, and, consequently, debilitated. It is called for in weak, delicate per- sons who are old dyspeptics, especially if they have abused their digestive organs by debauchery. In analyzing the drug we will speak first of its effects on the blood. We find Carbo veg. indicated in affections in which the composition of the blood is decidedly changed. There is decided sepsis or blood poisoning in many of the diseases in which Carbo veg. is the remedy. We find the drug indicated in haemorrhages, haemorrhages, too, of a very low type. Thus we give it in epistaxis or nose-bleed when the face is pale and sunken and almost hippocratic. The blood flows persistently for hours, perhaps for days. It is dark and rather fluid. It is apt to occur in old and rather debilitated persons and during the course of diphtheria. You find nearly the same symptoms under Camphor and Mercurius cyanatus. We also find Carbo veg. indicated in haemorrhages from the lungs, not only in haemoptysis but also in bronchorrhagia. In these cases 3i 482 A CLINICAL MATERIA MEDICA. the patient suffers from great anxiety and yet without any particular restlessness. The anxiety is very evident in the face and in the efforts at breathing, but there is no particular restless tossing about. The patient complains of burning pain in the chest. Carbo veg. is to be used especially in well advanced cases of lung degeneration. The pulse in these cases is apt to be intermittent and thready, the face is pale and often covered with cold sweat. The patient wants to be fanned, because fanning brings more air to the lungs. These same symptoms indicate Carbo veg. in haemorrhages from the uterus, whether metrorrhagia or menorrhagia. Here, again, you find marked burning pains across the sacrum and lower portion of the spine. If the haemorrhage continues any length of time you will notice the same trouble in the chest, with the difficulty in breathing above mentioned. Carbo veg. will here work hand in hand with Cinchona and Arseni- cum. Arsenicum is useful in these persistent haemorrhages of a low type, depending upon some degeneration in the organ affected. Both it and Carbo veg. have these violent burning pains. With the Arseni- cum, however, you have, as a distinction which applies in all con- ditions, irritability of fibre and mind, which is not the case with Carbo veg. Carbo veg. is a torpid, sluggish remedy, while Arsenicum^ has irritability, with restless tossing about, anxiety, etc. Ipecacuanha should also be remembered in haemorrhages, especially in haemorrhages from the lungs and uterus, when the patient takes long breaths, as if panting. Unless there is present coldness, amount- ing almost to collapse, you may prefer to begin with this drug rather than with Carbo veg. or Cinchona. Next we find Carbo veg. useful in varicose veins which occur on either the arms or legs, or even on the female genital organs. These varicose veins tend to ulcerate. They are bluish or livid, looking as though the blood had long remained in them. In the resultant vari- cose ulcers you will find very similar symptoms to those in other ulcers in which Carbo veg. is the remedy; burning pains, and mottled appearance of the surrounding skin as though the smaller veins had become enlarged. Bcchymoses are seen beneath the skin. The ulcers have a decidedly indolent appearance. Carbo veg. is also useful in ulcers other than varicose when they are of a very low type. The}^ are flat, tending rather to spread on the surface than to dip deeply into the parenchyma. They discharge not THE CARBON GROUP. 483 a laudable pus, but instead, that which is ichorous, corrosive, thin, burning and offensive in character. The burning is worse at night, depriving the patient of sleep and keeping him in torture the whole night. Even in cancerous ulcers, as in ulcerating scirrhus, you will find Carbo veg. useful. It may also be administered in carbuncle, particularly when the af- fected parts are bluish or livid, and when the discharges are offensive and associated with burning pains. In these cases it is not only your duty to give it internally, but also to apply it externally as a plaster. It tends to prevent decomposition of fluids, sweetens the sore and so prevents poisoning of the system. The same is true for gangrene. When carbuncles or boils become gangrenous, Carbo veg. may be indi- cated. In these cases it is distinguished from Arsenicum by the absence of this extreme restlessness. In febrile conditions, Carbo veg. is useful for the typhoid and inter- mittent types of fever, for collapse during fever, and for yellow fever. It is a preventive of yellow fever just as Sulphur is of cholera. If all the ejecta of the patient are buried in charcoal, the spread of the disease will surely be prevented. When the disease is fully established, Carbo veg. is of no more use than Sulphur is during the course of cholera. The intermittent type of fever in which you may employ Carbo veg. is of a low grade. The case is one of long standing, and has been abused by quinine. There is thirst during the chill. The feet are icy-cold up to the knee, a very characteristic symptom of Carbo veg. When the heat comes, it is in burning flashes. The sweat is either sour or else exceedingly offensive from alterations in the discharges of the skin. During the apyrexia the patient is pale and weak. Memory is weak ; the mind seems to be befogged. The patient is decidedly low-spirited and melancholy. In the hectic type of fever, Carbo veg. is indicated by pretty much the same symptoms as those which I have already mentioned. It is particularly useful for hectic fever dependent upon long-lasting suppu- ration, whether due to abscess in the lungs, or in the hip-joint, or about the vertebrae. Menyanthes is the remedy in quartan fever when the legs below the knees are icy-cold. You know that abscesses accompanying diseases of the spine may have to be opened. Sometimes surgeons are afraid to do this before they have prepared the system for it, because reaction is so slow that the patient may not survive. The danger from opening these abscesses 484 ; A CLINICAL MATERIA MEDICA. may be greatly lessened by the use of Carbo veg. or Cinchona, accord- ing to the particular indications. In collapse from various causes you may use Carbo veg. There is decided lack of animal heat. The nose, cheeks and extremities are cold. It is indicated in the late stages of typhoid fever; after pro- tracted loss of vital fluids, as after long-lasting haemorrhages; during cholera Asiatica; during pneumonia; and, in fact, in any form of dis- ease in which these symptoms appear. The body may be icy-cold, especially about the extremities; the breath is cool; the pulse is thread-like, scarcely perceptible and intermittent. The lips may be bluish from cyanosis. Breathing is very weak and superficial; the patient may be either conscious or unconscious. Now, Carbo veg. in just such cases comes in as a savior, and rescues many a case that would otherwise die. There are other remedies similar to Carbo veg. in collapse. Camphor ; especially, is similar to it in cholera Asiatica, but it is indicated rather in the beginning of cholera without any vomiting or diarrhoea; when the poison seems to have depressed or shocked the nervous system, so that the patient is icy-cold, dry or in a cold sweat; the tongue is cold. If he can speak it is in a squeaky or in a high-pitched voice, or else it is a husky, toneless voice. Camphor, in such cases, brings about reaction very quickly. Carbo veg. would be indicated in the later stage, when the prostration is the result of the drain on the system by the alvine discharges. Veratrum album is also similar to Carbo veg. in collapse. It has cramps in the calves of the legs, the thighs and the chest, and char- acteristically cold sweat on the forehead. I wish next to say a word about the action of Carbo veg. on glands. The glands, especially the mammae, become indurated. There are burning pains in the swollen glands, with tendency to suppuration. When they do suppurate, the discharged pus is not of a laudable char- acter. We find Carbo veg. indicated in catarrhal troubles which are pro- voked by warm moist atmosphere, such as we have in this latitude with southwest or southerly winds. The patient is worse in the even- ing or less characteristically in the morning. He has aphonia recurring regularly each evening, painless or associated with raw feeling down the larynx and trachea. There is dry tickling cough, at times quite spasmodic in character. THE CARBON GROUP. 485 It is here analogous to Phosphorus, and is often preceded or followed by that remedy. The Phosphorus aphonia is associated with rawness of the larynx, and is worse in the evening. In the morning aphonia, Carbo veg. is more closely allied to Sulphur, which has loss of voice, particularly in the morning. Still another concordant remedy is Causticum, which is suited to laryngeal catarrh in singers with rough hoarse voice, associated with tracheo-bronchial catarrh, and rawness and burning under the sternum. This group is found under both remedies. The main difference is that Causticum has hoarseness worse in the morning, and Carbo veg. in the evening. Causticum has aggravation in dry, cold weather, and Carbo veg. in a damp warm atmosphere. Another remedy is Eupatorium perfoliatum, which I use for hoarse- ness with soreness in the larynx, trachea and bronchial tubes. The hoarseness is worse in the morning, and is apt to be associated with aching all over the body. Carbo veg. may also be used in asthma, particularly in the asthma of old people and of people who are very much debilitated. They look, during the asthmatic attack, as if they would die, so oppressed are they for breath. They are greatty relieved by belching wind. It is especially indicated in asthma which is reflex from accumulation of flatus in the abdomen. It may also be used in threatening paralysis of the lungs in typhoid fever, after pneumonia, and in old people. The "paralytic catarrh " of old people calls for Ca?'bo veg. There are loose rattling rales when the patient coughs or breathes, a marked symptom of emphysema. The bronchial tubes are greatly dilated. In addition to this you will find coldness, symptoms of collapse, etc. The nearest approach to Carbo veg. in emphysema is Ammonium carb., which, like Carbo veg., has blood poisoned by carbonic acid, giving you the coldness, blueness, etc., incident to that condition. In threatened paralysis of the lungs, we have a great many reme- dies to consider, most of which I will reserve until we come to speak of Phosphorus, which stands very close to Carbo veg. Then, too, you should also remember Mochus and Antimouium tartaricum. A?iti??io?iiu?7i tartaricum applies when there are loud rales heard in the chest. It seems as if there was an immense amount of mucus there, and yet the patient can scarcely raise any of it. The extremities are cold and blue from the cyanosis developed by the blood poisoning. 486 A CLINICAL MATERIA MEDICA. The patient^soon becomes drowsy and passes into a stupor from which he can be aroused, but into which he readily relapses. You should also remember Antimonium tartaricum when, in the course of lung affections, whether there be bronchiectasia or catarrh on the chest in children (and here it is especially called for), the cough ceases or be- comes more rare and yet there is no diminution in the mucus-pro- duction itself. Your practiced ear placed on the chest detects just as copious an J exudation, and just as much rattling of phlegm in the lungs, and yet the child does not cough so frequently. The mother thinks the child is better, but in reality it is worse, for the lungs are losing their power. Carbo veg. is an excellent remedy for the terrible dyspnoea of chronic aortitis, especially when the patient has become very anaemic, drop- sical, etc. Here you should compare Arsenicum, Cuprum and Lachesis. Still further, I want to speak of the action of Carbo veg. on the stomach and bowels. We find it here, rivalling other well-known remedies in dyspepsia or indigestion, and those of a rather low type, too. We find it indicated, too, for the bad effects of debauchery, for excessive indulgence in table luxuries, and for bad effects from wines and liquors and all kinds of dissipation. As a result of dissipation, we may have just such symptoms as call for Carbo veg.; headache, par- ticularly in the morning when the patient awakens from sleep, having spent the best part of the night carousing; dull headache referred to the back part of the head, with a great deal of confusion of mind. There is humming or buzzing in the head as though a hornet's nest had taken its place there. The patient feels worse in the warm room. The pain also seems to go from the occiput through the head and into and over the eyes, with dull heavy aching in that region. There are nausea and usually a sort of burning distress and weakness referred to the epigastrium. He is unable to take any fat food, whether meat, gravy or fried food. He cannot drink milk because it produces flatu- lence. After eating the stomach feels heavy, as if it were dragged down. The abdomen is distended with flatus and both belchings and borborygmi are offensive. The wind belched has a rancid or putrid taste, and a decidedly offensive odor when passed from the bowels. He suffers from constipation with piles. The piles get worse every time he is on a spree; oozing of moisture from anus; perineum, sore, THE CARBON GROUP. 4.87 itching.* Sometimes they protrude and are bluish, they are so dis- tended with blood. At other times, he has morning diarrhoea with stool which is very watery and thin and accompanied by a great deal of straining. We find Carbo veg. particularly indicated here after the failure of Nux vomica. The patient is peevish, easily angered. Vertigo reflex from the gastric disturbance is present. It is especially worse after a debauch and excessive indulgence in high living. It is often associated with syncope, especially at meals or after eating. The nearest concordant remedy here is Arsenicum. Both remedies have bluish protruding piles, both have burning in the epigastrium, both have anxiety, and both are suitable for the bad effects of ice- cream, and ice-water in hot weather. The difference may be expressed in these few words : Carbo veg. is torpid, Arsenicumis always irritable ; of the two remedies, Carbo veg. has the burning most marked espe- cially in internal parts, as in the stomach. Nux vomica impinges on Carbo veg. in the bad effects of over-eating and high living. As I have already said, Carbo veg. comes in when Nux has ceased to act. The Nux toper is a thin, spare, yellow, wiry fellow. That of Carbo veg. is sluggish, stout and lazy. Next we are to distinguish Carbo veg. from Cinchona. This is easily done, because the two drugs meet only in the flatulent dyspepsia and in debility. Cinchona is suited to a peculiar functional debility, when the system is devitalized by loss of animal fluids. Carbo veg. is the better remedy when the debility arises from organic causes, and we have a picture of collapse with hippocratic face and coldness of the body, particularly of the knees. Both remedies produce great flatu- lence. Cinchona, however, does not have the rancid belching with burning. Belching temporarily relieves the symptoms in Carbo veg. In Cinchona they sometimes seem to be worse therefrom. Lycopodium also typifies perfectly this state of tympanites. The abdomen is enormously distended. The distinction to be made is this : Carbo veg. produces more flatulence of the bowels, Lycopodium more of the stomach. Again, Carbo veg. produces rancid belching, or else passage of offensive flatus, with bitter taste in the mouth. Lycopodium has more of a sour taste with its belching. * Perineum, moist, raw, oozing, etc.; Amnion, c, Alum, Natr. m., CARBO V., Carbo a., NITR. AC, Graph (and cracked), SuivPH., Rhus tox., Arsenic, Ant. cr. (mucous piles), THUJA (offensive oozing), SIIylCEA (moist), Sulphuric acid, Capsic, Petroleum (see also Fissures), Borax (slimy, purulent oozing), Sepia (oozing). 488 A CLINICAL MATERIA MEDICA. Carbo veg. may be indicated in dysentery. Here it is called for in very severe cases. There are burning pains situated deep in the abdomen, usually in one or the other of the bends of the colon. The abdomen is greatly distended and tympanitic. The pulse is weak and intermittent. The discharges from the bowels are horribly offensive and brown, watery and slimy in appearance. You see what a desper- ate case we have here, one that calls for great skill in prescribing. Here you must distinguish between two other remedies and Carbo veg., namely, Arsenicum and Cinchona. Arsenicum helps when there is, as I have said, that irritability of fibre. The patient is just as sick and just as near death's door as is the Carbo veg. patient, but he is restless, and complains of burning thirst and yet exhibits an intolerance of water. The discharges from the bowels are about the same in character under the two remedies. Arsenic, however, has less tympanitic distension of the abdomen. Cinchona and Carbo veg. are also similar in these cases. Both have these dark offensive fluid discharges, both have the distension of the abdomen, both have great weakness and hippocratic face. With Cin- chona, however, the movements from the bowels are provoked by every attempt to eat or drink. Belching gives but temporary relief . Again, the flatus is not so offensive as with Carbo veg. , nor are the burning pains so marked as under Carbo veg. or Arseyiicum. Carbo animalis. LECTURE XLVIL CARBO ANIMALIS, GRAPHITES AND PETROLEUM. Carbo Animalis. Bromine. Sepia, Natr. m. { Silic, Phos. I Badiaga. [ Merc, iod., Nitr. ac. Calc. phos. Carbo animalis and Carbo veg. do not follow each other well. They are so far inimical that one may not be given with benefit after the other. They are too nearly alike. Carbo animalis contains some phosphate of lime. Carbo animalis is complementary to Calcarea phos- phor ica, especially in affections of the glands. Carbo animalis is suited to old persons and to those who are greatly debilitated by disease, especially when there is a predominance of what is known as venous plethora. You find such patients particularly in- clined to blueness of the skin. The hands and feet readily become blue, with distended veins showing through the skin. They become ill from very slight causes. The cheeks often get bluish. Both remedies are indicated in decomposition of tissue of the body, as in gangrene and ulcerations of the surface or of internal parts, with putrid discharges. Both, too, are indicated in weakness of the digest- ive organs, both are indicated for the bad effects of loss of animal fluids, particularly during lactation. Now, as a general distinction between the two drugs, you may re- member this: although both drugs act on the glands, the predomi- nance is in favor of the Carbo animalis for glandular affections. For instance, we find it indicated in induration of glands, of the axillary glands and of the glands in the groin, particularly in syphilitic or gonorrhoeal patients. These buboes are hard like stone; Carbo animalis is especially useful when these have been opened too soon, and when 49° A CLINICAL MATERIA MEDICA. there is a gaping wound which has partly healed, leaving the sur- rounding tissues of an almost stony hardness. Badiaga rivals Carbo animalis in just these cases, particularly in in- durated buboes that have been maltreated. Again, we find Carbo animalis indicated in cancer more frequently than Carbo veg.; particularly is it useful in cancer of the breast or of the uterus. In mammary cancer you have the glands indurated in little nodes; or small circumscribed portions which are as hard as stone. LAmon. c. Fluorine. f Merc, Phos., Sulph., Calc. ostr. | >Sulph. Iodine. -{ Ars., Calc, Arg. n. Spong., Hep., Kaolin. [ Ant. tart. >Starch. >Hepar. >Arsen. Chlorine. To-day we begin the study of the chemical elements termed halo- gens; Iodine, Bromine, Fluorine and Chlorine are the elements in this group. As a group the halogens may be remembered by this great characteristic symptom, they all act upon the larynx and bronchial tubes, and in fact upon mucous membranes generally. They are de- cidedly irritating to the mucous membranes, producing violent inflam- mation, rawness and excoriation, as anybody can testify who has once inhaled the fumes of Chlorine, Iodine or Bromine. They all produce spasms of the glottis and this is most marked in Chlorine, although they all have it. They all tend to produce pseudo-membranous forma- tions on the mucous membranes. All excepting Chlorine tend to pro- duce croupous membranes; Chlorine tends more to diphtheritic than pure croupous membrane. All of the halogens act upon the glandu- lar system, producing enlargement, induration and even abscess in 502 A CLINICAL MATERIA MEDICA. glands. Thus we find them all useful in scrofulosis, especially Iodine, which leads the list. Cyanogen also belongs to this group chemically, although it is properly considered as belonging to organic chemistry. It has many similarities to these drugs, and, like Chlorine, is useful in diphtheritic deposits. Thus we use Hydrocyanic acid and Amygdala Per ska (which contains Hydrocyanic acid) for diphtheritic so re- throat, and we may use the Cyanide of Mercury, for some of the worst forms of diphtheria. The same is true to a less degree of Cyanide of Potassium. These general characteristics of the halogens lead you at times to say: "This patient needs one of the halogens, which shall it be?" To answer that question we must study these four elements separately and by comparison. Bromine. I will first call your attention to Bromine. Bromine produces a rather peculiar effect on the sensorium, causing a sort of vertigo, which is worse from running water. Anything moving rapidly pro- duces this vertigo. It is associated with a peculiar anxious state of mind. Now this anxiety belongs to all of the halogens. It hardly originates in the mind, probably coming from some defect in the body, itself. It is a common symptom in heart and lung affections, and it is probably thence that the symptom springs. This anxiety is expressed in this way: the patient expects to see objects jumping about or he feels as if on turning his head he must see something or some one. This is an effect of Bromi?ie, and those of you who are familiar with Bromide of Potassium will recognize whence it gets its anxiety. The vertigo is relieved by nose-bleed, showing at once that it is congestive in character. Another symptom indicative of congestion under Bro- mine is this: after dinner there is sensation deep in the brain as though a fit of apoplexy were impending. The patient feels as if he would lose his senses. The Iodine mental condition is more marked than that of Bromine. It is a decided erethism, during which the patient is very excitable and restless, moving about from place to place, now sitting here, now sit- ting there; he fears that every little occurrence will end seriously. In his anxiety he shuns every one, even his doctor. He has a great dread of people. At times he becomes quite excited and delirious, with vertigo, red face and anxiety. In children with tabes mesenterica here is a characteristic irritability, screaming when looked at. HALOGENS. 503 Next, the lymphatic system. Like all the other members of this group, Bromine attacks the glands and causes enlargement and indu- ration of the glands. Hence it is called for in scrofulosis. It is par- ticularly suited to scrofulous patients, children usualh 7 , when the parotid gland or glands are indurated, when there is a tendency to suppuration, with excoriating discharge, persistent hardness of the gland around the opening, and undue amount of warmth or heat in the gland. I have merely mentioned the parotid gland for purpose of illustration. Bromine also affects the mammary gland, for cancer of which it has been a very useful remedy. You may perhaps remember that I told you the other day that it was similar to Carbo animalis. Like Carbo animalis, it has induration of the glands in the axilla with burning pains. But ' Bromhie also has cutting pains. The breast is hard and on palpation, a dull subdued sort of throbbing may be felt in it. Sometimes the drawing or cutting is so marked that it feels as if a string were pulling from the gland into the axilla, a symptom more often calling for Croton tiglium or Paris quad. The testicles are acted upon by Bromine. We find them swollen, hard and perfectly smooth and unduly hot. The pain is worse from jarring. You will find that glandular affections yield to Bromine, especially in persons of light complexion, with fair skin and light blue eyes. I mention this symptom here to make use of it in a few moments as a symptom of comparative value. I do not mean to say that every scrofulous child with blue eyes must have Bromine, but I do mean that this symptom is of use to enable us to distinguish Bromine from the other halogens. The tonsils, too, are affected in Bromine. Thus we find them deep red and swollen and covered with a network of dilated bloodvessels. They are worse when swallowing, and are accompanied usually with swelling of the glands externally. There is a feeling of rawness in the throat with this tonsillitis. This, too, as you know, is common enough in scrofulous children. Many have a strong temptation to ex- cise the tonsils, but this is not good practice, for you can often cure this trouble by internal medication. In some cases, this enlargement of the tonsils may be looked upon as a forerunner of tuberculosis. We find Bromine indicated in enlargement of another gland, namely the thyroid gland, and curing what has been termed bronchocele or goitre. We next have to speak of Bromine in its action on mucous 504 A CLINICAL MATERIA MKDICA. membranes. Beginning with the nose, we find that it is useful in coryza or in nasal catarrh, when the discharge is profuse, watery and excori- ating. The nostrils, alternately, seem to be stopped up. There is peculiar headache associated with this coryza, a heavy pressure in the forehead which seems to be pushing the brain down and out at the root of the nose. The nose is very sore inside and also around the alae. This is a smarting soreness, just such as you would expect the fumes of Bromine to cause. Later, ulcers form in the nose, with the escape of crusts or scabs, which are blown out and which are always blood} 7 . Every attempt to blow the nose is followed by a discharge of crusts and blood. This you know is common enough with scrofulous children. Coming now to the throat and lungs, we find Bromine indicated in spasm of the glottis, sometimes called laryngismus stridulus. This is a very difficult disease to cure. It is often central in its origin. It commences by sudden closure of the glottis. The child turns blue in the face, and its body becomes convulsed. One spell ceases only to be followed by another. In the second stage, general convulsions appear, followed by emaciation. The trouble may be reflex from dentition, or from indigestion, or from enlargement of the thymus gland. If it can be found to be the result of enlargement of the thymus gland, then^ Iodine is clearly indicated. When it has been caused by retarded dentition, I think that Calcarea phosphorica promises better than any- thing else. Dr. Dunham records a case that had been given up by an allopathic physician, but, knowing the symptoms of Chlorine, which, above all other remedies, will produce this spasm of the glottis, he generated some Chlorine, and allowed the child to inhale the fumes, with almost instantaneous relief and final cure. All the halogens are useful in this condition, but Chlorine is here the best of them all. Their symptoms differ but little so far as the local symptoms are concerned. We may also think of Sambucus, Antimonium tartaricum, Belladonna, Lachesis, Arsenicum and, in some cases, Phosphorus. Lachesis is particularly indicated when the patient awakens from sleep with it. Ignatia, whenever a cross word or correcting the child brings on the spasm. Another remedy is Cuprum, especially when the spasms are general and the child clenches its thumbs. Ipecacuanha may be of some use in some cases, but I have no con- fidence in it. HALOGENS. 505 Nor have I in Sambucus, because, under Sambucus, I think the trouble is more in the chest, whereas, with Cuprum, the halogens, Cal- carea phos., Lachesis and Belladonna, the trouble is in the larynx itself. This spasm of the glottis often comes in the course of croup, in which disease Bromine may be the remedy when inspiration seems to be exceedingly difficult; the child is suddenly aroused from sleep as if choking. These symptoms are relieved by a drink of water, which seems to quiet the spasmodic condition. In membranous croup Bromine is indicated by the following symptoms in addition to the spasm already referred to: the child has at first a deep, rough voice, which, in the evening, amounts almost to aphonia. It cries with a hoarse, husky voice. The membrane seems to come up from the larynx into the throat. Every inspiration provokes cough, especially every deep in- spiration. Breathing is hoarse, rasping and whistling, as though the child were breathing through a sponge or through some loose metallic substance which is vibrating. This is caused by the vibration of membrane as it is deposited more or less uniformly over the interior of the larynx. Later, there is rattling in the larynx. When the child coughs it seems as if the larynx were full of the loose rnucus. Antimonium tartaricum is very similar to Bromine in croup. It has rattling and wheezing, extending down the trachea as well as in the larynx. Now, I wish to say a few words about other remedies in connection with croup, especially concerning Aconite, Hepar, Spongia and Kaolin. Kaolin is a kind of porcelain-clay, a combination of lime and silica, and has proved very useful in membranous croup. The relation which these remedies hold is this: Aconite is useful in the beginning of croup, whether spasmodic, catarrhal or membranous. It is indicated by the child suddenly arousing from sleep as if it were smothering. There is great restlessness. The skin is hot. There must be some anxiety present. Breathing is dry. There is no sound of mucus. Soon the child seems better and falls asleep, only to be aroused again. Arnica is especial^ indicated in these cases if the symptoms have followed exposure to drjr, cold winds. Do not stop your remedy too soon. If you do, while the child will be better in the morning, the symptoms may return with renewed violence the next night, and, before you know it, the mucous membrane of the larynx and trachea will take on fibrinous exudation and 3^ou lose your patient. 506 A CLINICAL MATERIA MEDICA. You will need to change to Spongia when you have these symptoms present: breathing during inspiration is hard. and harsh, as though the child was breathing through a sponge. The cough has a decidedly hard, barking, ringing sound. As yet the sputum is scanty. Spongia follows Aconite, especially after exposure to dry, cold winds, and in light-complexioned children with blue eyes. The symptoms are usually worse before midnight. Suppose this fails you, then you may have recourse to Hepar sulpharis calcarea. Hepar usually is worse after midnight and towards morning. The cough has the same harsh, croupy sound, but there is a great deal of moisture with it. This is the indication for Hepar. It, too, is worse from exposure to dry, cold winds. Sometimes all these drugs fail, and we have to resort to the halogens, especially to Bromine and Iodine. I have already given you the symptoms of Bromine; let me tell you how to distinguish it from Iodine. Iodine is particularly indicated after the failure of Hepar, when the membrane has formed; inspiration is exceedingly difficult, both from spasms of the throat and occlusion of the lumen of the larynx by the membranous formation. Inspiration is wave-like or in jerks. The cough is moist but harsh, just as you found under Hepar. The voice is almost extinct from the hoarseness. The child grasps its throat to relieve the pressure, throws its head far back so as to straighten the route from the mouth to the lungs and favor the passage of air. It is particularly worse in the morning. Iodine is especially adapted to dark-complexioned children with dark hair and eyes. This in itself is a great distinction between Iodine and Bromine. That is why I spoke of the use of Bromine in light-com- plexioned children, because this fact has been proven to be a good dis- tinction between these two drugs, and hence, as a comparative symp- tom, is one of great value to you. Iodine is particularly adapted to cases that come from damp weather. Long- continued damp cold weather will produce just such a cough as Iodi?ie will cure. Do not change the remedy in these cases too often. Do not change your remedy on account of alarming symptoms that spring up, unless you are certain that they indicate a cha?ige. Kaolin has been used successfully for membranous croup even when the membrane dips down deep into the trachea. There is extreme soreness of the chest. The patient does not want anything to touch him. He will not permit you to use steam or hot cloths, because the chest is so sore. HALOGKNS. 507 Returning to the study of Bromine, we find it useful in affections of the lungs. It is indicated in asthma, when the patient feels as if he could not get air enough into his lungs, consequently he breathes very deeply. The explanation of this lies not only in the lungs, but also in the constriction of the glottis. Although the patient expands his chest well, air does not go in on account of the narrowness of the opening in the larynx. It is especially indicated in asthma coming on, at or near the seashore. We also find Bromine useful in pneumonia, particularly when it affects the lower lobe of the right lung, hence lobar pneumonia. We often find nose-bleed as a concomitant symptom when Bromine is indi- cated in these cases. The patient also has the symptom just mentioned under asthma, "seems as if he could not get enough air into the chest; " while there seems to be plenty of mucus, the patient does not appear to be able to expectorate it. We also find Bromine indicated in tuberculosis of the lungs, par- ticularly when the tubercular deposit is more manifest in the right lung. The patient suffers frequently from congestion of the head and chest, which is relieved by nose-bleed. Notice how often that symp- tom occurs under Bro?ni?ie. There is also pain in the mammary region going up into the axilla. The eyes seem to be affected along with the chest symptoms giving rise to a chronic conjunctivitis. Bromine produces a very characteristic picture of uncomplicated hypertrophy of the heart, by which I mean, muscular enlargement without valvular lesion. The patient finds it difficult to exert him- self on account of the oppression about the heart. He has palpitation when he begins to move and when he gets up from a sitting to a stand- ing posture. The pulse is full, hard and rather slow, which is just the character that belongs to an over-active enlarged heart. It has cured many cases of this hypertrophy of the heart. I think it was Dr. Thayer, of Boston, who cured many cases of this trouble with Bromine. It may also be used in cardiac asthma, especially when the asthmatic paroxysms are better at sea than on land.* You here find Bromine similar to Aconite, but it lacks the anxiety of that remedy. Both remedies are suited to uncomplicated cardiac * Professor Farrington refers above to the asthma of Bromine as coming on at or near the seashore, and here he speaks of cardiac asthma better on sea than on land. Both may be right, for being at sea differs from being at the seashore* where you may have land breezes. — S. 1^. 508 A CUNICAL MATERIA MEDICA. hypertrophy, but Aconite has fear and anxiety. The patient fears that he will drop dead in the street. It is also similar to Aconite and Rhus tox., both of which remedies have uncomplicated hypertrophy of the heart from over-exertion. Iodine. So much for Bromine; now for Iodine; and first let me speak of the symptoms arising from its abuse. Iodine is an absorbent; it has the property of causing absorption, particularly of glandular structures- Its absorbent properties extend to other tissues, involving, finally, even nervous structures. We find, for instance, in persons who are poisoned with Iodine, great emaciation. With the female, the mam- mary glands become atrophied and the ovaries, too, no doubt. With the males, the testicles surfer in the same manner and there is the in- evitable progressive loss of sexual power. The skin becomes dark yellow and tawny, dry from deficient action, the sclerotica become yellow, yellow spots appear on the face and also on the body. There is excessive appetite, he is anxious and faint if he does not get his food. He is relieved while eating and yet he emaciates despite the amount of food he eats. Sooner or later the nervous system becomes involved and he is afflicted with tremor. He becomes nervous and ex- citable; every little annoyance, which would be unnoticed in his normal condition, causes trembling. He has a longing for the open air, as if the cold fresh air gave him more health. This gives a fair idea of the condition to which the patient is reduced by the over use of Iodine. One of the best antidotes to £his state is Hepar. Some cases require Sulphur. The individual symptoms decide. Now compare Iodine with Bromine in chest affections. Iodine is indi- cated in pneumonia, more so, perhaps, than Bromine. It is especially useful when the disease localizes itself, that is, when the plastic exuda- tion* commences. There is a decided cough with great dyspnoea, difficulty in breathing, as though the chest would not expand (and here the trouble is situated in the chest itself) , and blood-streaked sputum. You will find some portions of the lungs beginning to solidify. You may also give it later in the disease, after the stage of hepatization, in the stage of resolution, when instead of absorption *Under Mercurius and Iodine, exudates are plastic; Bryonia, serous and plastic; Hepar, purulent. HALOGENS. 509 and expectoration of the exudate, slow suppuration appears with hectic fever and emaciation; the patient feels better in the cool open air than he does in the warm room. Phthisis pulmonalis sometimes calls for Iodine. You here find it indicated in young persons who grow too rapidly, who are subject to frequent congestion of the chest, who are rather emaciated, and who suffer from dry cough, which seems to be excited by tickling all over the chest. The patient cannot bear the warm room. Expectoration is tough and blood-streaked. There is a well-marked feeling of weak- ness in the chest, particularly on going up stairs, The patient has a very good appetite, and is relieved by eating. The nearest remedy to Iodine here is Phosphorus, which is also well adapted to phthisis in the rapidly-growing young. Iodi?ie is also indicated in enlargement of the heart, whether or not accompanied by disease of the valvular structures. There is palpitation of the heart, particularly after any manual labor. It is suited espe- cially to dark-complexioned persons, with dark hair, etc. The heart feels as if it were being squeezed by a firm hand. At other times there is excessive weakness in the chest, with ' ' goneness ' ' or exhausted feeling. The patient can scarcely talk or breathe, so weak does he feel. This shows that Iodine acts on the connective tissue. In valvular affections there is a feeling of vibrat'ion over the heart, just such a sensation as you get when stroking a purring cat. Spigelia has that same purring, vibrating feeling over the region of the heart. Now let me give 5^ou the difference between Iodi?ie and Bromine in scrofulous affections. Iodine causes induration of the glands more marked than does Bromine. They are hard, large and usually painless. There is a characteristic of Iodine which is universal, and that charac- teristic is torpidity and sluggishness. The very indolence of the dis- ease is suggestive of Iodine. It also produces atrophy of the glands. The mammae waste away and the testicles dwindle. We find it indi- cated in scrofulosis of children, when they emaciate rapidly, despite a ravenous appetite. They are hungry all the time. They cry for their dinner, they feel better while eating, and yet they do not gain any flesh. They are always better in the open air and worse from any con- finement in the warm room. The mesenteric glands are enlarged, and you have what is known as tabes mesenterica. This indicates Iodine, particularly when you have these other symptoms present together with excessive mental irritability. 5IO A CLINIC AL MATERIA MEDIC A. We find Iodine causing a rather singular diarrhoea. In such cases the spleen is enlarged, quite hard, and very sensitive to the touch. The liver, too, must be affected, because the stools are whitish; some- times they are wheylike. This last symptom you will often find con- nected with obscure disease of the pancreas. Iodine has such an affinity for glandular structures, that it, no doubt, attacks the pancreas as well as other glands. We also find Iodine affecting the ovaries. It is indicated in ovarian dropsy. In such cases as this, the single fact that Iodine has helped in ovarian dropsy must not lead you to give Iodine in every case of that trouble. Other remedies have proved themselves useful. Apis, Colocynth, and other drugs, have cured cases, and they have sometimes failed. If the whole picture of the patient calls for Iodine, it is your duty to give that drug, but not unless such is the case. It must be given for weeks or months before it will bring about absorption of the tumor. We also find Iodine indicated in cancer of the uterus, particularly with profuse haemorrhages. The leucorrhoea is characteristic, being yellowish and very corrosive. This, in conjunction with the other Iodine symptoms, sallow, tawny skin, ravenous appetite, etc., makes Iodine the remedy which will relieve many cases and cure some. In this connection we have other remedies to remember, and notably among these, Hydrastis, which has cured epithelioma, and may be a remedy for uterine cancer. I have, however, had no personal success with it. It has been used both externally and internally, when indi- cated by symptoms which have already been given you in another lecture; especially has it marked goneness at the epigastrium, and pal- pitation after every motion. There is a substance, or remedy, known as Lapis albus. It is one of Grauvogl's remedies. He, at one time, went to a certain spring, the waters of which, it was claimed, would cure tuberculosis, scrofulosis, and even cancer. On examining the spring, he noticed that the water had gradually worn a crevice in the rocks. He took away a piece of this rock over which the water was falling, and made triturations of it. With this he cured several cases of goitre, and also several cases of scirrhus. This rock has been analyzed, but the analyses differ so that I hardly know which one to recommend. Iodine is sometimes indicated in rheumatic joint affections, with effu- sion and emaciation. Hydrarthrosis yields, according to Jahr, Jousset HAIX>GKNS. 511 and others, to Iodine. In acute cases, compare Apis; in the chronic, Sulphur. Both Iodine and Bromine are of some use in ulcers. Iodine, for in- stance, is useful in ulcers rather of a scrofulous form, with spongy edges, and discharges of a bloody, ichorous, or even purulent character. Now, Bromine is somewhat similar. It is useful in ulcers which have a carrion-like odor, with threatening gangrene. The surround- ing skin has a greenish-yellow hue. That is the form of ulcer to which Bromine is especially adapted. Now, a few words about Chlorine. I do not know much about it as a medicine. It may be given in a crude form by allowing the gas to be absorbed by ice-cold water, and thus it may be prepared for the cases to be enumerated. Chlorine, and in fact all its combinations, seem to have a special affinity for mucous membranes. Hence we find it indicated in catarrhs. Chlorine produces a watery discharge from the nose, with a thin, excoriating coryza, making the nose sore, both in- side and about the alse. On examining the mouth, you find it, too, affected with a low grade of inflammation. Chlorine here produces small, putrid-smelling ulcers, yellowish- white, which are aphthous in character. Chlorine is indicated in scorbutic states of the blood, as are all the chlorides. We find under Natrum ??iur. and Kali chloricum the same kind of stomacace, with excessive foetor of the breath. We find Chlorine also acting on the nervous system, probably through the blood. It is indicated in typhoid conditions; the patient has a fear of becoming crazy, or that he will lose his senses. He is very forgetful; he cannot remember names, etc. There is a constant fear of some impending disease. There is also, under Chlorine, a peculiar painful sensation in the vertex, passing down the left side of the body. This is a precursor of typhoid fever. It is worse after eat- ing. In such cases Chlorine will often modify the fever. Chlorine is also indicated in impotence, but when this impotence has been produced by inhalations of the fumes of Chlorine, Lycopodium is the proper antidote. Chlorine is a very good antidote to Sulphuretted hydrogen. 512 a clinical materia medica. Spongia. { Aeon., Bell., Hep., Iod., Brom. Spongia. J Anacardium. I Caust., Selen., Phos. ^ Badiaga. Spo?zgia is not a chemical substance. It is derived from the animal kingdom, but, because its symptoms are closely allied to those of the halogens, it is convenient to study the drug here. Spongia contains Iodine, also some Bromine and some calcareous matter, and probably other ingredients of minor importance. It differs from Iodine. In the first place, it is adapted to light-complexioned persons, and it has not the same property of producing plastic or fibrous exudates that Iodine has. It acts, however, on structures very similar to those in- fluenced by the halogens, especially the glandular system and mucous surfaces. We find it of service in tuberculosis, and we shall find it in- valuable in the treatment of heart disease. First, let us study its action on the glands. It is indicated just as are the halogens in indurations and enlargement of the glands. Thus we find it indicated in goitre. The swelling is hard and large, one or both sides are swollen, sometimes even with the chin, and particularly is this associated with suffocating spells at night. This suffocation does not come alone from the size of the goitre, because some very small goitres give rise to this symptom in a very great degree. I would also call your attention to the fact that goitres will vary in size at different times. They will be larger at one time than another. It is said that they increase and decrease with the moon. It has, there- fore, been suggested that you give Spongia, or whatever drug you select, with the waning moon. In this way you hurry its decline. Spongia acts on the testicles just as powerfully as the halogens, pro- ducing hardness and swelling of these glands. It is particularly useful in cases of maltreated orchitis or inflammation of the testicle after checked gonorrhoea. There is a peculiar sort of squeezing pain in the testicle and cord, worse on any motion of the body or clothing. In cases of orchitis, our first remedy is not Spongia. Pulsatilla stands at the head of the list, and next to it we may rank Hamamelis, or witch-hazel. The latter drug should be used both locally and in- ternally. It relieves the intense soreness and enables the patient to SPONGIA. 513 attend to his duties. Still another remedy is Mercurius solubilis , par- ticularly when what little gonorrhceal discharge is present is yellowish- green. Another remedy in the very beginning is Gelsemium. When, however, you have this peculiar screwing-like, squeezing pain in the cord and testicles, with hardness there, Spo?igia comes in as one of our best drugs. We find Spongia indicated in acute larjmgitis. This is an alarming disease. It is indicated after Aconite, when there are harsh, barking cough and suffocative spells during sleep, arousing the patient. The larynx is extremely sensitive to the touch. Do not give Lachesis in these cases, for the sensitiveness is not due to hyperesthesia of the cutaneous nerves, but it is the result of the inflamed condition of the laryngeal cartilages. Simply turning the head will bring on a suffo- cative spell. Now there is another remedy that I would have you remember in this connection, and that is Sambucus. This is useful when these spasms of the larynx occur frequently during the course of acute laryngitis. The same symptoms that suggest Spongia in laryngitis also indicate it in laryngeal phthisis. I will not speak of the application of Spongia to croup, because I gave that to you in the early part of this lecture when speaking of Bromine and Iodine. We come next to the lungs. We find Spongia indicated in true tuberculosis of the lungs. It is especially called for in the beginning of the stage of solidification of the lung tissue. You find the apices of one or both lungs dull on percussion. The cough is of a hard, ringing, metallic character. It is excited by deep breathing or by talking, by any little excitement, or by dry, cold winds, seldom by damp weather. It is relieved for awhile by eating or drinking. Ana- cardium also has this same symptom, eating relieves the cough. There is a great deal of congestion of the chest, especially when the patient is moving about, walking in the street for instance. This is accom- panied by sudden weakness as if the patient would fall. In such cases Spongia has cured when given early. Spongia is followed well by Hepar when the same kind of cough continues, but with rather more rattling from the production of mucus, whether blood-streaked or not. The symptoms are worse towards 33 514 A CLINICAL MATERIA MKDICA. morning, while with. Spongia they are worse before midnight. You find, too, that the Spongia patient is subject to frequent flashes of heat in these phthisical cases, and these return whenever he thinks about them. He also experiences a chill which usually commences across the back. He shakes even when near a warm stove. The heat which follows is all over the body except the thighs, which remain numb and chilly. Spongia is useful in organic affections of the heart. The patient cannot lie flat on the back with the head low without bringing on a spell of suffocation. He is frequently aroused from sleep as if smoth- ering. He sits up in bed with an anxious look, flushed face, and rapid, hard breathing. You will find a loud blowing sound over one or the other valve. Spongia is particularly indicated after Aconite. Here there is the same arousing from sleep with great distress, the face is red and there is probably great congestion of the chest. Aco?iite suits only the hy- peremia that precedes endocarditis. Spongia comes in when exudation has commenced and the mischief has been already done. While it does not remove the deposit, it prevents the disease from advancing. In treating heart cases do not begin too soon with Lachesis, Hydro- cyanic acid or Arsenicum. Begin rather with Aconite, Spongia, Spigelia, Bryonia of Phosphorus. Aj r se?iic and such remedies come in later. If you give them too soon you weaken the patient. Unless you have a complete picture for the remedy, do not give in the first stages one usually indicated in the last stages of a disease. LECTURE XLIX. THE ACIDS. Fluoric acid. Phosphoric acid. • Muriatic " ' Hydrocyanic " Nitric " ' Picric " Sulphuric " ' Lactic Oxalic " Malic Citric " Silicic Arsenious acid. . There are many of the acids, many more in fact than have been placed on the board. There are not many of them, however, with which we are thoroughly acquainted, and there are but few facts that need be stated with reference to others. The very idea of acid, you will at once understand, implies more or less of an electro-negative character. They all combine very readily with the electro-positive substances, as potassium and sodium. You must rid yourself of the impression that the term ' ' acid ' ' necessarily implies that these sub- stances are sour, for all acids are not sour nor do all acids redden litmus paper. It was formerly supposed that all acids contained oxy- gen, and that oxygen was one of their necessary ingredients. This has been disproved, for certain acids — as hydrofluoric and muriatic acids — contain no oxygen. These acids are derived from the mineral and vegetable kingdoms. Of those derived from the former, we use in medicine Fluoric and Muriatic acids, which are obtained from the halogens; Nitric acid, a combination of nitrogen and oxygen; Sulphuric acid, Phosphoric acid, Silicea or Silicic acid, which exists as sand in nature and is by no means sour. So, too, the substance which we term Arsenicum is an acid — Arsenious acid. From organic chemistry Hydrocyanic acid, sometimes called Prussic acid. That, we shall find, exists in a great variety of plants. Then here is Oxalic acid, with which you are already somewhat familiar. Many of you who have tasted the ' ' sorrel grass ' ' know how sour the leaves are. It is Oxalic acid which gives them their acidity. It exists also in the rhubarb. Rhubarb, either the medicinal or the edible 516 A CLINICAL MATERIA MEDICA. variety, may or may not be poisonous. When raised on new ground it is very apt to contain an undue amount of Oxalic acid, and thus may make some persons very sick. Malic and Citric acid are derived from the vegetable kingdom. Malic acid is found more particularly in ap- ples and pears and also in raspberries. Citric acid is found chiefly in oranges and lemons. Acetic acid is an organic acid, and is the principal ingredient of vinegar. Lactic acid is derived from sour milk. In the first place we may say a few words about the acids in general and tell what characterizes them as a class. It has been determined by careful experimentation with the acids as a class that they decrease the acid secretions of the body and increase the alkaline. If, for in- stance, a quantity of acid, such as Citric acid, is taken into the stomach, it will diminish the secretion of the gastric juice. On the other hand, it will increase the secretion of the saliva. The practical value of this hint is hygienic rather than therapeutic, and yet in that degree it is of great use. For instance, we know how intolerable, at times, thirst is in fevers. Now this thirst may be due, at least in part, to lack of secretion from the salivary glands. The mouth is parched and dry; the tongue cleaves to the roof of the mouth. In such cases as this, acidulated drinks, by acting reflexly, increase the flow of saliva, and will give your patient great relief. For instance, you may give lemonade, providing, of course, it is not antagonistic to your indicated remedy. There are some medicines which Citric acid will antidote and some which will disagree with it. Again, if you are giving Bella- donna, you would not think of using vinegar, as vinegar retards the action of that drug. But when giving Belladonna you may use lemonade, as that aids the action of the remedy. Antimonium crudum will not tolerate acids, but you may use tamarind water. Now if you find the mouth or throat sore in fever, the ' ' edge ' ' must be taken off the acid by the admixture of some mucilaginous substance to the drink. You might use gum Arabic, but that interferes with digestion somewhat. Irish moss, Iceland moss and slippery-elm are too medic- inal. They all act powerfully on the lungs, and you might induce medicinal symptoms if you employ them. Flaxseed has some medic- inal effect, but not sufficient to make its use inappropriate. Another substance which may be used is gelatin, that is, if you know that it is pure. Some of it is made from the refuse of the tanner; some from fish-bones, and this is quite palatable; but best of all is that made from calves' feet. This last may be used in water to relieve the sharpness of the acid. THE ACIDS. 517 We find that vegetable acids may be useful in dyspepsia, simply for their hygienic value. You may give them, for instance, in sour stomach. You then administer the acid before eating. Allow the patient to drink lemonade before meals and you will often find that the usual heartburn and sour risings after eating are thus diminished. Pepsin, which is often used as an adjuvant in the treatment of dyspepsia, is perfectly allowable, as it does not interfere with the action of any medicine and is not itself a medicine. It is often aided in its action by some kind of acid, particularly in the digestion of nitroge- nous articles of food. Vinegar has been used as an antidote for intoxication. There is a property of Lactic acid which is well worth noticing. This is a very corrosive acid. It will eat into every tissue of the body. In fact, it will dissolve the enamel of the teeth, so that great care must be used in its administration. When prescribed in material doses, it is usually administered through a tube, wmich prevents it from touch- ing the teeth. Dr. Hering w r as in the habit of recommending that the teeth be w r ashed occasionally with cream that had become sour by keeping twenty-four hours. Muriatic and Lactic acids favor digestion. Some persons are greatly relieved by drinking sour milk. Sulphuric acid must be avoided in any form whatever, because it tends to make the food insoluble \>y combining with its albuminous constituents. Sulphuric acid is not used in dietetics, except by children in the cheap candy called "sour-balls," which are acidulated almost exclusively with this acid. Hydrocyanic acid certainly aids digestion. There are some persons who have been cured of dyspepsia by eating peach-kernels, which con- tain this acid. There is a distinction between the mineral acids on one side and the organic acids on the other. The mineral acids, as a class, all produce an irritability of fibre together with weakness and prostration. I am now speaking of their medicinal effects. You will find them to pro- duce an irritable weakness — with the weak and irritable pulse — whereas the vegetable acids produce weakness without irritability. The acids, too, as a class, check haemorrhages. This is a quality that belongs to nearly all of them. We all know that Acetic acid is useful in this sphere. When I have a patient who is subject to haemorrhage, I am in the habit of instructing the nurse, in case haemorrhage sets in 518 A CLINICAL MATERIA MBDICA. before I can be called, to dip a cloth in vinegar and place it over the pubes. In many cases, this will be successful. We all know, too, that Citric acid will produce and cure haemorrhage. A child, after eating too freely of lemons, had haemorrhages from every orifice of the body, even from the conjunctiva. We shall see that Phosphoric, Sul- phuric and Arsenious acids all produce and all check haemorrhages. It is said that they all do this by reason of their astringency. But how can this be so when they act favorably even in the two-hundredth potency ? Another quality of the acids is their tendency to produce pseudo- membranes. Thus we find some of them indicated in diphtheria; Muriatic, Phosphoric, Stdphuric and Nitric acids, for instance. Here, again, caution is necessary. As these acids, particularly the vege- table acids, may cause croupous deposits, do not permit a child con- valescing from croup to partake of acid fruits. When the child is susceptible, any one of these acids may tend to produce this disease again. We find that all the acids cause a peculiar debility. This is not a simple functional weakness, such as might result from a rather ex- hausting diarrhoea, such as you find under Cinchona, or such a func- tional weakness of the nerves as will be curable by Zinc, but it is a debility which arises from defective nutrition, particularly from blood disease. Thus we find them called for in very low types of disease, disease in which blood poisoning is a prominent feature, in typhoid states and in scarlatina, particularly when of a low type, in conditions of exhaustion from abuse of various organs of the body. Thus drunkards, who have long been indulging in liquors to excess, may be relieved by Sulphuric, Phosphoric and Arsenious acids. We find them indicated, too, in diabetes mellitus. The principal acids for this condition are Phosphoric and Lactic acids. We find, too, that many of the acids are useful in scurvy, particularly when it has arisen from a diet of salty food with deprivation of vege- tables. So much for our general review of the acids. We will now begin to speak of the acids in order, and, first of all. of Fluoric acid. THE ACIDS. 519 Fluoric Acid. Silicea, Calcarea ostr. , Calcarea fluor. Kali carb. Fluoric acid, i Arsenicum, Phosphoric acid. Mercurius. ^Rhus tox. This is a highly excoriating acid, eating, as you know, even into glass. It is to be particularly remembered by its action on the bones and on the skin. It acts especially upon the lower tissues of the body. We find it indicated in caries, particularly when the long bones, as the femur, humerus and radius are affected. The discharges from the affected parts are thin and excoriating. The symptoms are frequently relieved by cold applications. Fluoric acid is frequently useful for caries of the temporal bones, and especially of the mastoid process, and that, too, whether it be the result of syphilis, or of scrofulous catarrh of the middle ear. We also find it indicated in dental fistulse. The discharge is bloody, and has a saltish, disagreeable taste, rendering the mouth foul, and gradually undermining the whole constitution. Fluoric acid will here relieve. There .is another remedy which has not been thoroughly proven, but which seems to act better here than the Fluoric acid, and that is the Fluoride of Calcium or Calcarea fluor ica. Calcarea fluorica is especially useful for osseous tumors and for en- largement of bones with or without caries, Last summer a lady came to my office with what the dentist had pronounced to be necrosis of the lower jaw on the left side. The teeth had been removed by him, but the patient, instead of getting better, grew worse, and there was a continual discharge from the cavity. The molar just back of the one taken out had been filled with gold, and that I found on examination to be rough at its root; and when she pressed her jaws together tightly, there would ooze, apparently from its socket, a fluid which was offensive, dark and bloody, and mixed with fine pieces of decayed bone. The gum around the bone was purple and offensive in itself. The dentist had said that a surgical operation was necessary. The first remed}^ given was Silicea, which seemed to have some effect. This was followed by Fluoric acid. These two remedies are comple- mentary, and you will frequently find in the bone disease that you will 520 A CLINICAL MATERIA MEDICA. have to give one after the other. Fluoric acid is especially indicated when Silicea has been abused. It is also indicated when Silicea appa- rently does some good, but fails to complete the cure. Now, in the case I have just related, Fluoric acid also helped for awhile, but im- provement again came to a stand-still, and now I noticed a swelling of the bone on the outer surface. This led me to think that Calcarea fluoriccu would act better, and I gave it in the sixth trituration. That she had been taking since the first of August. A week ago* the dis- charge had entirely ceased. The tooth, which had been filled with gold, was no longer painful. Pink granulations were springing up all over the gums. The probe can no longer detect bone which is diseased. You will remember, as a distinction between Fluoric acid and Silicea in bone affections and ulcers, that Fluoric acid has relief from cold, whereas Silicea cannot bear anything cold. The slightest draught is intolerable. We next have to speak of the action of Fluoric acid on the skin. It seems to produce a decided roughness and harshness of the skin, de- veloping cutaneous eruptions of various kinds. There is itching. I do not know of any remedy that causes such general and persistent itching as does Fluoric acid. There is itching in small spots here and there over the bod}'-. This is worse from warmth and better from a cool place. You will find, under Fluoric acid, that old cicatrices will become redder than normal and itch. By and by, little vesicles will form on or near the cicatrix, thus showing you the affinity of fluoric acid for this kind of tissue. I^ittle red blotches appear on the body, and you have well-marked tendency to desquamation. No remedy has this more marked than Fluoric acid. You will find that Fluoric acid also attacks the nails, causing them to grow rapidty. Thuja has the effect of making the nails grow soft. We may use Fluoric acid in felons, particularly in bone felons. Here, as in case of other diseases of the bones, the discharge is offensive. Here, also, we may make the same point of distinction between it and other remedies, namely, by relief from cold applications. Fluoric acid also acts upon the muscles. Here its effects are rather novel. It causes an increase in muscular endurance. Under its influ- ence a person is able to withstand unusual muscular exertion. More than this, he seems to be better able to withstand the heat of summer *The lecturer was speaking on October 17th. THE ACIDS. 521 and the cold of winter. Thus the drug has a general invigorating or tonic effect. This same effect we find under other drugs. We know how Rhus tox. will enable persons to withstand muscular fatigue. The same is also true of Arsenicum. But the remedy that has this property, more than any other I know of, is Coca. This interesting plant is used by the people of South America, particularly by those who climb the Andes. It prevents all the symptoms arising from the fatigue of the journey and from the disproportion between the external and the in- ternal atmospheric pressures. We may make use of this in persons who are weak, particularly for old people who get out of breath easily and particularly if they cannot stand a rarefied atmosphere. In that condition Coca relieves. Under the influence of Fluoric acid, a short sleep seems to refresh. This effect may also be produced by low potencies of Mephitis putorius. We find that Fluoric acid has produced, and therefore ought to cure, varicose veins. Little blue collections of veins in small spots were caused in two or three provers by the drug. It may also be of use in naevus. Other remedies here are Hamamelis, especially in acute cases. It is often used externally and internally in the treatment of enlarged veins. Muriatic Acid. f Debility, typhoid fever. Diphtheria. Muriatic acid. < „ Scarlatina. (^ Muscular weakness from Opium. f Rhus tox., Bry., Phos., Phos. ac. ^ r . . . , Apis, Rhus tox., Arsenicum. ( Camphor. Muriatic acid. < ~: ' ^ J _ . Opium. > < Bryonia. [_ Nitr. ac. ( Alkalies. Now that we have obtained an idea of the acids in general, we will find Muriatic acid a very easy drug to study. The continued use of Muriatic acid must give us pathological effects. Now this acid, when abused, produces pathogenetic effects, which present two series of symp- toms for study. We find its mental and nervous disturbances under 522 A CLINICAL MATERIA MEDICA. two stages or classes. Under the first effects of the drug there is con- siderable excitement. The patient is irritable and peevish, and the senses are all too acute. Thus light hurts his eyes, distant noises cause buzzing or roaring in the ears, or aggravating headache. Both smell and taste are abnormally acute. The patient is restless and changes his position frequently. His mind is actively engaged in visions in reference to the past and present and even to the future. The cheeks are quite bright red, the tongue and mouth are apt to be dry, and the heart-beat is quick and irritable but lacking in energy and force. If he is at all delirious, it is only slightly so. He is sleepy but unable to sleep, or he tosses about, dreamy and restless, all through the night. Now these are the transient symptoms of excitement or erethism which may occur under the influence of Muriatic acid. You are able to trace beneath these symptoms, from beginning to end, a certain amount of weakness. There is an appearance of over-strength, but it is in a weakened constitution. You know that it is not a true ' ' hyperaction, ' ' but only an irritability, that comes under the head of irritable weak- ness. The next stage, or that of exhaustion, has several grades, of course. Beginning with the mental S3'mptoms, we find that the patient is apt to be sad, and is absorded in self, taciturn, introspective, sad and brooding. If you question him you will learn that he is anxious about something real or imaginary. Headache may now appear, he feels as if the brain were being torn or bruised, or there is heaviness as if the occiput were made of lead. The patient becomes unconscious, with muttering delirium, sighs and groans during sleep, the tongue grows more dry and seems to have actually shrunken and become narrow and pointed; so dry is it that when he attempts to talk, it rattles like a piece of wash leather in his mouth. Still later, the tongue becomes paralyzed, so that he can scarcely move it at all. The heart-beats are regular and feeble. The pulse intermits characteristically at every third beat. He now becomes so weak that the muscles refuse their office. He has diarrhoea, which is watery and is accompanied by prolapsus of the rectum. Stool is involuntary when straining to urinate. He slides down in bed. He actually 'has not sufficient strength to keep his head upon the pillow. Paralysis of the brain is now threatening. This is indicated by vacant, staring eyes, dropping of the lower jaw, coldness of the extremities, and this, if not checked, is followed by death. Now these are the symptoms that call for Miuiatic acid, particularly in typhoid fever. THE ACIDS. 523 The concordant remedies of Muriatic acid here are Rhus, Bryonia, Apis, Phosphoric acid, A T itric acid and Arsenicum. Bryonia resembles it in the early stages of typhoid fever. Both have that nausea when sitting up in bed, both have dry tongue and soreness through the body, but there are quite a number of other symptoms which will enable you to distinguish, and which have been mentioned in the lecture on Bryonia. Rhus tox. , like Muriatic acid, has this restlessness in the beginning. The patient is continually moving and tossing about the bed. He can- not sleep at night. There is slight delirium, with muttering. All these symptoms are under both Rhus and Muriatic acid. Rhus has not so much debility as the latter, hence it is followed rather than preceded by the Muriatic acid. Phosphoric acid resembles Muriatic acid, but resembles it in this re- spect: Phosphoric acid has apathy and indifference; a complete "don't care condition;" indifferent to what may happen to himself, or to others. That is not the condition calling for Muriatic acid, for taci- turn^ is not indifference. Then again, Phosphoric acid does not cause the same prostration that we find under Muriatic acid. The character- istic stupor of Phosphoric acid is this: the patient is easily aroused from stupor, and is perfect^ rational when aroused, no matter how soon he may drop off again to sleep. Apis resembles Muriatic acid. Both remedies have this dry and shrunken tongue, both have sliding down to the foot of the bed, im- pending paralysis of the brain, etc. The Apis tongue is very charac- teristic, and differs from that of Muriatic acid. It is covered with little blisters, especially along the border. The patient cannot put the tongue out; it seems to catch on the teeth, or, if he does get it out, it trembles. Arsejiicum you can readily distinguish by the symptoms, which I will give you next week when I lecture on that drug. You should also remember in this connection Baptisia, which has, in common with Miiriatic acid, this great weakness. Baptisia, however, has a besotted look to the face; the teeth are covered with black sordes, and the tongue is red on the edges and yellowish-brown down the centre. Now, a word of caution. Do not mistake the symptoms of Muriatic acid for those of Belladonna. The novice is apt to do it. For instance, you notice the flushed face, the over-excitement of the senses, desire 524 A CLINICAL MATERIA MEDICA. to sleep but cannot; these are all symptoms of Belladonna. But try to find the meaning of the Belladonna symptoms and then of those of Muriatic acid, and you will find that they are by no means the same. The Belladomia symptoms apply to hyperemia, and to the beginning of the disease, and not to overwhelming of the system by disease, as in Muriatic acid. Next I wish to refer to Muriatic acid in scarlatina. The body is in- tensely red. There is rush of blood to the head, with bright red face and great drowsiness. Now the rash comes out very sparingly, and is scattered irregularly over the surface of the body, and interspersed with petechise, with bluish or purplish spots. The child is very rest- less, throws off the clothes, and will not be covered, As the symptoms progress, the skin becomes purplish and the feet decidedly blue. Catarrhal or even diphtheritic symptoms, the diphtheritic symptoms already referred to, may complicate the case. A thin, excoriating dis- charge escapes from the nose, making the upper lip sore. And so irritating are the discharges from the mouth that the mucous membrane becomes intensely red, and even denuded of its epithelium. By and by, yellowish-gray deposit forms in the mouth, and particularly in the fauces, and on the tonsils, uvula, and posterior wall of the pharynx. One of the provers had symptoms that made it difficult to decide be- tween those of diphtheria and those produced by Muriatic acid. The breath becomes very foetid, and the uvula, cedematous. Sometimes the latter hangs down as thick as your thumb, and lies on the tongue, causing the child to gag and choke. These are the diphtheritic and catarrhal symptoms, and they may occur with or without scarlatina. Belladonna is apparently, not truly, a concordant remedy here. These symptoms may cause you to give Belladonna, and incorrectly, too. The drowsiness and disturbed sleep, etc. , of this remedy are caused by congestion of the brain, which is not the case under Muriatic acid. More closely allied are Apis and Sulphur, which both produce red- ness of the skin to a marked degree. Kali permanganicum resembles Muriatic acid in the throat symptoms, especially in the cedematous uvula, but is marked by excessive fcetor. Other remedies having this symptom are Apis, Natrum arsenicosum, Mercurius cyanatus, Capsicum, Kalibichr., Arsenicum and Hydrocyanic acid. This last remedy resembles Muriatic acid in its throat symptoms, and in the blueness of the surface, and in the presence of petechiae in the rash. THE ACIDS. 525 Sulphuric acid resembles Muriatic acid in scarlatina in that both remedies have these bluish spots, great weakness and diphtheritic membrane. Sulphuric acid does not have relief from uncovering. Then again, there are appearances on the skin like suggillations. Spots ap- pear that look as though the parts had been bruised. I have also found Muriatic acid useful in the last stages of dropsy from cirrhosed liver. Of course it may be used in any other serious disease of the liver in which the symptoms indicate it. The dropsy progresses as it does ordinarily in cirrhosed liver. The patient finally develops a typhoid condition, and becomes drowsy. Now these are the symptoms for which I have selected Muriatic acid. It does not cure; it will only relieve. The patient is drows}^ and becomes very much emaciated. The mouth is dry or it is aphthous. The stools are often watery and involuntary. The stomach is so weak and irritable that no food can be retained. Nitro-muriatic acid is also to be remembered in these cases of weak digestion. Its symptoms you will find recorded in Allen, and are very similar to those of Muriatic acid. The antidotes to Muriatic acid are Camphor and Bryo?iia for the dy- namic effects of the drug, and alkalies for its acute poisonous effects. Mtiriatic acid may also be used for the muscular debility following the prolonged use of Opium. LECTURE L. PHOSPHORIC AND SULPHURIC ACIDS. {Debility — Aphthae — Typhoid. Haemorrhages. Diarrhoea. Phosphoric Acid. Rhus tox. China, Arsenicum, Veratrum. Phosphoric acid. { Nux vomica. Ferrum > Camphor. Baptisia. To-day we have to study Phosphoric acid. This is a combination of oxygen with phosphorus. Phosphoric acid produces weakness or de- bility. Sometimes it causes a transient excitement, but the main characteristic of the drug is this debility, which is characterized by indifference or apathy, by torpidity of both mind and body, by com- plete sensorial depression. The patient is disinclined to answer your questions. His answers are short, consisting generally of "Yes" or " No," and are made in a way that show that it is annoying to him to speak. The delirium is quiet, not violent, but accompanied with this characteristic depression of the sensorium and muttering, unintelligible speech. He lies in a stupor, or in a stupid sleep, unconscious of all that is going on about him ; but when aroused he is fully conscious. That is characteristic of Phosphoric acid. You see it is depressing to the sensorium and to the body in general, and yet these changes are in a certain sense superficial. It does not seem to dip deep down into the tissues, so to speak, and affect those serious changes in them that call for some such drug as Lachesis. You will find the quality above-mentioned pervading every Phosphoric acid symptom I shall mention. So, you would not expect to give the drug in advanced stages when the stupor is complete. PHOSPHORIC ACID. 527 Now the symptoms which indicate Phosphoric acid in typhoid fever are these : pointed nose ; dark blue rings around the eyes. The patient may suffer from nose-bleed, but which, however, gives no relief to the symptoms in the early stages of typhoid fever. This is the very op- posite of Rhus tox., which is otherwise similar to Phosphoric acid. Rhus has epistaxis in the beginning of typhoid fever, but the symp- toms are relieved, by the haemorrhage. The Phosphoric acid patient bores his finger into the nose. Now do not suppose because the patient is picking at the nose that he has worms and that you must give Cina. He may have itching of the nose. The symptom may also come from abdominal irritation not due to worms. With Cina, it occurs from worms ; with Phosphoric acid, from the irritation of Peyer's patches, consequently you will find the abdominal symptoms plentiful. For instance, the abdomen is apt to be distended and bloated. There is a great deal of gurgling and rumbling in the abdomen. There is often diarrhoea with stools that are watery, sometimes involuntary, and contain undigested food. For instance, the milk which you have given your patient passes more or less undigested, and there is copious escape of flatus with the stool. The tongue is dry, and may have a dark-red streak down its centre ; but it is apt to be pale and clammy, and some- times covered over with slimy mucus. Sometimes the patient bites the tongue involuntarily while asleep; this is a spasmodic motion; while the jaws come together the tongue protrudes. The urine you will find to be highly albuminous ; it has a milky appearance, decomposes very rapidly and you will find it also loaded with earthy phosphates. These are the main symptoms which would suggest the selection of Phosphoric acid in typhoid fever. The nearest remedies here are Rhus and Phosphorus. Phosphoric acid often follows Rhus after the latter has relieved the restlessness but not the diarrhoea, and the patient goes into this quiet sort of stupor. Phosphorus has more dryness of the tongue, more sensorial excite- ment ; all the senses are irritated ; the patient cannot bear an3 T noises or odors. If diarrhoea is present, the stools are blood-streaked and look like ' ' fresh- water. ' ' In this sensorial apathy you should also remember the Sweet spirits of nitre. The patient lies in bed, perfectly indifferent to every one. He answers questions readily enough, but is apathetic. That is the condition in which Hahnemann gave Sweet spirits of nitre. I have found it to succeed when Phosphoric acid failed. 528 A CIJNICAI, MATERIA MKDICA. Arnica is also to be placed by the side of Phosphoric acid. L,ike the acid, it has apathy or indifference. The patient does not seem to realize that he is as sick as he is. But the Arnica condition is more advanced state. The depression and stupor are more profound. He goes to sleep when answering your questions, showing you how over- powering is the stupor. Then, too, you have the petechise or ecchy- moses common to this remedy, and, still later, involuntary stool and urine. Opium is, more than Phosphoric acid, a remedy for stupor when that stupor is progressive. It is only in the beginning of the Opium state that the patient can be aroused from sleep. The stupor goes on until no amount of shaking can bring the patient to consciousness. Breath- ing grows more and more labored and stertorous; the face, instead of being pale, sunken and hippocratic, as in the acid, is deeper red, almost a brownish-red. The browner the red, the more is Opium indicated. Another important series constitutes the emotional symptoms of Phosphoric acid. It is one of the best remedies we have for the bad effects of grief and depressing emotions, particularly for the chronic effects of disappointed love. It is here particularly indicated after Ignatia. Ignatia suits the acute symptoms and Phosphoric acid the chronic. Phosphoric acid is also indicated for homesickness. The patient is sad; he often has hectic fever and flushing of the face, especially in the afternoon, evening or toward night. He has sweat towards evening, and complains of crushing weight on the vertex. That last symptom is verjr characteristic of Phosphoric acid. Now, we may carry these in- dications further than this. We all know how the emotions affect the body, how bad news affects the digestion, how mother's milk is made poisonous by some powerful emotion. We may find in Phos- phoric acid a remedy for uterine and ovarian diseases which arise remotely from emotional causes. Thus you may use it in prolapsus uteri which seems to have been precipitated by depressing emotions. If you have other symptoms to aid you in its selection, then all the more promptly will you find both local and constitutional symptoms removed by its administration. In homesickness you should also think of Capsicum. Natrum mur. may be placed alongside of Phosphoric acid for the chronic effects of grief with the " vertex headache," sadness, weeping, emaciation, etc. PHOSPHORIC ACID. 529 Next, I would like to say a few words about the diarrhoea caused by Phosphoric acid. It is particularly indicated in diarrhoea which is pre- ceded by rumbling in the bowels. The stools are frequent and per- sistent. Particularly is it indicated in young persons who grow rapidly. But the diarrhoea, despite its frequency, does not proportion- ately weaken the patient. The mother will tell you that her child has had diarrhoea for six weeks, with a great deal of rumbling of flatus, and yet it does not seem to be much weakened thereby. The stool may contain undigested food, and it may follow a meal. The distinction between Phosphoric acid and Cinchona lies in the fact that the Cinchona diarrhoea exhausts the patient excessively. Then another symptom of Phosphoric acid is, that the patient, though quite weak, is rested by a very short sleep. I presume that this action of the acid is owing to the stimulating effect of the Phosphorus it con- tains. Phosphoric acid is suited more to the remote effects of the loss of animal fluids rather than to the acute symptoms. Thus we find it indicated for the long-lasting effects of seminal emissions, whether oc- curring during sleep or when awake, with every effort at stool or uri- nation or from excessive venery, especially onanism. The whole system seems to be weakened. The patient is dizzy, feels as if he would fall. There is another peculiar form of dizziness. On lying down he feels as if the feet were going higher up than the head. The scrotum and testicles hang down flabby and relaxed. The penis has no power of erection, or erections are deficient. Semen escapes too soon during coitus. The patient complains of formication over the scrotum. The back and legs are weak, so that he totters when he walks. He has little or no absolute pain, except perhaps a burning in the spine, which is worse at night. Phosphoric acid is very similar to Cinchona, in fact it is superior to it in the chronic effects of loss of seminal fluid. Cinchona is useful for the acute effects. For instance, a man has emissions for three or four consecutive nights, and is thus much weakened; then Ci?ichona will relieve him promptly. When you give Phosphoric acid for this relaxed condition of the genitals, give it low. In headache, Phosphoric acid occasionally comes into play, especially when the trouble occurs in school-girls; the headache comes on when they study and continues as long as the mental effort is maintained. .34 53° A CLINICAL MATERIA MEDICA. Phosphoric acid, furthermore, is to be thought of as a remedy for the de- bility arising from excessive study. Phosphoric acid also affects the mucous surfaces. We have to re- member it particularly in chest affections. The cough arises from tickling in the chest, in the region of the ensiform cartilage. It is worse in the evening after the patient lies down. In the morning we find expectoration, which is yellowish or muco-purulent, and usually tasting salty. We may think of it, although less frequently than of Phosphorus, in cases of tuberculosis, when there is great weakness of the chest, so that the patient can hardly talk. This weakness seems to be a cause of dyspnoea. Every draught of air gives him fresh cold. He wraps his chest up warmly; he cannot bear a draught of air to touch his chest. When these symptoms are present, the acid is superior to Phosphorus. Next, the action of Phosphoric acid on the bones. You may give it in scrofulous affections of children; for example, in hip diseases and in curvature of the spine from caries of the vertebra, when this symptom is present: if the child is old enough he will complain of a feeling as if the bones were being scraped with a knife. This is from inflamma- tion of the periosteum. This symptom is worse at night and may occur after the abuse of mecury. Phosphoric acid, like all the mineral acids, affects the kidneys. It produces first what we may call polyuria or copious urination. The symptom, as it was produced in the prover, was this: the urine flowed so rapidly and so frequently that it came out as though the urethra were twice its natural size. You may see in Phosphoric acid a possible remedy for diabetes mellitus. The symptoms which led you to it are, first of all, this frequent and profuse urination, requiring the patient to rise often at night. The urine is often milky in appearance. Some- times it deposits jelly-like masses, particularly in catarrh of the bladder. I would also like to call your attention to Lactic acid. As a remedy in diabetes I have used it with great benefit. There are pronounced anaemia, nausea after eating, canker sores in the mouth, salivation and polysuria. Phosphoric acid has been recommended for growing pains. Guaiacum is also said to be useful for these. SULPHURIC ACID. 53 1 Sulphuric Acid. f Arnica, Conium, Ruta. Sulphuric acid. Pulsatilla. Sulphuric acid is indicated when the patient is hasty, quick and rest- less in his actions, sometimes, too, when there is the opposite condition, one of great depression, as in typhoid states. He answers questions slowly and with great difficulty, just as does the Phosphoric acid patient. You find that there is a general sensation of trembling in the Sulphuric acid patient. He feels as if he were trembling from head to foot, although there is no sign of it on the surface. The face in these con- ditions is rather peaked and is apt to be pale with blue rings around the eyes. Sometimes there is a feeling as though white of egg were dried on the skin. The patient is particularly weak about the digestive organs ; thus there is a cold, relaxed feeling about the stomach, mak- ing the patient long for some strong or stimulating drink, as brandy, and this, too, in persons who are not addicted to drink. So weak is the stomach they vomit all food ; the ejected matters are very sour. You will find Sulphuric acid indicated especially for inebriates who are on their "last legs." They have run down completely, and have long since passed the Nux vomica condition. You find them pale, shrivelled-looking and cold ; their stomachs so relaxed as not to be able to tolerate any food. They cannot even drink water unless it contains whiskey. The liver is enlarged. They have a dry stomach cough, often followed by belching, the act of coughing hurting the liver. The diarrhoea is watery and offensive, and is accompanied by excessive irritability of mind. ' They have a quick, hasty manner of doing every- thing. There is always dampness or oozing of moisture from the rectum. They frequently suffer from piles which burn, and are so large that they fill up the rectum. These cases are relieved by Sul- phuric acid. There is another use we may make of Sulphuric acid, and it is derived from its power of modifying the thirst for spirituous liquors. You 532 A CLINICAL MATERIA MKDICA. should take two or three drops of the pure acid and dissolve them in a glass one-half full of water. Give it to the inebriate every two or three hours in teaspoonful doses, and it will overcome the physical craving. Give it until he gets well, even if it produces a sore mouth. Should it produce diarrhoea, Pulsatilla is the proper antidote. Another effect of Sulphuric acid is its action in aphthous sore mouth occurring in debility from protracted disease, or in children with summer complaint or marasmus. The mouth is filled with yellowish aphthous spots. There is a profuse flow of saliva. With this there is apt to be vomiting of sour milk or sour mucus. The child smells sour despite the most careful washing. The stool is yellowish or slimy, having the appearance of chopped eggs. The child is very apt to have a cough, which is very likely a stomach-cough, with belching of wind after the cough. You may think of Sulphuric acid also in diphtheria. The tonsils are bright red and quite swollen, so swollen in fact that liquids escape through the nose. The child is deathly pale, so pale that it looks like a corpse. It is inclined to drowsiness or somnolence. It can hardly breathe or talk, or make any noise on account of the abundance of membrane. Sulphuric acid is also useful as a traumatic remedy. It may be used for bruises of soft parts after Arnica; in bruises of glands after Conium ; in injuries of bones after Ruta. Particularly may it be used when there are long-lasting black and blue spots with soreness and stiffness. Again, Sulphuric, more than any other acid, is useful in hsemor- rhages. It causes haemorrhage from every orifice of the body, the blood being dark and thin. You may differentiate Sulphuric acid from Carbo veg. in the dyspepsia of drunkards by the fact that Sulphuric acid is more of a " sour remedy ' ' and Carbo veg. a "putrid remedy." LECTURE LI. NITRIC, HYDROCYANIC AND PICRIC ACIDS Nitric Acid. f Calcarea ostrearum, Kali carb., Lycopodium. I Arsenicum, Carbo veg. , Phosphorus, Moschus, Anti- Nitric acid. ^ monium tart. Phosphoric acid, Muriatic acid. Hepar, Mercurius. V Arum triphyllum. Nitric acid. < Erosion of the mucous membranes, worse where they join the skin. Offensive discharges. Ulcers, irregular, exhibiting exuberant granula- tions ; worse from touch, from which they will bleed. Abuse of mercury. Typhoid.— Debility. Catarrh. Fibrous and osseous tissues. Nitric acid as a chemical substance need scarcely be explained to you, as you know its properties so well. I therefore pass on to con- sider its use as a medicine. You know its effects on the tissues, stain- ing the skin a dark and yellowish-brown. It is a highly corrosive acid, eating into the flesh. Hence it has been used for the removal of warts, tumors, ulcers and exuberant granulations. It acts very powerfully on the mucous membranes, and has a par- ticular affinity for the outlets of mucous surfaces where skin and mucous membrane join. Hence you will find its symptoms chiefly about the mouth, lips, nostrils, meatus urinarius and anus ; in fact, wherever skin and mucous membrane come together, there has Nitric acid a prominent action. 534 A CLINICAIv MATERIA MEDICA. As an illustration, we find it useful in stomacace or ulceration of the mouth. True to the character of the drug, this stomacace will present its most violent symptoms about the lips. There will be blisters and vesicles on and around the lips in connection with the sore mouth. Ptyalism will be present, particularly in cases that have been abused by mercury. So, too, you will find that the diarrhoea is associated with soreness and rawness of the anus.* Even fissures may be present, as I have already said. The characteristic discharges produced by Nitric acid are offensive, thin and excoriating, and, if purulent, are of a dirty yellowish-green color and not at all laudable. The ulcers calling for Nitric acid are offensive and characteristically irregular in outline, tending to spread at the peripher)^, but more deeply than those arising from the action of Mercurius, which produces a superficial flat ulcer. These ulcers of Nitric acid are very apt to be filled with profuse exuberant granulations, which bleed readily from the slightest touch. Even the dressing that you apply makes the ulcer bleed. The pains are of a sticking character, as if splinters were stick- ing into the affected parts. They are often associated with burning pains. The ulcers are worse from the application of cold water. Nitric acid is particularly indicated in syphilitic ulcers after abuse of mercury, and also in those of a scrofulous character after Calcarea has failed. Another evidence of the offensiveness of the exhalations and secre- tions in Nitric acid is found in the urine, which has a strong odor, very much like that of the horse. It probably contains an excess of hippuric acid. This symptom is most highly developed in Benzoic acid. So characteristic is it in that drug that you will seldom if ever find it absent in the great variety of diseases curable by Be?izoic acid. The leucorrhcea is acrid, foetid, thin, brown, watery or stringy. The stools, too, show the putridity of Nitric acid. They are very offensive, and are green in color, and in children contain lumps of casein. They are also slimy from excess of mucus and are associated with much straining; the tenesmus here closely allies it to Mercurms . At other times, particularly in scrofulous children, the stools are pale from deficiency of bile, and pasty and sour as well as offensive. Nitric acid affects the mucous membranes, producing catarrhs. We find it indicated in coryza, particularly when it is associated with some malignant disease, as scarlatina or diphtheria. Yellow foetid eczema *Sore excoriated anus: MERC, SULPH., Cham., Arsenic, Puis., Graph., China. NITRIC ACID. 535 with ulcers; the Eustachian tubes obstructed. In nasal diphtheria, Nitric acid is one of the chief remedies. The discharge from the nose is watery and very offensive, excoriating every part which it touches; frequent epistaxis. If you examine the nose, you will find that there is a well-developed white deposit therein. Another symptom, which is a very characteristic symptom, accompanying these conditions, is inter- mittent pulse. If the membrane has descended into the throat, you will have foetid odor from the throat, too. The child will complain of a feel- ing as though there was a splinter there. This is a general characteristic of Nitric acid, a sensation as of a fish-bone, splinter or piece of glass stick- ing into the affected part . It runs all through the symptomatology of the remedy. You find it in the ulcers, and you find it in the rectum as- sociated with the fistulse and piles, and you find it here in the throat. Nitric acid is here very similar to its complement, Arum triphyllum, which, like the former, causes excoriating discharge from the nose, making the lips sore; the corners of the mouth crack so that the child cannot open its mouth on account of the soreness. Another remedy is Muriatic acid, which has thin excoriating dis- charge from the nose, intermittent pulse and loss of appetite. Another effect of Nitric acid, and one, too, in which it has no su- perior, is its use to remove the bad effects of mercury. The particular symptoms which call for it in this condition are these: irritability, restlessness and mental anxiety. This irritability amounts to cursing and swearing. There are also periosteal pains; ophthalmia; inflamma- tion or ulceration of the cornea, with tendency of the ulcers to perfor- ate; hardness of hearing from catarrh of the middle ear and Eustachian tube; ptyalism; ulcers in the throat; caries of bones, particularly of the mastoid process of the temporal bone; dysentery, etc. It is adapted to secondary more than to primary syphilis, and more especially adapted to secondary syphilis after the abuse of mercury. Chancres have even returned and are phagedenic. There is great soreness in the bones at night, particularly in the bones of the head and along the shins, and this is worse from every change in the weather. On a damp day he will have a boring pain in the bones. Ulcers appear in the throat or on the surface of the body, and these are characteristically irregular in outline. Warts develop, and these are almost always more or less pediculated. There are yellowish- brown spots or copper-colored spots all over the body. There is great debility, with sweat and exhaustion. 536 A CLINICAL MATERIA MEDICA. When mercury has been abused, Hepar is probably the best antidote we have. When mercurialization is conjoined with syphilis, Nitric acid is the preferable remedy. Nitric acid may be needed in the treatment of phthisis. There are sudden rush of blood to the chest, and decided hectic fever, which indi- cates ulceration of the lungs from breaking down of tubercles. The chest is extremely sore to the touch. The patient suffers from frequent haemorrhages from the lungs, the blood being bright red and profuse. There is great dyspnoea, so that the patient cannot talk without getting out of breath. There are also morning hoarseness, exhausting phthisi- cal diarrhoea, worse in the morning, and sharp stitches through the right chest to the scapula. The pulse is intermittent. The least at- tempt at exertion causes palpitation of the heart and dyspnoea. The sweat comes particularly at night and towards morning, and exhausts the patient very much. The skin is apt to be cold towards morning. He is chilly on getting into bed. Heat comes in flashes, or it is only in the hands and feet. The cough is of a tickling character, and seems to annoy him all night. You hear on examination, loud rales all through the chest, and the expectoration is offensive, bloody and decidedly purulent, and of a dirty green color, not being yellowish- green and laudable, as you find under Lycopodium and Pulsatilla. Some- times the cough is loose and rattling in character. The patient is usually of thin build, with dark hair and eyes. Nitric acid is very often indicated in phthisis after Calcarea ostre- arum or Kali carb. Calcarea is especially suited to leucophlegmatic patients. The face is pale and sallow. There is soreness of the chest, which is very much aggravated by touch or pressure. The cough is loose and rattling. Diarrhoea, if present, is worse in the evening. Hoarseness, through persistent, is painless. When, however, the Cal- carea condition has run into the acid debility. Nitric acid is one of the very best remedies to follow. It does not often cure, but it relieves and prolongs life for years. Still another application that we may make of Nitric acid is in typhoid fever, particularly in the ulcerative stage, when Peyer's patches have begun to break down. You will find the patient greatly exhausted. The characteristic indications for Nitric acid are these: stools are green, slimy and offensive, and sometimes purulent from the pus coming from these ulcers, and there is profuse bright red haemor- rhage from the bowels, with fainting on the slightest motion. The HYDROCYANIC ACID. 537 tongue is either white and studded with vesicles or little sore spots, or it is brownish and dry. We may have well-marked pneumonic compli- cations. There seems to be threatening paralysis of the lungs, which you know is by no means an uncommon thing in typhoid fever. This incipient paralysis of the lungs is expressed by loud rattling of mucus in the chest. The pulse, in such cases, you will find to intermit at every third beat. Now, do not forget Moschus, Phosphorus, Antimonium tart. , Arseni- cum and Cuprum and other remedies that I have mentioned in this connection. In haemorrhage from the bowels during typhoid, you may also re- member Alumen, which is useful when there are large clots passed. Arsenicum is called for in this haemorrhage when the flow consists of dark watery blood, and is associated with anxiety and restlessness. We find Hamamelis indicated when there is a dark venous flow, without anxiety. Sometimes the blood is dark and pitch-like. Still another remedy is Leptandra, which is useful in typhoid fever with symptoms of a bilious character, when the stools consist of black blood, looking like pitch. Hydrocyanic Acid. f Spasms; epilepsy; tetanus. Hydrocyanic acid. \ _. f •.' Scarlatina. (^ Heart; cough. Hydrocyanic acid acts upon the cerebro-spinal nervous system, and particularly upon the medulla and upper portion of the spinal cord. It produces convulsions which are very much like those of the fully- developed epileptic attack. Dr. Hughes, of Brighton, England, rec- ommends it as a specific for epilepsy. This, of course, it is not. To cure any disease, you will have to take into consideration the symptoms of each case, and prescribe accordingly. Hydrocyanic acid also produces a tetanus which resembles very much that produced by Nux vomica. The body is stiffened and thrown back, there is cramp in the nape of the neck like Cicuta; breathing comes in paroxysms, the jaws are set, there is foaming at the mouth, but the face is flushed. 53 8 A CUNICAI, MATKRIA MKDICA. It is also useful in convulsions during severe attacks of illness, when the face is blue, and the prostration is very great. There are gasping breathing, clutching at the heart, and livid color of the surface of the body. You may also give Hydrocyanic acid for very severe cases of prostra- tion, with approaching paralysis of the brain and lungs, and when there is gurgling from the throat to the stomach when swallowing. In cholera, Hydrocyanic acid is to be placed by the side of Camphor, being indicated in marked collapse with sudden cessation of all dis- charges, as vomiting and purging. In scarlatina it is indicated in almost hopeless cases of a malignant type, in which the rash is livid from the very beginning. The feet are almost always cold. Hydrocya?iic acid may be given for the cough of heart disease when it is reflex from organic changes in the heart. It may also be used for the dry tickling cough of consumptives. You may prefer Laurocerasus for the dry, teasing cough of con- sumptives, worse at night, and indeed for heart cough. You may also give it for cough with expectoration which contains little specks of blood scattered through it. Picric Acid. Picric acid at first causes congestions. These are soon followed by weariness and mental inactivity, showing how intensely the remedy attacks the vital forces. This weariness progresses from a slight feel- ing of fatigue on motion to complete paralysis. It is accompanied by indifference, want of will-power, and desire to lie down and rest. Animals, poisoned with this acid, were affected with paralysis of the hind legs, with slow breathing and great muscular weakness. At the autopsies made on them, the cortex cerebri, the cerebellum, medulla oblongata and spinal cord were found reduced to a soft, pulpy mass. The blood was dark brown in color, and loaded with little shining, greasy particles. The urine was rich in phosphates and uric acid, and poor in sulphates and urates. Albumen and sugar were also found in the urine. The liver was full of fat granules and its borders dark with stagnant blood. These symptoms and pathological observations bespeak the use of Picric acid in diseases of the brain and spinal cord. To give it, we picric acid. 539 need not wait until paralysis has set in. We may find it useful in typhoid conditions and also in conditions of brain fag when the mind has been over- worked. In the latter affection, Picric acid is one of our best remedies. It is also useful in neurasthenia. You will find dull headache with aggravation from the slightest attempt at using the mind. This may be in the forehead or in a still worse place, in the occiput, and may then extend down the spine. The patient complains of feeling constantly tired and heavy. Any attempt to study brings on anew these symptoms of the brain, and also develops burning along the spine and very great weakness of the legs and back, with soreness of the muscles and joints. Sometimes sleep is restless and disturbed by priapismic erections. With these, of course, there will be frequent seminal emissions. Sometimes you will find severe pains in the neck and occiput going up to the supraorbital notch or foramen, then extending down into the eyes. There are hot feeling in the lower dorsal region, and aching and drag- ging in the lumbar region, which is worse from motion. On awaking from a sleep the patient has a tired aching in the lumbar region. The legs are heavy and, at the same time, weak. With this heaviness of the feet he sometimes complains of dull frontal headache. Sometimes he complains of numbness and crawling in the legs, with trembling and with pricking, as if from needles. He has tingling of the lips, formication about the head, and crawling as of ants over the surface. The least exertion causes prostration. He also has vertigo, worse when he stoops, walks or goes up-stairs. He has headaches, with dull, throb- bing, heavy, sharp pains, worse from study or movement of the eyes, and better from rest, the open air, or binding the head tightly. The pupils are dilated. Sparks appear before the eyes, which may even smart and burn. Thick matter forms in the canthi. The eye symp- toms are worse from artificial light. Accompanying the congestion of the head is nose-bleed. The nose is full of mucus. The patient can breathe only when the mouth is open. The saliva is either frothy or stringy. The taste in the mouth is like that of the acid itself, sour and bitter. The throat feels rough and scraped; better from eating and worse from empty swallowing, and worse after sleep. There is thick, white mucus on the tonsils. On swallowing, the throat feels so sore that it almost seems as if it would split. Sour eructations may accompany the frontal headache. Now, these gastric symptoms may accompany the brain fag. Nausea, which is worse about five o'clock 54-0 A CLINICAL MATERIA MKDICA. in the morning and worse when attempting to rise. He also complains of pressure and weight about the stomach. He wants to belch, but does not seem to have the power to do it. The irritating effect of the drug is further shown by diarrhoea with stools which are thin, yellow and sometimes oily, with a great deal of burning and smarting at the anus, with prostration and unsuccessful urging to stool. The kidneys are congested. The urine has an abnormally high specific gravity, and contains sugar. It is also albuminous. The conjunctivae are yellow, just as you find in jaundice. Papules appear on the face and turn into small boils. The feet are apt to be cold. These, then, are the main symptoms of Picric acid. Now, let us study those of a few of its related remedies. Phosphorus, like Picric acid, causes fatty changes in the blood, kid- neys, brain and spinal cord. Both remedies meet in sexual excesses and priapism, and both may be indicated in brain fag; both have con- gestive vertigo and crawling and tingling sensations here and there over the body. The distinction lies principally here: Phosphorus causes more irritability with the weakness, as displayed by over-sensi- tiveness to all external impressions. Hence, the senses are too acute, or, if failing, there are present photopsies; loud noises in the ears; sen- sitiveness to odors, to electric changes in the atmosphere; head weak; cannot think, with aggravation from loud noises. Phosphorus also has backache, with feeling as if the back would break on any motion, and with burning spots in the back, better on rubbing. Sexual excitement is very strong, but the erections are not so intense as under Picric acid, although the lasciviousness is more marked. Even when, in extreme cases, all irritability has ceased, the history shows that it once charac- terized the case. Nux vomica resembles Picric acid, somewhat, in the brain fag and in the gastric symptoms, in the sour eructations, in the aggravation to- wards morning, and in the inability to study. Nux is distinguished by the prominence of its gastric symptoms. Oxalic acid, more than Phosphorus, resembles Picric acid in the ex- treme picture of spinal softening. There are weakness about the loins and hips, extending down the legs, and numbness in the back. Picric acid has more heaviness and Oxalic acid more numbness. The legs are apt to be bluish and cold. The patient complains of paroxysms of dyspnoea. Another symptom, and one indicative of spinal meningitis, is intense inflammatory pain all through the back. A general PICRIC ACID. 541 symptom of Oxalic acid is pains coming in small spots, and greatly aggravated on thinking of them. Another remedy closely related to Picric acid is Sulphur. This causes congestion of the lumbar spine, so intense congestion that paraplegia, with numbness and tingling, results. Heat in the spine. Retention of urine. Phosphoric acid suits cerebro-spinal exhaustion from over-work. The least attempt to study causes heaviness, not only in the head but in the limbs; numbness; vertigo; confusion of thought; tingling, for- mication, especially in small of back; back and legs weak, yet no pain, except a subjective sense of burning; emissions even during stool; genitals relaxed, Argentum nitricum has backache, worse when first rising from a seat and better from moving about, with trembling weakness of the limbs; vertigo, with fear of projecting corners, etc.; bones at sacrum give out; limbs tremble; impotency; organs shrivelled. Alumina is indicated in cases somewhat like those calling for Picric acid, but is distinguished by the pains in the spine as though a hot iron had been thrust into the part. The patient staggers when walking in the dark. He also has painful feeling about the soles of the feet. Silicea is quite similar to Picric acid. It is useful in nervous ex- haustion, where the patient dreads any exertion either of body or mind. When he is warmed up to his work, he can get along pretty well. He also has numbness in the toes, fingers and back, and the constipation peculiar to Silicea. Zinc causes nervous exhaustion. Its backache is worse at the last dorsal vertebra, and is worse while sitting; burning along the spine; formication in the calves; weak limbs; weak back and limbs, with goneness when hungry, especially at 11 A. m. All the nervous symp- toms are worse from wine. Of the remedies which cause violent erections you may compare the following: Cantharis, Phosphorus, Capsicum, Agariais, Pulsatilla, Platinum, Opium, Ambra grisea, Zincum, Physostigma, Pet7'oselinum and Mygale. LECTURE LII. SILICEA. ( Asaf. , Phosphorus, Conium, Graphites. Silicea. < Sulphur, Calcarea ostr., Lycopodium. ( Gettysburg water. Sesquioxide of iron. >China. > Ipecac. > Ferrum. > Graphites. > Camphor. >Veratr. alb. Irritability. Inflammations: stomach, uterus, etc. Fevers: continued, typhoid, intermittent. Skin: exanthemata, indurations, gangrene, carbuncle, Arsenicum. Nux vomica, Terebinthina. Hepar. >Bell. >Merc. Aurum is a remedy of not very extensive application, but still it is well marked in its limited sphere. Its antidotes are principally He- par, Belladoyina and Mercurius. I am not positive that there is a com- plement to Aurum. Now, in studying the action of this remedy, we are to keep in mind, first, its marked power of producing hyperemia; and, secondly, its action on the emotional mind more than on the in- tellectual. First, let us study the hypersemia of Auyum. We find this in every part of the body upon which the drug acts. It affects the heart, caus- ing increased activity of that viscus, as shown by increased force of the THE NOBLE METALS. 6oi heart-stroke, just as you find in pure cardiac hypertrophy without dilatation. As a result of this increased action, there is enlargement and secondarily, actual rrypertroph}- of the heart. Consecutive to this trouble, you have a list of symptoms that are very characteristic. The lungs are too full of blood, so that the patient on attempting to walk up hill, or use any little exertion, feels as though there were a crushing weight under the sternum. He feels that if he did not stop walking the blood would burst through the chest. Auriun relieves this kind of a case very nicely. According to Kafka, Aurtim muriaticum is here preferable to the mctallicum . This is very similar to Ammonium carb., which has a similar sensa- tion of crushing weight on the sternum, but more tendency to somno- lence and venous fulness than has Aurum. Owing to this condition of the heart there is necessarily hypersemia in other organs. We find, for instance, this tendency to rush of blood to the head aggravated by mental labor, because study always increases the amount of blood in the brain, if there is any tendency to cerebral congestion. There is a feeling of fulness in the head, accompanied by roaring in the ears. The head feels sore and bruised, and the mind is confused. The face, in extreme cases of congestion, is rather bloated, and has a glassy look. Sparks or flashes of light before the eyes show pressure on the retinal vessels. Still further evidence of the hypersemia in the eye is revealed b}' the ophthalmoscope. You find a sensation in the eye as though it were being pushed out, with a certain amount of tension there. Two errors of vision may be associated with these symptoms; either he sees double, or he suffers from what is known as half-sight. Xow, these symptoms are suggestive of hyperemia of the brain, which may occur from various causes, among the most promi- nent being overuse of the eyes, or working in hot places. Glaucoma may suggest Aurum. In scrofulous ophthalmia we frequently find Aurum indicated, if there are present those sjmiptoms of congestion. The bloodvessels are very much injected; pannus is present; great vascularity is a characteristic in these cases calling for Aurum. In addition, you will find profuse scalding lachrymation. The eyes are very sensitive to the touch. Aurum may be used in cases of syphilitic iritis when the eye is de- cidedly worse from touch. There is a very characteristic soreness around the eye, as if in the bones. Especially is it indicated in syph- ilitic cases after the abuse of mercury. 602 A CIvINICAL MATERIA MKD1CA. In retinal congestion, you should compare with Aurum, Belladonna, Glonoin and Sulphur. In syphilitic iritis, with that sore, bruised sensation around the eyes, compare Asafcetida. This remedy, however, has it in less de- gree. You may also compare here, Mercurius corrosivus and Nitric acid. The nose, too, is congested and has a red, knobby tip, greatly dis- figuring the face. This may exist as a sequel to the long indulgence in alcohol, or it may be found in children as a symptom of scrofula. If the latter is the case, it is often accompanied by the characteristic catarrh for which Awtum is the remedy. In nasal catarrh or ozaena the nostrils are sore and cracked. There is foetid nasal discharge, often accompanied by caries of the nasal bones. There is ulceration of the soft parts with perforation of the nasal septum. It is especially indicated in cases of scrofulous or mercurio-syphilitic origin. The Aurum ear symptoms are not very numerous but are suggest- ive. The ears are congested, and you find roaring in the ears, as I suggested a few moments ago. Further than this, you find great sen- sitiveness to noises. Now, it is sometimes indicated in catarrh of the' middle ear. In these cases you note a foetid otorrhoea. In addition to this you will very likely find the membrana tympani seriously dam- aged. The external auditory meatus and the mastoid process of the temporal bone become affected by direct spread of the disease. There are boring pains in the mastoid process. The trouble may progress to caries. I have already shown you illustrations of the effect of Aurum on the bones. You noticed that it was indicated in iritis with pains in the bones around the orbits; and you know also that it affects the nasal bones, producing caries there. . In caries of the mastoid process Nitric acid is the nearest ally to the Aurum metallicum. For simple soreness or inflammation, beginning in the mastoid cells, Capsicum has won some laurels, but for caries of this process, Aurum, Silicea and Nitric acid are the best remedies. Aurum has some throat symptoms. The tonsils are apt to be red and swollen, and the parotid gland on the affected side feels sore, as if contused. The hard palate may be carious. With all this, there is a mercurial or syphilitic history. I have dwelt on these symptoms be- cause they are those which Aurum has most frequently removed. THE NOBLE METAES. 603 Returning to the circulatory disturbances of Aurum, we find a hyperemia of the kidneys. This is shown in the beginning by simple increase in the amount of urine passed. By and by the kidneys begin to undergo fatty degeneration. The urine then grows scanty and albuminous, or there may be granular or cirrhosed kidney. Aurum will not do any good in these cases, unless the renal trouble is second- ary to some heart affection. The nearest remedy, pathologically, to Aurum in granular kidney is Plumbum. We find, too, that the genital organs are affected by this hyperemia and there is strong tendency to erections. The testicles become in- flamed, particularly the right. Aurum is especially suited to chronic orchitis, particularly when the right testicle is affected. As another sequel to this effect of Aurum, we find hepatic conges- tion. The liver is swollen consecutive to cardiac disease. This hyperemia is associated with burning and cutting in the right hypo- chondrium. As the hyperemia continues, the liver becomes cirrhosed or else undergoes fatty degeneration. Ascites appears. The stools are of a grayish or ashy-white color from defective secretion of bile, and we have here, as in almost all ailments in which Aurum is the remedy, a peculiar state of the emotional mind, a melancholy or a low-spiritedness, which I shall describe to you presently. The lungs are also hypersemic. There is great oppression of the chest, which is worse at night, particularly in the first part of the night; it is worse from prolonged exercise, from prolonged walking. The face may be purple. In extreme cases, syncope may take place. On the female organs we find Aurum acting powerfully, causing congestion of the uterus. The uterus becomes prolapsed from its great weight. It is enlarged from chronic congestion. This is the form of prolapsus which Aurum will cure, and no other. The ordi- nary remedies for prolapsus, such as Lilhim or Nux vomica, cannot relieve this case, because the prolapsus is not the main characteristic. The cause of the prolapsus is the weight of the organ and not the relaxation of the ligaments or weakness of the general system. There is another salt of gold which has been successfully substituted for Atirum metallicum in these cases, and that is Aurum muriaticum natronatum. This has been used in the second and third potencies for prolapsed and indurated uterus. Aurum has some very characteristic mental symptoms. In almost 604 A CUNICAL MATERIA MEDIC A. all cases in which it is the similimum, there is present a melancholy, with disposition to weep, or with a feeling of self-condemnation, as if he was not fit to live. This feeling of self-condemnation or worthless- ness may amount to despair, sometimes even taking the form of religious mania. He prays all the time. He is sure that he is going to be condemned to the lower regions. He has suicidal thoughts, if he does not make actual attempts at suicide. With all this there is a great deal of mental anguish, associated with precordial distress, by which I mean distressed feeling referred to the cardiac region. In ad- dition to the melancholy, Aurum also produces weakness of the memory. Decided anger may also be characteristic of the remedy. Any contradiction or dispute excites the patient furiously. He be- comes red in the face and his pugnacity is aroused. Mental labor be- comes irksome to the patient. He is very apt to suffer from head- aches which are of a congestive character, as has already been de- scribed. Aurum on the bones I can dismiss in a very few words, as much of it I have already given you. It is useful in caries of the cranial bones, and of the bones about the nose and palate, particularly after the abuse of mercury, whether the case be syphilitic or not. LECTURE LVIII. THE PREPARATIONS OF SILVER. Argentum Nitricum. ( Arsenicum, Nitric acid. Argentum nitr. < Plumbum, Cuprum. ( Zinc. >Natrum mur. Argentum nitricum, or the Nitrate of Silver, in its action on the brain and spine furnishes us with a list of symptoms that lead to the use of the remedy in many forms of nervous diseases, from simple ner- vous debility to full-fledged locomotor ataxia, or paralysis. Among the anomalous sensations which it causes are the following, which are characteristic of the drug: a very common general symptom which may be present in the headache, ovarian affections and in many other diseases, is this, a feeling as if the body or some part of the body were expanding. In the case of headache, the patient has a sensation, as if the head were enormously large. Sometimes, with the ovarian pains, the patient says that she feels as if there were an immense swelling in the side affected; and yet an examination shows no enlargement of the painful organ. We find this symptom under several other drugs, but very prominently under Argentum nitricum, however. Again, vertigo is almost always present when it is the remedy. This vertigo is asso- ciated with general debility and trembling from nervous weakness. The patient staggers and reels as if he were intoxicated. The vertigo is so severe at times that he becomes momentarily blind in association with mental confusion, buzzing in the ears, nausea and trembling. The patient suffers from mental anxiety. He is very impulsive. He must be always busy and yet he accomplishes nothing. He is subject to frequent errors of perception. He hurries restlessly about to fulfill an engagement, thinking that he will be too late, when, in reality, he has an hour or so more than is necessary. In some cases, there is pro- found melancholy. He imagines if left alone he will die; full of appre- hension that he has some incurable disease of the brain. He constantly makes mistakes as to his estimation of distances. For instance, when 606 A ClvINICAL MATERIA MEDICA. walking the street, he dreads to pass a street corner, because the corner of the house seems to project and he is afraid that he will run against it. All these errors are traceable to imperfect coordination of muscles. This last is no imaginary symptom; it has been met with a number of times and it has been cured by Argentum nitriciim. This defective coordination of muscles is a prominent symptom in the disease known as locomotor ataxia, for the treatment of which allo- paths have long employed Argentum nitricum as a most valuable remedy. We also may use it when the following symptoms are pres- ent: the patient staggers in the dark or when his eyes are closed. The legs are weak and the calves feel bruised as after a long journey. There is a feeling of soreness in the lumbo-sacral region; also pain in the small of the back, very severe when rising from a sitting posture, but rather relieved by walking. Zincum is also better from walking and worse from sitting. The difference between the two remedies is that Argentum ?iitricum has pain when rising. Sometimes there is pain in the sacro-iliac symphyses, a feeling as if the bones were loose there. Here it is similar to sEsculus hippocastanum . Another symptom which I would like to specialize is trembling of the hands, which causes the patient to drop things. He is very nervous at night. When he does sleep, he has all sorts of horrible dreams. These nervous symptoms are especially worse at eleven a. m. So you see that Sul- phur is not the only remedy that has this eleven A. m. aggravation. You will at once see the resemblance between Argentum nitricum and Kali bromatum and Nalrum mur. That trembling weakness, with palpitation, is the exact counterpart of the Natrum mur. condition. This fearful and apprehensive mood, this imagining that he cannot pass a certain point, reminds you of Kali bromatum. But there are less severe symptoms that will call for Argentum nit- ricum, and one of them is what we may call functional paralysis, such as follows exhausting diseases, post-diphtheritic paralysis, for example. Gelsemium is here a concordant remedy of Argentum nitricum. Other nervous affections, for which we may use Argentum nitricum, are the following: it is one of the best remedies we have for hemi- crania. This is not a simple neuralgia. It is a deep-seated neurotic disease, and by some is supposed to be of epileptic nature. It comes periodically; for its relief the remedy under consideration is one of the best. There is frequently boring pain in the head, which is worse in the left frontal eminence. This boring is relieved by tight bandaging THE PREPARATIONS OF SILVER. 607 of the head, hence the wearing of a tight-fitting silk hat relieves. It is excited by any mental emotion of an unpleasant kind, or by any- thing that depreciates the nervous system, as loss of fluids, loss of sleep or mental strain. Sometimes the pains become so severe that the patient loses his consciousness. The paroxysms frequently culminate in vomiting of bile or solid fluid. There is another form of headache which is mostly neuralgic, and for which Argentum nitricum is the remedy. The bones of the head feel as if they were separating, or the head feels as if it were enormously large. The pains about the head increase to such a degree that the patient almost loses her senses. These attacks end in vomiting, prob- ably to recur once more within a few minutes or an hour. We also find Argentum nitricum indicated in prosopalgia, particu- larly when the infraorbital branches of the fifth pair and the nerves going to the teeth are affected. The pain is very intense and at its height is accompanied by unpleasant sour taste in the mouth. The pains are of the same character as those already described for the hemi- crania. I do not believe that this sour taste in the mouth is of gastric origin, but I think that it is due to some abnormality or disturbance in the gustatory nerves. The face, in almost all these cases, is pale and sunken, rather sallow than pure pale, and in extreme cases, when the blood is very much affected, the surface of the body is of a dark, muddy, leaden hue. We also find Argentum nitricu?n indicated in that troublesome dis- ease, gastralgia, a neurosis of the stomach. It is especially indicated in delicate nervous women. The gastralgia is excited by any emotion, by loss of sleep, and frequently at the catamenial period. There is a feeling in the stomach as though there was a lump there. This is sometimes accompanied by gnawing ulcerative pain referred to the pit of the stomach. From this spot, pains radiate in every direction. These pains seem to increase and decrease gradually, just as under Stannum. With this there is apt to be intense spasm of the muscles of the chest. The patient cannot bear to have a handkerchief ap- proach the mouth, as it would cause dyspnoea. The patient cannot bear the least food because it makes this pain worse. Sometimes the pain is relieved by bending double and pressing the hand firmly into the stomach. The paroxysms end with vomiting of glairy mucus which can be drawn into strings, or what is more common, they are ac- companied with enormous accumulation of wind. The patient for 608 A CLINICAL MATERIA MEDICA. a long time cannot belch, but when he does succeed in so doing, the flatus comes in an enormous volume. This is often accompanied with general tremor, and a nervous feeling, or by a sensation as if the head was being squeezed in a vise. The nearest ally to Argentum nitricum here, is Bismuth, which is indicated in pure nervous gastralgia. The main distinction between it and Argentum nitricum is in the vomiting. Just as soon as food touches the stomach it is ejected. Another nervous disease in which Argentum nitricum is indicated is epilepsy. The strong indicating symptom for Silver nitrate is this: for days or hours before an attack the pupils are dilated. After the attack, the patient is very restless and has trembling of the hands. It is especially indicated in epilepsy caused by fright or in that which comes on during menstruation. It may also be used for puerperal convulsions, when between the attacks, the patient is very restless, and tossing about, now on one side and now on the other. Nitrate of Silver is also indicated in angina pectoris. The patient complains of intense pain in the chest and about the heart. He can hardly breathe. We also find it indicated in pure nervous asthma. There are present spasms of the respiratory muscles. Marked with dyspnoea, worse in a crowded room. Leaving now the action of Argentum ?iitricum on the nervous sys- tem, we come to its use in inflammations and ulcerations. First of all, under this head, we will consider it in diseases of the eye. Nitrate of Silver cures purulent ophthalmia, and by this term I mean any inflam- mation of the lids or eyes which develops ulceration or pus. This pus is thick, yellowish and bland. It is useful in ophthalmia neonatorum when the pus is of the character just mentioned and is profuse. Es- pecially is it called for after the failure of Pulsatilla or one of the mer- curies. You may also use it for the purulent ophthalmia of adults with pus of this character. Like Pulsatilla, the symptoms are relieved in the open air and become intolerable in the warm room. In purulent ophthalmia, Pulsatilla stands very closely allied to Ar- gentum nitricum. You will notice that both have profuse, thick, bland, purulent discharge, and both have relief from the cool open air. It has been determined clinically that when Argentum nitricum ceases to act, a dose of Pulsatilla interpolated, helps. THE PREPARATIONS OF SILVER. 609 You may also use Argentum nitricum in blepharitis when there are thick crusts on the lids, suppuration and induration of tissues. Even the cornea has become affected by the continued inflammation. The heat of the fire makes the patient a great deal worse. This symptom you also find under Mercurius. Granular conjunctivitis also calls for Arge?itum nitricum. The con- junctiva is almost scarlet, and there is profuse muco-purulent dis- charge. Rhus tox. is very similar to Argentum nitricum, but it has more spasmodic symptoms. There is spasmodic closure of the eyelids, and when you force them open, hot, scalding tears gush forth, and these cause pimples around the inflamed eyes. Euphrasia is similar in granular lids; it differs from Argentum nitricum in this: the purulent discharge is excoriating, and there is, in addition, excoriating lachrymation. Kreosote may be used in inflammation of the eyelids, whether in the infant or the adult. There is a discharge of hot, scalding tears from the eyes, occurring early in the morning. Argentum nitricum may be useful in asthenopia from want of accom- modation. Even the coarsest kind of work strains the eyes. Coming now to the mucous membrane of the mouth and throat, we find Argentum nitricum producing a dark red appearance of the fauces. Thick mucus collects in the throat and the patient complains of a sen- sation as of a splinter there. With all this, there may be ulceration. The cause may be mercury, syphilis or scrofula. The papillae of the tongue are elevated. The gums are tender and bleed readily, but are very seldom swollen, thus giving you a distinction between it and Mercurius. There is often the sensation as of a splinter in the throat like Nitric acid, Alumina, etc. The larynx suffers from the action of Argeyitum nitricum. There is muco-purulent sputum, seeming to come from the posterior wall of the larynx. There is also marked hoarseness and sometimes even loss of voice. Singers frequently complain of a feeling as if there were some- thing clogging the vocal organs. Ma?iga?ium is similar to Nitrate of Silver, causing laryngeal symp- toms, particularly in anaemic or tubercular patients. The hoarseness is usually worse in the morning and grows better as they succeed in hawking up lumps of mucus. The Manganum patient has cough from loud reading, with painful dryness and roughness of the larynx. The cough is usually relieved by lying down. 39 6lO A CUNICAL MATERIA MKDICA. Selenium is also similar to Argentum nitricum. Paris quadrifolia is a neglected drug in laryngeal affections. We find it indicated when expectoration is noticed mostly in the morning and when it is green and tenacious. Nitrate of Silver may be used in ulceration of the cervix of the uterus when it is enlarged and indurated, with copious yellow, corrod- ing leucorrhcea and frequent bleeding from the points of ulceration. Next, I would refer you to the action of Argentum nitricum on the kidneys, because little attention is paid to this action of the drug. I think that it was Dr. Preston, of Norristown, who used the drug mostly in such cases. He gave it very frequently in nephralgia from congestion of the kidneys or from passage of calculi. The face is of a rather dark hue and has a dried-up look; there is dull aching across the small of the back and also over the region of the bladder. The urine burns while passing and the urethra feels as if swollen. There is sudden urging to urinate. The urine is dark and contains blood, or else a deposit of renal epithelium and uric acid. It is especially use- ful when Ca?itkaris, which it resembles, fails. Nitric acid is to be thought of for urinary calculi when the urine contains oxalic acid and when that substance is the principal ingredi- ent of the stone. Ivastly, I have to speak of the action of Argentum nitricum on the bowels. Here it is very similar to Arsenic. The stools are green and shreddy and consist of blood, slime and epithelium. This is often associated with the discharge of a great deal of flatus and is often pro- voked by the use of sugar. Especially is it indicated when diarrhoea follows any excitement, such as fright, the anticipation of some ordeal, or when the imagination has been played upon. The bowels are apt to move as soon as the least food or drink is taken. In cholera infantum it is indicated in children who are thin, dried-up looking, almost like mummies. The legs are apparently nothing but skin and bones. The stools are green and slimy, with noisy flatus, and are worse at night. Natrum mur. is the proper remedy to antidote the abuse of Argen- tum nitricum, or the after effects of cauterizing by the crude drug. THE PREPARATIONS OF SILVER. 6ll Argentum Metalucum. Argentum ?netallicum produces spasms which simulate those of epilepsy. The attacks are followed by delirious rage. The patient jumps about and tries to strike those near him. It produces spasmodic pain in various parts of the body; thus it gives rise to pain in the head, which gradually increases and, after reaching its acme, suddenly ceases. This pain is usually on the left side and is often associated with vertigo. The patient is extremely forgetful. The heart muscle sympathizes in these neuralgic pains. Thus, there will be spasmodic twitching of the heart muscle, particu- larly when the patient is lying on his back. Now, the debility which naturally follows is very easily understood if you remember one quality of the Argentum metallicum, and that is its action upon joints. It has a particular affinity for the cartilages of joints. Thus, we find general debility, with bruised feeling in the small of the back from the weakness of the spine, general weariness forcing the patient to lie down to obtain rest. The knees are particu- larly weak. There will be, not a true articular rheumatism, but an arthralgia, with pains of the same character as those of the head. All these symptoms are common enough. We find them in nervous, hysterical women and in men after loss of fluids, particularly semen. Argentum metallicum acts upon the mucous membrane of the throat and larynx. It produces in the larynx a copious exudation of pure mucus, not purulent or not serous, but looking exactly like boiled starch. It is associated with burning and rawness in the larynx, which rawness and burning are excited by talking and protracted use of the voice. The mucus is easily expectorated. Aigentum metallicum acts upon the left ovary, causing bruised pain in that organ and, sometimes, a feeling as though the ovary was growing large. {Argentum nitricum, the right ovary. ) This is a purely subjective sensation. Associated with this bruised pain there is often a prolapsed uterus. LECTURE LIX. PLATINA, PALLADIUM, AND ALUMINA. Platina. Platina. Mental symptoms. — Bell., Pallad., Phos., Lye. Nervous system. — Bell., Helon., Stan., Plumb. f Pallad., Arg. met., Helonias, Sexual organs pu p Aurum _ The action of Platina is to be studied under three headings, namely: the mental symptoms, its action on the nervous system in general, and its effects on the sexual organs of both the male and the female. The Platina patient is rather haughty and proud, egotistical. She seems to look down upon everybody and everything as beneath her. There is often accompanying this mental condition a peculiarity of vision; objects look smaller to her than natural. Platina also pro- duces an excitation of the mind and of the whole nervous system. Things seem horrible to her. In her imagination she sees ghosts, demons, etc. Here it resembles Kali bromatum and Hyoscyamus, both of which have this symptom. Everything seems strange to the pa- tient. When she enters her own home objects appear strange to her; she does not know where she is. At other times the patient is de- cidedly melancholy. She thinks that death is near at hand and she fears it, very much as we found under Arsenic and Aconite. Aconite predicts the hour or time of death, but otherwise the two drugs differ immeasurably. She may have a decidedly hysterical mood, with alter- nation of attacks of laughing and crying, especially when these are respectively inappropriate. Now these mental symptoms seem to de- pend upon excitement in the sexual sphere. The genitals, particu- larly those of the female, are acutely sensitive. There is constant titillation or tingling in the sexual organs, internally and externally. This excites the unfortunate victim to such a degree as to produce that horrible disease known as nymphomania. The patient seems to have the strength of a giant. She wishes to embrace everybody. PLATINA. 613 These nymphomaniac symptoms are accompanied by prolapsus with in- duration of the uterus, just like Aurum. The ovaries are very sensi- tive, and are the seat of burning pains. Platina has even succeeded in curing ovaritis when pus has formed, and Hepar and Lachesis have been insufficient to effect its evacuation. The menses are too early and too profuse, and consist of dark, stringy, clotted blood. They are accompanied by spasms, or by painful bearing-down in the uterine region. Now these spasms of Platina are quite frequently met with in hysterical subjects. They consist of a sort of tetanic rigidity with trismus, and this alternates with dyspnoea. When, as will sometimes happen, nymphomania occurs as the re- sult of worms escaping into the vagina and there exciting irritation, Caladium is the remedy. This menstrual flow of Platina brings to mind two or three other remedies, which are here deserving of mention. Crocus has a dark or black clotted flow, with or without miscarriage, and associated with a sensation as if there were something moving around in the abdomen. Chamomilla has profuse, dark, clotted menstrual flow, but its mental symptoms are different from those of Platinum. Millefolium and Sabina have bright-red, partly-clotted blood. Belladonna, like Platina, has a sensation in the forehead as if all would come out; face burning red; bearing down in uterus, etc.; but in Belladoyina the pains come and go suddenly, and the flow is bright; or, if dark, it is offensive in odor. Lycopodium is the nearest analogue in the egotistic state of mind. The Platina patient often suffers from neuralgia in various parts of the body. These neuralgias are very easily studied on account of their well-marked characteristic symptoms. The pains are of a cramp- ing character, and cause numbness and tingling in the parts affected. You find them frequently in the head. There will be pain at the root of the nose, as though the part were squeezed in a vise, and this is fol- lowed by tingling and numbness, which will indicate to you that it is in the course of the nerves that this symptom lies. The pains in- crease gradually, and decrease just as gradually as they came, as you will find under Stannum. Now, in these neuralgic symptoms, the nearest remedy we have to Platina is Belladoyina. In both remedies there is decided congestion of the head, with bright red face and delirium, but the gradually in- creasing, and just as gradually decreasing, pains distinguish Platina from Belladonna. 6 14 A CUNICAI, MATERIA MEDICA. Capsicum is suited to patients of lax fibre who suffer from burning pungent pain in the face, worse from the slightest draught of air, whether warm or cold. Verbascum is indicated in prosopalgia when there is a numbing, crushing as with tongs in the painful parts, worse from talking, sneez- ing, change of temperature, at times associated with numbness, and daily from 9 A. m. to 4 p. m. Gnaphalium has neuralgia alternating with numbness, especially in the lower limbs. Arse?iicum has prosopalgia, with darting, needle-like, burning pains. I have yet a few words to say about the action of Platina on the male system generally. We find it indicated for the ill-effects of pre- pubic masturbation. It is called for by the melancholy and the sheep- ish look that the children have. Also when, as a result of this un- natural vice, spasms of an epileptiform character appear. The youth has hollow eyes and yellow skin. During the attack the face is pale and sunken; in fact, it may be so at all times. Consciousness is not often lost. The limbs are usually drawn up and thus spread apart. It may also be used for spasms during labor. Teething children may require Platina when they are anaemic and pale; the jaws are locked, and after the spell the child lies on its back with flexed legs and knees widely separated. The spasms, both in adults and children, alternate between convulsive actions and opisthotonos. Platina may also be used in hysterical spasms or spasms caused by nervous excitement, when they are preceded or followed by constric- tion of the oesophagus and respiratory embarrassment, a sort of asthma in other words; sudden arrest of breathing when walking against the wind. In this last symptom it is similar to Calcarea ostrearum and Arsenicum. Moschus is similar to it in hysteria. In its abdominal symptoms, Platina very much resembles Plumbum, and it has been used very successfully for the cure of the well-known colic produced by the latter remedy. Like Plumbum, Platina produces a constipation from inertia of the bowels. It is attended with frequent unsuccessful urging to stool. The stools when passed seem to be like putty or glue, and adhere tenaciously to the anus. It has been highly recommended for the constipation of emigrants. The Chloride of Platinum has only one symptom that I care to men- tion, and that is caries of the tarsus. You may use it in syphilitic cases, or after the abuse of mercury. PALLADIUM. 615 Platina has some further action on the female genital organs, as I have already intimated. It is useful in cases of indurated and pro- lapsed uterus, associated with continual pressure in the groins and back; parts are painfully sensitive to touch. The patient exhibits sensitiveness, even vaginismus, during coitus. In indurated uterus compare Sepia, Aurum (which has more suicidal mania), Argentum nitricam and Helonias. For sensitiveness to coitus compare Sepia, Belladonna (from dry vagina), Kreosote (when followed by bloody flow), Ferrum, Natrum mur., Apis (when associated with stinging in ovaries), Thzija, etc. Palladium. Palladium is chemically and symptomatically near to Plati?ia. It is of use principally for its action on the female genital organs. Its characteristic mental symptoms seem to find origin in the sexual symptoms, and form, with the latter, a useful and precise group for practical use. The patient is inclined to weep. She suffers from mental excitement, particularly in company. She always, has an ag- gravation of her symptoms* the day following an evening's entertain- ment. She is easily put out of humor, and is then inclined to use pretty strong language. She imagines herself very much neglected, and as she attaches great importance to the good opinion of others, this annoys her very much. The Platina woman is very different. She is egotistical in another form. Under Palladium, pride is easily wounded. In Platiiia the patient is haughty and egotistical; she looks down on others as not being good enough for her. Palladium has a very characteristic headache, which makes the pa- tient very irritable. It extends across the top of the head from ear to ear. The face is sallow, with blue rings around the eyes. There are also nausea, usually worse in the evening, and very acid eructations. The bowels are constipated, the stools often being whitish in color. We come now. to the special uterine symptoms of Palladium, and these we find quite numerous. They are as follows: soreness in the abdomen with downward pressure, a very common symptom in uterine diseases; pain in the uterus and bladder after any exertion during the day; knife-like cutting pains in the uterus, which are relieved after stool; constant tired feeling in the small of the back; she is so tired that she actually reels; she feels drowsy; she complains that she feels 6i6 A CLINICAL MATERIA MEDICA. sore and bruised all over; heaviness as from lead, deeply seated in the pelvis, worse from any exertion, and worse standing; walking is much less irksome to her than is standing; lying on the left side relieves; swelling in the region of the right ovary, with shooting pains from navel into the pelvis, and with this there is bearing down, relieved by rubbing. Jelly-like leucorrhoea. These local symptoms, together with those of the mind, make up the complete Palladium picture. Argentum metallicum, like Palladium, has affections of the ovaries and uterus. It is useful in prolapsus uteri when accompanied by symp- toms of the left ovary. The special characteristic sensation in Ar- gentum metallicum is a feeling as though the left ovary were growing enormously large. Still another drug is Lilium tigrinum. This resembles Palladium and Platinum both, and you will have to keep these three remedies to- gether in your minds. They all have irritability, "easily angered," and " things don't go right," but only Palladium has this over-sensi- tiveness to offence, and only Platinum the hauteur. Helonias is also similar to Palladium, in its irritability, soreness and. above all, a feeling of " tiredness." Alumina. V . Bryonia. ALUMINA. Puis, (chlorosis, ozaena), Calc. ostr. (fears crazy), Lach. (worse awaking), Sepia. Plumbum (colic). Arg. n., Nuxv., Sulph. (spine). Mercurius (bubo). Bry., Cham, (stomach). Ruta, Con., Natr. m., Sep., Graph., Zinc. Eyes. Blood. Nerves. Mucous mem- branes. Glands. Stomach, liver and bowels. Genitals. Ivarynx. Skin. >Cham. >Bry. Alumina or the oxide of Alumi?iium, is a form of pure clay and is known as argilla. According to Hering, the symptoms which Hart- laub obtained are not pure, because he simply washed his preparation of clay, while Hahnemann subjected his to a red heat. ALUMINA. 617 You notice by the table on the board that I have placed Bryonia as the complement of Alumina. This is particularly true of the gastric symptoms. These drugs follow each other well in gastro-enteric affec- tions. Bryonia, also, acts as an antidote to Alumina, as does also Chamomilla. I have placed several of the concordant remedies with a few words in parenthesis to indicate the points of resemblance. Thus Pulsatilla is marked by chlorosis and ozsena, showing that in these two affections particularly, Pulsatilla is concordant with Alumina. Then you notice that Plumbum is similar to it in colic, smdiVux and Sulphur in spinal affections, etc. Alumina acts best in aged persons of spare habits, who are rather wrinkled and dried-up looking, or in girls at puberty, especially if they are chlorotic, and also in delicate or scrofulous children, particularly children who have been artificially fed — that is, nourished by the many varieties of baby foods with which the market is glutted. Such children are weak and wrinkled; nutrition is decidedly defective. The bowels are inactive. This constipation is characteristic. There is a great deal of difficulty in voiding the stool even though the faeces be soft, showing you at once that the inactivity of the bowels is the main influence at work in its causation. Here, it is like Bryonia. Except- ing that the latter has more hardness and dryness of the faecal matter. The child suffers from ozaena or chronic nasal catarrh, with a great deal of dryness of the nose. This you know by the dry sniffling sound which the child makes in breathing through its nose. The child, too, when teething, may suffer from strabismus. This comes from weak- ness of the internal rectus muscle of the affected eye. This symptom is sometimes curable by medicine, and when it is so, this method is preferable to any surgical procedure. Sometimes, it follows worms. Then Ci?ia is the remedy; when it comes from brain irritation, Bella- donna; and Cyclajnen when from menstrual or gastric irregularities. The Alumi?ia patient is very low-spirited and inclined to weep, like Pulsatilla, and this low-spiritedness is worse on awakening, here re- sembling Lachesis, Pulsatilla, Sepia, etc. At other times, you find the patient troubled with an apprehensive state of mind, a fear that he will go crazy, and this is an exact counter part of Calcarea ostrearum, Iodine, etc. This shows you the irritable state of brain fibre. Another peculiarity that may be present, particularly in hysteria, is suicidal tendency when the patient sees blood, or a knife, or something of that kind. 6l8 A CLINICAL MATERIA MKDICA. Men in whom Alumina is useful are hypochondriacal. There is a great deal of lassitude and indifference to labor or work. An hour seems to them half a day. They are exceedingly peevish and fretful; and here you find Alumina rivalling Nux vomica and also Bryonia. Now, on the right side of the board, you will notice several headings under which I propose to consider Alumina. First, what changes are made in the blood by Alumina? I cannot tell you how it alters the blood, but there are diseases of the blood to which it is applicable, and it is convenient here to bring these to your notice. We find it indi- cated in anaemia, and also in chlorosis, especially in 3^oung girls at puberty, when the menses are pale and scanty, and there is an abnormal craving for certain indigestible articles, such as slate pencils, chalk, whitewash, etc. The leucorrhcea to which they are subject is usually transparent, and quite ropy and tenacious, or else is composed of yel- lowish mucus, which is profuse, sometimes running down the limbs to the feet. This exhausts them very much, because it is rich in albumen. With these symptoms, you will almost always find the mental states that I have given you. Now in nervous affections. Alumina has been used in nervous af- fections of a very grave character. Boenninghausen used the metal Aluminium for the following symptoms in that dreaded disease, loco- motor ataxia: frequent dizziness; objects turn in a circle; ptosis, diplopia or strabismus; inability to walk in the dark or with the eyes closed without staggering; feels as if walking on cushions. There is formication, or sensation as from creeping of ants in the back and legs. The nates go to sleep when sitting. The heels become numb when walking. A feeling in the face as though it was covered with cob- webs, or as though the white of an egg had dried on it. Pain in the back, as though a hot iron were thrust into the spine. These are the symptoms indicating Alumina, and these are the symptoms which led Boenninghausen to Aluminium, and enabled him to cure four cases of the disease. Next, the mucous membranes. Alumifia is a unique drug here. It acts in a limited but very well-described class of cases. It causes un- mistakable dryness of the mucous surfaces. If you keep that fact in mind you can explain all the symptoms which it causes. You have at once the key to its dyspepsia, nasal catarrh, sore throat and constipa- tion. There is dryness of the mucous membranes. After a while, there is formation of mucus, which is thick, yellow, and very difficult ALUMINA. 619 of detachment. Let me show you a few illustrations of this. In the eyes, for instance, it will be indicated in blepharitis particularly, with great dryness of the conjunctiva. The lids feels stiff and they crack, so dry are they. The nearest analogue here is Graphites, which has the same symptoms, only it has more bleeding than has Alumina. Alumina is useful in asthenopia from irritated conjunctiva; also in granular lids and chronic blepharitis. For dry eyes, Allen recommends, also, Berberis, Natrum carb. , and Natrum sulph. Eyes dry on reading, Crocus, Arge?ttum nitricum, Cina, Natrum mur. Drooping eyelids, Nux moschata, Sepia, Rhus, Gelsemium. Alumiyia also has loss of power over the internal rectus. Here it is like Agaricus, Jaborandi, Conium, Ruta, and Natrum mur. The latter, according to Woodyat, is the best. In nasal catarrh you will find Alumina indicated in children with great dryness of the nose, formation of scabs and remotely, thick, tenacious yellow phlegm or mucus, which is difficult of removal. The cough indicating Alu??iina is dry and spasmodic. It is worse in the morning when the patient coughs until he detaches a small amount of tightly adherent mucus, which relieves for a while. You find it indicated in disease of the throat, in a relaxed condition of the mucous membrane, just that condition you meet with in clergy- men's sore-throat. The throat is very dry on waking with husky, weak voice. It is dark red, the uvula elongated. The patient is better from hot drinks. Hoarseness appears worse in the morning, with a feeling as of a splinter in the throat when swallowing. This last symptom you find also under Hepar, Argentum nitricum, Nitric acid, etc. The mucous membrane of the stomach is dry, and, therefore, there is defective secretion of gastric juice. Here you have the same dys- pepsia as is curable with Bryo?iia. The distinctive symptoms for Alumina are these: there is a feeling of constriction along the oesophagus when swallowing food. The patient is always worse from eating potatoes; that is a good indication for Alumina. There is aversion to meat and a craving for indigestible substances. The liver is sensitive to touch, and there are stitching pains in that organ, as under Bryonia. You find the constipation with urging to stool already described, even though the stool be not dry and hard. Piles itch and burn, and are moist. 620 A CLINICAL MATERIA MBDICA. Next, we consider the action of Alumina on glands. Here I have only one symptom for you, and that is the use of the drug in treating buboes. You may give it in gonorrhceal bubo when there exists with it a yellowish gonorrhceal discharge, with burning and itching along the urethra, particularly at the meatus. Lastly, the skin. Alumi?ia acts here just as it does on the mucous membranes, producing dryness and harshness of the skin; as a conse- quence, we find it indicated in rough, dry eruptions, which crack and may bleed, although not often, and which itch and burn intolerably, and are worse in the warmth of the bed. You will recall here that Argentum nitricum, Nux vomica, and Sul- phur are similar to Alumina in spinal affections. Mercurius is the most similar remedy. Alumina has been used as an antidote to the colic caused by Plum- bum. LECTURE LX. PLUMBUM AND STANNUM. Plumbum Metalucum. ( Belladonna, Platina, Nux vomica, Cuprum, Opium. Plumbum. < < Opium. ( China. ^ ( Alumina. The symptoms of Plumbum, or lead, may be studied from its main property, that is, its tendency to cause contraction of muscular fibre, both voluntary and involuntary. It will cause this contraction of muscles, and it will also cause contraction of the bloodvessels, because it affects the involuntary or non-striated muscular fibres. The first symptom that usually follows poisoning by lead, whether taken by the stomach in small doses, as in case of drinking water impregnated with it, or whether by inhalation, as in the case of painters, is lead colic, and this consists of horrible griping cramp-pains, with retraction of the abdominal walls, making the abdomen concave rather than convex. There is understood to be spasm of the recti muscles; as these are con- tracted, of course they draw the abdominal walls in. Pain radiates in all directions, generally following the course of the nerves, sometimes causing delirium when extending to the brain, dyspnoea when involv- ing the chest, retraction of the testicles when extending in that direc- tion, and violent cramps in the legs when reaching the nerves there. With this colic there is obstinate constipation, and in some cases, even stercoraceous vomiting. The colic is antidoted by Alumi?ia, Alume?i, Platina, Opium, Nux vomica, Arsenicum, Colocyntk, Sulphuric acid, Zincum, or Belladonna, and is prevented by alcohol. Next the symptoms of Plumbum that are of a paralytic character. The first characteristic symptom here is wrist-drop from paralysis of the extensor muscles of the wrist. This Plumbum has cured when it has arisen from other causes than lead-poisoning. This paralysis ex- tends to other parts of the body, always involving extensor muscles in 622 A CLINICAL MATERIA MEDICA. preference to flexors. There appears on the border of the gums a blue line, known as the gingival line of lead poisoning. It is caused by the sulphur that exists in the tartar on the teeth combining with the lead in the bloodvessels, and forming a deposit of insoluble sulphide of lead. As I have said, the paralysis extends and involves other parts of the body, and then it is characterized by atrophy of the affected parts, which is therefore due to true organic changes. Thus you find Plumbum indicated in paralysis from disease of the spinal cord when that nervous structure has undergone fatty degeneration or sclerosis. Plumbum suits very nicely that disease known as multiple cerebro- spinal sclerosis. It is indicated by this symptom: tremor, followed by paralysis. We often find Plumbum indicated in paralysis with contracture. Progressive muscular atrophy may also call for Plumbum. Plumbum tends to produce non-development of the uterus. We may, therefore, find it indicated in cases of tendency to abortion. The foetus in utero increases in size, but the muscular fibres of the uterus do not develop in proportion, hence the uterus is no longer able to ac- commodate the growing foetus and abortion ensues. Sometimes we find Plumbum indicated in delirium, very much like that of Belladonna; the patient bites and strikes at those near him; but it differs from that of Belladonna in this: there is tremor of the head and hands, and yellow mucus collects about the mouth and teeth. The delirium, moreover, alternates with colic, which is not the case in Belladonna . Other cerebral disturbances from lead-poisoning are not common, but still the following may be met with: insomnia, severe headache, either occipital or frontal, with or without vertigo; noises in ear; dis- ordered vision; diplopia; amaurosis; contraction of pharynx, though liquids are swallowed in gulps and greedily; mind weak, morose, and sad; preceded by albuminous urine. Plumbum has frequently caused epilepsy. The characteristic symp- toms which indicate it are paralytic heaviness of the legs before the attack, and paralysis and prolonged snoring sleep afterwards. It is especially indicated in convulsions from cerebral sclerosis or tumor. In constipation you may use Plumbum when the retraction of the abdomen already mentioned is present, and when there is marked spasm or contraction of the sphincter ani. There is urging to stool, and the patient complains of a sensation as though a string were draw- ing the anus up into the rectum. STANNUM. 623 It may be mentioned in passing that Baryta carbonica has a colic with retraction of the umbilicus like Lead. Thallium has the same symp- tom as an accompaniment of violent lancinating pains through the stomach and bowels, following each other rapidly like electric shocks. This remedy has relieved the fulgurating pains of locomotor ataxia. In its action on the kidneys Plumbum produces granular degenera- tion or cirrhosis of those organs. There is very little dropsy or albu- minuria, but a marked tendency to uraemia and consequent convul- sions. Stannum. ( Causticum. Stannum. \ Phosphorus, Sulphur. Sepia, Pulsatilla, etc. \ V Pulsatilla. f Exhaustion. Paralysis. Nerves. < . bpasms. ^ Neuralgia. Mucous membranes. Fevers. Organs. Stan?ium is a drug that has not many symptoms; hence it can be disposed of very quickly. Its complement is Pulsatilla. The Sta?i?ium patient is usually sad and lachrymose, just like Pul- satilla. Crying usually makes the patient worse. This low-spirited- ness is found in the lung troubles for which Stannum is your remedy. This is rather different from the usual mental state of consumptives, who, you all know, are generally hopeful, almost to the last hour of life. Stannum is particularly indicated when they are low-spirited, hence it is rarely indicated in true tuberculosis. The woman for whom Sta?mzim is indicated is also nervous and weak; so nervous, irritable, and weak is she, that she becomes anxious and has palpita- tion of the heart, even from so little exertion as giving directions con- cerning her household affairs. She complains of a sensation of gone- ness in the stomach and chest. This nervous exhaustion is exhibited in various ways; it is particularly induced when the patient goes down stairs, more than when ascending. She feels as if she could not walk down stairs, or as if she had not sufficient strength in her limbs. 624 A CLINICAL MATERIA MEDICA. This exhaustion may be exhibited in another way: the patient does not complain much about walking, but on trying to sit down she fairly drops into the chair. This is not an imaginary symptom. You will meet it in uterine affections. In the mental symptoms you may compare Stannum with Natrum mur., Pulsatilla, and Sepia. Natrum mur. has melancholy, sad, weep- ing mood, but consolation seems to aggravate. On trying to comfort him, he becomes enraged. The Pulsatilla patient is of a mild, tearful, yielding disposition. She rather likes consolation. She has scanty, delayed menses, while Stannum has the opposite. The Sepia patient has sadness concerning her own health, while she exhibits great indifference to her family. She is easily offended and is inclined to be vehement. In this relaxation of tissue, producing goneness or weakness, we have several remedies. First of all, when you find patients are weak from talking, compare: Cocculus, Veratrum alb., Phosphoric acid, Sul- phur, Sulphuric acid and Calcarea ostrearum. For the functional paralysis that may come from fatigue or from mental emotions, compare with Stan?ium, Cocculus, Ig?iatia, Phospho- rus, Natrum mur. and Collinsonia. The Stannum patient is troubled with disordered digestion, other- wise called dyspepsia. There are nausea and vomiting in the morn- ing, or, as in Colchicum, the odor of cooking causes vomiting. This last symptom is a particularly strong indication for Stannum, espe- cially in women. There is weak, gone feeling in the stomach, as in Sepia ; also bitter taste in the mouth. The rectum is inactive. Much urging is required to evacuate even a soft stool. The face is apt to be pale and sunken, with dark rings around the eyes. These symptoms indicate debility, with which women suffer, and they may call for the exhibition of Stamium when worms are present. Even when con- vulsions result from the irritation of these parasites, Sta?inum is still the remedy if other symptoms agree, thus placing it alongside of Cina, Artemisia, etc. Men may require Stannum when they are hypochondriacal. They have gastralgic pains, which compel them to walk about for relief, and they are so weak that this exercise is very fatiguing to them. The tongue is coated yellowish. The Sta?inum patient suffers from prolapsus uteri. This prolapsus STANNUM. 625 so often calls for Stannum, that Dr. Richard Hughes generally finds this remedy useful for simple prolapsus uteri. You will find, too, that under Stannum the vagina is prolapsed. These prolapsus symptoms are worse during stool. The menses are always profuse. The leucor- rhcea corresponds with the prevailing character of the drug. It is yellowish or else it is clear mucus, and is always associated with un- bearable weakness. The patient is so weak that she can scarcely move about. The prostration is so great that, on dressing in the morning, she has to sit down several times to rest. There is trem- bling of the arms and legs. The limbs feel as heavy as lead. This weakness is always worse when descending, as when going down stairs or assuming a sitting posture. These uterine symptoms may be associated with weak or gone. feeling in the chest. The patient feels so weak she can scarcely talk. As somewhat similar to Stannum in prolapsus uteri, with aggrava- tion of symptoms during* stool, you may remember Podophyllum, which has prolapsus uteri with diarrhoea. The stool is usually green, and comes with a rush. Calcarea phosphorica, Nux vomica, Pulsatilla should also be studied in this connection. As you might expect, a patient, so thoroughly weakened as to the nervous system as is the Stannum patient, must suffer from neuralgia. The general characteristic guiding you to its use is, the pains increase and decrease slowly. They are especially liable to occur in the course of the supra-orbital nerve. With this character to the pain, we find Stannum useful in prosopalgia following intermittent fever and abuse of quinine. In these pains that increase and decrease slowly, the nearest rem- edies are Platina and Strontiana carb. Spigelia, Kalmia and Natrurn mur. also have the symptom, though perhaps less markedly. Epilepsy has been treated with Stannum, particularly when reflex from abdominal irritation, as from the presence of worms in the intes- tinal canal. The patient has a pale face and dark rings around the eyes, and colic, which is relieved by pressing firmly on the abdomen. If the child is old enough to describe his sensations, he will complain of a sweetish taste in the mouth. It is also useful in epilepsy with sexual complications; opisthotonos; clenching of the thumbs. Hysterical spasms may also call for Stannum, especially when asso- ciated with pain in the abdomen and diaphragm. 40 626 A CLINICAL MATERIA MEDICA. Next, the action of Stannum on mucous membranes. When it is the remedy, you find that there is copious secretion from the mucous membranes. This is bland and unirritating, and is yellowish or yellowish-green; hence it is a muco-purulent secretion. Sometimes, although not so often, this mucus is tenacious, viscid and intermixed with blood. It accumulates in the throat and is detached with great difficulty, even exciting vomiting. The mucus collects very rapidly in the chest and is quite easily expectorated, with great relief to the patient. The oppression, the weakness, and the tightness of the chest are all relieved when this sputum is raised. The voice, which is husky and hoarse, seems to be raised in pitch by this expectoration. Dyspnoea, too, is decidedly better after expectoration. The cough is very annoying and teasing. It is worse at night, and is excited by talking and walking rapidly. The patient, in addition, complains of that weakness of the chest. It seems as if he had no strength there whatever. Dyspnoea comes on, worse towards evening. Now these are the symptoms w 7 hich indicate Stannum in cases of neglected cold. They also suggest the drug in what has been very properly termed catarrhal phthisis. There is marked hectic fever. The chills come characteristically at ten o'clock in the morning. To- wards evening the patient becomes flushed and hot, with aggravation of his symptoms on any exertion. At night he has profuse sweat, which is particularly worse towards four or five o'clock in the morn- ing. L,et me say here that in this hectic fever, with chill at ten o'clock in the morning, I have several times tried Natrnm mur. } but without obtaining any benefit from it. Stannum is a remedy which you must select with great care, or it will surely disappoint you. This symptom of weakness must be pres- ent if you expect results. When you find Stannum insufficient in catarrhal phthisis, you may think of the following remedies: Silicea is indicated in catarrhal as well as in true tubercular phthisis when there is cough, which is increased by rapid motion. There is copious rattling of phlegm in the chest. The expectoration is more purulent than that of Stannum. There are usually vomicae in the lungs. You will find Silicea frequently indicated in the catarrhal phthisis of old people. Phosphorus must often be carefully compared with Stannum, as the two remedies are frequently misused for each other. Both have hoarse- ness, evening aggravation, weak chest, cough, copious sputum, hectic, etc. Phosphorus has more blood or blood-streaks, tightness across the STANNUM. 627 chest, aggravation from lying on the left side and thirst for ice-cold water. Se?iega is a drug which produces great soreness in the w T alls of the chest and great accumulation . of clear albuminous mucus, which is difficult of expectoration. These symptoms are often accompanied by pressure on the chest as though the lungs w 7 ere pushed back to the spine. It is especially indicated in fat persons of lax fibre. This Senega contains Senegin or Polygalic acid, which is identical in com- position with Saponin, the active principle of the Quillaya saponaria. This also produces the same kind of relaxed cold as the Senega does. Coccus cacti is useful in whooping cough, with vomiting of great ropes of clear albuminous mucus. It may be useful in catarrhal phthisis when, with this ropy phlegm, there are sharp stitching pains under the clavicles. Balsam of Peru is indicated in catarrhal phthisis by copious puru- lent expectoration. We know but little concerning this drug. We must, therefore, adopt the expedient of selecting it by a process of ex- clusion. Yerba sa?ita or the Eriodiction Californicum is indicated when there is asthmatic breathing from accumulation of mucus. There are con- siderable emaciation and fever. Among other remedies with much phlegm on the chest are Anti- monium crudum and tartar icu?n, Ckamomilla, Belladonna, Calcarea ostrearu?n, Calcarea phosphoidca and Ipecacuanha (in children), Lyco- podium, Sulphur, Phosphorus, Balsam of Peru (purulent sputum), He- par, Scilla, Yerba santa (fever, emaciation, asthma from mucus), Co- paiva (profuse greenish-gray, disgusting-smelling sputa); Illicium anisatum (pus, with pain at third cartilage, right or left) ; Plx liq : (purulent sputum; pain at left third costal cartilage); Myosotis (copi- ous sputa, emaciation, night sweat). In pleurisy you find Stannum indicated by sharp, knife-like stitches, beginning in the left axilla, and extending up into the left clavicle. Sometimes they extend from the left side down into the abdomen. They are worse from bending forward, from pressure and on inspira- tion. Stannum is sometimes used in functional paralysis arising from onanism or from emotions. Sometimes persons of the weak, nervous temperament I have described are so affected by emotions as to lose the power of motion. Here Stannum compares with Staphisagria and Natrum mur. LECTURE LXL CUPRUM AND ZINCUM. Cuprum. V Calc. ostr. Cuprum Metaulicum. Suuphur. Argentum nitricum, Arseni- cum, Veratr. alb. Colocynth, Puumbum, Cho- los terrapinse. Stramonium, Belladonna, Hyos. r Sugar. Albumen. i. Blood.— a. Chlorosis. b. Fever. c. Heart. 2. Nerves. — a. Spasms. b. Cramps. c. Neuralgia. d. Lack of reaction. e. Paralysis. 3. Collapse. — Cuprum metaixicum and Cuprum aceticum are used interchange- ably by many physicians as having the same symptomatology. The original idea of those who proposed the substitution of the latter for the former was based on the supposition that the acetate of copper is soluble, while the metallic copper is not. This applies, of course, to the crude drug, but not to the potentized preparations. Copper has for its complement Calcarea ostrearum. It is antidoted by sugar and albumen. Hepar, as a general astidote to the metals, comes into play as a dynamic antidote, as do also Belladonna and Stramonium. Copper possesses considerable interest as a prophylactic in disease. Workers in copper seldom contract Asiatic cholera. Here it resembles Sulphur. Unlike Sulphur, however, it is a remedy for the symptoms of cholera. It is indicated for the following symptoms: intense coldness of the surface of the body, blueness of the skin, cramps of the muscles, the muscles of the calves and thighs are drawn up into knots. There is considerable distress, referred by the patient to the epigastrium, and this is associated with most intense dyspnoea. So intense is the dyspnoea that the patient cannot bear his handkerchief approached to his face; it takes away his breath. Now, this picture CUPRUM. 629 of Cuprum seems to place it between Camphor and Argentum ?iitricum. Camphor has symptoms of collapse, like Cuprum; and Argentum nitri- cum has terrible distress in the epigastrium with dyspnoea. It differs from Camphor \n this: Camphor lacks the prominence of the cramps which are ever present in the collapse of Cuprum. There is another condition in which Cuprum may be used, and that is in the uraemia or ursemic convulsions following cholera. The char- acter of these convulsions will appear in a few minutes when I speak of the nervous symptoms of the remedy. We find Ctiprum indicated in chlorosis, after the abuse of iron. The symptoms are worse in hot weather. We also find it indicated in fever with marked tendency to frequent relapses; hence, in a sort of relapsing fever. It is not the specific re- lapsing fever, but rather a fever in which the relapses are the result of defective reaction. Cuprum, when taken in large doses, produces an inflammatory colic, presenting a combination of neurotic with inflammatory symptoms; these are gastro-enteric. We find the abdomen as hard as a stone; the bowels are, at first, obstinately constipated, the constipation being suc- ceeded at times by bloody, greenish, watery stools. The vomiting is terrific and is spasmodic in its character. It seems to be relieved by a drink of cold water. Hence it is very different from Arsenicum, Veratrum and other remedies. Now, what takes place in this group of symptoms ? In the first place, Cuprum not only acts on the bowels, inflaming them, but it acts upon the nerves, causing constriction of fibre, particularly of the involuntary muscular fibres, as in the blood- vessels, and with this we have direct irritation producing inflammation. Now, to clearly understand the character of Cuprum, you must re- member the other side to this picture. This condition is soon followed by collapse with great prostration, from which it is exceedingly difficult for the patient to rally. Thus, we have as a remote symptom of Cuprum, and one, too, which has been greatly neglected, lack of reaction. We have seen that- quite a number of remedies are useful in this condi- tion. We all know that Sulphur may often be used; we have learned under what circumstances Carbo veg. is called for; that Laurocerasus , Valerian and Ambra grisea are suited in some nervous temperaments; Capsicum in flabby, lazy individuals of lax fibre, and Psori?ium in well- marked psoric cases. But here we have, when Cuprum is the remedy, a tendency of all the symptoms to relapse. Especially is it an indication 630 A CUNICAL MATERIA MEDICA. when this lack of reaction occurs in persons who are thoroughly 11 run down " by overtaxing both body and mind. I know of a case in which Cuprum prevented paralysis of both legs, and this was the indication; deciding its choice was the fact that the disease was caused by overtaxing of both brain and body. So, too, in pneumonia, we may have to use Cuprum to bring about reaction before the appropriate remedy will cure. It is indicated by sudden suffocative attacks, with coldness of the surface of the body, with great prostration and dyspnoea disproportionate to the amount of solidification. The body is covered with a cold viscid sweat. The main action of Cuprum and that which will call for its most frequent use in practice, is on the nervous system. We find it indi- cated, for instance, in spasms with affections of the brain, as in menin- gitis. No remedy in the materia medica excels it, and very few equal it, in this direction. We find it indicated when there has been an eruption suppressed, whether that be scarlatina, measles or erysipelas. The symptoms which call for it are these: delirium of a violent char- acter very much like that of Belladonna; the patient bites the offered tumbler, loquacious delirium on awaking from sleep, or on becoming conscious he appears frightened. Here it is the exact counterpart of Stramonium. But it is a far deeper-acting remedy than Stramonium. The convulsions usually start from the brain with blueness of the face and lips, the eyeballs are rotated and there are frothing at the mouth and violent convulsive symptoms, especially of the flexor muscles. The convulsion is followed by deep sleep. . Now this spasm, especially if epileptic, may be ushered in by a violent shriek or cry. There is grinding of the teeth. Cuprum is not very frequently indicated in neuralgia, but it may sometimes be used in sudden attacks of neuralgia with active conges- tion affecting the nervous supply of the involuntary muscles. Cuprum arse?iicosum I have used in the third potency, on the recom- mendation of Dr. J. H. Marsden, for neuralgia of the abdominal viscera. I have prescribed it in cases in which no other remedy seemed to be indicated, and I believe with excellent success. ZINCUM. 63L ZlNCUM. Zinc. Nervous depression. Undeveloped diseases from enervation. ( Hemispheres. Brain. < Sensorium. I Pons medulla. Spine. Anaemia. Organs. (^Skin. f Belladonna, Cuprum, Stramonium. Hyoscyamus. Zinc. ^ Calcarea ostrearum. 1 Camphor. (^ Plumbum. >Ign. Hep. Zincum metallicum is the preparation we most frequently use. You will notice the very peculiar fact that two preparations containing strychnia, Nux vomica and Ig?iatia, hold opposite relations to Zinc. Ignatia follows Zinc well, and may even act as an antidote to its effect on the nervous system. Nux vomica tends rather to increase the effects of Zinc y in fact, is inimical to it. Hepar also antidotes Zinc, as it does every other metal. It is a safe remedy to fall back on in cases of me- tallic poisoning when the symptoms point to no special antidote. Zi7ic often precedes Apis when there are sharp cutting pains all over, com- ing quickly, jerks of tendons in sleep, head hot, feet cold; kidne3?s still act. I have had mapped out on the board some of the sphere of action of Zinc. I wish to impress on you all that this is not placed here as an exhaustive analysis of the remedy, nor is it intended to teach you that you are to use Zinc only in the diseases here named. This table is only for convenience sake, to give a sort of starting point around which you may group the symptoms of the remedy. In poisonous doses the salts of zinc cause formication, that is, a sen- sation as of ants creeping over the body. This creeping or tingling is relieved by rubbing or by pressure. There is even a tremulous vibra- tion all through the body. This is not only experienced by the patient, 632 A CLINICAL MATERIA MKDICA. but is noticed, too, by the observer. Later, there appear fainting spells, with a great deal of numbness and deathty nausea. As soon as water touches the stomach, it is vomited. This is increased by acids, so, if any one should give the patient vinegar or lemon-juice, it only adds to his torment by increasing the nausea. With all this, there is vertigo. The head reels, the eyes feel as if they were being drawn together, and there is a hard heavy pressure at the root of the nose. These symptoms are followed by convulsions and stupor, and finally, if the poison cannot be antidoted, by death. I would warn you, too, if you meet with such a case of poisoning, not to give wine or other stimulants, for every symptom of Zi?ic, from head to foot, is made worse by wine. Other remedies having aggravation from drinking wine are Rhodo- dendron, Glonoin, Nux vomica, Selenium, Ledum, Fluoric acid, Anti- monium crudum, Pulsatilla, Arsenicum, Lycopodium, Opium and Silicea. Glonoin has congestive headache, made worse by wine. Ledum is indicated in drawing pains in the joints, made worse by drinking wine. Fluoric acid has aggravation from red wines. Pulsatilla from sulphurated wines. Antimonium crudum is suited to the bad effects of Rhenish sour wines. Bovista, easily intoxicated. Also Conium. Silicea, ebullition of blood, with aggravation from wine; Carbo veg. blushes up after a little wine. Workers in zinc, after ten or twelve years' exposure, suffer from the following symptoms: pains in the back; sensitiveness of the soles of the feet; formication, numbness and coldness of the legs; sensation as of a band around the abdomen; crampy twitching of the muscles. Reflex excitability is increased so that irritation in one part of the body will produce violent jerking in another. Muscular sensibility is lessened, hence patient staggers when his eyes are closed, or when he is in the dark. There are muscular tremors which almost simulate those of shaking palsy. Still later, the gait becomes stiff, motions are spasmodic with the step on the full sole. From involvement of the sympathetic nervous system there are anaemia and progressive and general emaciation. In studying Zinc as a remedy we are to remember, then, that it is a medicine which acts prominently on the nervous system. This influence ZINCUM. 633 which it has on the nervous tissue, is one rather of depression than stimulation. It weakens the cerebro-spinal nerves, and also those of the sympathetic, or ganglionic nerves more accurately called. It is, therefore, to be used in those diseases in which there is weakness of the nervous system. One very useful condition in which we may em- ploy this drug comes under the second heading, undeveloped disease from enervation. By that I mean that Zinc is an invaluable drug when the patient is nervously too weak to develop a disease, and hence he suffers all the consequences of hidden disease, or disease spending its force on the internal organs. To give you an illustration of this in exanthematous diseases, we find Zinc called for in scarlatina, or in measles when the eruption remains undeveloped. As a result of the non-development of the disease, the brain suffers, as we shall see pres- ently. Manganese resembles Zinc by causing progressive wasting, stagger- ing gait and paralysis. Like Phosphorus it causes acute fatty degener- ation of the liver. Now, as another evidence of this nervous condition of non-reaction, we find pains in the ovaries which are relieved during the menstrual flow. Further illustration of this action of Zinc will be found in the catarrhal asthma in which it is indicated. This asthma is accom- panied by great constriction of the chest {Cadmium su/ph., Kali chlor. and Cactus g.), and is relieved as soon as the patient can expectorate, like Sepia, Antimonium tart, and Gri?idelia. So, too, in the male organs there is a local irritation which may be the result of spinal irritation, or self-abuse. This irritation is relieved by a seminal dis- charge. Again, during dentition, the child gives way under the nervous strain, the teeth fail to develop; it has a slow pulse, seeming to come in long waves; it is drowsy, and lies with the back of the head pressed deeply into the pillow, with the eyes half-closed and squinting, the face pale and rather cool, or alternately red and pale. It gives forth loud cries, not exactly the cri encephalique, but something akin to it, with trembling all over, boring the fingers into the nose (as you find under Cina, Arum triphyllum, Veratrum and a few other remedies), or pulling nervously at the dry, parched lips, again reminding you of Arum. There will be automatic motion of different parts of the body, usually the arms and hands, and, particularly, restless, fidgety move- ments of the feet. This last symptom is a very strong indication for 634 A CLINICAL MATERIA MKDICA. Zincum. If still conscious enough to take water, the child drinks it hastily. In extreme cases the abdomen is hot and sunken, and the stools and urine involuntary. In milder brain symptoms the child awakes delirious, as if frightened by horrible dreams. It seems to know no one. It rolls the head from side to side. It may have con- vulsions, with anxious screams and springing up out of bed, gnashing the teeth and rolling the eyes. It is exceedingly cross and irritable before the attack, with hot body and great restlessness, particularly at night. Zincum may be indicated in chorea or St. Vitus' dance, when caused by fright or suppressed eruptions, especially when the general health suffers very much. There are great depression of spirits, and irritability. Still another form of cerebral trouble calling for Zinc is meningitis. Here it is indicated when, in the beginning either of a case of rheu- matism, or in fact from any cause, you find these sharp, lancinating pains through the head; they are worse from wine, * or from anything that stimulates. There are, also, pressing, tearing pains in the occi- put, particularly about the base of the brain; and these pains seem to shoot through the eyes, and, sympathetically, into the teeth. There is a very distressing, cramplike pain at the root of the nose, just as we found in the poisoning symptoms. Now these symptoms will suggest Zinc to you in quite a variet} 7 of ailments, but especially in meningitis arising from the non-development of an eruption. So you find Zincum indicated in scarlatina with the brain symptoms that I have mentioned, and with the following additional symptoms: the eruption is imperfectly developed; the skin is rather livid; the child is restless and delirious, or else quiet and unconscious; even in the smooth or Sydenham scarlatina, Zinc may supplant Belladonna by reason of this enervation of the child. A still worse case than this may occur, and still Zincum be indicated, and that is, when the skin is bluish and cold, the body is heavy, and the pulse is almost thread- like, it is so weak and volumeless. Let us now compare Zincum with other remedies. Cuprum has cerebral symptoms, convulsions with screaming out,. *In headache worse from wine, compare: Rhododendron, Glonoin, Nux vomica, Oxalic acid and Selenium. Both Conium and Zinc have aggravation from small sips of wine ; Conium is easily intoxicated thereby. Zinc has nearly all symptoms by taking small quan- tities. ZINCUM. 635 clenching of the thumb into the palm of the hand, boring of the head into the pillow, and predominant spasm of the flexor muscles: the face is usually red, or even purple; the teeth are clenched; the child foams at the mouth; it awakens from its sleep frightened, and does not know anybody about it, just as in Zinciun and Stramonium. All these symptoms in Cuprum are the result of a suppressed eruption. In Zinc they are due to an undeveloped eruption. The symptoms are more violent under Cuprum; and are more like those of active inflam- mation. In scarlatina the case is different when Belladonna is indicated; it is the remedy in the smooth variety of scarlatina, in the early stages. The vomiting is violent, and the cerebral symptoms prominent. There are screaming out, wild look about the eyes and redness of the face. The throat is bright red and swollen, and the tongue covered with elevated papillae; the patient springs up from sleep screaming, and clings to those about it. Suppose, however, this case goes on, and the rash does not come out; the child becomes pale and livid; it rolls its head in the pillow, grinds its teeth, and screams out whenever you move it, and the feet are restless; then Belladonna , Cuprum or Lachesis will do no good; no remedy but Zinc will. If the case goes on in spite of Zinc, and the skin becomes livid and cold, the pulse filiform, Camphor may still bring about reaction, espe- cially if there is cold sweat. In some cases Veratrum album will come in. In still others I would have you remember Hydrocyanic acid. Calcarca ostrearum is often forgotten in scarlatina. It is to be placed alongside of Zinc, particularly in scrofulous children, when the rash is either undeveloped, or else recedes, leaving the face unnaturally pale and bloated. Zincum is indicated in several forms of headache. One of them is a stinging, tearing headache, worse in the side of the head, greatly in- creased by wine; this headache is also worse after dinner. Sometimes you will find Zinc indicated in obstinate pain in the head, obstinate in its persistence, yet intermittent in its quality, now very severe, and now fading away, but continually returning. It is also indicated for hypochondriasis and pressure on the top of the head, increased after dinner. You will also find Zincum indicated in hydrocephaloid, following cholera infantum. The child rolls its head; it awakens from sleep as 636 A CLINICAL MATERIA MKDICA. if frightened, and looks around the room terrified; the occiput is apt to be hot and the forehead rather cool; there is grinding of the teeth; the eyes are sensitive to the light, and are fixed and staring; the face is sunken and pale, or alternately red and pale; the nose is dry; there is jerking of the muscles during sleep; and last, but not least, there is constant fidgety motion of the feet. In hydrocephaloid, Zincum is closely allied to Calcarea phos. Next, I would like to speak of the action of Zincum on the spine. Zinc is a good remedy in disease of the spine of a functional character, especially in spinal irritation. The symptoms which call for it are these: first and foremost, dull, aching pain about the last dorsal or first lumbar vertebra, and this is worse when the patient is sitting than it is when he walks. The symptom, I can assure you, is a good indi- cation for Zinc. I think that very nearly the same symptom is found under Sepia. It is not situated in the same locality, however, but has the same aggravation. It is also found characteristically under Kobalt. This backache of Zi7icum is associated with burning along the spine, which I believe to be purely subjective and not congestive in character. We also find under Zinc, trembling of the limbs, with a feeling as if they were about to be paralyzed; sudden spasmodic bursting sensation about the heart; the heart is beating regularly, when it suddenly seems as if it would burst through the chest; constriction of the chest, caus- ing shortness of breath; the pulse is slow, or weak and irregular; weak- ness or goneness in the stomach at 11 A. m. This last symptom you will also find under Phosphorus, Natrum carb., Natrum phos., Sulphur, Asafoztida, Hydrastis and Indium. Manganum should be thought of in conjunction with Zinc when the lumbar spine is affected and there are burning pains, worse on bending backwards; legs weak; tension here and there; marked anaemia. Zincum is also indicated in paralysis from softening of the brain, fol- lowing suppressed foot-sweat, with vertigo, trembling, numbness and formication. These symptoms are relieved by friction, and greatly aggravated by wine. There may be marked ptosis with this paral- ysis. In these paralytic affections, Zincum is similar to Phosphorus and Plumbum. It is similar to Phosphorus, in that both remedies suit cases of enervation and of softening of the brain with the accompanying trembling. Phosphorus has not the aggravation from wine or the ptosis. ZINCUM. 637 Plumbum has nearly the same symptoms as Zinc, but there is added to these, impaired nutrition, or atrophy of the paralyzed part. There will be pains in the atrophied limbs, alternating with colic. Now a word or two as to some local effects of Zinc, and we will have done with the remedy. First of all, we find it indicated in some affec- tions of the eyes; for instance, in amblyopia, accompanied by severe headache, which is probably dependent upon some organic change in the brain or its meninges, and with severe pain at the root of the nose. The pains are particularly worse at the inner canthus of each eye. The pupils are contracted. We may also use Zinc for opacities of the cornea following repeated and long-lasting attacks of inflammation of that membrane. The best preparation here is Zincum sulphuricum. Pterygium may be removed by Zinc, particularly if there are smart- ing and stinging pains at the inner canthus. Zi?icum is also useful for granular lids. Here again the sulphuricum being preferable to the metallicum. It is also indicated in prosopalgia when the pains are severe and are accompanied by blueness o»f the eyelids. Zincum has marked gastric and hepatic symptoms. It produces bitter taste, which is referred by the patient to the fauces. As soon as a spoonful of water reaches the stomach it is ejected. Heartburn is present, and this is increased by wine and also during pregnancy. When occuring during pregnancy it is apt to be accompanied by vari- cose veins of the legs. Hunger is particularly manifested towards noon. Zincum also affects the liver. You will find recorded in the original provings a symptom, the exact language of which I have for- gotton, but which is in substance this: there is a feeling as of a hard tumor in the neighborhood of the umbilicus, and this is accompanied by griping pains. This symptom has led to the use of the drug in en- largement of the liver. Zincum affects the abdomen something like Plumbum, producing griping pains about the navel, with most obstinate constipation. This is accompanied by a great deal of pressure backwards, as though the abdomen were being drawn back toward the spine. Now, in almost all cases in which Zincum is useful you will find that the predominant pain and pressure is on the sides of the abdomen; so it must affect prin- cipally the ascending and the descending colon. The urine often contains blood; it is sometimes turbid and loam-colored, and has a 638 A CLINICAL MATERIA MKDICA. yellowish sediment. The patient cannot pass urine unless he sits cross-legged, even though the bladder be full. The cough of Zinc is spasmodic, as if it would draw the chest in pieces. The sputum may be bloody. This is particularly noticed just before or during a menstrual period. It is also aggravated by eating sweet things. You will sometimes find Zincum helping in children, who, every time they cough, put their hands on the genital organs. In its action on the male genital organs Zincum is similar to Conium. It is indicated in spermatorrhoea following long-lasting abuse of the genital organs, with great hypochondriasis. The face is pale and sunken, with blue rings around the eyes. There is a great local irrita- tion. The -testes are drawn firmly up against the external ring. Conium differs in that it lacks the excessive irritability. In this remedy, when there is urinary difficulty, the urine is apt to pass more readily while the patient is standing. Zincum is also useful in diseases of the female organs, especially for irregularity in the menstrual function, particularly when it is associ- ated with ulceration of the cervix uteri and boring pain in the left ovarian region. All the symptoms improve at the onset of the menstrual flow. LECTURE LXII. FERRUM AND THE MAGNESIA SALTS. Ferrum Metallicum. f Ipecacuanha, Arsenicum,. China, Veratrum alb. - | Pulsatilla. Ferrum. <( V V China. Alumina. Iodine. j Arsen. Cuprum. > 1 Pals. Ferrum has two complements, Cinchona or China, and Alumina. Ferrum and Alumina are complementary in chlorosis; and Ferrum and Cinchona in anaemia from loss of animal fluids. Now the best antidote to Iron I know of is Pulsatilla. And, as good fortune will have it, Pulsatilla also antidotes Cinchona, which is so frequently given in combination with Iron by old-school physi- cians. Ferrum acts best in young persons, male or female, who are subject to irregular distributions of blood. The cheeks are flushed a bright red, giving them an appearance of blooming health; and yet this is only a masked plethora. When they are unexcited and quiet they are apt to be pale, and the face has an earthy color. Among the evi- dences of this irregular distribution of blood we have the following symptoms: violent hammering headache, which is usually periodical in its return and worse after twelve o'clock at night; nose-bleed, with bright red flushing of the cheeks; the nose is filled with dark, clotted blood during an attack of catarrh; asthma, associated with an orgasm of blood to the chest, and worse after twelve o'clock at night, at which time the patient must sit up and uncover the chest. He uncovers the chest to get cool, and sits up in order to breathe, and moves slowly about for relief. Ferrum is also suited to haemoptysis, especially in young boys or girls who are subject to consumption and who are just in the incipient stages of phthisis florida. Almost all these symptoms are excited by any emotion and are accompanied by great fatigue, 640 A CUNICAL MATERIA MKDICA. despite the appearance of health. Even the neuralgia which Ferrum may cure has fulness of the bloodvessels as a concomitant condition. This neuralgia is excited by washing in cold water, especially after being overheated. The pains are of a throbbing character, and are worse at night. Almost all of these symptoms, both the congestions and the pains, are relieved by slowly walking about. Now, you may understand the action of Ferrum if you remember this one quality of the drug. It has the power of dilating the blood-vessels, probably by diminishing the action of the vaso-motor nerves; hence, you do not find a full, bounding pulse, as under Aconite, but a full, yielding pulse. You will find, when Ferrum is indicated, that the walls of the abdomen are sore, as if bruised. This is due, not to inflammation, but to dilatation of the blood-vessels. This places Ferrum alongside of Gelsemium and separates it from Aconite. We have next to study Ferrum as a chlorotic remedy. We do not use Ferrum, or, at least, we should not, as allopathic physicians do, because, in this disease there is a defective amount of iron in the blood. That is not the homoeopathic principle for giving the drug. Homoeopathy aims to correct the defective supply of haematin which lies back of the want of iron in the blood. This deficiency is due not to want of iron in the food taken,. but to want of power on the part of the system to assimilate it. Therefore, Ferrum is not the remedy in chlorosis. It may, however, be called for in that disease when the following symptoms are present: in the first place, in a general way, it is called for in erethistic chlorosis — that is, chlorosis with erethism of blood. It may be aggravated during the cold weather, less so, however, than it is during warm weather. The face is ordinarily of a pale, waxen or earthy hue, and subject, at every little emotion, to flush up red. The slightest emotion of pleasure or distress, the sudden entrance of any one into the room, the meeting of a stranger, and, in fact, anything that is calculated to disturb the mind, causes flushing up of the face. The cheeks become bright red. Now, this is not a true plethora; it is a masked case. The face is really of an earthy hue, but flushes up on any little emotion. The stomach is always out of order, the patient being subject to gastralgia and heavy pressure in the region of the stomach. With this there is a feeling as if some- thing rolled into the throat and closed it like a valve. There is great aversion to meat, and, in fact, to anything that is really nourishing. Food has little or no taste. The patient has frequent spells of nausea^ FERRUM. . t 641 which come as soon as he eats, or periodically at twelve o'clock at night. Here it reminds one of Arsenicum. Mucous membranes are abnormally pale. For instance, the vermilion of the lips is exchanged for a simple pale pink. In the case of a male patient the glans penis is shrivelled and white, almost as pale as the prepuce. So, too, the cavity of the mouth and the gums are almost white, showing this bloodlessness. The menses are profuse and consist of watery and lumpy blood, and are attended with labor-like pains in the abdomen. The patient is very inactive; it is with great effort that she can move about. She is relieved by exercise. She is chilly during most of the day, with bright red flushing of the cheeks in the.. evening. There is palpitation of the heart, well-marked bellows murmur. The blood- vessels all over the body throb violently. Sometimes the anaemia progresses so far that the patient becomes affected with oedema of the feet. Manganese is very like Iron in its haematin effects but in nervous symptoms is more like Cuprum, Argentum and Zinc. Symptoms agree- ing, it may be interpolated to favor the action of Ferrum in chlorosis, etc. The Ferrum patient is subject to frequent; congestive headaches,' with pulsating pain in the head, worse usually after midnight. The face is fiery red during the attack, and the feet are cold. It is here very much like Belladomia, but is indicated in a very different class of cases from those calling for that remedy. Such patients always com: plain of vertigo or dizziness, which is worse when they rise suddenly from a lying to a sitting posture. Walking over a bridge or by some running water or riding in a car or carriage also causes this vertigo. These are the cases in which you will find Ferrum to succeed. An English physician has advised that Ferrum, be administered after a meal instead of before. He thinks it acts better then. I do not know whether this is so or not. Another use that we may make of Feryum, arising from its tendency to produce ebullitions of blood, is in phthisis florida. It is indicated in young people who are subject to tuberculosis, here rivalling the well-known Phosphorus. It is indicated more than Phosphorus when there is this apparent plethora, with great oppression of the chest from any little exertion. The nostrils dilate with the efforts to breathe. There is frequent epistaxis or nose-bleed, and also haemoptysis, the blood being bright red and coagulated. The cough is of a dry, teasing 4i 642 A CUNICAI, MATERIA MKDICA. character, and is made worse after drinking anything warm. It is usually associated with bruised, sore feeling in the chest, and with dull, aching pain in the occiput. In addition to this erethistic phthisis, we may have Ferrum indicated later in the case when expectoration is purulent and greenish and has a very bad odor, and is mixed with blood streaks. This reminds me of a salt of Ferrum, Ferrum phosphoricum. This is a remedy which was suggested by Schussler in all cases of inflamma- tion before exudation has taken place. He bases his prescription on the combined effects of Ferrum and Phosphorus, berrum phos. stands midway between Aconite and Gelsemium. In fact it develops that stage of inflammation which the pathologists describe as indicated by enlargement of the blood-vessels, paresis of the vaso-motor nerves. Schussler proposed Ferrum phos. as a substitute for Aconite. It has been confirmed so many times that I now offer it to you with these qualifications. The indications for Ferrum phos. are these: the pulse is full, round and soft; the inflammation has not yet gone on to ex- udation; the discharge, if it is a mucous surface that is affected, is blood-streaked. In other words, the condition calling for it is sur- charged bloodvessels, t If a patient with phthisis should take cold, and so become greatly prostrated, and have this blood-streaked expector- ation, Ferrum phos. even in the two hundredth potency will quickly quiet the pulmonary congestion. So, too, in the secondary congestion following pneumonia. The right lung, for instance, is inflamed, when suddenly the left becomes congested. Here Ferrum phos. again acts. Or, again, on a warm summer's day, a child is exposed while perspir- ing, and the perspiration is checked. In consequence of this, inflam- mation of the bowels sets in. The stools are watery and bloody. Here, again, is a case for Ferrum phos. In the beginning of dysentery, Ferrum phos. never does any good if there is tenesmus. Then you will have to give Mercurius or some other remedy. We may use the metal itself in diarrhoea. The stools contain un- digested food, and come as soon as the patient attemps to eat. In summer complaint of children or cholera infantum, we find these symptoms recurring quite regularly or periodically just after midnight, when the lienteric stools may be accompanied by periodical vomiting. These symptoms of Ferrum place it with Cinchona and Arsenic in a little group of diarrhoea remedies, and rather in advance of Oleander, this last-named drug being indicated when the lienteric stools occur MAGNESIA CARBONIC A. 643 hours after eating. The child passes one day that which he had eaten the day before. With Cinchona and Arse?iic, the stool appears more after than during eating, and with Arsenic more after midnight. Argentum nitricum may also be thought of in these cases of diar- rhoea. It seems as if the child had but one bowel, and that extended from mouth to anus. In uterine haemorrhages, Ferrum is useful when there is a flow of bright red blood, often mixed with coagula, and this is associated with a great deal of flushing. The face, which is ordinarily earthy and sallow, becomes bright red and flushed, breathing becomes rapid and a little labored, just as it is in Ipecac. The pulse itself is very much increased in frequency and in strength. Ferrum in haemorrhages seems to stand between Cinchona and Ipecac. Like Cinchona, it is suited to very much prostrated cases in persons naturally anaemic. It is allied to Ipecac, in the bright red gushing flow of blood and the difficulty of breathing. Ipecac, suits haemorrhage that conies with a gush. It may be asso- ciated with nausea and it may not, but there is very apt to be loud, hurried breathing. Ferrum has sometimes been of use in prolapsus uteri; but the Ferrum iodide is a better preparation here. Soreness in the abdominal walls. On sitting down he feels as if something were pushed upward in the vagina. Lastly, Ferrum is indicated in intermitting types of fever, particu- larly after the abuse of quinine. You find during the heat distension of the bloodvessels, particularly about the temples and face, throbbing headache, enlargement of the spleen, and even dropsy. Magnesia Carbonic a. j Arsenicum, Phosphorus. Magnesia carb. \ Belladonna, Camphor, Pulsatilla, Merc, Colocynth. I Ratanhia, Sepia, Cocculus. > Pulsatilla. >Rheum. >Chamomilla. >Belladonna. Magnesia is much used in one form or another by allopaths as a purgative medicine. When thus abused several results may follow. 644 A CLINICAIy MATERIA MEDIC A. It may become injurious from its tendency to accumulate in the intes- tines as an incrustation of ammonia-magnesian phosphate, and also from its remoter effects on the nervous system. Its action on the latter is not unlike that of Zinc, and it may be used for similar forms of neuralgia. Nux vomica is the remedy for constipation resulting from large doses of the crude drug. Rheum is also to be given for the abuse of Magnesia when diarrhoea, with sour, slimy stool and tenesmus, results. Pulsatilla may be useful in some symptoms. Colocy?ith is called for in case griping pains result from abuse of Magnesia. Chamomilla is indicated when Magnesia causes neuralgia. Almost all the symptoms of Magnesia carb. seem to centre around the action of the drug on the gastro-intestinal organs. All other symptoms depend upon this action more or less, or else are secondary in importance. To describe the Mag?iesia carb. patient to you, I must say that the drug acts on both adult and child. If the patient is a child, you will find it puny and sickly from defective nutrition. Milk is refused, or, if taken, causes pain in the stomach, or is passed undi- gested. The child is subject to frequent griping, colicky pains, which are very much like those of Colocynth. It draws its limbs up to relieve these abdominal pains which are also frequently relieved by motion. The stools are characteristically sour, green and slimy, are preceded by much griping and rumbling in the bowels, and have been very aptly compared in appearance to the scum on a frog pond. Sometimes, when the stool is not exactly diarrhoeic, it looks as though there were lumps of tallow in it. In severe cases you will find the child poorly nourished, and its mouth full of aphthous ulcers, which are simply in- dications of the impoverished state of the system from defective nutri- tion. With these symptoms you can see how Mag?iesia carb. may be used for marasmus in children. There are several drugs which are here very similar to Magnesia carb., and it will be well for us to con- sider them. In the first place, Magnesia carb. is similar to Colocynth, in that it has griping, colicky pains, doubling the child up, but it is distinguished from that remedy by the green, slimy stool. Still greater is the resemblance between Magnesia carb. and Rheum. Both have the sour, slimy stool, etc. The former is the deeper acting remedy of the two, and if you are in doubt as to which to give, Rheum MAGNESIA CARBONICA. 645 should precede. I must say that Rheum is a rather treacherous remedy. With the sour, slimy, frothy stools it has gripfng colic and twitching of the muscles of the face and fingers during sleep. Chamomilla resembles Magnesia carb. in many cases, particularly in diseases of children. In both remedies anxiety and restlessness are prominent. But in Chamomilla there is a yellowish-green stool, look- ing like chopped eggs. Both remedies have relief from moving about, and both have griping pains before stool, and both have irregularity in feeding as a cause of the illness. Mag?iesia carb. is of course the deeper acting of the two. Magnesia carb. is also similar to Calcarea ostrearum. Both have sour stool, rejection of milk, and imperfect nourishment of the body. Calcarea, however, may readily be distinguished from the other by the sweat on the head, face and scalp, by the damp and cold feet, and by the enlargement of the abdomen. In marasmus compare Magnesia carb. also with Antimonium crudum , Sulphur, Podophyllum, Sepia, and Natrum carb. If the Magnesia carb. patient is an adult, we may have some of the following symptoms to guide us: the gastric and hepatic symptoms predominate. The patient suffers from what has been termed acid dyspepsia. Food, such as cabbage and potatoes, and starchy food generally, are indigestible in such cases. He becomes anxious and warm while eating; and at night so hot that he can't sleep; yet he dreads exposure. Pregnant women may require Magnesia carb. when they suffer from toothache, and when the pains are worse at night and force the patient to get up and walk about. There is another remedy which I shall mention in this connection, one which you would hardly think of. Some years ago, it may be twenty, a physician of this city was treating a lady in the first months of pregnancy, who suffered terribly from toothache. He gave her Magnesia carb. and other remedies. Still the pain continued. Dr. Lippe was called in consultation, and he thought of Ratanhia, which has toothache at night, compelling the patient to get up and walk about. This remedy promptly cured the case. You can remember these two remedies then, and you may place them with Chamomilla, which is complementary to Magnesia carb. The menses are usually late and scanty, and they have this pecu- liarity: they flow more at night or on first rising in the morning, are 646 A CLINICAL MATERIA MEDIC A. scanty during the day and even cease altogether in the afternoon. The flow is also more profuse between the pains. This is true, whether they be profuse or scanty. In all the Magnesia salts the menstrual flow is dark or black, almost like pitch. Magnesia card, also has some relation to rheumatism and to affec- tions of the muscles and joints. It is suitable for rheumatism in the right shoulder. It also has rheumatic pains in the limbs, which are worse after a long walk, better from warmth, and worse in bed. Sangninaria is similar to Mag?iesia carb. , in that it has rheumatism affecting the right deltoid muscle. Several years ago I used Sangni- naria quite a number of times without any effect, and I became so dis- gusted with it that I announced to the class that I did not believe in it. Within a week after that I had two cases promptly cured by it. Nux moschata is indicated in rheumatism affecting the left deltoid. There are two cases of cataract on record as having been cured by Magnesia carb. In one of these the patient was predisposed to head- ache and boils. Magnesia Muriatica. Caulophyllum, Actea racemosa. Chamomilla, Pulsatilla, Mercurius. Magnesia mur. \ . Sulphur, Lycopodiurn, Sepia. [ Phosphorus, Ignatia. > Chamomilla. The next remedy of which I shall speak is the Chloride of Magnesia or Magnesia mur. This remedy acts particularly on women and chil- dren, especially in hysterical women and in scrofulous children. It is indicated in women who suffer from hysterical paroxysms, with the following symptoms: after dinner the patient is seized with nausea, eructations, trembling and fainting spells. These occur after dinner, because that is the principal meal, and more is eaten then than at other times. The patient is anxious and restless, and is always made worse from mental exertion. The headaches are described as congestive, with sensation as of boiling water in the cranium, or as a frontal numbness. The pains are referred to the temples, and seem to be relieved by firm pressure with the hands. They are also better from wrapping the head up warmly. The patient also complains of a MAGNESIA MURIATIC A. 647 sensation as of a ball rising from the stomach into the throat. This is relieved by eructation. This shows that the accumulation of gas in the stomach is the cause of this reflex symptom. She also has bear- ing down in the uterine region and uterine spasms. The menses are black and pitch-like, and are accompanied by pain in the back when walking, and in the thighs when sitting. She also has leucorrhoea after every stool, or following the uterine spasms. In nearly all these cases in which Magnesia mur. is indicated, you will find characteristic constipation, in which the stools are passed with great difficulty, being composed of hard lumps, or they are so dry that they crumble as they pass the anus. If you find that symptom present with the uterine symptoms, you may be sure that Magnesia mur. will help the patient. In other cases we find the liver affected. Magnesia mur. is one of our best remedies for liver disease. The liver is enlarged and the ab- domen bloated. There are pains in the liver, which are worse from touch or from lying on the right side. The tongue is large, coated yellow, and takes the imprint of the teeth. You will see at once how this resembles Mercurius, but it is differentiated from that remedy by the characteristic crumbling stool. The feet are often cedematous from interference with the portal circulation, and there are palpitation of the heart and dyspnoea, both of these last-named symptoms being reflex symptoms from the hepatic disorder. Frequently we find Mag?iesia mur. indicated in the enlarged liver of children who are puny in their growth and rachitic. They suffer, too, from skin affections. They have what is known as tinea ciliaris, an eruption which occurs at the roots of the hairs, particularly of the eye- lids. The hairs drop out. A scaly eruption appears around the hairs, the skin ulcerates, and the hairs drop out. With this tinea there are pimples on the face, and acrid ozsena, with redness and swelling and scaliness of the nose. With these symptoms there is sweat of the feet. Here we are reminded of Silicea, but the sweat under Silicea is offensive. A general characteristic of Magnesia mur., belonging to either men or women, is palpitation of the heart, which is worse when the patient is quiet, and better from moving about. The symptom has been con- firmed many times. Then there is another symptom which occurs fre- quently in women, and that is inability to pass urine without pressing on the abdominal walls. The analogues of Magnesia mur. must be studied here, or else you 648 A CLINICAL MATERIA MKDICA. will not be able to separate it from similarly acting drugs. We find that in uterine spasms, Caulophyllum and Actea racemosa act like Mag- nesia mur. I must say that I believe Caulophyllum leads the list. I know of no other drug that produces such continued spasmodic condi- tion of the uterus unless it be Secale. " Silicea ought to be mentioned as similar to Magnesia mur. in the treatment of scrofulous children. Both remedies have sweating of the feet, enlarged liver, rachitis, and ozaena. The difference lies in this: the Silicea patient has offensive-smelling sweat, both of the feet and of the head. That is one good distinction. There are many others. There is a resemblance between the headaches of the two remedies. Silicea and Mag?iesia mur. both have headache, relieved by wrapping the head up warmly. Mercurius is similar to Magnesia mur. in liver affections. It is dis- tinguished from the latter by its diarrhoea, with tenesmus, or, more exceptionally, with gray or ashy stool. - Also similar to Magnesia mur. is Plelea, which is useful in conges- tion of the liver when there is a feeling as of weight and pressure in the right hypochondrium. The liver is found to be enlarged. The patient here finds relief by lying on the right side. I may say that the Magnesia salts have been placed with Zinc as remedies acting on the nervous system. This fact led Schiissler to "nesia phos. as a nerve tonic. LECTURE LXIII. BARYTA CARB., STRONTIANA CARB., AND LITHIUM CARB. Baryta Carbonic a. Barium and Strontium are very closely related to each other chemi- cally. Of the elements themselves we have no provings. The carbo- nates of these have, however, been proved, as have also the Muriate and the Sulphate of Baryta. Baryta is somewhat of a poison, although there are not many cases of poisoning by it on record, because it is rarely used in domestic practice. Baryta carb. has Antimonium tartaricum as its complement, particu- larly in the complaints of old people. Animals poisoned with Baryta ca?'b. exhibit some irritation of the abdominal organs, resembling great inflammation there, with increased peristaltic action of the bowels. The heart, too, is affected by it, the animal apparently dying from paralysis of the cardiac in systole. Its action is here very much like that of Digitalis. So much for the toxic action of Baryta. In all its symptomatology, we find Baryta adapted to ailments occur- ring at the extremities of life, age and childhood; to old age, when there are mental symptoms and bodily weakness, and to children, when there is in addition, scrofula. The child to whom we may give Baryta effectively is almost an imbecile. He, very unnaturally, shows no de- sire to play; he sits in a corner doing nothing. He cannot remember well, and is slow in learning to talk, to read, and to understand. This slowness in learning to talk does not come from defect in the apparatus of speech — of the tongue, for instance — but it is the result of mental weakness. The child is rather emaciated, with the exception of the abdomen, which is large. The face, also, is bloated. He may have a voracious appetite, but food is not appropriated by the system, because of the diseased condition of the mesenteric glands. A case of chronic hydrocephalus in a child improved after the exhibition of Baryta selected by these symptoms. Adults — especially old people — have a 650 A CLINICAL MATERIA MEDICA. rather peculiar aversion to strangers, and shun the approach of any unfamiliar face. They seem to have a fear of the presence of others. They imagine that they are being laughed at. They are easily angered and suffer from cowardice. You all have seen similar symp- toms to these in persons of a half-imbecile state of mind from disease, whether in old age or in early life. A peculiar mental symptom of Ba?yta which I give you on the authority of Dr. Talcott, of Middletown, N. Y., is this: the patient thinks his legs are cut off and that he is walking on his knees. You may use Baryta carb. for old people when they suffer from paralysis, particularly paralysis following apoplexy. Very frequently in old people, the brain shrinks and, as the skull does not yield, there would be a vacuum formed, were it not that an effusion of serum takes place. This is followed by a more or less severe paralysis. You will find, in such cases, that the patient is childish and has loss of memory, trembling of the limbs and well-marked paralysis of the tougue. Baryta carb. is one of the few remedies that cause positive paralysis of the tongue. You will see these paretic symptoms also in children of this half-imbecile character of which I have spoken. The mouth is kept partly open and the saliva runs out freely. The child has a silly, vacant look, showing at once that it is non compos mentis. Baryta is one of the remedies for the apoplexy of drunkards. ( Vide lecture on Opium.) Baryta also seems to induce paralysis by causing degeneration of the coats of the bloodvessels, even to the production of aneurisms. Causticum acts similarly to Baryta in paralysis, but the paralysis of this remedy has more contractures or spasms. Secale acts on the bloodvessels; but its symptoms are apt to be associ- ated with burning and numbness; gangrene. Colchicum and Arsenic have loss of sensibility of the tongue. Both the Muriate and the Carbonate of Baryta may be used in multiple sclerosis of the brain and spinal cord. This is not an un- common disease in infants and children in whom it may give rise to the idiotic symptoms mentioned above. These same symptoms indicate it in disseminated sclerosis occurring in old people. For the trembling associated with this disease, Hyoscyamus should be thought of. When associated with the symptoms just enumerated, you may use BARYTA CARBONICA. 65 1 Baryta for non-development of the brain in early childhood. The Chloride of Baryta has been used by old-school physicians for this sclerosis, and with more or less success. The remedy which most resembles Baryta here is Causticum. The use of Baryta in catarrhs demands attention. It is one of the best remedies we have for the tendency to tonsillitis, particularly in scrofulous children with dry scurf on the head. Baryta mur. and Baryta carb. cause induration of connective ti.-sue. They control pro- liferation of connective tissue, hence their use in tonsillitis, enlarged tonsils, indurated glands, etc., general symptoms agreeing. " Every little exposure to damp or cold weather awakens anew the inflamma- tion of the tonsils. This is not a simple sore throat, a swelling up of the mucous lining of the fauces with trouble in swallowing, but it is an actual inflammation of the tonsils with formation of pus. In these cases, you will find enlargement of the glands in the neck, under the jaw and behind the ear. Baryta is one of our remedies to prevent the return of this condition. It changes the constitutional tendencies of the patient. It is thus more the remedy for the effects of the trouble than for the acute symptoms. The local symptoms for the throat are principally these: the right side of the throat is worse than the left, just as you find under Belladonna; the throat feels worse from empty swallowing. In the treatment of tonsillitis, I frequently use the same prescription that I employ in diphtheria, namely, a gargle of alcohol and water. This seems to remove the accumulation of phlegm from the throat. In tonsillar affections, you may compare the following remedies with Baryta: Calcarea ostrearum, in fat, leuco-phlegmatic children. Calcarea pAos., in chronic cases; bones diseased. Ignatia, large tonsils, with small, flat ulcers on them; pain between the acts of swallowing. Hepar, large tonsils, hearing poor, sensation as of fish-bone in throat. Lycopodiu?n, large tonsils, studded with small indurated ulcers. Calcarea tod. is similar to Baryta in some cases with enlarged glands, particularly when there are enlarged tonsils which are filled with little crypts or pockets. Conium is suited to enlarged tonsils without any tendency to suppu- ration. 652 A CLINICAL MATERIA MEDICA. Baryta may also be used in children who, in addition to this tonsil- litis, have post-nasal catarrh. Scabs form in the posterior nares and at the base of the uvula. The upper lip and nose are swollen just as you find in Calcarea, but the mental symptoms are different. Baryta is also called for, for a chronic cough occurring in strumous or scrofulous children with swollen glands and enlarged tonsils. Every little exposure to cold or damp causes headache, backache and diar- rhoea. Here Baryta is similar to Dulcamara. The ears may be in- volved in the catarrhal process; crackling in the ears on swallowing, reverberations in the ear on blowing the nose, sneezing, etc. The late Dr. McClatchey used Baryta in catarrh of the middle ear after scarla- tina. Baryta is sometimes indicated in scrofulous ophthalmia, the pains are relieved by looking downward. The general symptoms are like those of Calcarea ostrearum. We find Baryta also indicated in old people who have what is known as suffocative catarrh, with orthopnoea. I think you can understand this when you remember the influence of Baryta on the voluntary and involuntary muscular fibres. It paralyzes them. In old people, the chest is very much weakened. They get a catarrh, which is not very severe, but appears suddenly in the night, with difficulty of breathing and blueness of the face, etc. Baryta carb. is one of the remedies that come in after the failure of Antimonium tartaricum. The patient com- plains of a sensation as of smoke or pitch in the lungs. Baryta should not be given in catarrhal asthma or asthma with emphysema; but when the disease is of the purely nervous variety, in the aged, when aggravation occurs in wet, warm air. You will see that its aggrava- tions are much like those of Aurum. Amblyopia, in the aged, sometimes calls for Baryta; the patient cannot look long at any object; sparks before the eyes when in the dark. It is also indicated in the headaches of the aged, with aggravation after waking, after meals and near a warm stove; the patient has a stupefied feeling. We also find Baryta carb. of use for the fatty tumors which occasion- ally appear here and there over the body. It is very easy to remove these with the knife. But it is much better to cure them by medicine, if you can do so. In tabes mesenterica, Baryta is indicated, when in addition to the STRONTIANA CARBONICA. 653 foregoing symptoms, the following are present: food, when swallowed, seems to pass over sore spots in the oesophagus. There is always pain in the stomach after the child eats. The stool is sometimes un- digested. With this, you find the abdomen hard and swollen, and an offensive sweat on the feet, just as you find in Silicea. Now, there are remedies which may be compared with Baryta in this form of disease. Iodine is similar to Baryta in that it is suitable in torpid cases. The complexions of the patient in the two remedies are different. The Iodine patient has a dark complexion, dark hair and eyes and sallow skin. There is, too, extreme hunger. If you observe the child carefully, you will find it anxious and fretful, until he eats, which relieves him for the time being; and yet he grows thin despite the quantity of food consumed. Then, there is a mental symp- tom which is almost always present when you find Iodine indicated in tabes mesenterica, and that is intolerable crossness, which is even worse than that belonging to Antimoninm cmdum. Calcarea bhosphorica is indicated in children who are weak-minded, who cannot walk, although they are old enough to do so, who are anxious and restless in their manner and who suffer from defective osseous growth. The bones are thin and brittle. Like Baryta, the Silicea patient suffers from damp weather. He also has offensive sweat and general emaciation with the exception of the abdomen. The difference between the two remedies lies princi- pally in the mental symptoms. The Silicea child is obstinate and self- willed, and, too, his head is disproportionately large. Lactic acid has copious sweating of the feet, but is not offensive. For the offensive foot sweat, compare Silicea, Thuja, Nitric acid, Kali card., Graphites and Car bo veg. STRONTIANA CARBONICA. Strontiana carbonica has a few symptoms that are of importance. It has more effect on the circulation than has its relative, Baryta. We have, as a characteristic, flushes in the face and violent pulsation of the arteries. It may be useful in case of threatening apoplexy with violent congestion of the head, and hot and red face every time the patient walks. Mere exertion increases the circulation upwards to- wards the head. Some erethism is shown in the chest in some patients. There is a smothering feeling about the heart; they cannot rest; there 654 A CLINICAL MATERIA MEDICA. is a feeling as of a load on the chest. These are the congestive symp- toms of the heart, lungs and head which suggest Strontiana card., and they may occur at the time of the climaxis when flushes of heat are so common. The peculiarity which will distinguish these symptoms from those of any other remedy is, that the head symptoms are re- lieved by wrapping the head up warmly, just as you find under Silicea and under Mag?iesia mur. These patients cannot bear the least draught of air, therefore, despite this congestive tendency, they wrap the head up warmly, though it may cause perspiration. It certainly does resemble Silicea, in that both remedies have congestion of the head relieved by wrapping the head up warmly. The Silicea conges- tion seems to come up the spine and go into the head. That is not characteristic of Strontiana carb. Another effect that we find caused by Strontiana carb., and one, too, for which it is not often used, is diarrhoea, which is worse at night, and which has this peculiar urgent character: the patient is scarcely off the vessel before he has to return. It is better towards morning at three or four o'clock. Strontiana carb. has a marked action on the bones. It has a particular affinity for the femur, causing swelling and caries of that bone; usually in scrofulous children. This trouble is often associated with the diar- rhoea just described. Strontiana carb. causes an eruption which very much resembles that of sycosis. Hence, it has been given for a sycotic eruption on the face or other parts of the body, and which is moist, and itches and burns. Another peculiarity of the drug, and the last one I care to mention, is its effects in chronic sprains, particularly of the ankle-joint, when both Arnica and Ruta have failed. The long interference with the circulation has produced some oedema about the joint. Lithium Carbonicum. Lithium carb. has not a very extensive range of action nor does it greatly depress the vital forces. In its provings, debility is noticed only in connection with or as a sort of sequel of the joint affection. It is particularly useful in affections of the joints. It is efficacious in rheumatism, and, above all, in some forms of gout. Of the various organs attacked by Lithium carb., the most important in the order of their importance are the heart, stomach, kidneys and bladder. The LITHIUM CARBONICUM. 655 mucous membranes are also affected by the drug. At first they are unduly dry, and this dryness is followed later by thick mucous secre- tion. The skin does not escape. There appears an erythema, with itching of the skin, which occurs particularly about the joints, and is very annoying. It is particularly noticed along with rheumatism. Further than this, Lithium carb. may produce roughness of the skin and an eruption about the face resembling barbers' itch. Studying now the symptoms of the drug with this general action before us, we find confusion of the head; headache on the vertex and in the temple, worse on awakening; the eyes pain as if sore, and it is difficult to keep the eyelids open. This vertex headache and soreness of the eyes follows suppression of the menses. The patient has pain from the left temple into the orbit of that side; relieved while eating and worse afterwards. A very characteristic symptom of the retina, or rather of vision, is, the right half of objects vanishes. In keeping with its effect on mucous membranes, we find the drug causing conjunctival asthenopia, just as does Alumina. The conjunc- tiva of both lids and eyeball is painfully dry and the eyes feel sore when the patient reads. The nose is affected, too, in the Lithium proving, being swollen and red. Sometimes there is dryness of the nose when in the house, and mucus dropping from it when in the open air; or mucus seems to hang in strings from the posterior nares. Another symptom of Lithium is sensitiveness of the mucous membrane when the inspired air is unduly cold. Lithium cures a cough which seems to come from a certain spot in the throat. There is a form of gastralgia which Lithium will cure. It is accom- panied by the pain in the left temple and orbit, which is better by eat- ing. Lithium has some effect on the bowels. Drinking chocolate or cocoa will cause diarrhoea. Lithium irritates the neck of the bladder. This, you know, is often a symptom of rheumatic patients. The urine is turbid and flocculent. The pains extend down either ureter and into the spermatic cords or testicles, and are followed by red urine with mucous deposit. In the female, you had Lithium carb. indicated when the menses are late and scanty. The provers found that all the symptoms accompany- ing the irregularity in menstruation were on the left side. 656 A CLINICAL MATERIA MEDICA. Now, we will consider the rheumatic symptoms of Lithium carb ■. , including under this head those of the heart also. I have succeeded, in several instances, in relieving chronic rheumatic patients by this remedy. The symptoms which indicate the drug are these: rheu- matic soreness about the heart; valvular deposits will be found in many instances; mental agitation causes fluttering of the heart like Natrum mur. , Sepia and Calc. ostr. ; very marked is the pain in the heart when the patient bends forward; the cardiac muscle is evidently irritated, for we find shoeks or jerks about the heart; the cardiac pains are re- lieved when the patient urinates. Now, the symptoms of the body, joints and limbs: tenderness, with swelling and occasional redness of the last joints of the fingers; clumsi- ness in walking from unwieldiness of the muscles; intense itching on the sides of the feet and hands without any apparent cause. The pains in the joints are usually worse in the knee-, ankle- and finger-joints. The whole body feels stiff and sore as if beaten. Pains go down the limbs. The whole body increases in weight and becomes puffy. I may say that this puffiness is not due to a healthy fat, but is a flabby condi- tion which belongs to all the alkalies. Gettysburg spring water, which contains carbonate of lithia, is very efficacious in scrofulous children when there are ulcers involving the joints, as in Pott's disease and hip-joint disease, when there are offen- sive pus and diarrhoea. This character of the catarrh of Lithium carb. in which the inspired air feels cold is also found under Kali bichr. , sLsculus, Cistus, Hydrastis and Corallium rubrum. Kali bichr omicum, Baryta carb., Sepia and Teucrium have catarrh, with expectoration of solid chunks from the posterior nares. In valvular deposits in the heart you may compare Lithium carb. with Ledum, Kalmia and Be?izoic acid, the latter remedy being selected by the offensive character of the urine. Zincum, Conium and Aurum have sudden jerks or shocks about the heart. In rheumatism and gout you may compare Kalmia and Calcarea ostrearum, which resemble Lithium in the rheumatism of the finger- joints. When there are nodular swellings in the joints, compare Calcarea ostrearum, Natrum muriaticum, Benzoicacid, Lycopodium and Ammonium phos. LECTURE LXIV. THE AMMONIUM PREPARATIONS. Ammonium caust. Ammonium carb. Ammonium phos. Ammonium mur. Blood.— Scorbutus. Uraemia. Carbonized blood. Heart. Mucous membranes. — Nose. Throat and larynx. Lungs. Skin. — Erythema. Scarlatina. Organs. We have on the board to-day several of the salts of ammonia, the Carbonate of Ammonia or Ammonium carb., Caustic Ammonia or Ammonium causticum, Muriate of Ammo?iia or Ammonium muriaticum and Phosphate of Ammonia or Ammonium phosphoricum . The am- monium salts taken as a class, we find best suited to rather fat and bloated persons. Ammo?iium carb. is particularly indicated in fat flabby individuals of indolent disposition who lead a sedentar}- life. This is very different from Nux vomica and Sulphur, both of which are indicated in complaints arising from sedentary habits. But Ammonium carb. is especially indicated in fat lazy individuals. Ammonium ?7iur. is best indicated for fat sluggish individuals par- ticularly when the adipose tissue is mostly distributed over the trunk, the legs being disproportionately thin. That is the distinction that may be made between the Carbonate and the Muriate. The salts of ammonium exert a considerable influence over the blood. Thus if Ammonium carb. is taken for awhile there will be produced symptoms simulating those of scurvy. There will be haem- orrhages from the mouth, nose and bowels, showing you that there is a disintegration of the blood. The muscles become soft and flabby and there is well-marked tendency to emaciation. 42 658 A CLINICAL MATERIA MEDICA. We find that all the salts of ammonium act powerfully on the mu- cous membranes, of which tissue every one of them produces inflam- mation. This inflammation is of a violent character, starting with a simple feeling of burning and rawness, progressing to a complete in- flammation of the mucous membrane and ending in the destruction of the epithelium, which peels off in layers and leaves a raw, burning, ulcerated surface. It is, then, not to be wondered at, that the salts of ammonia have won considerable praise in affections of the nose, throat, and larynx, and somewhat of the lungs. The ammonium salts also have an impression on the skin. When applied locally, there is produced a simple erythema followed by der- matitis and some little swelling. Soon, however, an eruption appears, and this varies with the different ammonium salts. It is at first pap- ular, then vesicular and finally advancing to ulceration. These condi- tions are common to all the ammonium preparations of which we have any knowledge. Therapeutically, the salts of ammonia are antagonized by Veratrum viride, Digitalis, Acotiite, cold and other cardiac sedatives. Their action is favored by heat, Opium, Iodine, Valerian, Asafcetida, Alcohol, etc. Ammonium Carbonicum. f Arnica, Antimonium tart. Belladonna, Apis, Lachesis. Ammonium carb. { A A _ , _ Arsenicum, Aurum, Carbo veg., Curare. Conium, Senega, Kali bi., Calcarea ostr. (Camphor. ^ \ Arnica. < Lachesis. We will first study Ammonium carb. Let me call your attention to the fact that the Carbonate of Ammonia may be antidoted by Camphor; and some of its symptoms by Arnica. Despite the apparent resemblance between Carbonate of Ammonia and Lachesis, these two drugs have been found to be inimical. Ammonium carb. may be studied from its action on the blood. As I have already said, its prolonged use produces a scorbutic condition. The vital powers are weakened. Haemorrhages of dark fluid blood appear. There is degeneration of blood tissue. The muscles become THE AMMONIUM PREPARATIONS. 659 soft and flabby. The teeth loosen and the gums ulcerate. With these scorbutic symptoms, there is developed also a hectic form of fever. I now take up the indications for Ammonium card, in uraemia. These symptoms which I am about to give you are very important. They are not only characteristic of A??i?nonium carb. in ursemia, but also in any other disease in which this remedy may be indicated. We may find them present in scarlatina with decomposition of the blood, and also in heart disease. Now for the symptoms: you will find Ammonium carb. indicated for somnolence or drowsiness with rattling of large bubbles in the lungs, grasping at flocks, bluish or purplish hue of the lips from lack of oxygen in the blood, and brownish color to the tongue. You recognize in these symptoms some condition of blood-poisoning from the presence of carbonic acid. This may be in ursemia, or it may be in catarrh of the lungs, or in any other disease in which there is deficient oxygenation. The nearest analogues here are A?itimonium iartaricum, Carbo veg. and Arse?iicu?n. A similar condition obtains in Arnica in typhoid states when the patients are drowsy and heavy, and fall asleep while answering ques- tions. With the symptoms just enumerated you can remember Am??io?iium carb. for oedema of the lungs or emphysema. Ammonium carb. is also of use in poisoning by charcoal fumes. Arnica is sometimes of use in these cases, as is also Bovista. Still another use we may make of Ammonium ca?'b. , and one, too, that would hardly suggest itself to you, is in the beginning of cerebro- spinal meningitis. Sometimes, in the beginning of this disease, the patient is stricken down by the violence of the poison and falls into a stupid, non-reactive state. He is cold, and the surface of the body is cyanotic. The pulse is very weak. In just such cases you should give Ammonium carb., which will bring about reaction. Then you may select some more specific remedy which will cure the trouble. I would now like to mention the action of Ammonium carb. on the heart. This drug is useful in dilatation of that organ. The patient suffers when ascending a height, as when going up stairs or up a hill. He also suffers intolerably in a warm room. He frequently has cough which is accompanied by bloody sputum. There is palpitation of the heart with dyspnoea and retraction of the epigastrium. You may also find cyanotic symptoms present. Ammonium carb. is also indicated in pneumonia when there is great 66o A CLINICAL MATERIA MEDICA. debility, together with symptoms pointing to the formation of heart clot. It is also indicated in chronic bronchitis with atony of the bronchial tubes, which favors emphysema. There are copious accumulation of mucus in the lungs, dilatation of the bronchial tubes, and oedema pulmonum. The patient in these cases is weak and sluggish in his movements, coughs continually, but raises either not at all or with great difficulty. Drowsiness, or even some delirium with muttering, may be present. Another use we may make of Ammonium carb. is in scarlatina. It is undoubtedly a useful remedy in the treatment of this disease, even when of a rather malignant type. We find that it produces a rash re- sembling that of scarlatina, but which is, however, of a miliary char- acter. The throat is swollen internally and externally with enlarge- ment of the glands externally, and with bluish or dark red swelling of the tonsils. The neck externally is engorged, that is, there is, in ad- dition to the swelling of the cervical lymphatics, inflammation of the cellular tissue. The nose is often obstructed, particularly at night, causing the child to start from its sleep as if smothering. Frequently it has to lie with its mouth wide open in order to breathe. The child is drowsy, and may even go into a stupid sleep. We frequently find, too, an enlargement of the right parotid gland. Let us now study some of the concordant remedies of Ammonium carb. in this disease. First of all Belladonna. Between this remedy and Ammonium carb. the resemblance is only apparent. Both reme- dies have right side of the throat affected, bright red rash, scarlatina and drowsiness. But the distinction between the two lies in this: there is in Ammonium carb. a miliary eruption on the skin, which Belladonna has not. The throat in Ammonium carb. is of a darker red than in Belladonna y and the drowsiness is more complete. The drowsi- ness of the latter remedy alternates with either wildness or starting from sleep, or restless delirium or crying out in sleep. In Ammonium carb. the patient is in a state of simple somnolence. The starting from sleep is not from irritation of the brain, but from stoppage of the child's breathing. There is some resemblance between Ammonium carb. and Apis yin that both remedies have miliary rash, and both are indicated in low types of scarlatina with somnolence. Apis has, however, more dropr sical symptoms. Whenever it is the remedy, you will find puffiness of THE AMMONIUM PREPARATIONS. 66 1 the throat and oedema of the uvula. But you will also find inflam- mation or irritation of the meninges of the brain in Apis, as indicated by the sudden shrill crying of the child. This is a sudden shriek, and not a mere start as if frightened. There is rolling of the head in the pillow. Lachesis, though apparently similar to Ammonium carb. in scarla- tina, is really inimical to that remedy. It resembles A?nmonium carb. in the blueness of the surface, in the somnolence, in the engorgement of the neck and in the dark red or bluish swelling of the throat. Lachesis has almost always, if not always, that extreme sensitiveness of the surface, so that the patient cannot bear to have anything touch the neck. Then, too, Lachesis affects more the left side and Ammo- nium carb. the right. This sensitiveness of Lachesis is not the same kind of soreness that you find in other remedies, as in Apis. This symptom is here due to a hypersesthetic condition of the spinal nerves ramifying through the affected part. Firm pressure does not aggra- vate, although a light touch will. Rhus tox. is similar to Ammonium carb. , in that both remedies have dark throat and both have drowsiness. It is the left parotid gland that is most likely to be affected under Rhus; with Ammo?iium carb., it is the right. There is more restlessness under Rhus. Next, the action of Ammonium carb. on the mucous membranes. This remedy is useful in nasal catarrh. The nose is stopped up at night; the patient wakens gasping for breath. He is worse at three or four o'clock a. m. The cough is dry and tickling, associated with hoarseness, and with a great deal of oppression from mucus in the chest. The nostrils are sore and raw, and sometimes, in children, there is a discharge of bluish-colored mucus. This symptom is also found under Kali bichromicum, Natrum arsenicosum, Arundo Maurit., Ammonium muriaticum and Ambragrisea. At times the coryza is scalding, ex- coriating the upper lip, with burning in the throat and along the trachea. There is a feeling as of a lump in the throat. Dry night cough comes, which seems to threaten suffocation; copious flow of saliva, with consequent expectoration; beating like a pulse in the chest. Ammonium carb. is particularly suited to winter catarrhs. The sputum is slimy and contains specks of blood. Its near relative, Ammonium muriaticum, will be considered presently. It is similar in these catarrhs. Differentially the Carbonate cures catarrhs, worse in winter, nose stopped up, worse at night, awakening the patient 662 A CLINICAL MATERIA MEDICA. from sleep, gasping for breath, worse three to four a. m. Cough dry, tickling, hoarseness, chest oppressed with mucus. The Muriate causes stoppage of one nostril; both stopped up at night; nostrils sore and raw; discharge of bluish mucus or scalding coryza, severe burning in the throat, etc. In the three a. m. aggravation of Ammonium card., you may com- pare the Kali salts. In this catarrh, with stoppage of the nose, excoriating discharge and rawness down the sternum, there are a few drugs which I would have you compare. One of these is the Ammonium causticum, which is one of the best remedies in the whole materia medica for aphonia, with burning rawness in the throat. Causticum and Carbo veg. are very similar to Ammonium carb. in this rawness and burning down the sternum. Laurocerasus has that expectoration containing little specks of blood. Ammonium carb. has also been used for sprains when the injured joint is hot and painful; it follows Arnica. Here you may compare Sulphuric acid and Ammonium mur. Ammonium Muriaticum. ( Apis, Arnica, Natrum mur. Ammonium mur. < Kali bichromicum. ( Sepia, Sulphur. As I have already explained to you, Ammonium mur. is suited to sluggish persons, who are rather corpulent as to the body, but dispro" portionately thin as to the limbs. L,ike the carbonate^ it produces violent inflammation of the mucous membranes. It also disturbs the circulation of the blood. The face reddens during a short, animated conversation, especially so, as you might expect, in a warm room. There are ebullitions of blood, violent throbbing in all the arteries, ac- companied by anxiety and weakness, as if paralyzed. The nervous system surfers, too, from the action of Ammonium mur. There is a certain periodicity of symptoms, as shown in the chills and fever. The paroxysms return every seven days. There are many other symptoms of the nervous system; especially do we find this characteristic: pain in the left hip, as if the tendons were too short; this makes the patient limp when walking. While sitting there is gnawing referred to the bones. THE AMMONIUM PREPARATIONS. 663 Sciatica is very readily cured by Ammonuim mur. when the symp- toms call for it. The pains are worse while the patient is sitting, some- what relieved while he is walking and entirely relieved when he lies down. Ammonium mur. has also been used for the neuralgic pains which may occur in the stumps of amputated limbs. Compare Cepa Staphi- sagfia. Ammonium mur. is also useful for tearing, stitching pains from ulceration in the heels, worse at night in bed and better from rubbing. Other remedies attacking the heels are, Pulsatilla (inflamed); Causticum, Manganum, (cannot bear the weight on them); Aiitimonium crudum, Ledum, Graphites, Ignatia, (they burn at night); Natrum card,, and Allium cepa. Sabina is particularly suitable in plethoric women who suffer from what they call rheumatic inflammation. Ma?iganum is an excellent remedy in rheumatic patients when the heels are affected and the patient cannot bear any weight on the heels. In addition to this you will find that Manganum is indicated when the rheumatic symptoms come in dark, almost bluish, spots. Antimonium crudum is useful in soreness of the heels, worse walking on a hard pavement. Ledum palustre, Graphites and Natrum carb. cause blisters on the heels. Sepia, ulcers. Allium cepa cures ulcers on the heel when developed by friction of the shoe or stocking. Anunonium mur. has some influence on the joints. It causes a feeling of constriction in these parts. It is one of the remedies that have been used in the treatment of chronic sprains. It also affects the fibrous tissues about the joints. Thus, it is one of the remedies when there is contraction of the hamstring tendons. When the patient walks these seem to be drawn tight. This symptom is relieved on continued motion. On the female organs, Ammo?iium mur. acts more powerfully than does Ammonium carb. It has a great many symptoms referred to the inguinal and hypogastric regions which would suggest the use of the drug in uterine and ovarian diseases. For instance, the patient com- plains of tensive pain in one or the other groin. Sometimes this symp- tom is described as a feeling as if she had sprained herself. There are stitches, cutting and soreness, or, what is more characteristic than all, a strained feeling in the groin, which forces the patient to walk bent. That is an indication which leads to Ammonium mur. in the treatment 6,64 A CLINICAL MATERIA MEDIC A. of deviations of the uterus, and also in ovarian diseases. You will find in almost all these cases the characteristic muriate stool, crumbling as it passes the anus. We have, too, a characteristic leucorrhcea attend- ing the symptoms, a brown and lumpy or else clear and albuminous leucorrhoea, which follows every urination. Ammonium mur., in that feeling as if sprained in the groin in women, finds its counterpart in several other remedies: in Arnica, which has that same strained feeling in the groin; in Apis, which has it all the way across the hypogastrium, with a sensation as if the skin were tight or stretched. Next, we have to consider the action of Ammonium mur. on the mucous membranes. Beginning with the nose, we find that it causes coryza. The nose is "stopped-up" more at night than in the day- time. One nostril is usually stopped-up at a time; there is an ex- coriating, watery discharge from the nose, which makes the inside of the nostrils and upper lip sore. The throat is swollen so that the patient cannot open his mouth. The mouth and throat are filled with a viscid phlegm, which the patient expels with great difficulty. There is throbbing in the tonsils. This is characteristic of Ammonium mur. It is a symptom which may suggest it in tonsillitis or in scarlatina when the faucial symptoms are so severe as to produce almost com- plete strangling. The chest symptoms are by no means unimportant in Ammonium mur. We find a cough which may accompany the foregoing symptoms or which may be separated from them. The cough is very violent, and seems to excite the salivary glands, for during it the mouth fills with saliva. Hoarseness, with burning and rawness in the larynx, necessarily belong to such an acrid remedy as Ammonium mur. Cold- ness between the shoulder-blades accompanies the chest affections, as in bronchitis and phthisis. The patient also complains of heaviness in the chest. This is also noticed in Ammo?iium carb. where it is associated with burning. Sometimes the patient will describe his sen- sation to you as a feeling as of a lump in the chest. Again, he will complain of certain spots in the chest which burn, throb and beat with the pulse. Ammonium mur. may be used in chronic congestion of the liver. Depression of spirits accompanies the disease, and the stools are coated with mucus. THE AMMONIUM PREPARATIONS. 665 Ammonium Phosphoricum. I have one or two symptoms of Ammortium phosphoricum to give you. It has been successfully used in the treatment of constitutional gout when there are nodes or concretions in the joints. It is not to be used for the acute symptoms, not for the twinges of pain, but when the disease has become systemic, and when concretions of urate of soda appear in the joints. The worst case of this kind I ever saw was that of a man who had been bedridden fifteen years. He showed me a box which was filled with these concretions, which he had picked out of his joints. They varied in size and looked like lumps of chalk. Some of these same concretions could be seen under the skin and along the tendons. His hands were twisted out of shape. His feet also were affected. He had a cough, which finally killed him, and he ex- pectorated from the lungs these lumps of urate of soda. Ammonium phos. relieved him for awhile. LECTURE LXV. SALTS OF LIME.— CALCAREA OSTREARUM Calcarea ostrearum. Calcarea caustica. Calcarea fluorica. Calcarea phosphorica. Nutrition. Blood ( Anaemia. ( Leucocythaemia. Glands. Bones. There are quite a number of the salts of lime which have been more or less proven. The first one on the list is Calcarea ostrearum or the lime of oysters. This preparation, which was given to us by Hahnemann, was proven as Carbonate of Lime or Calcarea carbonica. It was obtained from the middle stratum of the oyster-shell, where Hahnemann supposed he could secure a perfectly pure specimen of the carbonate of lime. Chemically speaking, this is not a pure car- bonate of lime, for it must contain some of the animal matter belong- ing to the oyster. Moreover, it always contains a trace of Calcarea bhos. You will thus see the reason why Dr. Hering proposed to call it Calcarea ostrearum instead of Calcarea carbonica. Calcarea caustica is the ordinary caustic lime. Calcarea fluorica was proven by Dr. Bell, of Massachusetts. Of it we have a few symptoms. It is one of Schiissler's twelve tissue remedies. This combination of fluoric acid with lime gives us a very powerful drug in the treatment of diseases of the osseous system. I have already related to you a case in which Calcarea fluorica acted well in necrosis of the jaw. We shall also find it a useful drug in bone tumors. Calcarea phosphorica is also a valu- able drug. It should be your duty and your pleasure to know the distinctions between these various salts of lime, and especially between Calcarea ostrearum and Calcarea phosphorica. They are not indicated in pre- cisely the same cases. When one is indicated, the other cannot be. They are not difficult to distinguish, so I think we will readily differ- entiate them. One chapter in the history of Calcarea phosphorica is of some little interest. Some years ago a preparation for the cure of a certain SALTS OF LIME. 667 disease was put on the market in Europe. It soon gained quite a repu- tation. After awhile, cures effected by it became less and less fre- quent. Finally, a wealthy man who failed to be cured by the prepa- ration, sued the company for deceiving him. Analysis of the preparation became necessary. The main ingredient was found to be phosphate of lime. In the beginning the manufacturers used the phosphate of lime from bones; but later they found a cheaper way of making it in the laboratory, and without using bones at all. The company claimed that phosphate of lime is phosphate of lime, no mat- ter how made or where found. That there is a difference between the phosphate of lime as obtained from the chemist's laboratory, and from the bones of animals, is shown by the difference in therapeutical efficacy of the two preparations, as illustrated in the above case and many others. Calcarea sulphurica, or the Sulphate of Lime, is another one of Schtissler's remedies. It was proven by one of the students of the New York College. Schiissler claims that Calcarea sulphurica acts energetically in curing suppuration and in removing the tumefaction of boils. The proving, while not positive, rather favors this idea. There is a use which you may make of this drug, and that is in croup; it will act like magic in a case like Hepar, with cough that is loose from the mucus in the larynx but which has the opposite modality as to heat and cold, namely, the child wants to be uncovered and cool. The Hypophosphite of Lime given in the second decimal, has pro- duced the following: dull heavy pain on top of the head, causing de- pressed feelings, fulness and oppression around the heart, fulness of head and chest; veins on hands, arms, neck and head, stand out like cords; difficult breathing, must have window open; profuse sweat all over; limbs powerless from weakness of the muscles. All the salts of lime act prominently in the direction mentioned on the board. They all affect the nutrition of the body, hence they are of great use in infancy and childhood, when growth must be accom- plished. They favor the development of bones and other tissues. You will find that some of them, the ostrearum and phosphorica, cause anaemia when pushed to the extreme. They all affect the glands and they all act on the bones. 668 A CLINICAL MATERIA MEDICA. Calcarea Ostrearum. Calcarea ostrearum is a drug that may come into use in almost every form of disease, and is second in importance only to Sulphur. You will recall that it is not a perfectly pure carbonate of lime, but con- tains some phosphate of lime and some organic matter from the body of the oyster. Chemically it differs but slightly from the carbonate of lime made in the laboratory. Calcarea ostrearum is suited to cases in which there is defective growth, hence it is a very necessary remedy in childhood and in in- fancy. It affects chiefly the vegetative system, altering materially the nutrition of the body. Under its influence secretion and absorption progress rapidly, and so it becomes a favorite remedy in cases in which the " constitution" is to be changed. The glands are readily affected by Lime; they swell, inflame and even become the seat of pathologi- cal deposits. This is especially true of the cervical and mesenteric lymphatics. The nervous system, is not primarily affected, but be- comes eventually influenced by general nutritive failure, thus causing spasms, excitement, etc. The Calcarea ostrearum patient is fat and plump, rather of a bloated than of a solid, hard fat. It is especially suited for children who are scrofulous ; who are fleshy, yet not well developed as to bone, brain or muscle. The face is rather pale, occasionally, however, flushing up red. Usually the color is of a watery or chalky paleness. The child is slow in its move- ments. It is not active, nervous, or quick, as we find in the case of the Sulphur child. It is peevish and self-willed, especially towards morning. Growth is irregular, so that the head is disproportionately large to the rest of the body. This defect is one of osseous growth; thus you find the fontanelles remaining open, particularly the anterior fontanelle. The abdomen is large and has been compared to an in- verted saucer or basin. The features are rather large, and the lips, particularly the upper, are swollen. Dentition is slow. There is craving for boiled eggs. The scalp sweats profusely, particularly during sleep. This is not usually a warm sweat, nor is it a cold sweat; but it is cool from natural evaporation. When the child awakes, you notice the pillow damp or wet for some little space around the head. The feet are often cold and clammy. Do not, however, be deceived by this symptom, for there are some children who, by wearing too CALCAREA OSTREARUM. 669 heavy a stocking, will have sweaty feet. This patient suffers from partial sweating of still other parts of the body. That is in itself an almost certain symptom of Calcarea ostrearum. Thus it may affect the chest or knees when all other parts of the body may be perfectly dry. Now, from this extreme picture we may have the opposite con- dition, one of great emaciation. The skin hangs flabby and in folds. Despite this emaciation, the abdomen remains abnormally large. Such children are scrofulous, and it is genuine scrofula, for which Calcarea ostrearum is indicated. There is another form, which is tubercular in its character, and in this form we have Phosphorus indicated. We find the same swelling of the glands, the same indolent ulceration, and the same difficulty in learning to talk and walk, but the patient has a delicate, refined skin, and the features are sharp and rather handsome. The eyelashes are long and silky, and the hair dark and glossy. This is the kind of scrofula which will, if not neutralized, ultimately end in consumption of the lungs. As the Calcarea child grows older it is slow in teething. It may even have fever or convulsions attending the tardy eruption of the teeth. In cases in which the convulsions persist, Calcarea is far superior to Belladonna. Belladonna may help for a while, but the deeper acting remedy must follow to complete the cure. Scrofulous inflammation of the eyes is almost always present. There are pustules on the cornea, and these threaten to destroy that membrane. The parts about the ulcer are very vascular. The child dreads artificial light in particular, although it complains bitterly of the daylight hurt- ing its eyes on awaking in the morning. The discharges from the eyes are apt to be bland. The cornea is left more or less opaque by ulceration. Calca?-ea has often been used after the acute symptoms, to remove the corneal opacity and the chronic thickening of the eyelids. No remedy excels Calcarea in corneal opacities; but compare Apis, Saccharum officinale, Cuprum, Alumen, Kali bi., Natrum sulph., etc. Saccharum officinale in particular is to be remembered as similar to Calcarea ostrearum. This drug has been proved on several persons, and has many confirmations. It is indicated in children who are large- limbed, fat and bloated, with a tendency to dropsy. It has produced opacity of the cornea, and it ought to cure it. The mental states which lead me to the use of Cane-sugar are these: the child is dainty and capricious; he cares nothing for substantial food, but wants little 670 A CLINICAL MATERIA MEDICA. " nicknacks;" he is always cross and whining, and if old enough he is indolent, and does not care to occupy himself in any way. Everything seems to be too much trouble to him. You will find that in the eye-symptoms Calcarea acts better after Sulphur than before. It is suited to advanced cases that are sluggish and refuse to react to Sulphur. Hahnemann noticed that Calcarea particularly followed Sulphur when there was tendency to dilatation of the pupils. Another remedy which holds a relation to Calcarea ostrearum in scrofulous and tubercular ailments is Nitric acid. This must be sub- stituted for Calcarea if the ulcers on the cornea progress and threaten to perforate or destroy the cornea. The Calcarea children are subject to eruptions on the skin, particu- larly eczema. This eczema is quite characteristic, too. It appears on the scalp, with a tendency to spread downwards and over the face. Frequently it appears in patches on the face or scalp, forming thick crusts, which are often white like chalk deposits. Another symptom which may suggest Calcarea is this: the child scratches its head on awakening from sleep. The change from sleep to activity seems to excite the itching of the existing eruption. We find in these scrofulous children calling for Calcarea, inflamma- tion of the external ear or auditory canal, and also of the middle ear or cavity of the tympanum. First, Calcarea produces thickening of the membrana tympani, with all the symptoms of defective hearing. There are humming, roaring and buzzing in the ears, all dependent upon the abnormal pressure on the chain of bones. The otorrhoea has a sort of pappy or fatty appearance. It is purulent, but it also has a pappy appearance, looking just like chewed-up paper. Now, on cleansing the external ear of this pus and looking at the membrana tympani, you find it perforated from previous inflammation. You will find the edge of the rupture thickened and granular, and you may even notice a tendency to the formation of polypi. The pains are of a sudden, jerking, pulsating character. In three different cases, Calcarea 30 produced vesicles in the auricles. Here Calcarea is, according to the best authorities, to be followed by Silicea, if the ulceration becomes very indolent and will not heal despite the exhibition of Lime. The Silicea patient has a head dispro- portionately large to the rest of the body. The sweat appears on the whole head and face rather than on the scalp alone, and the offensive CALCAREA OSTREARUM. 67 1 foot-sweat causes soreness of the feet. These symptoms you will recall from our lecture on Silicea. Besides Silzcea, you should here compare Calcarea with Hepar and Mercurius. Attending these inflammations of the eyes and ears with Calcarea we may have scrofulous enlargement of the lymphatic glands of the neck, axilla, etc. These are hard and firm, and yield very slowly to medicine. We have also in these cases a coryza or chronic nasal catarrh. The wings of the nose are thickened and ulcerated. There is apt to be a moist scurfy eruption about the nostrils. There is an offensive odor, as of rotten eggs, gunpowder or manure from the nose. The nose is stopped-up, with thick yellow pus. The patient often has nose-bleed in the morning. Here you may compare Bellado?ma which follows Calcarea well. Xow, if the Calcarea children are attacked with summer complaint or a genuine cholera infantum, you will find these symptoms of the digestive organs: there will be an unusual craving for eggs. Why this is I do not know; it may be because of the sulphur in the eggs. This is a very common symptom. Milk disagrees. As soon as they take it they vomit it in sour cakes or curds. That is a strong symp- tom for Calcarea. Or the milk may pass by the bowels in white curdled lumps. There are ravenous appetite and thirst, the latter being worse toward evening. The diarrhoea, too, is worse toward evening, thus being distinguished from Sulphur. The stools are greenish, and may contain undigested food. They are more or less watery and sour. In these symptoms Calcarea ostrearum is similar to two or three other drugs. One is sEthusa cyyiapium, or fool's parsley. This is indicated in vomiting of children, when they vomit everything they drink, particularly milk, which is ejected in white or yellowish or greenish curds. This vomiting exhausts the child, so that it at once goes to sleep. Still another remedy is Antimonium crudum, which has this condi- tion: after nursing, the child vomits its milk in little white curds, but refuses to nurse afterward; the Aithusa patient, on the contrary, wants to nurse again. There is also the characteristic diarrhoea of Antimonium crudu?n, which will help you to distinguish it from cases that call for Kreosote. If the latter remedy had no other symptom than the following it would still be invaluable, and could not be $7 2 A CLINICAL MATERIA MEDICA. replaced: the stomach is so weak that it cannot retain or digest food, so that food is vomited either immediately or hours after eating. Phosphorus and Arsenicum should also be compared in this vomiting. _Mag?iesium carb., Ipecac and Sulphur should be compared in the sour vomiting. In diarrhoea with green stools do not forget Calcarea phos. Again, we may find Calcarea ostrearum indicated in acute hydro- cephalus in the early stages. Here, as in many other cases, it acts particularly well after Sulphur. It may even do good when symptoms of effusion are present. It is indicated mainly by the general consti- tutional symptoms present in the case. In these cases you frequently find that it follows the previous use of Belladonna. You are called to attend one of these cases. You find the patient with hot head, flushed face, starting in sleep, and you give him Belladonna, which relieves. In a few days a relapse occurs; again you give Belladonna, and this time it fails. This intermittency of the disease shows that it is not a Belladonna case. Then you have to select another drug, which is sometimes Sulphur and very frequently Cal- carea, the latter especially if the patient be the characteristic Calcarea child. Bellado?ina and Calcarea are complementary, particularly in affections of children, in brain troubles and in dentition. Again, we may find Calcarea ostrearum indicated later in life, at puberty. Here it is more frequently indicated with girls than with boys. We find it called for at the time for the onset of the menses, when they are delayed. The girl is apparently plethoric, and suffers from congestions of the head and chest. She is fat and apparently robust, but if you were to examine the blood of such a patient you would find it disproportionately full of white blood-corpuscles or leu- cocytes. She complains of palpitation of the heart, dyspnoea and headache, worse when ascending. Calcarea will bring on the men- strual flow, and will relieve all these symptoms. Again, you may find it useful at puberty for similar symptoms when tuberculosis of the lungs threatens. The patient has this dyspnoea, palpitation and rush of blood to the chest on ascending, and even haemorrhages from the lungs. There is dry cough at night, which becomes loose in the morning. The patient has fever, which is worse in the evening, with partial sweat and soreness of the chest to touch, this soreness being worse beneath the clavicles. Digestion is greatly disturbed. The patient cannot eat any fat food without becoming CALCAREA OSTREARUM. 673 sick. There is chronic tendency to diarrhoea, and with it prolapsus ani. So you see Calcarea is a companion to Phosphorus •, but there is a difference between the two remedies. The difference is expressed in these few symptoms. In Calcarea, you find the patient scrofulous and fat, and his or her past history shows the well-marked symptoms of Calcarea. As children they have been slow in teething, have had slowly-closing fontanelles, and often there is yet remaining dispropor- tionate swelling of the upper lip. On the other hand, the Phosphorus patient is slender and overgrown, for his years, and narrow-chested. He has a fine grain of tissue, rather than fat and coarse as in Calcarea. Calcarea is indicated late in phthisis when large cavities are forming. It acts particularly upon the right lung about its middle third. There will be pain in the middle of the right side of the chest; loud mucous rales are heard all over the chest, of course worse on the right side. Expectoration is purulent, yellowish-green and bloody. The patient has great repugnance to animal food, as meat, which passes undi- gested. Emaciation progresses, sweat increases, and the menses, if it is a female, become checked. These are the symptoms calling for Calcarea in tuberculosis. Both Calcarea ostrearum and Calcarea phosphorica affect the middle lobes of the lungs. Sepia is here similar, but lacks the external sen- sitiveness to touch, in fact may be ameliorated thereby. Senega is somewhat similar to Calcarea in fat persons, but may be distinguished, having soreness that is worse on moving the arms, espe- cially the left arm. Still later in life we find Calcarea indicated for the ailments of women, particularly for irregularities in menstruation. It is especially indicated when the menstrual flow is too frequent, coming every two or three weeks, and is profuse, amounting almost to a menorrhagia. The flow is provoked by over-exertion or by emotions. The patient complains of sweating of the head and coldness of the feet. One of the best remedies I know of for ordinary profuse menstrual flow, coming frequently and yet without any decided constitutional character by which to judge the case, is Trillium pendulum, especially if the flow exhausts the patient very much. I have never given it in any potency but the sixth. That has been sufficient in all my cases. In suppression of the menses Calcarea has several concordant reme- dies. Belladonna is suitable when there are hyperemia, rush of blood 43 674 A CLINICAL MATERIA MEDICA. to the head, subjective feeling of coldness, wakefulness, and throbbing about the temples. Gelsemium is indicated in menstrual suppression when there is a drowsy, apathetic state. Glonoin is an admirable remedy when there is violent throbbing about the head, and particularly if the urine is albuminous, as it may be, from congestion of the kidneys. Aconite is indicated for suppression of menses from violent emotions, as fright. Still other drugs called for under these last-named circumstances are Actea spicata and Lycopodium. The leucorrhcea of Calcarea ostrearum is rather profuse, with con- siderable itching and burning, and is generally milky, purulent and yellow or thick in appearance. It is especially indicated for leucor- rhcea occurring before puberty, even in infants. Another remedy that I have found very valuable in the leucorrhcea of little girls is Caulophyllum, when the discharge is profuse and weakens the child very much. Sepia, Cannabis saliva, Mercurius, Phosphorus, Pulsatilla and Cubeba have also been sufficiently confirmed to be listed here. Calcarea ostrearum is useful in diseases of the male sexual organs. It is one of that little group of remedies, Nux, Sulphur and Calcarea, first suggested by Jahr for sexual weakness arising from masturbation or other excesses in sexual indulgence. Calcarea is indicated when there is excessive sexual desire, but this sexual desire is more mental than physical — that is, there is more passion than the objective con- comitants of passion. Erections are diminished or imperfect during coitus, emission is imperfect or premature. Calcarea is also indicated when, after abuse of this kind, a man settles down to a moral and quiet life. His sexual power is of a character just described, and its gratification is followed by vertigo, headache and weakness in the knees. In milder cases, which have not been traced to so deep an origin as defective nutrition, you will find Dioscorea all-sufficient for the exces- sive loss of semen with weakness of the legs, particularly about the knees. In old men, who, having spent their youth and early manhood in the practice of excessive venery, are just as excitable in their sexual passion at sixty as at eighteen or twenty, and yet they are physically CALCAREA OSTREARUM. 675 impotent, Agnus castus is a good remedy. They suffer from constant dribbling of semen. We may use Calcarea ostrearum from its action on the nervous sys- tem. It is indicated in nervous fevers, even in typhoid fevers, in the beginning of the disease, with these symptoms: the patient falls into a troubled sort of sleep and dreams of some perplexing subject which awakens him. He again goes to sleep and dreams of the same thing. As soon as he closes his eyes, he sees persons, objects, etc., which dis- appear as soon as he opens them. Later, in the course of typhoid fever, about the second week, you will find Calcarea ostrearum indi- cated when, for instance, the rash will not appear, and the patient goes into a sort of stupor. The abdomen swells and becomes more tympanitic. The patient becomes very restless and anxious and dis- tressed, although he may be unconscious. He cries out, twitches and grasps at flocks. The body may be too hot and the limbs cold and clammy. There may be diarrhoea or constipation present. He starts up from sleep and looks about him as if frightened. A drug which is complementary to Calcarea here is Lycopodium. But diarrhoea maybe present in Calcarea. This is never the case with Lycopodium. Another use that we may make of Calcarea ostrearum in nervous affections is one which would not appear from a superficial study of the drug, and that is its application in insomnia. The sleeplessness that calls for this remedy does not consist simply in lying awake an hour or two, but it is that long wakefulness which is the precursor to some dis- eases and the accompaniment of others. For instance, during child- bed a woman cannot sleep. In such cases you have this class of symptoms: she has visions on closing the eyes; she starts and twitches at every little noise, and is beside herself with anguish. The tongue is dry. She borders on the state of acute mania. Calcarea ostrearum, particularly in the thirtieth potency, given every three hours during the day, almost invariably produces a desire to sleep the next night. How does Calcarea produce it? Like opium, caffeine or chloral? No; but by bringing about a health}- sleep. Still another use of Calcarea ostrearum is in that unhappy affection, delirium tre- mens. It is indicated when there are pretty much the same symp- toms as I have mentioned for the insomnia, particularly with visions of rats and mice, and of horrible objects which terrify the patient. He talks deliriously about fire and murder. He has a constant fear that he is going crazy. 676 A CLINICAL MATERIA MEDICA. Calcarea ostrearum seems to be able to cure epilepsy, not so much the paroxysms themselves, as to aid in the change of constitution by which this dreadful disease may be cured. The aura which precedes the attack in some cases begins in the solar plexus and moves up- wards, and the patient is at once thrown into convulsions, a character- istic also of Nux vomica, Bufo and Silicea. In some cases it feels as if a mouse were running up the arm. In still others the aura may go from the epigastrium down into the uterus or into the limbs. The causes for the Calcarea ostrearum epilepsy are fright, suppression of some chronic eruption, and also excesses in venery. It follows Sul- phur well in these cases. You are apt to think first of Sulphur for this sensation as of a mouse creeping up the arm; the symptom is just the same in Sulphur and Calcarea; the causes, also, are the same, viz., excessive venery or suppression of an eruption. Calcarea is particu- larly indicated if Sulphur does not cure, or if the pupils do not dilate after the use of Sulphur. For the paroxysms, Hydrocyanic acid is a useful drug. Artemisia vulgaris is indicated in cases which have arisen from fright, and in which the attacks are duplicated. If indigestion starts the trouble, Nux vomica is the first remedy to be thought of, especially if the aura starts in the epigastrium and spreads upwards. Calcarea ostrearum is useful in diseases of the bones and in curva- tures of the spine, especially for curvatures in the dorsal region in children who are slow in learning to talk and walk, who are weak at the ankles, and turn their feet in or out according to the muscles that are affected. In weak ankles compare Natrum carbonicum, Silicea, Car bo animalis, Sepia. There is a remedy which has been suggested for this weakness of the legs which I have never been able to confirm, and that is Pinus sylvestris. This is said to have cured emaciation of the lower extrem- ities, with tardiness in learning to walk, in scrofulous children. Calcarea ostrearum is also indicated in affections of the joints; for instance, in white swelling and in hip- joint disease. It is indicated in the second stage of these diseases, when abscesses have formed. Now, you must learn to distinguish between Calcarea and Silicea. To the superficial observer the cases are very similar, but there are some differences which you may note. In the first place, the Silicea patient has sweat about the whole head, and this sweat has a sour or CALCAREA OSTREARUM. 677 offensive odor; the head is unduly large, the rest of the body being rather emaciated; the sweat of the feet in Silicea is apt to be offensive, and produces soreness between the toes and on the soles of the feet; the face is rather of an earthy or yellowish- waxen hue. The Silicea child is nervous and excitable rather than sluggish, as is the case with the Calcarea ostrearum patient. Silicea has the same imperfect nutri- tion from defective assimilation that Calcarea has. There seems to be, in the Silicea child, a decided weakness of the cerebro-spinal nervous system; and yet, with this weakness, there is a certain amount of irri- tability, so that it is made worse by any external impression. Thus, if there is any tendency to epilepsy, any little emotion will tend to throw it into convulsions. There is more tendency to ulceration in Silicea than you find in Calcarea. The discharge from these ulcers is not a healthy, laudable pus, but it is rather thin and excoriating. Calcarea ostrearum is of service in rheumatism. The symptoms indicating it are these: rheumatic affections, caused by working in water; rheumatism of the muscles of the back and shoulders after failure of Rhus. It is also indicated for gouty nodosities about the fingers. It may be useful in constitutional gout and in arthritis de- formans. Rhus tox. seems to be the best remedy we have for lumbago, whether the pains are better from motion or not. It seems to have a special affinity for the deep muscles of the back. Calcarea fluorica is a good remedy to follow Rhus in chronic cases; for lumbago, worse on beginning to move but improving on continued motion. Secale cornutum is indicated for sudden " catch " or " kink " in the back. Nux vomica is called for in rheumatism of the back, when the pa- tient is unable to turn over in bed without first sitting up. The uses of Calcarea in eruptions have already been touched upon in former lectures. It is one of the best remedies in chronic urticaria. It produces herpes, one prominent locality being on the parts of the face covered by whiskers, here suggesting a comparison with Mezereum, which has itching in the whiskers as from vermin, scaliness; Lithium carb., cheeks under the whiskers rough as a grater, itching; and Cicuta virosa, thick honey colored scabs in the whiskers as well as about the corners of the mouth. LECTURE LXVL CALCAREA PHOSPHORICA AND HEPAR. Calcarea Phosphorica. f Cinchona, Zinc, Phosphorus (hydrocephaloid). Dulcamara, Silicea, Sulphur. Calcarea phos. -j Rhus, Causticum. Sulphur, Calcarea ostr., Silicea, Phosphorus. Baryta c. (mental weakness). The complementary drugs of Calcarea phos. are: Zinc, Ruta gra- veolens, and Sulphur. Zinc you will find complementary to Calcarea phosphorica in hydrocephaloid; Ruta in affections of the joints and periosteum; and Sulphur pretty much as we found under Calcarea ostrearum. Now there are many symptoms that are common to both Calcarea ostrearum and phosphorica. It is not a little perplexing at times, in a case which seems to call for lime, to decide which one of these prep- arations we should give. Perhaps I can give you distinctions enough to enable you to judge. To determine the efficacy of Calcarea phos- phorica you must remember its ingredients, lime and phosphorus, and you will see how they are modified in their chemical combination, so that while we have some resemblances to Calcarea and others to Phos- phorus, we have still other symptoms which belong to the combina- tion, Calcarea phosphorica, and which are found neither in Calcarea nor in Phosphorus alone. Calcarea phos. seems especially called for in defective nutrition, hence it is often useful in childhood as well as at puberty and in ex- treme old age. Beginning with the infant, we shall find it of inesti- mable service when the child is thin and emaciated, with sunken, rather flabby abdomen, and predisposed to grandular and osseous disease. The head is large, and both fontanelles are open. The cranial bones are unnaturally thin and brittle. The teeth develop tardily. It has curvature of the spine. The child is slow in learning to walk, and the spine is so weak that it cannot support the body. The neck is so thin CALCAREA PHOSPHORICA. 679 and weak that it cannot support the head, which falls whichever way- it happens to be inclined. The child vomits milk persistently, whether it be the breast milk or that artificially prepared from the cow. It suffers from colic after every feeding. The stools are often green, slimy and lienteric, and are accompanied by the passage of a great deal of foetid flatus. Sometimes, the stool is very profuse, watery and hot. In cholera infantum, the stools may be of the character men- tioned, or they may present a flaky appearance from the admixture of a small portion of pus. There is, in this cholera infantum, great ema- ciation of the whole body. The little face is pale, and the prominent parts of the body are cold. There is craving for bacon or ham. Mentally, these children are very much depressed, so that they are slow of comprehension. They seem to be stupid. Even cretinism may be developed by the continued use of Calcarea phosphorica. This will place it in your mind, along side of Baryta carb., in mental symptoms. As the child grows in years, if not in stature, any exposure to damp- ness or wet causes a feeling of general aching or soreness, particularly when it is moved. The least motion is unbearable. Do not be misled by this aggravation from motion and give Bryonia. It is not here a symptom for Bryonia, for it indicates the incipient symptoms of rachitis. Every little exposure produces a feeling of heat all over the body. The periosteum and the articulations are irritated and inflamed, and cause this aggravation from motion. You will find Calcarea phos- phorica an excellent remedy to prevent rachitis. If it fails you, you may still fall back on Silicea. This sensitiveness to dampness enables us to use Calcarea phos. in diseases of adults. This I consider an important qualification of the drug. Thus, it is indicated in women with a feeling of weakness and distress referred to the hypogastrium with uterine displacements, and worse by passage of either stool or urine. Especially is it indicated in women whose joints ache in every change of the weather. This quality separates it from other similarly-acting drugs. The uterine symptoms are aggravated by this change in weather, a symptom that is prominent in Calcarea phosphorica, more so, in fact, than in either Calcarea or Phosphorus. Phosphorus has the gone, weak feeling in the hypogastrium, just like Calcarea phos . , but the modality just mentioned is absent. So, too, we may use Calcarea phos. in rheumatism appearing in any change of weather. On exposure to dampness, we find stiffness of the 680 A CLINICAL MATKRIA MEDICA. neck, aching and soreness in the limbs and wandering pains through the limbs, particularly around the sacral region and down the legs. All these symptoms appear with every change of weather. If the patient contracts a cold, it is associated with dryness and sore- ness in the throat, stitches in the chest, heat on the lower part of the chest and upper arms, and a yellow sputum. Another use of Calcarea phos. arises from its action on joints. I refer to its use in the treatment of fractures. Wherever bones form a suture or joint, there Calcarea phos. has an action. We find it, for instance, causing pains along the sagittal suture. Again, where the sacrum unites with the iliac bones, forming the sacro-iliac symphyses, there Calcarea phosphorica produces pain. If, during pregnancy, a woman complains of pain in this locality, Calcarea phosphorica ought to help her. Now, when there is a sort of artificial suture, as there is at the point of coaptation of broken bones, there, also, Calcarea phos. has an action. In some cases, the fractured ends may fail to unite; you give Calcarea phosphorica, which stimulates the formation of callus. It is better to use a low potency of the drug in this case. In this respect, Calcarea phos. compares favorably with Symphytum, which is also used for non-union of fracture, particularly when the trouble is of nervous origin. Conchiolin may here be mentioned. It is useful in osteitis at the ends of the diaphyses. This " mother of pearl " causes such a disease among workmen. We have yet another use for Calcarea phosphorica, and that is for school-girls, particularly when they get near the age of puberty and they are exceedingly nervous and restless. They want to go away from home, and when away, they want to come back again. They suffer from headache when at school. They develop very slowly and are often chlorotic. We may use Calcarea phosphorica in children who are suffering from marasmus. They have the peculiar craving and the diarrhoea that I have already described. The face is white and pale, or else sallow. The circulation is so imperfect that the ears and nose are cold. These cases, too, have that inability of the neck to support the head, of which I have already spoken. There is a resemblance between Calcarea phosphorica and Cinchona. The latter may prevent this extreme picture if you give it for the CALCAREA PHOSPHORICA. 68 1 drowsy, exhausted condition and has cold face, that follows the fre- quent and protracted discharges. In these cases, the administration of Cinchona will bring the child up and prevent the condition calling for Calcarea phos. On the other hand, you will find Calcarea phos. will give place to Zinc when you have the rolling of the head, grinding of the teeth, cold pale face, hot occiput, fidgety motion of the feet ? and other symp- toms of this remedy that I have already given you. From Baryta carb. this drug is to be distinguished when the child under treatment is mentally stupid. Ruta holds a complementary relationship in periosteal and articular pains. And lastly, Silicea resembles Calcarea phos. especially in rachitis, but has more offensive head sweat, more constipation and a strong tendency to sup- puration, boils, etc. In aggravation from exposure to wet we may compare Dulcamara, Sulphur, Silicea and Causticum. It is highly important to be able to distinguish between Calcarea ostrearum and Calcarea phosphoiica. This you can do by comparing the descriptions I have given you to-day and yesterday, as follows: Calcarea ostrearum has an enlarged abdomen; Calcarea phos. has flabby abdomen, from the admixture of phosphorus with the lime. In cholera infantum Calcarea ostrearum has craving for eggs; Calcarea phos. for salt or smoked meats. The Calcarea ostrearum stools are sometimes green, but generally watery, white and mixed with curds. The Cal- carea phos. diarrhoea has green, slimy or hot watery stools accom- panied by foetid flatus. Calcarea ostrearum has particularly the ante- rior fontanelle remaining open; Calcarea phos. has both anterior and posterior fontanelles open. 682 A CLINICAL MATERIA MEDICA. Hepar Sulphuris Calcarea. Hepar { Belladonna, Lachesis, Merc. J Spongia, Iod., mine, Aeon., (^ Silicea, Sulphur Bro- i . Nervous system ■{ { Depresses sensorium. Irritability of all nerves. 2. Plastic exudations. 3. Suppuration. 4. Catarrhs. 5. Glands — Bones. 6. Skin. 7. Organs. 8. As an antidote to metals. Next, we will consider Hepar sulphuris calcarea. This is really an impure calcium sulphide, containing traces of the sulphide of lime, organic matter possibly, and very likely, too, minute proportion of the phosphate of lime, since it is made from the middle layer of the oyster shell and flowers of sulphur. It is a valuable addition to the powers of lime and sulphur used separately. It possesses many similarities to and marked differences from its components. Hepar has some action on the nerves. It is to be remembered as a drug that causes over-sensitiveness of the nervous system. Pain seems to be intolerable to the patient, and may even cause fainting. An in- flamed part feels sore and bruised, and cannot bear the touch of the hand or even of a dressing. I mention this as a universal character- istic of the drug. I have often given Hepar for cold-sores in the corners of the lips when they were about to suppurate, in inflamma- tion of the eyes and in styes and pimples, when there was present this extreme sensitiveness to touch. Mentally, the Hepar patient is rather sad and low spirited, particu- larly in the evening. At times there is an impulse to suicide. While walking in the open air the patient feels discouraged and cross, and is annoyed by the recollection of all the past unpleasantnesses that have figured in his previous life. Memory is weakened so that he forgets words and localities. And this is most evident when he is particularly irritable. He is over-sensitive so that his speech is hasty. Hepar is indicated in neuralgia, particularly of the right side of the face, after the abuse of mercury and after the unsuccessful exhibition HEPAR. 683 of Belladonna, which seemed indicated, particularly after exposure to dry, cold winds. In the neural'gia and other nervous symptoms Hepar belongs with Belladonna, Silicea and Sulphur. It frequently follows Belladonna, as I have told you; and from Silicea and Sulphur you may distinguish it by the other symptoms. A symptom in connection with the mental irritability of the patient that I have already men- tioned is hasty speech and hasty actions. We find precisely the same symptom under Belladonna. "Hasty speech and hasty drinking" is the way the symptom reads under the latter remedy. We find it also under Lachesis, Dulca?nara and Sulphur. To show you that this is a genuine symptom, I will mention a case of hysterical mania cured by a physician on the other side of the ocean. He had this one symptom to guide him: the patient's speech was hasty and words rolled out in profusion. The clinching symptom was that she had taken a great deal of Mercury. Hepar cured the mental condition completely. We next have to consider Hepar as a remedy in inflammation. It is suited to inflammations of a croupous form and inflammation with suppuration. In all the inflammations and congestions in which Hepar is the remedy, you will find that there is extreme sensitiveness of the affected part to touch. This is so characteristic that it must be present more or less prominently before Hepar may be the remedy. The parts feel bruised and sore, like a boil. This, as I have already said, you can carry through all the Hepar inflammations. For instance, in ophthalmia, or inflammation of the eyes, or lids, you will find that the eyelids are swollen and cedematous, and some- times, too, suppurating styes will form. With this there is a bruised, sore sensation. The patient cannot bear to have the eye touched; neither can he bear the cold air. Cold air and cold applications in- crease the suffering, and here you have a good indication separating it from Mercurius. Little pimples surround the inflamed eye. Simi- lar to Hepar in this particular are: Euphrasia, which has pimples on the cheek over which the acrid tears flow, and Phosphorus, which has small ulcers around the large ones. So again in inflammation of the ear, whether of the external audi- tory meatus or of the middle ear, you will find the same soreness to the slightest touch. We find Hepar indicated in earache when suppuration impends, after Belladonna, Chaniomilla or Pulsatilla. It is seldom indicated in the beginning. 684 A CLINICAL MATERIA MEDICA. We find these same characteristics of the inflammation present in the coryza. The nose is swollen and sore to the touch, especially in the inside of the alae or wings of the nose. So, again, in face-ache, the bones are exquisitely sensitive to any pressure. These are all illustrations of the character of the drug. I need not multiply them, because they are found in any part of the body in which inflammation occurs. If suppuration occurs as the result of the inflammation, we have Hepar indicated and exercising a double function. If you give it in a high potency when the throbbing, stabbing pains in the affected part and the general rigor show the onset of inflammation, it may abort the whole trouble. In other cases, if you see that suppuration is necessary, and wish to hasten the process, then you give Hepar low. In tonsillitis and in boils, particularly in the former, Hepar is indi- cated after Belladonna when the latter does not succeed in reducing the inflammation before suppuration commences. I will simply re- mind you here that I have already mentioned the distinction between Bellado7i?w, Hepar, Mercurius and Silicea in this class of diseases. Now, if the inflammation becomes croupous, Hepar may be indi- cated, whether it be the throat, larynx, bowels or kidneys that are involved. The characteristics indicating Hepar in croupous inflam- mation of the larynx are these: after exposure to dry, cold winds the patient becomes hoarse, with whistling breathing. Respiration is so difficult that the child throws its head far back in order to straighten the air-passages. The cough is hard, barking and ringing, and at the same time accompanied by rattling of mucus. So sensitive is the child to cold, that the least exposure, even uncovering an arm or a foot, excites a spell of coughing. Thus you see the extreme susceptibility of the patient to cold air. Hepar is especially indicated when the cough is worse towards morning. Occasionally Hepar may be given for cough which occurs before midnight, but then it must be moist and not dry. You will see from these symptoms that Hepar follows rather than precedes A conite and Spongia. Aconite is indicated in the beginning of croup when there are great anxiety, high fever, and distressed breathing. I would advise you to continue the Aconite some time after the symptoms have been relieved, because these cases are very apt to relapse. If, however, Aconite fails and the cough gets worse the next night, HEPAR. 685 Spongia is usually the remedy, especially if there are dry, hard cough, sawing respiration, little or no expectoration, and starting up from sleep choking. If towards morning, although there is increased secretion and moist sound, the croupous symptoms still continue, then the case calls for Hepar. Bromine usually follows Hepar when the latter is unable to remove the exudate. Hepar was used by Kafka, in Bright' s disease following scarlatina. He was led to this by the power of the drug to produce fibrinous or croupous exudations. Hepar has succeeded in these cases many times, so that it must have some action on the kidneys. Kafka gives it after scarlatina when the urine becomes albuminous and dropsy appears. Next we have to consider Hepar in ordinary catarrhs, or what is commonly called a "cold" with aching through the body. Hepar seldom is a remedy in the incipiency, but for the advanced stage of a "cold." If it be given at the commencement, it frequently spoils the case, whether it be one of coryza or of sore throat, because it is more suitable to what has been termed ' ' a ripened cold ' ' when phlegm has formed. The catarrhal process may have affected the ethmoid, with boring pain in the parts and exquisite soreness. When the patient swallows, there is a sensation as if he was swallowing a fish- bone, or as if there were something sticking in the throat. Sometimes he will describe the sensation to be as if there were a crumb of bread or toast sticking in the throat. This symptom allies Hepar with Mercurius, Nitric acid, Argentum nitricum and Alumina. These colds, for which Hepar is the remedy, are re-excited by any exposure. It is often indicated when the abuse of mercury has developed in the system a susceptibility to cold. In affections of the lungs, we find Hepar indicated in two or three classes of disease. We find it called for in pneumonia, especially dur- ing the stage of resolution. It comes in late in the disease (and not in the beginning) when, during resolution, pus forms and you have pres- ent suppuration instead of the normal resolution. Hepar ought also to be indicated in croupous pneumonia. Here, as in all other croupous inflammations, it is called for late in the disease. You may also give Hepar successfully in the treatment of that fright- ful disease, pulmonary tuberculosis, when, with the deposit of tubercles in one or the other apex, you have a hard, croupy cough, with 686 A CLINICAL MATERIA MEDICA. production of mucus, worse in the morning. It here frequently follows Spongia. It may bring about absorption of the tuberculous deposit. When a cold reaches the chest, Hepar does wonderfully well if the catarrh threatens to affect the capillary tubes. A good distinction between Hepar and Antimonium tartaricum in this connection is that the latter has loose rattling mucus; the former wheezing, purring sound, as if the exudate was more tenacious. Com- pare also Jaborandi, which has increased production of bronchial mucus. In glandular disease, Hepar is indicated in the stage of suppuration, when the inflammation has gone on to the formation of pus. You will find it especially useful in the treatment of bubo, whether venereal or not, especially after the abuse of mercury. Even old buboes remain- ing open after mercury, and discharging continually, sometimes heal under Hepar. It is not uncommon to find cases of indigestion embraced under the name dyspepsia, which have resulted from a long course of mercurial treatment by physicians of the dominant school. Hepar, as one of the antidotes to mercury, will sometimes cure these cases. Sometimes a cure is impossible. Still, I think, relief is always obtainable from one remedy or another. We may also find Hepar indicated by dyspepsia, independently of this cause, by the following symptoms: there are usually a sour taste in the mouth and a longing for strong tasting sub- stances, for alcoholic drinks, for wines, for acids, and for condiments of various kinds. These seem to relieve by stimulating the stomach; so it is the purely atonic form of dyspepsia in which Hepar is indicated. There is hunger, a gnawing, empty feeling in the stomach in the fore- noon, a longing for something to eat. This craving for food shows the atonic condition of the stomach. At other times, although eating does him good and increases his general strength, yet it produces a fulsome- ness about the stomach. He can bear no pressure about the epi- gastrium. Sometimes there is burning in the stomach from congestion of that organ. The bowels are usually constipated. Urging to stool is often ineffectual, although the faeces be not abnormally hard. With Bryonia the stool is large, brown and dry; it is not necessarily so with Hepar. In Nux vomica the constipation is of a spasmodic, fitful urging and not ineffectual. HEPAR. 687 In these dyspeptic symptoms Hepar seems to be complementary to Lachests, in that both have this condition: any kind of food, no matter how wholesome, provokes indigestion. Hepar must not be forgotten in the marasmus of children. Stand- ing as it does between Sulphur on one side and Calcarea on the other, as a combination of these two, it is here of value. The symptoms which lead you to Hepar in the complaints of children are these: there seems to be this same weakness of digestion; they cannot manage their food, no matter how well-selected it may be. If they are old enough, they will tell you the symptoms that I have already mentioned. If you give them any strong substance, as a preparation of beef-tea, they will show signs of enjoying it very much. Diarrhoea is present, and is usually worse during the day and after eating. The stools may be greenish or slimy, undigested, or white and sour; this last is a very important symptom. The whole child smells sour. The most promi- nent remedies for sour stools are Magyiesia carb., next to that Calcarea ostrearum, then Hepar, and lastly Rheum. The symptoms for Rheum are as follows: sour stool; the whole child smells sour; the stools are frequent, brown and frothy, and attended with a great deal of straining and violent pain, which makes the child shriek. If the liver is involved under Hepar, we find soreness and stitches in the region of that organ. The stools then become clay-colored, or even white. The same condition is found in the bladder that we have already noticed in the rectum, viz., atony of the muscular coats. Hence, when urine is voided, it passes very slowly; it drops almost perpen- dicularly from the meatus urinarius instead of being ejected with some force. It takes the patient some time to empty his bladder. If with this trouble of the bladder you find wetting of the bed at night, Hepar is the remedy. It is not often indicated in this condition, however. In this vesical paresis you should compare Sepia. The ulcers which call for Hepar are very sluggish and indolent, slow to heal. They are rather superficial and often serpiginous. The discharge is bloody and purulent, and has an odor like that of old cheese. They have this to characterize them, extreme sensitiveness of the border of the ulceration. The action of Hepar on the skin is important. In the first place, it 688 A CLINICAL MATERIA MEDICA. produces a condition of non- healing as just indicated. Every little scratch of the skin suppurates. The same is also found in Mercurius, Chamomilla, Silicea and Lycopodium. It also produces a moist erup- tion in the folds of the skin. There is itching, especially in the bends of the joints. When Hepar is called for in eczematous eruptions which have a purulent discharge, we find it indicated by these symptoms: after the abuse of salves or ointments containing zinc or mercury, and the eruption is worse in the morning and accompanied by itching. Ulcers bleed easily, are extremely sensitive and emit an odor like old cheese. Hepar is an antidote to metallic poisoning generally, but especially to mercury and iodide of potassium. It also antidotes Cinchona and Iodine. In symptoms of the skin Hepar is similar to Carbo animalis, Sepia , Psorinum, Cuprum, Thuja, Zinc, Graphites, Natrum muriaticum and Croton tig Hum. LECTURE LXVIL PREPARATIONS OF SODA. The preparations of soda are quite similar, both chemically and medicinally, to those of potash, yet this similarity is not such that they may not follow the potash salts. We will see that Kali carb. is com- plementary to Natrum mur. in some of its symptoms. It seems that the salts of soda are indicated particularly in complaints that arise every summer or in the spring. Hot weather, electric changes in the atmosphere, or the direct rays of the sun give rise to various ailments. For instance, we find Natrum carb. useful for chronic headache, trace- able to exposure to the rays of the sun. Under Natrum mur., we find great debility in summer; the patient feels as though he would faint away when walking in the sun. The soda salts used in our materia medica are Carbonate of Soda or Natrum carb., Chloride of Sodium or Natrum mur., Arseniate of Soda or Natrum arsenicosum, Sulphate of Soda or Natrum sulph., Phosphate of Soda or Natrum phosphoricum, Natrum hypochlorosum and Borax. Natrum Carbonicum. Natrum carbonicum is the first preparation of soda we have to con- sider. It is much used in the allopathic school of practice as a remedy for acidity of the stomach. It is also used by the physicians of that school in eczema; for instance, in a case in which there is chronic thickening of the skin, the affected parts are bathed in carbonate of soda. No doubt, it relieves, but it cannot cure, unless it happens to be the indicated remedy, in which case it will cure as well as palliate. Carbonate of soda has also been introduced as a remedy for burns. In our practice the drug claims a high place, being something of a polychrest. Its most prominent action seems to be on the stomach and bowels. Many of its symptoms spread from this central point of attack. For instance, we will find that it has mental symptoms pointing quite plainly to hypochondriasis. We find the patient depressed and 44 690 A CLINICAL MATERIA MKDICA. exceedingly irritable. This is especially noticed after a meal, particu- larly after dinner, which is usually the heaviest meal. The degree of hypochondriasis seems to be measured by the stage of digestion. Just as food passes out of the stomach into the duodenum, this hypochon- driacal mood lessens, and continues to do so as the food gets further down into the bowels. You will find such a patient decidedly averse to society, even to his own family. The indigestion is more marked after a vegetable diet, particularly starchy foods. The indigestion is accompanied by sour eructations, water-brash and by retching in the morning, with spasmodic contraction of both oesophagus and stomach, with little or nothing coming to the mouth and, perhaps, copious sali- vation. The abdomen is hard and swollen, especially so after eating. There is accumulation of flatus in the abdomen, and this, when passed, is noticed to be foetid. There is a sort of griping colic just after a meal. The stool is difficult to expel, although not especially hard, just as we found in Hepar last week, and as we find still more marked in Sepia, which, by the way, is complementary to Natrum carb. At other times, the patient suffers from diarrhoea. The stool is papescent or watery, with violent urging. This characteristic of the soda salts, you will find to be quite general. You find it also in Natrum sulph. It seems to be due to the purgative effect of the soda itself. Wine in such cases as this causes faintness and vertigo, not agreeing with the patient at all. In these gastric and nervous symptoms we find the nearest analogue to Natrum carb. in Sepia, which, as I have mentioned a few moments ago, is also its complement. We find in both remedies this aversion to society and indifference to one's own family. We find, too, that both remedies have sour eructations and the formation of foetid gas in the abdomen. I remember curing a case of dyspepsia with Sepia, in which there were very few gastric symptoms, nothing more than a feeling of discomfort, but the mental symptoms were prominent and always ushered in an attack of indigestion. The patient, a lady, became in- different to her business affairs and also to her friends. She became excessively irritable. She would hardly tolerate even a civil question addressed to her. Sepia entirely cured this patient after she had been six or seven years under allopathic treatment. This shows you how the mental symptoms of Sepia come in, to enable you to decide for it as the remedy. Natrum carb. has almost precisely the same class of symptoms. It may not be so often indicated, but nevertheless, it comes PREPARATIONS OF SODA. 69 1 in to supplement Sepia when the general symptoms are those of Soda rather than those of the former remedy. Natrum carb. has rather dis- tension of the abdomen, with fulness and hardness, like all alkalies, while Sepia has more goneness and empty, sinking feeling, which food does not fill up, except, perhaps, at supper. Natrtim carb. has one exception to the fulness of the abdomen, and that is, at ten or eleven o'clock in the morning the patient feels anxious and weak, very much as you find under Iodine, but eating relieves this and produces disten- sion. Then, again, you should remember Natrum carb. in connection with Nux vomica. Both remedies have this retching in the morning. This symptom is strongest, however, in Nux vomica. You are often called upon to give Nux vomica when it occurs in pregnant women, or after a debauch, etc. Then, too, you find Natrum carb. parallel with Nux vomica in this hypochondriasis. You must compare the two remedies carefully before you decide which you will give. We shall see, too, that Natrum mur. will have to be compared with Nattum carb. It is necessary to distinguish between the two because they are both soda salts. Evidence of the effect of Natrum carb. on the nervous system is shown by the electric changes in the atmosphere. Thus, we find it causing nervousness or anxiety, which is worse during a thunder-storm. These symptoms occur independently of the timidity which belongs to some people during thunder-storms, at which times they secrete them- selves in the cellar, etc. They are due to the direct effect of the electric changes in the atmosphere on the nervous system, precisely as we find in other remedies, notably in Phosphorus, Rhododendron, Silicea, Bryonia, Natrum muriaticum, Nitric acid and Petroleum. So nervous and restless may the Natrum carb. patients become, that playing on the piano makes them worse and aggravates their complaints. It is not only the music that has this effect, but the efforts they use and the position they take. This is a common symptom in hysterical women. They get very nervous from playing on the piano or from hearing music. Another property of Natrum carb. is its use in ill-effects of sum- mer weather; this is common to all the soda salts. We find Natrum carb. indicated when there is a great deal of debility caused by the heat of summer, particularly when the patient is subject to chronic headaches, which are worse every time he exposes himself to the heat 692 A CWNICAI, MATERIA MEDICA. of - the sun. Natrum carb. is particularly called for in the chronic effects of sunstroke. It may have been years past that the patient was overcome by the heat; and now, with the return of hot weather, he suffers from headaches. Natrum carb. also weakens the nervous system in another direction. We find it exhibiting great debility, which is marked with every exertion on the part of the patient. His walk becomes unsteady; any little obstruction on the pavement causes him to fall. His ankles turn in when he attempts to walk. I have a patient, apparently in good health, who has had five falls within one year, and, for these accidents, I can find no reason. These are the cases that require a remedy, not for the effects of the fall, but to tone up the joints or muscles. Other remedies besides Natrum carb. having this weakness of the ankles in children are Sulphuric acid, Causticum, Natrum mur., Natrum hypo- chlorosum } Sulphur and, perhaps, Pinus sylvestris. I mention this last remedy with reserve, for while it has been highly recommended in our literature for weak legs, it has failed in a number of cases. Natrum hypochlorosum or L,abarraque's liquid is not a pure salt, for it contains carbonate of soda and calx chlorinata or ordinary " chloride of lime." The indications for its use in uterine disease has already been given you in a former lecture. (Seepage 142.) It suits lax, flabby, indolent children who, in addition to weakness of the ankles, have curved spine with prominence of the scapulae and eczema on the scalp and behind the ears. They are subject to purulent otonhcea, aphthae, to scalding urine, to wetting the bed at night, and when asleep, they may have a ghastly look as if dead. You will find that Natrum carb. will relieve soreness of the feet, and particularly the soles, accompanied by swelling of those parts. You may also use it for ulcers on or about the heels after a long walk. This symptom brings to mind a peculiar circumstance that I would like to mention. Certain remedies have an affinity for certain parts of the body. A soldier, who had been marching a great deal, had two ulcers, one on the heel, the other on the instep. Natrum carb. cured the one on the heel but not the one on the instep, which was afterwards cured by Lycopodium. Lycopodium acts on the instep and Natrum carb. on the heel. The same thing you note all over the body. There are drugs that act on the right tonsil and not at all on the left. You find some remedies which act on the great toe and not at all on the others. PREPARATIONS OF SODA. 693 On mucous membranes, too, we find Natrum carb., exerting consid- erable influence. The crude drug has been known to produce in work- men engaged in its manufacture small ulcers on the cornea. Given internally, it has cured small corneal ulcers or phlyctenules, with great photophobia and stinging pains; particularly are these symptoms marked in scrofulous children. The catarrhs curable by Natrum carb. are not commonly met with, but when they do occur, there is no drug that can take its place. The coryza is fluent, and is provoked by the least draught of air, and seems to have a periodical aggravation every other day. It is entirely re- lieved by sweating. Chronic cases of nasal catarrh or ozsena, even call for Natrum carb. when we find thick yellowish- green discharge from the nose, or hard foetid lumps. The tip of the nose is red, the skin peels off. You find not infrequently, when Natrum carb. is indicated, that there will be accumulation of mucus in the posterior nares, or in the throat, in the morning, causing "hemming" and hawking until it is raised. This is a very common symptom in all the alkalies. The cough seems to have its aggravation whenever the patient enters a warm room, and is attended with purulent green sputum of a salty taste. Among other remedies which have this cough worse in a warm room, Bryonia stands foremost. Coccus cacti has it in almost equal degree. Natrum carb., as I have already told you, is often used in the treat- ment of eczema. It seems to have a particular affinity for the dorsa of the hands. The skin then becomes rough, dry and chapped. Here, again, you find Sepia closely related with Natrum carb. , being par- ticularly indicated for this form of eruption when there are little ulcers about the joints of the hands. Natrum carb. also cures herpetic eruptions in yellow rings. On the genital organs, Natrum carb. has some effect. Particularly do we find it indicated in diseases of females when there is pressure across the hypogastrium as if something were being pushed out. If you make an examination in these cases, you will find the os uteri indurated and misshapen. There is considerable congestion of a pas- sive kind in the uterus, causing pulsation there during and after coitus. The extra influx of blood caused by sexual erethism brings about this pulsation. The leucorrhcea which Natrum carb. causes is thick and yellow, and sometimes has a putrid odor, and ceases after urinating. 694 A CLINICAL MATERIA MKD1CA. There is another use you may make of Natrum carb., and that is when labor pains are weak and cause a great deal of anguish, tremor and perspiration with every pain, and are relieved lyy gentle rubbing, which by the way is a general characteristic. We also find Natrum carb. to be one of the remedies useful for ex- pelling moles or the products of a false conception. Natrum Sulphuricum. Natrum sulphuricum would hardly have been used by members of our school had it not been alluded to by Grauvogl as the central remedy for his hydrogenoid constitution. Patients having this consti- tution feel every change from dry to wet; cannot tolerate sea air; nor can they eat plants that thrive near the water. They feel best on a dry day. It is this constitution in which, according to Grauvogl, the gonorrhceal poison is most pernicious. It finds here the richest soil in which it may grow rank. Therefore, he claims that if gonorrhoea occurs in such a constitution, to cure the patient not only of the local gonorrhceal discharge, but of the constitutional effects, the constitution must be altered. This he does with two remedies, Natrum sulph. and Thuja. The Natrum sulph. cures obstinate cases of gonorrhoea. In the chronic effects of injury, especially to the head, Natrum sulph. is almost indispensable. You will find Natrum sulph. especially indicated for ailments which are either aggravated or dependent upon dampness of the weather or dwelling in damp houses. You may think of Natrum sulph. then in the sycotic constitution of Hahnemann or the hydrogenoid of Grau- vogl. It may even be necessary to give this remedy when there is no bubo or urethral discharge to be seen. There is a kind of phthisis, not a true tuberculosis, which appears in those who have this constitution. The cough is attended with muco-purulent expectoration, loud rdles are heard through the chest, and the seat of inflammation seems to be the lower lobe of the left lung. The patient complains of pain about the ninth and tenth ribs on the left side. The Natrum sulph. patient has a marked tendency to this catarrh of the chest. If it appears as the result of suppressing haemorrhoids or anal fistula, Natrum sulph. is even more strongly in- dicated. Natrum sulph. is also indicated in asthma which is excited or made worse by every spell of damp weather. PREPARATIONS OF SODA. 695 Natrum sulph. also acts on the stomach and abdomen. It produces a great deal of flatulence, belching after eating, eructations being tasteless or sour. There is a great deal of rumbling of wind in the bowels, particularly in the right side of the abdomen, probably in the ascending colon. We find, too, a subacute pain in the ileo-csecal region, because it has some action on that portion of the intestinal tract. Associated with this there is diarrhoea, which comes on regu- larly in the morning after rising and returns quite regularly each day. Much wind is passed with the stools and is worse in damp weather. It is distinguished from Sulphur by this: with Natrum sulph. the diar- rhoea comes on more in the forenoon after getting up, whereas, with Sulphur it hurries the patient out of bed. It is distinguished from Bryonia which has diarrhoea on first rising in the morning by the fact that the latter has less flatus, and is aggra- vated by hot weather. Natrum sulph. is also useful in affections of the left hip-joint in patients of this hydrogenoid constitution. The pains are worse at night, and arouse the patient from sleep. They cease when he turns over in bed. Stillingia is useful for hip diseases in secondary or in inherited syph- ilis, with pains in and through the hip, worse at night and worse in wet weather. LECTURE LXVIIL NATRUM MURIATICUM. Natrum muriaticum. Bryonia, Rhus tox. Caust., Kalic, Sepia, Lycopod. Puis., China, Eupator. perf., Apis, Arsen. Lach., Mercurius. V l Arg. nitr. Apis. Arg. nit. > Nitri sp. dulc. > Arsenicum. > Phosphorus. To-day we begin our study of Natrum muriaticum or common table-salt. This has always been held up to us as an opprobium against medicine, and as a confirmation of the fallacies of Homoe- opathy. A physician once said to me: "What! will you use a sub- stance which is used in almost every food and call it a medicine, and say that you obtain good effects from it ? " I can assure you, gentle- men, as I assured him, that Natrum muriaticum is a medicine, and I can assure you, too, that that man afterwards became a warm advo- cate of its medicinal virtues. When you potentize a drug you will find that you no longer have to depend upon the ordinary laws of die- tetics, hygiene or chemistry, but you step into a realm which is dis- tinct from the laws of chemistry and of physics. Medicines are then no longer subject to the grosser laws. Natrum mur. was re-proved by a company of Austrian physicians who made heroic provings of some of our drugs. Some of these men died from the effects of their provings, so large and powerful were the doses of the medicines they took. One of the provers, whose name I have forgotten, said, when he published his provings of Natrum mur., that the higher potencies of the drug produced the most symptoms, and these symptoms, moreover, were more valuable than those pro- duced by the low. It is true of Natrum mur. as of most other drugs, that the high potencies act best. You will notice on the board that I have placed Argent um nitricum and Apis as complementary to Natrum mur. Argentum nitricum NATRUM MURIATICUM. 697 holds a complementary relation to Natrum mur. It also, at times, antidotes. It acts as a chemical or as a dynamic antidote according to the quantity of the drug taken. The relation between Apis and Natrum mur. is particularly evident in the treatment of chills and fever, and skin affections. Salt is one of the substances used to antidote the poisonous effects of bee-stings. When salt has been abused as a condiment, sweet spirits of nitre may be used as a successful antidote. Some other effects of Natrum mur. are antidoted by Arse?iicum, and still others by Phosphorus. I do not now recall any remedy inimical to Natrum mur. Natrum muriaticum or Chloride of Sodium may be considered first in its physiological relations, so that we may learn something of its value as a medicine. It enters into every tissue of the body, even into the enamel of the teeth. Speaking now physiologically, it is regarded as a stimulant to the various tissues into which it enters. It exists in quite considerable quantities in the various humors of the eye, par- ticularly in the aqueous humor and crystalline lens, and also in the vitreous humor. It has been said that its function here is to preserve the transparency of the respective tissues. Virchow, in his Pathology, quotes an authority who gave Chloride of Sodium to dogs until he pro- duced opacity of the crystalline lens. Hence, cataract may be pro- duced by Natrum mur. Chloride of Sodium in the stomach stimulates digestion and this, too, within the bounds of physiology. It stimulates digestion in various ways. First, it improves the flavor of food. We all know how insipid certain articles of diet are unless salted. We know from physiology that if a substance has its taste enhanced, its digestibility is also in- creased. That which is agreeable, digests more readily than that which is unsavory. Salt also acts on the stomach itself by favoring the secretion of gastric juice. Salt acts on the glands, producing an increase in the glandular secretions. Thus we find it acting on the sudorific glands and also on the mucous glands. Schiissler argues that salt is excreted through the mucus, which is true. Therefore, he says, that as salt has a function here, it must be the remedy for all catarrhs. That is too sweeping a conclusion for so limited a premise. It is true that if you examine healthy mucus you will find that it contains considerable salt. It is true also that Chlor- ide of Sodium produces an excessive flow of normally constituted mucus. From this you may take a useful hint. Wherever you find 698 A CLINICAL MATERIA MEDICA. a catarrh with a copious secretion of clear normal mucus, there Natrum mur. may be the remedy. We find it acting also on the sebaceous glands. These little glands are quite numerous in certain parts of the body, particularly around the wings of the nose and the cheeks. Their function is to lubricate the skin. Natrum mur. stimu- lates these, and as a result the skin becomes oily in appearance. We notice this particularly in the face, in the scalp, though it occurs, more than likely, in other parts of the body. Salt also has a stimulating effect on the nervous system, keeping up its tone. Muscular tone is also favored by the presence of salt within the tissues of the muscles. This brings me to give you the hint that common salt may be used as an external application in weaknesses of the muscles and nerves that favor deformities of the limbs. When you first notice that a child is walking on the side of its feet, or when you meet with a case of post-diphtheritic paralysis, you may use fric- tion with salt to great advantage. I do not mean to say that it will cure all deformities, for some arise from inflammation of the anterior gray cornua of the cord. Chloride of Sodium cannot cure these, for the trouble is due to organic disease. In weak ankles study Causticum, Sulphuric acid, Sulphur, Natrum carb., etc. Again, we may sometimes use salt in the form of the sitz-bath for obstinate amenorrhcea. We shall frequently find Natrum mur. indicated when the blood is impoverished. The nutrition of the whole system, therefore, suffers. We find it indicated in anaemia, particularly in anaemia provoked by loss of fluids, hence often with women who suffer from menstrual dis- ease and with men who suffer from loss of semen. We shall often find it indicated in scorbutic states of the system when the patient suffers more or less from scurvy. It is quite likely that the prolonged use of salt meat is a common cause of scurvy. In these cases the mouth becomes sore, ulcers form on the tongue and on the gums, and the breath has a foetid odor. The tongue presents a mapped appear- ance, a symptom we also find in other remedies, as Arsenicum, Rhus tox., Kali bichromicum and Taraxacu?n. Again, as a result of this impoverishment of the blood, we find the nervous system suffering secondarily. Natrum mur. may be given for the following symptomatic indica- tions: the patient is emaciated, and this emaciation is very marked. NATRUM MURIATICUM. 699 The skin is rather harsh and dry and of a yellowish hue. The patient feels greatly exhausted from any little exertion of mind or body. On account of the anaemia we have the circulation readily excited, so that every little exertion produces throbbing all over the body. The pa- tient suffers frequently from palpitation of the heart, and this, too, is excited by every motion and ever}' strange or sudden noise. It is often described by the patient as a sensation as though a bird's wing were fluttering in the left chest. Mentally, w T e find these patients sad and tearful. You will seldom find Natrum mur. indicated in chronic affections unless there is this low-spirited condition of the mind. The patient seems to be made worse by any attempt at condolence. Consolation may even make her angry. This tearful condition is accompanied by palpitation of the heart and intermittent pulse. Xow, this intermittent pulse does not necessarily imply organic disease of the heart, but simply a nervously weak heart. At other times the patient is decidedly hypochondriacal, just as we have already found with Natrum carb. This hypochondriasis is directly associated with indigestion, as in Natrum carb. But there is this difference: with Natrum mur., the remedy under consideration, this hypochondriasis keeps step with the degree of constipation, not alone with the indigestion, as in the other. In addition to this melancholy mood we also have irritability devel- oped by Natrtun mur. The patient becomes angry at every little trifle. He stores up in his mind every little real or imaginary offence. He wakes up at night with palpitation of the heart and cannot go to sleep again, because past unpleasant events occupy his mind. Intellectual ability is impaired. He becomes disinclined for mental work; makes mistakes, as if confused; has loss of memory; study aggravates. Frequently school girls suffer from headache, as if little hammers were pounding the head, whenever they study. Excitable, laughs immoderately at something not ludicrous; fingers move invol- untarily, as in chorea; trembling of the limbs; muscular jerks; awk- ward; she drops things. Now add to these chronic symptoms the following, and you have a complete picture of Natrum mur. Excite- ment is always followed by melancholy, anxiety, fluttering at the heart; limbs go to sleep, with "crawling," is noted also in the lips and tongue; limbs heavy, especially in anaemic girls, whose faces are yellow, skin dry and shriveled, and menses scanty or checked. Men- tal emotions cause such weakness that one or more limbs are useless. 700 A CUNICAL MATERIA MEDICA. Sometimes Kali card, follows in menstrual difficulties. It may bring on the menses when Natrum mur. fails. While on this subject of the nerves we may as well add the remain- ing symptoms: spinal irritation; backache relieved by lying on some- thing hard; small of back pains, as if broken; paralyzed feeling in lumbar region, worse in the morning after rising; tongue stiff, clumsy speech; joints weak, especially the ankles, worse in the mornings. This last symptom accompanied by imperfect nutrition, growing thin in spite of good appetite, has led to the successful topical and internal use of salt in children with weak ankles; the feet turn under while walking. Now, in mental symptoms, Natrum mur. runs against several drugs. One of these is Pulsatilla, which is the most lachrymose remedy of our materia medica. But Pulsatilla has rather a tender, yielding disposi- tion, that seeks consolation. The more you console her the better she likes it. Sepia is more similar to Natrum mur. than is Pulsatilla, in that both remedies have this low-spiritedness and vehement angry disposition combined. Both have Indian-like hatred of those who have injured them. In fact, these remedies are complementary to each other. The Sepia patient, however, has marked indifference to her household affairs. The patients who suffer from these mental symptoms calling for Natrum mur. are generally chlorotic. They suffer from leucocy- thsemia. The menses are often late and scanty, or else cease altogether. When the menses have not entirely ceased and are scanty they are ac- companied by such marked symptoms as these: decided increase of the sadness before menses; palpitation of heart, which, too, is apt to be of this fluttering variety, and throbbing headache, which headache con- tinues persistently after the menstrual period. The Natrum mur. patient frequently suffers too from uterine displacements. She has quite characteristically prolapsus uteri, which is induced particularly when she gets up in the morning. The symptom reads, ' ' When she gets up in the morning, she must sit down to prevent prolapsus." This is a functional disease altogether. There is no organic change in the uterus, but there is great relaxation in the ligaments which support that organ. As she arises in the morning, relaxed instead of refreshed after her night's sleep, the uterus falls and she has to sit down to prevent this dragging. You will find these uterine symptoms NATRUM MURIATICUM. 70I accompanied by backache and decided spinal irritation, which is greatly relieved by lying flat on the back or by pressing a pillow firmly against the back. That I have confirmed over and over again as an excellent indication for Natrum mur. In addition, you will have a characteristic symptom of the bladder that is just as often present as is the prolapsus itself, and that is, cutting in the urethra after urina- tion. That symptom, I have seen successfully applied many times. Backache and morning aggravation are symptoms which will aid you in the selection of Natrum mur. Natrum mur. produces a headache, worse from any use of the mind. In the morning on awaking, there is throbbing, mostly in the fore- head, as if from many little hammers beating in the head. This, too, is worse from any use of the mind. The pain is so severe at times as to make the patient almost maniacal. With this kind of headache, the tongue is dry and almost clings to the roof of the mouth, although it may look moist when put out. There is great thirst. The pulse is almost always intermittent. This helps you to distinguish it from its complement, Sepia, which has a similar symptom. I do not want you to forget that sharp headache of Sepia, in the lower part of the brain, apparently in the meninges, shooting upwards. The patient can bear neither light nor noise. The pain is usually attended with nausea and vomiting as a secondary symptom. This headache of Natrum mtir. resembles that of Arsenic, Veratrum album and China, none of which however have the accompanying dry tongue and intermittent pulse of the former. Natru??i mur. also produces a headache simulating that of Bryonia; sharp stitching about the head and sore bruised feeling about the eye- balls, especially when the eyes are moved. I may say that these head- aches of Natrum mur. are particularly common in school children at the age of ten or eleven. Calcarea ostrearum is also a good remedy here. You may have occasion to use Natrum mur. in ciliary neuralgia, especially when the pains are periodical, returning from sunrise to sun- set, being worse at mid-day. Spigelia is a drug which also has headache or ciliary neuralgia, coming and going with the sun and worse at mid-day. The eyes feel too large. Gelsemium and Glonoin have not so much neuralgia as throbbing in the head, which grows worse with the sun. 702 A CLINICAL MATERIA MKDICA. Natrum mur. also causes headache with partial blindness; here it re- sembles Kali bichrornicum, Iris and Causticum. Natrum mur. has a very powerful influence on the various portions of the eyes. Now all over the body, the drug produces weakness of the muscles. This is especially manifest in the muscles of the eyes. The muscles of the lids feel stiff when moving them. Letters blur and run together when looking steadily at them, as in reading. You see that there is marked asthenopia. Natrum mur. is especially indicated when the internal recti muscles are affected. These asthenopic symp- toms depend upon a general break-down. The spine is weak and irritated, digestion is slow and imperfect, and nutrition is not as rapid or as complete as it should be. Another form of eye disease in which Natrum mur. is indicated, is scrofulous ophthalmia. You will be called upon to use the drug in such cases when nitrate of silver has been abused. There are smart- ing and burning pains and a feeling as of sand beneath the lids. The tears are acrid and there is very marked spasmodic closure of the eye- lids. You can hardly force them apart. Ulcers form on the cornea. The eyelids themselves are inflamed and agglutinated in the morning. In addition to these eye symptoms, these scrofulous children suffer from eruptions particularly marked at the border of the hair. Scabs form on the scalp and from these there oozes a corrosive matter. There are moist scabs in the angles of the lips and wings of the nose, and with these, emaciation. In scrofulous ophthalmia you should compare with Natrum mur. , Argentum nitricum, Arse?iicum and Graphites. For scabs in the corners of the mouth and wings of the nose, com- pare Antimonium crudum, Graphites and Causticum. Natrum mur. also causes half -sight. Here you should compare Aurum, Lithium carb., Lycopodiwn and Tita?iium. Natrum mur. acts on the mucous membranes. We find it indicated in catarrhs with mucous secretion abnormal in quantity rather than in quality. This hypersecretion of mucus is accompanied by paroxysms of sneezing. Fluent alternates with dry coryza. Every exposure to fresh air gives the patient cold. The wings of the nose are apt to be sore and sensitive. There is almost always in the Natrum mur. catarrh loss of smell, and in the acute, frequently loss of taste. Natrum mur. is one of the best remedies for hawking of mucus from the throat in the morning, when the symptoms call for no other remedy. NATRUM MURIATICUM. 703 The tonsils are often very red. The uvula is elongated, probably from relaxation of its muscles. There is a constant feeling as of a plug in the throat and the patient chokes easily when swallowing. The tongue is coated in insular patches. The cough arises from the accumulation of clear mucus in the poste- rior nares, pharynx and larynx. Of course, there is hoarseness. An- other form of cough calling for Natrum mur. y is cough arising from tickling in the throat or at the pit of the stomach. This kind of cough is accompanied by bursting headache, here reminding one of Bryonia, and sometimes, by involuntary spurting of urine, as we find under Scilla and Causticum, and often, too, by stitches in the liver. Natrum mur. has marked action on the male genital organs. It causes great weakness of these, giving rise to seminal emissions dur- ing sleep. These are followed by debility and great weakness. The genital organs are greatly relaxed. Wet dreams may even occur after coitus. That may seem to you an anomalous symptom, but it is not. During the act of coitus, erections are not strong and the ejaculation of semen is weak or even absent. The consequence is, there is not an entire emptying of the seminal vesicles. There is still irritation re- maining there. When the man goes to sleep, this irritation, by reflex action, excites lascivious dreams. As consequences of the excessive seminal loss, we find backache, night-sweat, weakness of the legs and the melancholy which is characteristic of the remedy. Natrum mur. is not alone among the soda salts in this class of ailments. Natrum phos. was proved by gentlemen in this college. They had seminal emissions every night. At first, there seemed to be erethism with lascivious dreams, but later, emissions took place, one or two in a night, without any sensation whatever. These were followed by weak- ness of the back and by trembling of the knees, which felt as though they would give way. You will find, too, that gonorrhoea is curable by Natrum mur., espe- cially when chronic. The discharge is usually clear, though it may be sometimes yellowish. There is well-marked cutting in the urethra after urination. Natrum mur. is especially indicated in cases that have been abused by the nitrate of silver. Nutrition is greatly impaired under Natrum mur. as I have already told you. Emaciation is marked in almost every case in which it is the similimum. We may make use of this fact in children who suffer from marasmus from defective nourishment. They are thin, 704 A CLINICAL MATERIA MEDICA. particularly about the neck. They have a ravenous appetite and, despite this, they grow thin, at least they do not grow fat. Here you find it comparable with Iodine, but the peculiar emaciation of the neck, disproportionate to that of the body, is sufficient to distinguish it from that drug. In addition to this, you may have, at times, well-marked thirst. The child craves water all the time. This is what the laity term inward fever. There is constant heat and dryness of the mouth and throat, which the water relieves. If there is constipation when Natrum mur. is the remedy, there is a very characteristic stool, hard, difficult to expel, Assuring the anus and, as a consequence, there is bleeding with the stool. Of course, smarting and soreness is the result of the laceration from this large stool. Veratrum album has emaciation about the neck, especially in whoop- ing-cough. Lycopodium has dwindling of the upper part of the chest. Natrum mur. , like the other salts of soda, is a first-class remedy in the treatment of dyspepsia. We find it indicated when farinaceous food, particularly bread, disagrees. The symptom reads, "He is averse to bread of which he was once fond." On the other hand, there is craving for oysters, fish and salty food or for bitter things. After eating, the patient is very thirsty. There is a distressed in- describable feeling at the pit of the stomach. This is relieved by tightening the clothing, just the opposite to Lachesis and Hepar; and precisely the same as Fluoric acid. The constipation, which I have described, causes hypochondriasis. The patient is low-spirited and ill-humored, and this mental condition seems to keep pace with the degree of constipation. When the bowels are moved, the mind is re- lieved. You must use this symptom rationally. Those who have been accustomed to taking purgative medicines will almost always feel badly if their bowels remain costive longer than the usual time. They have dull headache, nasty taste in the mouth, etc. , and when the bowels move, they feel better. Here, Nux vomica is the remedy. It is not often that undisturbed constipation produces this condition of mind, but when it does, Natrum mur. is the remedy. The rectum suffers from tenesmus with slimy discharge as in chronic proctitis. Prolapsus ani with discharge of bloody mucus and water, and burning preventing sleep; dryness and smarting of rectum and anus, with tendency to erosions of the mucous membrane. Sensation of a rough substance in the rectum and yet the bowels are loose. NATRUM MURIATICUM. 705 Constriction of the anus, faeces hard and evacuated with such exertion as to tear the anus. Chronic water}' diarrhoea with dry mouth, second- ary to dry stool. In proctitis and constipation you should compare Sepia, which has lump in rectum: sEsculus and Collinsonia, which have sensations as of splinters or sticks in the rectum. The extreme dryness of the rectum resembles Alumina, Graphites, Magnesia mur., Ratanhia, sEsculus, etc. G 'rap Jutes has mucus-coated stools; Alumina has smarting soreness; Mag?iesia mur., crumbling stools; Ratanhia, feeling of splinters of glass and fissures. We find Natrum ??iur. indicated in affections of the coarser tissues, for instance, of the skin. I have already told you how it affects the sebaceous glands. We find that it produces urticaria. The itching is very annoying. It occurs about the joints, particularly about the ankles. Wheals form on different parts of the body and these itch, smart and burn. Especially do we find Natrum mur. indicated when these symptoms accompany intermittent fever, or occur after exposure to damp cold, especially at the seaside. Exercise makes this nettle- rash intolerably worse. • Just here, we find Natrum mur. comple- mentary to Apis. Apis is an excellent remedy in the treatment of urticaria, but it is not so good, I have found, in the treatment of the chronic form of the disease. Here we have to use other drugs, as Natrum mur., and above all, Calcarea ostrearum. There is another form of eruption yet to be thought of for Natrum mur., and that is herpes. Thus, we find particularly characteristic of Natrum mur., what are called hydroa-labialis. They are little blisters which form on the borders of the lips and which accompany every marked case of chills and fever indicating Natrum mur. They are akin to what are commonly known as fever blisters. Hepar, Natrum mur. and Rhus tox. are the remedies which have this symptom most marked. Arsenicum also has it. In the very beginning of these cold sores, the application of camphor will stop the trouble. If, however, they are well advanced, Hepar relieves them and prevents their return. Camphor is not a curative remedy, but Hepar is. Herpes circinatus, a variety of ring-worm, calls for Natrum mur. Other remedies for this trouble are Sepia, Baryta carb. and Tellurium. Another form of eruption calling for Natrum mur. is eczema, which appears in thick scabs, oozing pus, and matting the hair together, a crusta lactea in fact. 45 706 A CLINICAL MATERIA MEDICA. Lastly, I come to speak of the well-known application of Natrum mur. to intermittent fever. There it shares the honors long accorded to Cinchona and Arsenic. Natrum mur. is to be considered when the chill comes characteristically between ten and eleven a. m. The chill begins in the small of the back or in the feet. It is accompanied sometimes by thirst, and by aching pains all over the body. Some- times urticaria complicates the case. Fever is usually violent. Thirst increases with the heat. The headache becomes more and more throb- bing. So severe is this cerebral congestion at times that the patient becomes delirious. By and by, sweat breaks out quite copiously and it relieves the headache and also the other symptoms. This is the in- termittent fever curable by Natrum mur. When chill occurs at ten a. m., as a result of hectic fever or phthisis, Stannum is to be used and not Natrum mur. Natrum Arsenicatum. Natrum arsenicatum, or the arseniate of soda, affects markedly the mucous membranes, producing dryness and sensitiveness to dust, smoke and even to the indrawn air, and later the secretion of tough, gluey mucus, crusts, etc. This property of the drug has led to its use in catarrhs of the respiratory passages. It is indicated in a coryza which, as you will observe, resembles somewhat that of the parent arsenic. There is a copious discharge of watery fluid from the nose, and yet the nasal passages feel stuffed up. This is accompanied with dull, supra orbital headache, compressive pain at the root of the nose, dry- ness and smarting of the eyes, injected conjunctivae, flushed and puffy face and dryness of the throat. There is sometimes a good deal of sneezing, which is provoked by the least draft or inhalation of cold air. All these symptoms are worse in the morning and forenoon. This continues until the mucous secretion becomes thicker. Tough, yellow or yellowish grey mucus drops down from the post-nares into the throat, or hard, bluish mucus is blown from the nose every morn- ing and its removal is followed by bleeding. At night and in the morning the nose is stuffed up so that the patient breathes with mouth open. Looking at the throat, you will find it dark red, swollen, and cov- ered with yellow gelatinous mucus which gags the patient when he attempts to hawk it out. NATRUM MURIATICUM. 707 As the ' ' cold ' ' creeps downward a dr5^ cough supervenes. There is a sensation of oppression in the chest and of stuffiness as if the lungs were full of smoke. Soreness in the supra-clavicular regions and pain over the fourth and fifth costal cartilages of the right side. The oppressed feeling in the chest has this peculiarity: it is better when the patient urinates freely, and it is aggravated by dust or smoke. You may use the remedy in bronchitis when the above S3^mptoms are present, or even in graver forms of disease. It maybe of great service in tuberculosis, with emaciation, dry heat of the skin, chilliness at night and thirst for small quantities of water frequently repeated. Lastly, I have to speak of the use oiNatrum arsenicatuni in psoriasis. It should be classed here with Arse?iicum, Arsenicum iodatu??i and Sepia. The scales are thin and whitish and when removed leave the skin slightly reddened. The eruption is apt to appear on the chest and itches when the patient warms up from exercise. LECTURE LXIX. BORAX VENETA. ( Staphisagria, Mercurius. Borax. < Sepia, Pulsatilla. ( Bryonia. > Chamomilla, Coffea. \ Vinegar. / Wine. Borax is the biborate of soda. As a medicine, it won its first laurel in the nursery, where it has long been used in the treatment of sore nipples and children's sore mouth. Like all popular remedies, it has been greatly abused. Homoeopathy has rescued it from the nursery and now offers it to the profession as a medicine of great value, telling when it may and when it may not be used. Underlying this sore mouth, which seems to be the keynote for the use of Borax, is a system or constitution which will permit of the sore mouth, that is, an illy- nourished system. Thus the infant becomes pale or of an earthy hue, its flesh grows soft and flabby; it cries a great deal when it nurses, screams out during sleep and awakens clinging to its mother as if frightened by a dream. It is excessively nervous, so much so that the slightest noise, the mere rustling of paper, as well as a distant heavy noise, will arouse and frighten it. This nervous excitability qualifies the pains. For instance, in the earache, you will find that each paroxysm of pain causes the child to start nervously. The ear- ache is accompanied by soreness, swelling and heat of the ear, just as you find in Belladonna. Pulsatilla and Chamomilla. There is a mucous or muco-purulent otorrhcea. Borax is distinguished from these remedies by this starting with the pain or from slight noises, by the paleness of the face and above all by another well-proved symptom, the dread of downward motion. Thus if the little one is sound asleep in its mother's arms and she makes the attempt to lay it down in its crib, it gives a start and awakens. If she attempts to carry it down stairs, it will cling to her as if afraid of falling. This must not be con- founded with the excitability of other medicines, as Chamomilla and BORAX VEXETA. 709 Belladonna. It is not simply the motion that awakens the child, for the child will not awaken if it is moved without any downward motion. It must, then, be the downward motion that arouses it. The reason for this is, that the child is suffering from cerebral anaemia and this downward motion causes a feeling as though it were going to fall. This symptom may also be utilized in adults, as, for example, in the case of invalids who have been ordered to take horseback rides, but who cannot do so, because when the horse lets them down, they feel as if they were in torture. You will also find that ladies, after some exhausting disease, cannot use a rocking-chair, because when they rock backwards, they feel as if they would tumble. The digestion in the Borax case is impaired, as you might infer from the defective nutrition. Colic precedes the diarrhoea in the child I am describing. The stools are usually green, or they may be soft and yellow, but they always contain mucus. Here you have another illus- tration of the affinity of Borax for mucous membranes. Aphthous in- flammation of the mouth appears as a concomitant of the diarrhoea. Aphthae form in the pouches on the inside of the cheeks, on the tongue and in the fauces. The mouth is hot, which the mother notices when the child takes hold of the nipple. The mucous membrane around these aphthae bleeds easily. The child lets go of the nipple and cries with pain and vexation, or else refuses the breast altogether. Similar to Borax are the following remedies: first, Bryonia; this remedy has caused and has cured infants' sore-mouth. But the char- acteristic symptom in Bryonia is this: the child refuses to nurse or makes a great fuss about it, but so soon as its mouth is moistened, it takes hold of the nipple and nurses energetically. Is not this in keep- ing with the character of Bryonia? Those of you who know anything of that drug will remember how dry the mouth is, and how devoid of secretion is the mucous tract. Hence, when the mucous membrane of the mouth is moistened the child nurses at once. Mercurius comes in as a substitute for Borax when, with the sore mouth, there is profuse salivation. Water dribbles from the child's mouth. The diarrhoea is accompanied by well-marked tenes- mus. These are sufficient distinctions between Mercury and Borax. Again, you must remember a neglected remedy, and that is sEthusa cynapium, or the fool's parsley. This is to be preferred when the colic and crying are accompanied by the violent vomiting characteristic of this drug. 7IO A CUNICAI, MATERIA MEDICA. Another remedy is Arum triphyllum. This is readily distinguished from Borax by the violence of the symptoms. The inflammation of the mouth is exceedingly violent and is accompanied by soreness and scabs around the mouth and nostrils. Another common baby symptom in the Borax case is that the infant screams before urinating. The urine when passed is hot and has a peculiar pungent foetid odor. Now this is not to be confounded with gravel, which is not uncommon in little children, and which will call for Sarsapari/la. Lycopodium, Benzoic acid, etc.; but it is the equivalent of the inflammations of other mucous membranes, so that it compares with Aconite, Cantharis and another excellent baby medicine, Petrose- linum. Do not forget this last named drug. It is not generally men- tioned in our materia medicas, yet it is an excellent remedy for condi- tions very similar to those calling for Borax when there is sudden violent urging to urinate. It may be indicated even in gonorrhoea when this sudden urging is present. Passing from child to adult, we find that although the aphthous condition is still master, we still have many of the other symptoms of Borax, the same difficulty in digesting food, the same weakness, and the mucous membranes still the point of attack. We find, for instance, the conjunctiva, particularly the palpebral portion, affected by Borax, giving you soreness especially marked along the borders of the lids. The eyelashes grow inwards instead of outwards and irritate the eye- ball. You should remember it as a remedy which will sometimes help in trichiasis or " wild hairs," and here you should compare it with Graphites. The nostrils ulcerate in the Borax case, causing a great deal of sore- ness, pain and swelling of the tip of the nose. On the mucous membrane of the throat we find Borax having an action, being indicated, like all the soda salts, for accumulation of mucus there. But under Borax, the mucus is tough and difficult of detachment. The leucorrhoea of Borax is clear, copious and albuminous. Like all the other secretions of Borax, this, too, has an unnatural warmth or heat to it. The action of Borax on the lungs must not be forgotten. We find it indicated when there is cough which is accompanied by sharp stick- ing pain, worse through the upper part of the right chest. So sharp are these pains that they make the patient catch his breath. The BORAX VENETA. 7II expectoration has a sort of musty, mouldy odor and taste. You can often use Borax in lung troubles and even in phthisis when these symptoms are present. Lastly, we have to mention a few symptoms of the skin. The skin is unhealthy ; every little cut or scratch suppurates readily. There is itching of the skin, particularly on the backs of the fingers, here being something akin to the dorsal eczema of Natrum carb. Little ulcers form about the joints of the fingers. The best remedy we have for these small ulcers about the joints is Sepia. Lastly, Borax has been used in erysipelas of the face, particularly of the cheeks. The distinctive character of the drug is a feeling as though there were cobwebs on the face. I would advise to caution your nurses, if you can do so, not to use powdered borax every time the child has a sore mouth. It may do harm if it is not indicated. I think that I have noticed after this use of the drug that the bowels suffer and the child grows paler and dwindles rapidly, which it did not do before the meddlesomeness of the nurse. LECTURE LXX. SALTS OF POTASH. Toxicologic ally, potash may be of some interest to you when, by accident, caustic potash is swallowed. Its great affinity for water makes it attack the tissues with great avidity, producing very deep escharotic effects. It has more power to penetrate the tissues than have some of the other caustics, nitrate of silver, for instance ; hence, it has been selected as the caustic for use when it is desired to reach far into the parenchyma of a part, as in the treatment of carbuncle ; when a large portion of tissue has become gangrenous and a slough must be produced, caustic potash is used. The tissues thus acted upon have a greasy appearance, which is due to the formation of a soap made from the combination of the fats with the potash. Thus it differs materially in its action from the mineral acids, which make the tissues dry and dark, almost like a mass of tinder. When swallowed by accident, for it is seldom used for suicidal pur- poses, the effects of caustic potash are violent. It causes such violent contraction of the stomach that what little of it gets that far is imme- diately ejected by violent vomiting. If the amount of caustic taken is sufficient, it causes a brownish film over the mucous membrane, or there may be spots here and there in the mouth and throat which are denuded of their epithelium. The inflammatory process may increase to such an extent that these spots ulcerate, and as they heal they form cicatricial tissue with the subsequent unfortunate contraction and stricture of the part. The antidotal treatment to such accidents is both chemical and mechanical ; chemical, to relieve the effect of the drug, and mechan- ical, to relieve the trouble that remains. Vinegar, lemon-juice and large draughts of mucilaginous drinks are mostly relied upon to relieve the acute symptoms of this poisoning. But there are many cases of slow poisoning with the potash salts, particularly when our allopathic friends use bromide of potassium so extensively. We, therefore, have the chronic effects to treat. These may require to antidote them : Hepar, which is an antidote to the metals in general ; Sulphur, and other remedies may be called for according to the symptoms present. SAI/TS OF POTASH. 713 It has been determined by experiments on mammals, that potash, particularly the carbonate, acts paralyzingly on the muscles. This ac- counts for the general weakness which belongs to all potash prepara- tions. This paralyzing effect is very manifest in the case of the heart muscle, which becomes early affected in poisoning with potash, the animal eventually dying with the heart in diastole, that is, the heart is widely dilated at the moment it ceases to beat. With this hint, you would expect to find potash salts of use in great muscular weakness, in what has been termed paresis, such exhaustion as accompanies con- valescence from protracted diseases as typhoid fever. We have it on the authority of Dr. Hering, that mushrooms contain a large percentage of potash, and are therefore to be recommended as an article of diet in cases of exhaustion. Kali Bromatum. The first potash preparation we will consider is Kali bromatum or Bromide of Potassium. We find that this drug is antidoted by Hepar mainly. It has some few analogous or concordant remedies, Ambra grisea, Hyoscyamus , Stramonium, Tarcntula and My gale. Bromide of Potassium acts mainly upon the nervous system and acts, in two opposite directions. Primarily, it decreases reflex action; secondarily, it depresses the mind. This property of the drug to modify reflex action has led to its extravagant use in the treatment of epilepsy. It is given in progressively increasing doses until the system is affected by what is known as bromism. When the system has be- come saturated with the drug, then it is discontinued for awhile. The first effect of the drug seems to be to increase reflex action, particularly reflex motor action, and it is on this quality of the Bromide of Potassium that the allopath bases his prescription. Every little disturbance in the periphery of the nerves, every little alternation in the function of an organ, is at once reflected to the nervous centres, and produces some other disturbances, either an uncomfortable sensation, twitching of muscles, anxiety, headache or even absolute convulsions. This is the first condition of the Bromide of Potassium. You know that this is the starting point of almost all convulsions. Witness, for instance, a case of eclampsia, where the pressure of the child on some of the nerves in the pelvis or against an undilating os, causes spasms; or still an- other case, where some indigestible substance in the stomach produces 714 A CLINICAL MATERIA MEDICA. convulsions. This reminds you at once of Stramonium, in which a bright light, by affecting the retina, reflects the irritation to the brain and causes convulsions, and of Strychnine, in which the slightest touch or a little draft of air, sound or odor, will renew the paroxysms. As a result of this oversensitiveness to external impressions, we have quite a number of the characteristics of the Bromide of Potassium. Many of these are symptoms of the drug calling for its exhibition in acute mania when there are sleeplessness and strange imaginations. The patient imagines that he will be poisoned ; that he is pursued by some demon ; that he is hated by everybody, or that his honor is at stake. Some such impression acts on the mind irresistibly, and causes him to resort to violent procedures ; thus, he will try to com- mit suicide in order to avoid the supposed danger. All this time, the pupils are dilated, and the face is bright red and expressive of anguish and fear. The body trembles, and the muscles twitch in various parts the body. You see how this resembles Hyoscyamus , and they are par- allel remedies in this form of disease. Kali bromatum has also acted very well in the night-terrors of chil- dren, when from over- excitement of the brain, whether it be reflex from dentition or worms, or even from affection of the brain itself, the child shrieks out in its sleep, and if old enough, will complain of see- ing hob-goblins, ghosts or something of that kind. Even when that symptom occurs in impending dropsy of the brain, Bromide of Potas- sium may be the remedy. We have another condition calling for Kali bromatum, and this seems to be an irritability of the nerves, not only of the brain, but of the whole body. This irritability is expressed by the following symp- toms : the patient is nervous and cannot sleep, and feels better when engaged at some work. He is either busy playing with his fingers or he is walking about, or in some way occupying his mind or body in some exertion; then feels better. Simple sleeplessness will not be relieved by Kali bromatum unless there is this relief from activity or motion. In this respect, I find it similar to Tarentula, which also has this irritation of the periphery of the nerves relieved by exercise and by rubbing. The patient plays with her dress, or with her watch-chain, as if to work off this over-irritation of the peripheral nerves. Even in the case of the headache of this remedy, the patient rubs the head against the pillow for relief. SALTS OF POTASH. 715 Another remedy which is similar to Kali bromatam in this over- excitability, is A??ibra gtisea, which has this same sensitiveness to external impressions, the slightest influence causing excitement and difficulty in breathing. Ambra grisea, however, almost always has some sort of vertigo associated with its other symptoms. It is also a very quick-acting drug. Conversely to this primary action of Kali bromatum, we have an- other, one of great depression of the cerebro-spinal nervous system. Thus we find it producing absolute loss of memory. The patient can- not remember words particularly. Associated with this symptom we find a distressing melancholy; everything looks dark and gloomy. He cares nothing for anybody nor for his occupation. This condition of things often follows excesses in venery, in which case Kali bro- matam is an excellent remedy. There is also a sort of ataxia developed. The patient seems to be unable to manage his legs as he should. There are numbness and tingling in the legs and in the spine; this symptom being accompanied, in the first stages, by an increase in the sexual appetite, but as the case advances it is associated with absence of erection and frequent nightly emission of semen, thus increasing the melancholy. You will find Bromide of Potassium indicated for business men who have worked long and hard, who have pored over difficult problems until they have this dizziness, this staggering gait, and this benumbed feeling in the brain. It was only yesterday that I prescribed it for a business man on Third street, who has been working himself almost to death. I expect that it will relieve him promptly and effectually. He said that when he had been working at his books he would get a numbness in the back of the head, and a certain indescribable terrified feeling, as though he were going to lose his senses. Good results might also be obtained in this case by the galvanic current, the posi- tive electrode being applied to the cervical region and the negative on the vertex. But Kali bromatum will give a more permanent relief. Now, a word about Kali bromatum as an anti-epileptic remedy. I do not believe that it ever cured epilepsy. In almost all cases in which it has been given, it has not cured but simply suppressed the disease, and thus has produced a worse condition than the one previously existing, namely, imbecility. Kali bromatum produces lesions of the skin. Its long-continued use gives rise to little, hard, dark red papules on the face, surrounded by 716 A CLINICAL MATERIA MEDICA. little vesicles and ending in suppuration. We may, therefore, use the drug in acne, particularly that resulting from masturbation. Another form of eruption which the Kali bromatum produces is a livid blotch as large as one's thumb-nail, covered with scales, and hav- ing in its centre a yellowish appearance as if it were suppurating. After a while it does suppurate and discharge, leaving a central depression, something like that of the small-pox pustule. Still a third form of eruption, is an eczema which evidently arises from the action of Kali bromatum on the sebaceous or sudoriferous glands, causing an abscess in each of these and developing a scaly eruption. Kali Hydriodicum. The Iodide of Potassium, or Kali hydriodicum, does not, like the Bromide of Potassium, act on the higher tissues of the body. It seems to affect more the lowest tissues, as the fibrous, particularly the periosteum and the connective tissue wherever they may be found. It attacks the nervous tissues ultimately, probably by involving the neuroglia. The tendency of the drug is to produce infiltration, so that when it is thoroughly indicated you will almost always find an oedematous or infiltrated state of the part affected. Some of the symp- toms produced by Iodide of Potassium are due directly to the iodine which it contains. For instance, what is known as iodine intoxication may be developed by the drug. The patient is very talkative; exhibits a great deal of anxiety about the heart; the face is flushed, the head is hot, in fact, he acts pretty much the same as one under the partial influence of liquor. The headache which Kali hydriodicum causes is one of the external head, probably from the action of the drug on the aponeurosis of the occipito-frontalis muscle, because there appear sharp lumps like nodes on the scalp and these pain excessively. This may be a remote symp- tom of syphilis or of mercurialization, or it may appear in a patient with the rheumatic diathesis. In affections of the eyes Kali hydriodicum is called for principally by the violence of the symptoms, especially in syphilitic iritis after the abuse of mecury. Now, if mercury has not been abused, I do not con- sider the Iodide of Potassium to be the best remedy. If there is any best remedy for iritis it is Mercurius corrosivus. We may also use Kali hydriodicum for inflammation involving both choroid and iris, the result SALTS OF POTASH. . 717 of syphilis. More externally we find pustular keratitis, with chemosis, especially after the abuse of mercury. Coming next to the nose, we have the following indications for the Iodide of Potassium : coryza or catarrh, occurring repeatedly in patients who have been mercurialized; every little cold or exposure, or every damp day causes the nose to become red and swollen; and acrid watery discharge flows from it, and the eyes smart and lachrymate, and be- come puffed. The patient is alternately chilly and hot, the urine is high colored (as the patient expresses it) and scanty, and there is usually some sore throat. Every exposure provokes a return of these symptoms. Kali hydriodicum also cures this thin excoriating nasal discharge when it appears as an inheritance from syphilitic parents. The ozsena which it cures is either scrofulous, syphilitic or mercurial, or a combi- nation of all these. The discharge may be either thin and acrid, or else thick, green and offensive, and attended with burning sensation in the nose and even perforation of the nasal bones. Next, the action of Iodide of Potassium on the lungs and heart. It is not a little singular that all the preparations of Mercurius produce sharp, stitching pains through the lungs (through either the right or left lung, and shooting in different directions), and that the very best antidote to mercury also produces stitching pains through the lungs, particularly through the sternum to the back; worse from any motion. Now, there are two very different conditions in which Iodide of Potas- sium is indicated by these symptoms. One of these is in pneumonia, in which disease it is an excellent remedy when hepatization has com- menced, when the disease localizes itself, and infiltration begins. In such cases, in the absence of other symptoms calling distinctively for Bryonia, Phosphorus or Sulphur, I would advise you to select either Iodine or Iodide of Potassium. It is also called for when the hepatiza- tion is so extensive that we have cerebral congestion or even an effusion into the brain as the result of this congestion. Now, the symptoms in these cases are as follows: first, they begin with very red face, the pupils are more or less dilated, and the patient is drowsy; in fact, showing a picture very much like that of Belladonna. If you are hasty, you may be led to give that remedy, but it does no good. The patient grows worse, the breathing becomes more heavy, and the pupils fail to react to light. You know then that you have a grave serous effusion affecting the brain, which must be speedily checked or 7l8 A CUNICAL MATERIA MEDIC A. the patient will die. Why did not Belladonna cure ? Because all of the symptoms were not taken into account. The trouble did not start in the brain. The cerebral symptoms are secondary to others. What, then, is the primary trouble ? You put your ear to the patient's chest and you find one or both lungs consolidated; hence the blood cannot circulate through the lungs as it should, and the different organs in the body become congested. Here then is a symptom, previously over- looked, which explains the failure of Belladonna. Until you have proved that Belladomia has produced such a condition, you cannot ex- pect it to do any good. Another condition in which we may use Iodide of Potassium is in pulmonary oedema, thus again showing the infiltration producible by the drug. This is almost always, as you know, a secondary trouble. The expectoration looks very much like soapsuds, but it is apt to be a little greenish. We may also have Kali hydriodicum indicated in phthisis pulmo- nalis, particularly if there are present this same sort of frothy expecto- ration, night-sweats, and loose stools in the morning. The cough is of a violent racking, tearing character, and is worse in the morning, thus keeping up the tendency of the potash salts, to have aggravation of the chest symptoms from two to five o'clock in the morning. I may say that these symptoms of the lungs are often consecutive to Bright' s disease, in which disease Kali hydriodicum may be the remedy. Yerba santa is used by eclectics for phthisis of catarrhal origin. It is used empirically. There is a gentleman who has a tendency to catarrhal asthma, with thickening of the bronchial tubes and constant oppression of breathing. I treated him for a year. Sulphur seemed to be indicated, but was given with only partial relief. Finalty, I gave him Yerba santa in the tincture. It so far relieved him that every morning he coughed up a quantity of sputum, and there then followed a freedom of breathing he had not had for years. The action of Kali hydriodicum on the heart is also characteristic. It produces a horrible smothering feeling about the heart, awakening the patient from sleep and compelling him to get out of bed. This symptom is also found under Lachesis, Kali bichromicum y Lactuca, Euphrasia, Graphites, and some others. It is also useful for repeated attacks of endocarditis or pericarditis of rheumatic origin. There are sharp, darting pains in the heart, worse from any motion, and particularly bad from walking. SALTS OF POTASH. 719 In disease of the spine you will find Kali Ziydnodieum indicated by these symptoms : feeling as if the small of the back were being squeezed in a vise ; bruised pain in the lumbar region and difficulty in walking: spinal meningitis with oedema or exudation, particularly when of syphilitic origin. When gummatous tumors involve the nervous tissues Iodide of Potassium is your only hope. It may also be of use when rheumatism involves the spine and para- plegia results. In these cases I think that it is the neuroglia that is attacked. It may still further be used in rheumatism of the joints, particularly of the knee. This knee-joint is swollen and has a doughy feel ; here, again, you see the tendency of the remedy to produce infiltration of tissue. There is no fluctuation to be detected. The skin above the inflamed joint is apt to be spotted, and the pains are of a gnawing, boring character, and are worse at night. In sciatica you may give Kali hydriodicum when the pains are worse at night, and from lying on the affected side, and when the trouble is of mercurial or syphilitic origin. You will find that the Iodide of Potassium will sometimes help you in the treatment of the so-called contracted kidney, especially when of mercurial origin. Iodide of Potassium, like all the potash preparations, produces an eruption of a papular or of a pustular character. Especially do these appear on the scalp and down the back ; when they heal they leave a cicatrix. You may also remember Iodide of Potassium as a remedy for tertiary syphilis, particularly rupia. The best antidote to Iodide of Potassium is Hepar.' LECTURE LXXI. KALI BICHROMICUM. Today I shall lecture on Kali bichromicum, or the Bichromate of Potash. You would expect in a drug having the combination of this one, to obtain not only the results of potash, which forms the base of the salt, but also the modifying influence of the chromic acid. You will find, therefore, that while there are evident general resemblances to the other Kalis, there are decided differences arising from the acid combined with it. Chromic acid, as you probably well know, is a highly irritating acid. It is a powerful escharotic, destroying animal tissue very rapidly, and penetrating quickly into the part, and so pro- ducing a deep ulcer or sore. Kali bichromicum is a drug which acts generally, although not ex- clusively, on fat persons, and fat, chubby children more than on adults. We find that it possesses great virtues in inflammation of mucous surfaces, with tendency to plastic exudation and pseudo-mem- brane. It attacks mucous membranes, causing at first inflammation of these, violent in character and associated with a great deal of red- ness and swelling, and at first a production of an excessive amount of mucus, from over-action of the muciparous glands. This excessive mucous secretion is very rapidly turned into a fibrinous exudate ; hence there is a tendency to the formation of false membranes. This character of the exudation on mucous surfaces gives us the well-known characteristic of the Bichromate of Potash, discharges are ropy and stringy. This S3miptom is true of the coryza, it is true of the discharges in pharyngitis and laryngitis, and it is true of the vomited matters in gastric catarrh. It also applies to the leucorrhcea and also to the gleety discharge from urethra, which may sometimes call for Kali bichromicum. Illustrations, then, of this general charac- teristic of the drug are not wanting in any part of the body. We find this same quality of the mucous discharges even in scrofulous children, for whose diseases Kali bichromicum is often an excellent drug. For instance, it is indicated in inflammation of the middle ear, particularly when it affects the membrana tympani. There is ulceration not only of the membrana tympani, but also of the mucous surface of the middle KALI BICHROMICUM. 721 ear. The distinction between Kali bichivmicum and other remedies in these cases is that the discharge is tenacious, stringy and purulent. With this there will be earache, with pains of a sharp stitching character which shoot up into the head and down into the neck. You will find the glands of the neck swollen and also the parotid gland on the affected side. This becomes large and indurated, and pains shoot from the ear down and into the swollen parotid. In these stringy discharges compare Alumen, Senega, Kali carb., Asafcetida, Coccus cacti, etc. In diseases of the mucous membrane of the throat we find this same character to the exudation. Thus, in diphtheria, we find Bichromate of Potash indicated under two or three contingencies. It may be a remedy when diphtheria assumes the croupous form. The membrane is quite thick, and is dicidedly yellow-looking, like wash-leather. The tongue is coated yellow or is red, dry and glossy; pain in the throat extending to the neck or shoulder.; swollen cervical glands; well defined slough in the throat. The discharges, whether coming from the nose or throat, or both, are decidedly stringy. This has been, in nry mind, a sufficient distinction between Kali bichromicum and the Iodides of Mercury. When I am giving Iodide of Mercury in diphtheria, as soon as I find that the expectoration becomes stringy I change to Kali bichromicum because it suits that condition, and also because it may prevent the extension of the disease to the larynx. Although, in general, Kali bichromicum is suited to rather sthenic types of inflam- mation, yet we have indications enough to prove that it may be suited to the adynamic cases also. So far as our knowledge of this drug goes it does not produce many neurotic symptoms or blood changes, but what few are recorded belong to weariness, sleepiness and prostra- tion, etc. , and at times, especially if there is gastro-enteric inflammation, there is cold sweat, lowered temperature, pale sunken face, showing that the drug may suit actual collapse and cases of asthenic type. The Iodide of Mercury is to be thought of in diphtheria when the membranous deposit is more or less profuse, involving the tonsils and posterior nares. The glands in the neck are swollen. The tongue is coated dirty yellow. There is excessive production of mucous in the throat, causing a great deal of "hawking." Carbolic acid and Kali per man ganicum are kindred remedies in diph- theria. Both have putridity well marked, the former associated with burning pains in the mouth to the stomach, or little or no pain, dusk} T 46 722 A ClvINICAL MATERIA MEDICA. red face, pale about the mouth and nose, rapid sinking of vital forces; the latter with painful throat, soreness of the muscles of the neck. We find Kali bichromicum indicated in forms of inflammation of the throat other than diphtheritic. Thus, it is called for in follicular pharyngitis. The follicles of the throat become hypertrophied and look like little tubercles on the pharyngeal walls. These discharge a white cheesy-like mass, which, when crushed between the fingers, gives forth a foetid, disagreeable odor. These are attended by a feeling of roughness and dryness in the throat, and at times by an accumula- tion of tenacious mucus. You will find this disease a stubborn one to treat. In addition to Kali bichromicum, it will be well enough to remember Hepar, Kali chloricum (especially when there is a great deal of foetor of the breath) and /Esculus hippocastanum , or the horse- chestnut. sEsculus resembles Kali bichromicum very closely, but lacks the tenacious stringy mucus. There is dry, rough, burning feeling in the throat and pharynx and yet no swelling. The face is sallow and digestion is slow. There is tendency to portal congestion, as shown by deep throbbing in the hypochondrium, and constipation and haemor- rhoids. In other cases you will have Nux vomica indicated by well-known symptoms, which I need not here repeat. Still other cases call for Secale cornutum, which has hawking up of these little follicular exudates; Sulphur, Hepar, Ignatia, Mercurius jod. t also Chimaphila maculata, which produces swollen tonsils, and tensive pain in the throat on swallowing. We have Kali bichromicum indicated in yet another form of throat disease which is neither scrofulous nor croupous nor diphtheritic, but syphilitic. Ulcers form on the fauces and tend to perforate. The sur- rounding mucous surface is of a coppery-red color. It is also indicated in nasal catarrh. It produces, at first, dryness of the nasal mucous membrane, with tickling in the nose and sneezing, these being especially marked in the open air. The secretion from the nose is ropy and stringy, and often collects in the posterior nares. It may or may not be offensive. In catarrh of the post-nares compare Spigelia, Hydrastis, Natrum sulphuricum. The latter hawks up saltish mucus every morning. At other times, as in ozsena, there are discharges from the nostrils or posterior nares consisting of plugs, or clinkers, as they are sometimes called. Lumps of hard green mucus are hawked from the posterior KALI BICHROMICUM. 723 nares, particularly in the morning. At other times (often in syphilitic cases) you will find ulcers which carry out the perforating character of Chromic acid, and tend to perforate the parts on which they are located. Kali bichromicum is indicated in true membranous croup. It suits best, although not exclusively, light-haired, fair-complexioned chil- dren who are rather fat and chubby. The cough has a decidedly metallic sound. It has more than the mere bark of catarrhal croup. The fauces you will generally find quite red; the tonsils, perhaps, are somewhat red and a little swollen. The cough seems to descend; that is, the rattling goes down lower and lower until it apparently reaches the upper part of the epigastrium, or rather the lower third of the sternum, the irritation of the cough seeming to start from there. In this position, as well as in the throat, there seems to be a smothering, oppressive sensation; breathing becomes very labored. The child has smothering spells, arousing it from sleep, choking. The whole chest heaves with the efforts at respiration. The membrane forms quite thickly in the larynx, narrowing its lumen. The expectoration is tough and stringy, and, perhaps, mucous, and contains pieces looking like boiled macaroni. The patient is worse in the morning from three to five o'clock. Sometimes there is a tendency in these cases of croup to extend downwards and involve the trachea, and even the bronchi, giving rise to what has been termed croupous bronchitis. This is not a very common disease, but it is an exceedingly dangerous one. I remember treating a patient who, after taking Kali bichromicu?n, expectorated pieces looking like vermicelli and having numerous little branches, probably casts of the ramifications of the bronchial tubes. One of the remedies following Kali bichromicum well in the throat and croupous diseases is Lachesis. It suits particularly when the spasmodic cough becomes so violent as to cause choking spells, and when the patient drops off to sleep, he awakens as if smothering. Kali bichromicum has modified the inflammation, but has not succeeded in preventing spasm of the throat. Then Lachesis comes in and relieves the remaining symptoms. Should the croupous symptoms increase, you ma3- return to Kali bichromicum. There is also a resemblance between Mercurius cyanatus and Kali bichromicum in diphtheritic croup. Kaolin is very useful for membranous croup when it extends down- wards, and when one of the characteristic symptoms is intense soreness along the trachea and upper part of the chest. 724 A CLINICAL MATERIA MEDICA. The mucous membrane of the stomach, too, falls under the influence of Kali bichromicum . The drug is so irritating that it causes gastritis. Thus it produces gastric symptoms varying in severity all the way from those of simple indigestion to those of malignant disease of the stomach. In the milder forms of dyspepsia we find it indicated when there is headache, the pain usually being supra-orbital. This may be periodical in its return, but is particularly excited by gastric irritation. Although it is neuralgic in its character, it is reflex from gastric irrita- tion. Another form of headache which is associated with these gastric symptoms is one of a peculiar kind. The patient is affected with blindness more or less marked, objects become obscured and less distinct, the headache then begins. It is violent, and is attended by aversion to light and to noise, and the sight returns as the headache grows worse. I have met with that symptom in my practice four or five times. I have found the same symptoms precisely given under Gelsemium, but I have never used that drug under these circumstances, so I have not confirmed it. There are quite a number of remedies having blinding headache, but Kali bichromicum is the best of them. We have Causticum sometimes indicated for blindness with the head- ache, but not diminishing as the headache increases. We also find it under Natrum mur., Iris versicolor, Psorinum and Silicea. In the latter remedy the blindness comes after the headache; in Psorinum before, the sight returning before the pain begins. With this headache of Kali bich? r omicum the face is apt to be blotched and bloated, and covered with pimples or acne. It is also sallow and yellowish, as if the patient were bilious. The whites of the eyes are yellow and a little puffed. The tongue is thick and broad and scalloped on its edges, as though it had taken the imprint of the teeth. The stomach seems to swell up immediately after a full meal, just like Lycopodium. The bowels are constipated, or else there is early morning diarrhoea, as you find under Sulphur, Rzimex, Bryonia and Natrum sulph. The stools are watery, and are followed by tenesmus, which distinguishes this drug from Sulphur, Rumex, Bryonia and Natrum sulphuricum, all of which have morning diarrhoea. These are some of the gastric symptoms which will yield to Kali bichromicum. They are particularly apt to occur after excessive beer drinking. Kali bichromicum is one of the best remedies for the chronic effects of ex- cessive indulgence in beer and ale. KALI BICHROMICUM. 725 G?iaphalium is one of the little used remedies that has diarrhoea worse in the morning. The stools are watery and offensive, with nausea and vomiting. It is sometimes useful in the beginning of cholera infantum. Urine dark, scanty. Irritability of temper, con- tinuing even after the diarrhoea ceases. We also find Kali bichromicum producing gastritis, herein very much resembling Arsenicum. The vomited matter is sour, and is mixed with clear mucus. You see how Kali bichromicum everywhere excites an over-production of mucus. The vomit may be bitter from admix- ture of bile. It is renewed by every attempt at eating or drinking, and is associated with a great deal of distress and burning rawness about the stomach. With this kind of vomit you may give Kali bich- romicum in the vomiting of drunkards and in the round, perforating ulcer of the stomach. In dysentery, Kali bichromicum is sometimes indicated. The disease occurs periodically in the spring or in the early part of the summer. The stools are brownish and watery, and mixed with blood and attended with great tenesmus. The distinctive symptom is the appear- ance of the tongue, which is dry, smooth, red and cracked. In its action on the skin, Kali bichromicum causes, first of all, a rash which very much resembles that of measles. Kali bichromicum is par- ticularly indicated in measles after Pulsatilla. The latter remedy is suited for the milder symptoms, the former for the more severe. The inflammation of the eyes grows worse with the formation of vesicles or pustules on or about the cornea. The meibomian glands or other structures of the lids ulcerate, so that the lids agglutinate, and there is more or less purulent discharge from the eyes. The ears, too, be- come involved, and there is a discharge from the ears of quite offen- sive pus. There are also violent, stitching pains which extend from the ear to the roof of the mouth and to the parotid gland on the affected side. The external auditory meatus is greatly swollen. Kali bichromicum is one of the best remedies we have, when measles is asso- ciated with these ear symptoms and swelling of the glands, with sharp pains shooting from the ears into the glands. There is also diarrhoea which resembles that of Pulsatilla, but differs from the latter in the presence of slight tenesmus. The rash is the same as we find in nearly every case of measles. In a general way, we may say that it resembles Pulsatilla, only it is much worse. It has the simple catarrh of Pulsatilla, watery or more commonly yellowish green secretions, made worse and even advancing to ulceration. 726 A CUNICAL MATERIA MEDICA. We next find Kali bichromicum , like all the potash salts, producing papules. These papules are hard and tend to enlarge and develop into pustules. If the crude drug itself be applied to a slight abrasion in the skin its caustic action is severe enough to eat down to the bone. In extreme cases these pustules may even develop into deeply eating ulcers. L,upus, with severe burning pains, has been relieved and in some cases cured by this remedy. We have also developed by Kali bichromicum symptoms resembling those of sycosis. This places the drug alongside of Thuja, Pulsatilla, and Sarsaparilla. We find scabs on the fingers, often about the nails, and also on the corona of the glans penis. There is a gleet3^ discharge from the urethra, which is very often stringy, thus keeping up the general action of Kali bichromicum on mucous membranes. Ulcers looking like chancres, and tending to eat deeply rather than spread superficially, form about the glans penis and prepuce. In addition to these symptoms you must have the inflammation of the nose and throat of the character already described, w T ith perforating ulcers affecting even the bones. Kali bichromicum is also called for in inflammations of the eyes; this inflammation being rather indolent in character. There is lack of reactive power, so that ulcers form which progress slowly and show but little tendency to heal of their own accord. The same is true of the conjunctivitis, which may be of scrofulous or of sycotic origin. The lids are swollen and agglutinated, especially in the morning, with thick yellow matter, and, to keep up the indolent character of the remedy, you find very little photophobia. Sometimes we find chemosis with these cases. It is very similar to Graphites and Calcarea ostr., in the indolent ophthalmia. Graphites has more cracking of the tarsi and photophobia especially in artificial light. Calcarea and Kali bichrom. meet in fat children, leukoma, etc., only Calcarea has the photophobia, the sweaty head and large abdomen. You will find that iritis, whether syphilitic or not, may call for Kali bichromicmn . It is indicated, not in the beginning but late, when there has been exudation posteriorly between the iris and crys- talline lens, causing adhesions of these structures to each other. These exudations, if not too great, will be absorbed under the action of Kali bichromicum. Characteristic of this iritis is indolence. There is little or no photophobia and not a very decided redness attending the inflammation. This is a general hint which will guide you to Kali KALI BICHROMICUM. 727 bichromicum, and will save you the memorizing of less characteristic symptoms. Do not, therefore, forget the indolence of the ulceration, the absence or deficiency of inflammatory redness and the dispropor- tionate absence of photophobia. We next come to the action of Kali bichromicum on the chest. It is indicated in bronchitis, particularly if the glands are involved. Pos- teriorly, on either side of the spinal column, you find dullness on per- cussion. The cough is of a hard, barking character, almost as in croup. It seems to start from the epigastrium. The expectoration is generally of a stringy character. Sometimes it consists of bluish lumps, and is attended with a great deal of difficulty of breathing, arising mechanically from thickening of the lining membrane of the bronchial tubes. The cough is almost always made worse after eating, and is better when warmly wrapped up in bed. There is a great deal of feeling of tightness in the epigastrium. You must also remember Kali bichromicum as a remedy indicated in asthma dependent upon bronchiectasia. The bronchial tubes are filled up with this tough tenacious exudation. But we find Kali bichromi- cum indicated in another form of asthma, which is worse from three to four o'clock in the morning, and is especially liable to return in the winter weather or in summer time, when chilly. The patient is com- pelled to sit up in bed in order to breathe. Relief comes when the patient raises stringy mucus. This kind of asthma calls for Kali bich- romicum, whether the patient be stout or thin. If you have this after midnight aggravation and relief from sitting up and bending forward, and from the expectoration of stringy mucus, you have a certain remedy in Kali bichromicum. Here is it a perfect complement to Arsenicum , which has nearly the same symptoms, but lacks the tena- cious sputum. The low potencies have been most successful in the treatment of asthma. The high potencies have not failed, but in all of the literature that I have been able to see, the low potencies have seemed to be the most successful. Whether this is true or not, I do not know. I only give you the facts as I find them, that you may judge for yourselves. Aralia racemosa is another remedy for asthma when the patient must sit up for relief. It seems as if he would suffocate if he did not. Dry, wheezing or loud musical whistling respiration. But the ex- pectoration, at first scanty, later increases, is warm and of a saltish taste. 728 A CLINICAL MATERIA MEDICA. Lastly, I have to speak of the use of Kali bichromiaim in rheu- matism, particularly in rheumatism which occurs in spring or summer weather, when there are cool days or nights. The smaller joints seem to suffer. Thus we have pains about the fingers and wrists more than in any other part of the body. Pains wander about, suddenly jump- ing from one part of the body to another and relieved by moving the affected part. Gastric and rheumatic symptoms alternate. I have had several instances in which I have been able to confirm this char- acteristic of the drug. It is somewhat like Artemisia abrotanum, in which remedy diarrhoea and piles alternate with rheumatism. LECTURE LXXII. CAUSTICUM. Causticum is evidently a potash preparation, but its exact compo- sition I do not know. Hahnemann was not able to define it, and chemists since his time have not been able to tell of what it is com- posed. Nevertheless it is a unique remedy, and is one that we can- not do without in practice. The drug is conveniently studied under the heads placed on the board. Carbo veg. Lachesis. Causticum. <{ Coloc. Rhus, Dulc. Guaiac um. Aconite, Colch. Phosphorus. Paralysis. Spasms. Rheumatism. Mucous membranes. Skin. Organs. It has a tendency to cause paralysis and spasmodic symptoms, rheu- matism, affections of the mucous membranes, and diseases of the skin and organs generally. You will recall the fact that there is an inimi- cal relation between Phosphorus and Causticum. These remedies do not follow each other well, although indicated in the same class of diseases. This is to be remembered particularly by those who use the higher and medium potencies. The main power of Causticum is the first one on the list, the para- lytic weakness which the drug exhibits. This paralytic tendency is a genuine potash weakness. Causticum is especially suited to patients who are timid, nervous and anxious, and full of fearful fancies, par- ticularly in the evening at twilight, when shadows grow longer and fancy more rife. The child, for instance, is afraid to go to bed in the dark. This applies not to the unfortunate child who entertains these fears by reason of faulty education, but to the child who is afraid as the result of nervous disease. As an adult, the patient is apprehensive that something is about to happen, or he feels conscience stricken, as if he had committed some crime. When closing his eyes, he sees 73° A CLINICAL MATERIA MEDICA. frightful images. This is no new symptom to you, as you will recall it as belonging to several remedies. The patient, especially if a woman, is apt to be tearful and melancholy. The face is a correct picture of the mental condition, and is expressive of this low-spirited state. The face is apt to be sallow and sickly looking. The patient is either taciturn and distrustful, or is inclined to fits of anger, with scolding. This is, as you know, by no means dissimilar to Phos- phorus, and yet you must not make the mistake of giving one, when the other is indicated. Memory' fails. Any attempt at mental labor is followed by untoward symptoms, such as stitches in the temples when reading or writing, feeling of tension in the head and scalp, particularly in the forehead and about the temples. This is worse in the evening, and also on awakening from sleep. Here again it is very similar to Phosphorus, which also has that feeling of tension. The patient also has a rather odd sensation, and one that is not frequently met with, and that is a feeling as though there were an empt)^ space between the brain and the cranial bones. This is relieved by warmth. As odd as this symptom may seem to you, it is not too uncommon for you to make note of. Our materia medica is not over rich in this direction, and so we ought to utilize every such symptom that we can get. The vertigo of Causticum is that which belongs to an excited brain and spine, such as we find in the incipiency of paralysis, and even of locomotor ataxia. There is a tendency to fall either forward or side- ways. There is with this vertigo a constant feeling of anxiety and weakness of the head. It is worse on rising and on trying to fix the mind, indicating a weakened cerebral circulation. The sight is be- dimmed as though the patient were looking through a fog. Now, concomitant with these brain symptoms you have the following symp- toms, one or two of which ought to be present in order to make the picture complete. The skin in these cases is apt to be dry and hot, and there is almost always constipation, which constipation is quite characteristic. It is attended with a great deal of urging, probably from defective expulsive effort in the rectal muscular fibres, with red- ness of the face and fulness of the bloodvessels. This symptom is very common in weak persons and in children when they are nervously debilitated. Very characteristic of the drug is paralysis of single parts or of single nerves. Thus you may have to use it in paralysis oKthe facial CAUSTICUM. 731 nerve, particularly when it is the result of exposure to dry or cold winds. It may also be called for in ptosis, when the result of the same cause. Causticum is still further called for in paralysis of the tongue, when deglutition and speech are more or less destroyed, paralysis of the lips, and in glosso-pharyngeal paralysis. In this last-named disease, you cannot expect much improvement from any remedy. The larynx and the bladder may be attacked. These are illustrations of the local pal- sies which come within the range of Causticum. These paralyses ma3* be caused either by deep-seated nervous disease, or, very characteris- tically, by exposure to cold, particularly to the intense cold of winter, when the patient is of the rheumatic diathesis. Aconite, like Causticum , is useful in paralyses which are traceable to exposure to cold, especially to dry cold winds. Aconite suits well in the beginning, and Causticum more when the paralysis has become chronic and refuses to yield to the Aconite. Rhus tox. and Dulcamara compare favorably with Causticum for paralysis of rheumatic origin, provoked by exposure to a damp and cold atmosphere, particularly when there have been changes from tol- erably warm to cold and wet days. Dulcamara is suited to the begin- ning of such cases, and not when the trouble becomes chronic. Rhus tox. is suited to chronic cases. Nux vomica and Colchicum are also to be thought of in paralysis from exposure. Stammering has been cured by Causticum when caused by imperfect control of the tongue. In paralysis of the tongue, it may require to be followed by Stramonium, Dulcamai'a, Muriatic acid or Baryta car- bonica. You may also find Causticum indicated in paralysis which arises from apoplexy; it is not called for, for the immediate results of the stroke, not for the congestion, nor for the exudation, but for the remote symptoms, when, after absorption of the effused blood has taken place, there still remains paralysis of the opposite, side of the body. Causticum may be applied in diseases of children. It is suited to children of a scrofulous habit in whom, though emaciated generally and particularly about the feet, the abdomen is large and tumefied. The3 T are slow in learning to talk. There is a tendency to scrofulous inflammation of the eyes, scabs form about the tarsi ; the conjunctivae become injected, and the cornea inflamed. There is a constant feeling 732 A CUNICAL MATERIA MEDICA. as of sand beneath the eyelids. An eruption appears about the scalp, especially behind the ears, making this portion of the skin raw and excoriated. The discharge is slight in quantity and sticky in character. Often there is otorrhcea, purulent in its character. The child stumbles when it attempts to walk. The cause of this symptom will be found in disease of the brain or spine. These cases do not recover rapidly. There is defective nutrition in the whole nervous system. You must instruct your patients that hygienic measures must be observed in conjunction with medicinal, and that you can promise a cure if they will but be patient with you. Other remedies which may be thought of here are, first, Sulphuric acid, which is a good remedy for this weakness or giving way of the ankles; another is Sulphur, and still another, Silicea. Still further, as illustrating the paralytic effect of Causticum, we find it causing aphonia or failure of the voice. This may or may not be catarrhal. It is associated with great weakness of the laryngeal mus- cles, which seem to refuse their office. This is often the case in phthisis and in laryngeal troubles, whether of a tubercular nature or not. The paralytic tendency is further illustrated in the cough. The patient is unable to expectorate. Just as under Sepia, Drosera, Kali carb., Arnica and a few other remedies, the patient succeeds in raising the sputum so far, when it slips back into the pharynx. The remedy also has this as characteristic: the patient cannot cough deep enough for relief. In addition to these paretic symptoms in catarrhs, you may also add the following: rawness and burning down the throat and trachea, feeling as if these parts were denuded, and hoarseness with aggravation in the morning. At this time, also (consistent with the action of the potash salts generally), there is accumulation of mucus in the fauces and larynx. The sputum often tastes greasy and soapy. Drinking cold water relieves the cough. Accompanying the cough, we find pain over the hips, which is very characteristic, and, too, the cough is often associated with involuntary spurting of urine. This last symptom is very characteristic of Causticum. It is also found under Natrum mur., Apis, Phosphorus, Pulsatilla and Scilla, which is excellent in spurting of urine in old people. In the laryngeal symptoms, it is necessary to make a distinction be- tween Causticum and Phosphorus. One point of difference is that Phosphorus often has evening aggravation of the hoarseness; Causti- cum has aggravation in the morning. Both have this nervous causticum. 733 weakness. One sj'inptom I have often found indicating Phosphorus, and that is, extreme sensitiveness of the box of the larynx. The pa- tient dreads to cough, because it aggravates the laryngeal soreness. He dreads to talk for the same reason. Relief from cold drinks is found only under Causticum. More similar to Causticum yet, is Carbo veg. Here you can make no serious mistake, because both drugs follow each other well. If you do make the mistake of giving one of these when the other is indicated, you will not injure your patient any more than from the delay caused by your imperfect selection. Both remedies have this rawness and soreness down the throat ; both have hoarseness, Carbo veg. having aggravation in the evening and Causticum in the morning. The former is indicated after exposure to damp evening air; the latter, after dry, cold, severe winter weather. Eupatorium perfoliatum is very similar to Causticum in that it causes hoarseness worse in the morning. Both remedies are indicated in in- fluenza with aching all over the body, but Eupatorium has more sore- ness than burning and rawness in the chest. In the hoarseness of singers or those who exert their voices a great deal, Causticum resembles Rhus tox., Graphites, Arum tri. and Selenium. In some cases, when Causticum fails in chronic hoarseness worse in the morning or evening, Sulphur is an all-sufficient remedy. Still another kind of cough for which you may give Causticum is one which improves up to a certain point and then remains stationar)', getting neither better nor worse. Causticum is a good remedy for buzzing and roaring in the ears, or tinnitus aurium, when sounds reecho unpleasantly in the ears. A voice which is of an ordinary tone, sounds loud and reechoes in the ear with unpleasant confusion. When Causticum is the remedy, these symptoms may be concomitant with catarrh of the throat involving the Eustachian tube. They may also be symptoms of Meniere's disease, of which affection I once cured a case with Causticum. There are two drugs which you may compare here, namely. Salicy- lic acid and Salicylate of Soda, which have caused and cured Meniere's disease. You may also compare Carbon bisulphide and the well-known Cin- chona. When sounds reecho in the ear, think also of Calcarea ostr. and Phosphorus. 734 A CLINICAL MATERIA MEDICA. We find Causticum indicated in involuntary urination or enuresis, particularly in children. It is especially called for when the accident occurs, during the first sleep. The trouble is aggravated in the winter and ceases or becomes more moderate in summer. The urine is espe- cially liable to escape involuntarily during the day in winter, as the result of any excitement. Compare in enuresis, Plantago major and Kreosote (involuntary dis- charge of profuse, pale urine); Calcarea ostr. (fat children); Sepia, (little girls, worse in first sleep); Belladonna (nervous children); Fer- rumphos. (during the day). For nursing women we may use Causticujn when over-exertion or loss of sleep threatens their supply of milk. This makes them very low-spirited, and they are apt to have this sallow, sickly complexion which is characteristic of Causticum. Causticum may be used in spasmodic diseases, even in convulsions. Thus it may be used in epilepsy, particularly in la petit mat. When walking in the open air, the patient falls, but soon recovers. During the unconscious stage, the patient passes urine. Causticum may even be used when the attacks are of a convulsive nature, especially when they recur at the new moon. Now you are not to consider that the moon has anything to do with these epileptic attacks. It is only the laws which govern the relation of the planets, which regulate the tides and have to do with the periodicity of nature generally that also apply to the moon and to the disturbances within the human body; so it is that some symptoms are worse at new moon, others at full moon; some at the rise and others at the fall of the tide. It does not, therefore, follow, be- cause the patient is worse every time at new moon, that the moon causes the aggravation. Causticum is, moreover, indicated in epilepsy when it is connected with menstrual irregularities, and also when it occurs at the age of puberty. In these symptoms Causticum is closely allied to Calcarea ostrearum. Causticum is indicated in chorea when the right side of the body is affected more than the left. The muscles of the face, tongue, arm and leg are all involved in the disorderly movements. When the patient attempts to speak, words seems to be jerked out of the mouth. The patient is anxious and restless in bed at night. He must sit up and change his position. He involuntarily throws the head about, and finally he falls asleep exhausted. During sleep the legs and arms are constantly " on the go." Lastly, we may be called upon to use Causticum in rheumatism, causticum. 735 especially when the joints are stiff and the tendons shortened, drawing the limbs out of shape. It is frequently indicated in what has been termed rheumatoid arthritis. Rheumatic pains attack particularly the articulation of the jaw. They are worse from cold and are relieved by warmth. Causticum is also useful in rheumatism of the right deltoid, here be- ing comparable with Phosphoric acid, Sanguinaria and Ferritin. Now, you will have to distinguish Causticum here from several other remedies. Rhus tox. also has rheumatism from exposure to cold. Some of the distinctions between it and Causticum I have already given you. There is yet another good one. Rhus tox. has restlessness and relief from motion all the time. In Causticum the restlessness only occurs at night. Further Rhus is worse in damp weather, Causti- cum in dry weather. Guaiacum is to be preferred to Causticum, and follows that remedy well when, in either gout or rheumatism, there are contractions of the tendons, drawing the limbs out of shape, aggravated by any attempt at motion, particularly if there are well-developed gouty nodosities in the joints. Colocynth is to be remembered for articular rheumatism when the joints remain stiff and unwieldy. The pains in the affected parts are of a boring character. Causticum also acts on the skin, one of its most characteristic symp- toms being warts. It is useful in the cure of these hypertrophies of the papillae when they occur on the hands or face. I remember once giving Causticum to a child who had two warts on the under e3^elid. At the end of the third week after taking the remedy, there was a string of warts over the inner canthus of the other eye. I believed that these resulted from the Causticum. Of course, I stopped the medicine. At the end of several weeks more, all the warts had disap- peared, and the child has had none since. This shows you that Caus- ticum really produces and cures warts. Causticum may be called for in colic after the failure of Colocynth. The pains are of a griping, cutting character, and are relieved by bending double. Particularly do you find pains of this character suggesting the drug in menstrual colic. Previous to the menses, these colicky pains appear, and are associated with tearing pains in the back and limbs. The menses cease almost entirely at night, or continue for days after the normal time. All the sufferings cease entirely at night. LECTURE LXXIII. KALI CARBONICUM. Phos. , Carbo veg., Arsen. Ant. tart. Hypophosphite of lime, Psorinum. Caust., Senna. Natr. m. V I^Lachesis. Kali carb. < Carbo veg. To-day I will study with you Carbonate of potash, known in our nomenclature as Kali carb. This is complemental to Carbo veg. and similar to it in many forms of disease, particularly in lung inflamma- tions. Sometimes when one fails' the other completes the cure; hence the origin of the complemental relation. We have quite a number of analogues to Kali carb., some of which have been placed on the board. We will have occasion to refer to some of these as we go on. There is also somewhat of a complemental relation between Kali carb. and Phosphorus. Kali carb. exerts an influence over the manufacture of the blood, quantitatively as well as qualitatively. This is shown in the anaemia which the remedy causes. And is illustrated by the following symp- toms: frequent chilliness; every time the patient goes out of doors, he becomes chilly if the air is in the least cool, not having the normal resistance to temperature; quite consistent with this anaemia, there is throbbing in the bloodvessels all through the body. This is not plethora, but only an appearance of plethora. It is associated with local congestions which are really anaemic in origin; the blood being normal volumetrically, but is not as rich in red corpuscles as it should be. The congestion to the head is associated with humming in the ears. The patient surfers from vertigo when he turns his head rapidly, or from riding in a carriage, or from anything that diminishes, the supply of blood to the brain. He suffers from weakness of sight, especially following excessive sexual indulgence. Again, we find Kali carb., by reason of this anaemia, indicated after KAU CARBONICUM. 737 severe or protracted diseases. It thus becomes useful for the weak- ness following labor or abortion when we have the following symptoms: there is a very troublesome backache, a weak, lame feeling in the small of the back, which makes walking very difficult to the patient; the patient suffers from cough and frequent sweating at night. You find persistent discharge of blood from the uterus. The urine is loaded with urates. This latter symptom, this excess of urates, shows great waste of tissue, and is evidence of the exhaustion which Kali carb. causes and cures. You will recall that I mentioned Kali carb. as a drug which causes great exhaustion in the muscular system, and it is frequently in this kind of exhaustion that the urates are excessive in the urine. Kali carb. acts not only on the voluntary muscles, but on the heart also. The heart becomes weakened when it is indicated, and you thus have a pulse which is irregular or intermittent, or, being rapid, is very weak. Now, this character of the pulse in Kali carb. will qualify every disease in which you may use the drug. It is a characteristic of the drug which lies at the very root of its symptoms; therefore, you will seldom find Kali carb, indicated when there is a full round pulse. This condition of the urine, in which it is loaded with urates as evi- dence of exhaustion from disease, is also found under other remedies. Perhaps the best remedy in the materia medica for this symptom, other things being equal, is Causticum. Remember that this assertion is to be qualified. A symptom of this character has not the same value as a symptom of the mind would have. It is characteristic in its place, and yet, if symptoms more characteristic of the case indicate another drug, then you should not think of using Causticum. Sup- pose you have a patient whose other symptoms are those of Kali carb. , for example, a woman after confinement with backache, sweat, and other symptoms of importance, then you may give Kali carb. with confidence. But if you have a patient with no prominent symptoms, and with this excessive deposit of urates in the urine, Causticum will help you out. Still another remedy for this symptom is Senna, which is one of the best remedies in the materia medica for simple exhaustion with exces- sive nitrogenous waste. The particular combination of symptoms that we have under Kali carb., the sweat, the backache and the weakness, are found in no other remedy. It acts as well with the high as the low potencies. 47 738 A CLINICAL MATERIA MEDICA. You may also remember the Hypophosphite of Lime, which comes near to the Kali carb. in the excessive sweating, weakness and pallor of the skin. You may also remember, as akin to Kali carb., Psorinum, which, as you have already learned, is eminently useful in convalescence from disease when there is great weakness, profuse sweat and, in addition, a mental state of abject hopelessness. The patient despairs of perfect recovery. Next, let us look at the action of Kali carb. on the nervous system. Viewed mentally, the patient is excessively peevish and nervous, and is very easily startled. You often find this in women. They are startled by imaginary hallucinations; they imagine that some one is in the room or some figure comes before the mind and tantalizes them. Especially is this anxiety manifested on any noise, as the mere shut- ting of a door or window, particularly if the noise be unexpected. They are not only startled as many healthy persons would be under similar circumstances, but they are so frightened, that they are driven into a fit of trembling. You will sometimes find the intellect seriously impaired when Kali carb. is indicated. The patient does not seem to care for anything. This indifference is associated with great bodily exhaustion. When questioned, the patient, usually a female, does not seem to know exactly what to say or what she wants. The con- dition borders somewhat on that of Phosphoric acid, but still the apathy of the two remedies is not exactly the same. Kali carb. has not a sen- sorial apathy, but it has exhaustion too great to frame the answers to your questions. You will frequently find these symptoms of the mind calling for Kali carb. in puerperal mania and in puerperal fever. Again, we find that spasms may occur as a symptom of the nervous system under Kali carb. The patient does not lose consciousness dur- ing the convulsions, hence the remedy is not indicated in true epilepsy; but it may be indicated in puerperal eclampsia, the spasms seeming to pass off with eructations of wind. The spine suffers severely in the Kali carb. patient. In addition to the backache, already mentioned as the result of anaemia or of abor- tion, we have spinal irritation, which, by the way, is just as vague a symptom as is any other of a general character, as headache. You must always know what causes this spinal irritation. Does it come from loss of fluids, from brain troubles, from emotional causes, or what ? In the Kali carb. patient you will find it frequently occurring KALI CARBOXICUM. 739 with the uterine symptoms. Thus, you will have pressure in the small of the back as though there were a heavy weight pushing down there. There are also bearing down in the uterine region during the menses, burning along the spine, especially along the right side of the spine. This is not a real congestion. It is merely a subjective sensa- tion caused by irritation of the posterior spinal nerves. The backache is worse while the patient is walking. She feels so exhausted that she must drop into a chair or support herself in some way. Some- times you find, in the morning, a pulsation in the small of the back, quite akin to the pulsations occurring in other parts of the body. Here the drug is quite analogous to Sepia and the well-known Cimici- fuga. This pulsating and drawing backache is particularly relieved when the patient lies down. This suggests a comparison between Kali carb. and Natrum mur. You will recognize at once the resem- blance in the spinal symptoms, the spinal irritation, the backache and the relief from lying down. Natrum ??itir. has, particularly, relief by lying flat on the back with firm pressure. Further than this, you will find these two drugs playing into each other's hands in the treatment of amenorrhcea. Hahnemann says that Kali carb. will bring on the menstrual flow when Natrum mur., though indicated, fails. I once cured a singular backache with Kali carb. A very nervous patient came under my treatment for dyspepsia. She said to me: ' ' There is something very strange about my case. Every time I eat a meal I suffer for half an hour or more with most intense pain in the back." This was certainly an odd symptom. I did not know where in the materia medica to find it. I hunted, and found under Kali carb. this symptom: pain in the spine while eating. I gave her Kali carb., which cured her completely. On the mucous membranes, Kali carb. acts, causing quite a series of catarrhal symptoms. We may give it in coryza with hoarseness or loss of voice. The patient catches cold at every little exposure to the fresh air. This is a very strong symptom of Kali carb. The Kali carb. patient has a tendency to obesity, and is rather weak in muscular de- velopment. With the catarrhal symptoms of this remedy there often occurs a sensation in the throat as though there were a lump there which must be swallowed. The neck is stiff and the uvula elongated. There are stinging pains in the throat when swallowing just as marked as under Apis. Sometimes we have a more chronic form of catarrh in the nose ; the 74-0 A CUNICAI, MATKRIA MKDICA. nasal passages are obstructed, and the patient can only breathe with the mouth open. This obstruction is relieved in the open air, but returns so soon as the patient enters a warm room. There is either a discharge of foetid green mucus or, in the morning, the nose is swollen and red, and there is a bloody discharge. There is a sticking sensa- tion in the pharynx, as from a fish-bone lodged there, whenever the patient becomes cold. This is a good symptom for Kali card. You will find it in Allen' s Encyclopedia in large type. Now, in addition to these symptoms, there is almost always accumu- lation of mucus in the pharynx. The patient "hawks and hems" in the morning. This hawking is found under every alkali, but this one peculiarity, sensation as of a fish-bone in the throat as soon as he " catches cold," with the hawki?ig, is found under no other remedy. Hepar, Nitric acid, Alumen, Carbo veg., and Argentum nitricum all have this sensation as of a splinter or fish-bone in the throat. In coughs, we sometimes find Kali card, of use. The cough is of a paroxysmal character, and is accompanied by gagging and by vomit- ing of sour phlegm and of food. This suggests the use of Kali carb. in whooping cough, in which disease it has been very successful. Boen- ninghausen has given us a characteristic symptom for Kali carb., namely, a little sac filled with water between the upper lids and eye- brows. You will often meet with that symptom. I would warn you not to confound it with a similar condition which is in no particular patho- logical at all, and that is a certain looseness of the tissues in this locality occurring in persons advanced in years. Now for the action of Kali carb. on the lungs. We find it indicated in bronchitis, pneumonia and phthisis pulmonalis. I will give you the symptoms calling for it in these separate states as we go on. The most characteristic symptom of all, and one which runs through the symptomatology of the drug, is stitching pains which are prominently located in the walls of the chest. They are made worse by any motion, but unlike Bryo?iia } they come at all times independently of this ag- gravation. They occur characteristically in the lower third of the right lung, going through the chest to the back. They may occur all over the chest, but that above mentioned is their most frequent site. Then, too, they are erratic and wander all over the body. Here it reminds you of Kali bichromicum, Pulsatilla and Sulphur. Kali carb. is indicated in infantile pneumonia or capillary bronchitis when the following symptoms are present: intense dyspnoea; although KALI CARBONICUM. 74I there is a great deal of mucus in the chest, it is raised with difficulty. The child is so oppressed that it can neither sleep nor drink. Breath- ing is wheezing and whistling in character, and the child has a choking cough. You should here compare Kali carb. carefully with Antimo- nium tartaricum and thus determine which suits the case best. One cannot be the remedy when the other is indicated. In phthisis, Kali carb. is indicated when the constitution favors it. The patient has a bloated alkaline look to the face. There are also present these well-defined stitching pains through the chest and over the body, with the puffiness of the upper eyelids. Cough is difficult. The patient cannot get up the sputum. He raises it partly, when it slips backwards into the pharynx. Now, if you examine this expec- toration, you will find that it is often bloody, and that there are little globules of pus scattered through it. There is an aggravation of all the symptoms from three to five o'clock in the morning. This hour of aggravation belongs to all the potash salts. There is also a very stubborn sensation, namely, chilliness at noon. Kali carb. is indicated in cardiac inflammations, in endo- and peri- carditis when these sharp stitching pains are characteristic. Do not give it too soon in the case. It is not an early remedy in cardiac dis- ease. It is indicated rather late when there is a deposit on the cardiac valves. In such a case as this Spigelia is apt to precede the exhibition of Kali carb. The latter follows when the sharp pains persist and there is the characteristic 3 A. m. aggravation. We find these same stitching pains under Kali carb. in lumbago, a very stubborn form of rheumatism. The same symptom applies in cases of impending miscarriage and during labor; sharp stitching pains in the lumbar region shooting down from the buttocks into the thighs. The same kind of pain suggests this remedy in nephritis from cold, or from a blow over the region of the kidneys. Lastly, in connection with the stitching pains, I want to refer you to its application in puerperal fever of the metritic form, that is, when metritis is a prominent condition. There are sharp, stabbing, cutting pains in the abdomen, the abdomen is bloated and distended, and the urine is dark and scanty, the pulse is rapid but feeble, and you have present the state of mind described in the early part of the lecture. One more symptom and we are done with the drug, and that is its use in dyspepsia. You will find it called for in indigestion, particu- larly in old persons, in those who have lost a great deal of vital fluids, 742 A CLINICAL MATERIA MEDICA. when there is an empty, weak feeling in the stomach before eating and bloatedness after eating, especially after soup or coffee. There are sour eructations, heart-burn, and uneasy, nervous feeling when hungry. You see then that Kali carb. is a remedy indicated in a great variety of diseases. It is a drug much neglected in practice, for the same reason that many other remedies are — because the hurried and careless physician falls into routinism. INDEX OF REMEDIES. ABIES CANADENSIS prolapsus uteri, 146 ABIES NIGRA dyspepsia, 305, 350, 370 mental symptoms, 305 ABROTANUM see Artemesia Abrotanurfi ABSINTHIUM, 243 epilepsy, 420 delirium tremens, 243 typhoid fever, 243 ACALYPHA INDICA haemoptysis, 369 haemorrhages, 369 ACETIC ACID dropsy, 104 ACIDS remarks on the, 515 ACONITIC ACID, 315, 336 ACONITINE, 315 ACONITUM FEROX, 314 ACONITUM NAPELLUS, 314 abortion, 325 amenorrhoea, 674 cerebral congestion, 320 cholera infantum, 324 colic. 287, 324 conjunctivitis, 321, 397 continued fever, 316 coryza, 294, 326 croup, 323, 505, 684 diarrhoea, 324 dysmenorrhoea, 325 dysentery, 324 episcleritis, 321 eyes, 321, 397 fever, 291, 316, 318 gastric catarrh, 324 gastric fever, 291 gastritis, 324 glaucoma. 321 haemoptysis, 324 haemorrhages, 243 headache, 200 heart, 225, 322, 507, 514 hernia, 325. hypertrophy of the heart, 323, 508 inflammations, 36, 99, 316 labor, 325 measles, 174, 326, 361 meningitis, 294, 320, 407 mental symptoms, 316, 321, 409 milk fever, 325 nephritis, 325 nervous system, 315 ACONITUM NAPELLUS v Continued) neuralgia, 321, 322 paralysis, 315, 322, 731 pleurisy, 293, 323. pleurodynia, 331 pneumonia, 295, 323 poisoning, 315 pregnancy, 325 puerperal fever, 321, 325 pulse, 317 scarlatina, 325 serous membranes, 293 skin. 326 sunstroke, 320 tetanus, 180 typhoid fever, 317 worms, 246 ACTEA RACEMOSA, 327 abortion, 328 after-pains, 328 angina pectoris, 329 chorea, 74 cough, 329 dysmenorrhoea, 202, 648 eyes, 327 female genital organs, 143, 328, 356 headache, 176, 328 heart, 225 hysteria, 76 labor, 328 loquacity, 39 myalgia, 143, 327 nervous system, 76, 143, 327 neuralgia, 327, 356 phthisis, 329 pregnancy, 328 pleurodynia, 296, 329 puerperal mania, 328 spinal irritation, 329, 739 uterine diseases, 327, 356 ACTEA SPICATA amenorrhoea, 674 rheumatism, 297, 327 AESCULUS HIPPOCASTANUM back. 606 follicular pharyngitis, 722 haemorrhoids, 187 AETHUSA CYNAPIUM, 450 awkwardness, 102 colic, 710 dentition, 420 vomiting, 450, 578, 671 AGARICUS MUSCARIUS blepharospasmus, 189 chorea, 74, 79 744 INDEX OF REMEDIES. AGARICUS MUSCARIUS (Continued) delirium, 423 eyes, 203 loquacity, 39 spinal irritation, 329 torticollis, 194 AGNUS CASTUS agalactia, 356 sexual excesses, 674 spermatorrhoea, 175 AILANTHUS diphtheria, 212, 403 erysipelas, 417 hay fever, 557 scarlatina, 212, 233, 403 typhoid fever, 403 ALCOHOL diphtheria, 211 ALETRIS FARINOSA constipation, 359 neurasthenia, 359 prolapsus uteri, 146 uterine diseases, 359 ALLIUM CEPA see Cepa ALLIUM SATIVA skin, 85 ALOE SOCOTiviNA alimentary canal, 478 diarrhoea, 137, 165, 166 dysentery, 188 female genital organs, 478 haemorrhoids, 137, 187, 478 headache, 137, 187 liver, 137 prolapsus uteri, 137 ALSTONIA SCHOLARIS, 168 diarrhoea, 168 intermittent fever, 168 ALUMEN corneal opacities, 669 haemorrhage, 537 typhoid fever, 537 ALUMINA, 616 anaemia, 618 antidotal relations, 616, 620 aphonia, 619 asthenopia, 619, 655 blepharitis, 619 blood. 618 buboes, 620 chlorosis, 617, 618 complementary relations, 617 constipation, 186, 271, 461, 617 constitution, 617 cough, 619 dyspepsia, 618, 619 eyes, 131, 619 gastric symptoms, 619 glands, 620 granular lids, 619 hypochondriasis, 618 lead colic, 620, 621 leucorrhoea. 618 locomotor ataxia, 541, 618 menses, 152, 158 mental symptoms, 617 ALUMINA (Continued), 'mucous membranes, 618 nasal catarrh, 617, 619 nervous system, 195 ozaena, 617 ptosis, 131, 170, 618 skin, 620 spine, 541 strabismus, 617, 618 throat, 619, 685, 740 ALUMINUM MET. locomotor ataxia, 618 AMBRA GRISEA, 151 asthma. 152 constipation, 152 cough, 151, 152, 546, 661 epistaxis, 152 female genital organs, 151 insomnia, 151 leucorrhoea, 152 lying-in, 152 metrorrhagia, 152 nasal catarrh, 661 nervous system, 151, 195, 715 reaction, defective, 121, 151, 270, 465, 629 softening of brain and spine, 151 varices, 152 vertigo, 151 whooping cough 152 AMBROSIA ARTEMESIAFOLIA hay fever, 332 AMMONIACUM GUMMI, 4 49 asthenopia, 449 chest symptoms, 120 hysteria, 116, 120 AMMONIUM preparations of, 657 AMMONIUM BENZOICUM urine, 66 AMMONIUM CARB., 658 antidotal relation, 222, 658 asphyxia, 661 blood, 658 bronchitis, 660 cerebro-spinal-meningitis, 659 constitution, 657 coryza, 661 cough, 661 emphysema, 485, 660 heart, 601, 659 inimical relation, 658 menses, 65 mucous membranes, 658 nasal catarrh, 661 nervous system, 79 paralysis of the lungs, 582, 659 pneumonia, 659 poisoning by charcoal fumes, 659 rhus poisoning, 222 scarlatina, 659, 660 sprains, 662 scurvy, 659 uraemia, 659 AMMONIUM CAUST. aphonia. 662 coryza, 662 diphtheria, 211 INDEX OF REMEDIES. 745 AMMONIUM CAUST. (Continued). skin,, 85 AMMONIUM MUR., G62 bronchitis, 664 circulation, 662 constitution, 657, 662 constipation, 664 coryza, 661, 664 cough, 662, 664 face, 662 female genital organs, 663 heels, 663 intermittent fever, 662 joints, 663 leucorrhoea, 664 liver, 187, 664 nasal catarrh. 661 nervous system, 662 neuralgia, 662 phthisis, 664 scarlatina, 664 sciatica, 663 sprains, 663 tonsillitis, 664 AMMONIUM PHOS. gout, 656, 665 joints, 656 AMYGDALA AMARA diphtheria, 213, 414 tonsillitis, 414 AMYGDALA PERSICA, 161 AMYL NITRITE See Nitrite of Amyl ANACARDIACEAE, 217 ANACARDIUM OCCIDENTAL E erysipelas, 221 rhus poisoning, 221 skin, 85, 221 ANACARDIUM ORIENT ALE, 218 antidotal relation. 222 anus, 165 constipation, 219 coryza, 221 cough, 513 gastralgia, 497 gastric symptoms, 219 haemorrhoids, 220 headache, 219 heart, 221 hypochondriasis, 219 joints, 221 mental fatigue, 219 mental symptoms, 218, 219, 302 pericarditis, 221 pregnancy, 220 profanity, 219 rheumatism, 231 skin, 85. 220 ■spinal cord, 221 suicidal tendency, 219 torticollis, 231 typhoid fever, 218 variola, 218 vomiting of pregnancy, 220 ANGUSTURA, 180 caries of bones, 545 cough, 152 ANGUSTURA (Continued). injuries, 180 necrosis of lower jaw, 180 podarthrocace, 180 scapular pain, 282 tetanus, 180 ANILINE SULPHAT^, 479 ANISUM STELLATUM chest pains, 83, 306 phthisis, 83 ANTHRACINUM carbuncle, 80, 22,2 561 ANTIMONIUM ARSENICOSUM emphysema, 558 ANTIMONIUM CRUDUM, 577 callosities, 332, 579 complementary relations, 577 diarrhoea, 578 diphtheria, 580 eczema, 579 eyes, 580 female genital organs, 580 gastric catarrh, 351, 378, 578 gout, 580 heels, 663 lungs, 627 marasmus, 645 mental symptoms, 219, 308, 577 nails, 579 nasal catarrh, 497 ophthalmia, 217 prolapsus uteri, 580 skin, 86; 579, 702 teeth, 340 tongue, 578 vomiting, 450, 578, 671 wine, aggravation from, 632 ANTIMONIUM TART., 580 antidotal relation, 583 asphyxia neonatorum, 582 capillary bronchitis, 381, 581. 686 complementary relation, 649 cough, 270, 582, 583 croup, 505 eyes, 583 headache, 581 intestinal symptoms, 583 laryngismus stridulus, 504 lungs, 627 measles, 581, 583 mental symptoms, 581 ophthalmia, 300 paralysis of the lungs, 485, 582, 650 pneumonia, 279, 283. 295, 583 scarlatina, 581, 583 skin, 85, 581 suppressed eruptions, 303, 581 variola, 303, 581, 583 vomiting, 265, 387 whooping cough, 581 ANTIMONY remarks on preparations of, 576 APIS MELLIFICA, 98 albuminuria, 66 amenorrhoea, 112 antidotal relations, 114 aphthous sore mouth, 47 746 INDEX OF REMEDIES. APIS MELLIFICA (Continued). apoplexy, ioo. 269 asthenopia, 113 asthma, no awkwardness, 102 complementary relationships, 114 conjunctivitis, 113, 217 corneal opacities, 669 cough, in cystitis, 93 diarrhoea, 114, 166 diphtheria, 51, 95, 107, 109, 213, 413 dropsy, 66, 67. 102 dysuria, 145 erysipelas, 46, 106, 232, 417 eyes, 113, 217 face, 44 female genital organs, 112, 615, 664 fever, 317 heart, 103, no hydrocephaloid, 114 hydrocephalus, 103 hydropericardium, no hydrothorax, 103 . no hysteria, 100, 112 inflammation, 99 inimical relation, 114 intermittent fever, 70, 107 keratitis, 383 kidneys, 559 , larynx, no mammary abscess, 574 meningitis, 100, 294 mental symptoms, 99 modalities, 114 mode of preparation, 98 oedema glottidis, no oedema pulmonum, no ovarian tumor, 64, 112 ovaries, 64, 112 ovaritis, 112 panaritium, 114 paralysis, 107 pleurisy, 103, 472 poisoning by, 99 post-scarlatinal dropsy, 67 prolapsus, 64, 113 pulse, 317 relationships, 114 rheumatism, 107 scarlatina, iooj 108, 109, 524, 660 scrofulous ophthalmia, 113 soreness, 36 staphyloma, 113 stomatitis. 95 suppressed eruptions, 100 synovitis, 103, 296, 353 tubercular meningitis, 100, 103, 337, 470 typhoid fever, 40, 100, 107, 108, 268, 523 urine, 66 urticaria, 106, 705 uterus. 112 variola, 107 vertigo, 82 APIUM VIRUS, 98 APOCYNACEAE, 163 APOCYNUM CANNABINUM, 163 APOCYNUM CANNABINUM (Continued) ascites, 104 diarrhoea, 164 dropsy, 104, 163, 337 fatty degeneration of heart, 164 haemorrhoids, 165 heart, in, 164 hydrocephalus, 164 hydrothorax, 104 joints, 164 rheumatism, 164 urine, 163 APOMORPHIA sea-sickness, 265 vomiting 265, 436 ARACEAE, '208 ARACHNIDA, 73 ARALIA RAC. asthma, 727 ARANEA DIADEMA bones, 81 constitution, 80, 81 diarrhoea, 81 headache, 81 intermittent fever, 80, 373 nervous system, 81 toothache, 81 ARCTIUM LAPPA crusta lactea, 168 polyuria, 168 rheumatism, 298 ARGEMONE MEXICANA skin, 274 tape worm, 274 ARGENTUM METALLICUM, 611 arthralgia, 509, 611 chlorosis. 599 debility, 611 epilepsy, 611 heart, 611 joints, 611 larynx, 611 neuralgia, 611 ovaries, 611, 616 prolapsus uteri, 599, 616 ARGENTUM NITRICUM, 605 angina pectoris, 608 antidotal relations, 610 asthenopia,, 609 asthma, 608 blepharitis, 609 brain, 605 cholera infantum, 610 chorea, 629 conjunctivitis. 347 diarrhoea, 166, 176, 255, 610, 643 epilepsy, 608 eyes, 608, 619 female genitals, 616 gastralgia, 607 gastro-enteric symptoms, 554 gonorrhoea, 91 granular conjunctivitis, 609 headache, 605, 606 hemicrania, 606 kidneys, 610 larynx, 609 INDEX OF REMEDIES. 747 ARGENTUM XITRICUM (Continued). locomotor ataxia, 606 marasmus, 272^ 534 mental symptoms, 605 mouth, 609 nephralgia, 610 nervous system, 606 neurasthenia, 541 ophthalmia, 217, 347 ophthalmia neonatorum, 347, 608 ovaries, 605 paralysis, 606 poisoning by, 600 prosopalgia, 607 puerperal convulsions, 608 purulent ophthalmia, 608 renal calculi, 610 scrofulous ophthalmia, 702 spinal cord, 605, 620 throat, 609, 619, 685, 740 urinary organs, 91 urine, 610 uterus, 615 vertigo, 605 vomiting, 607 ARNICA MONTANA, 237 abscess, 242 antidotal relations, 658 apoplexy, 242, 269 apoplexy of retina, 43 asphyxia from charcoal, 158, 273, 659 bed sores, 242 bloodvessels, 238 boils, 242 cholera infantum, 22, 242 conjunctivitis, 397 cough, 152, 732 diarrhoea, 242 dysentery, 242 dyspepsia, 242 ecchymoses of the sclerotic, 190 enteritis, 60 female genital organs, 664 gout, 369 hypertrophy of heart, 225, 239, 323, 507 hemiplegia, 242 injuries, 239, 532 lying-in, 242 muscular exertion, 229, 239 myalgia, 240 peritonitis, 60 pleurodynia, 296 pyaemia, 241 relationship, 237 retinal apoplexy, 43 rheumatism, 240 skin, 242 sprains, 229, 238, 654, 662 soreness, 239 testicles, 352 typhoid fever, 40, 228, 239, 336, 402, 527 659 urine, 66 vertigo, 82 whooping cough, 242 ARNICIN, 238 ARSENICUM ALBUM, 549 ARSENICUM ALBUM (Continued) abdomen, 488 albuminuria, 67, 559 angina pectoris, 559 antidotal relations, 372, 541 aortitis, 486 aphthous sore mouth, 47 asthma, 381, 558, 727 bladder, 271 blood, 552 boils, 561 Bright's disease, 559 burns, 97 cancer, 552, 561 carbuncle, 232, 552, 561 catarrhs, 380, 557 cholera Asiatica, 156, 553 cholera infantum, 553 cholera morbus, 156, 553 chorea, 79 collapse, 69 complementary relations, 549 conjunctivitis, 113, 397 continued fever, 316, 557 convulsions, 44 coryza, 380, 557 cough, in, 152 croup, 560 debility, 367, 369 delirium tremens, 269, 551 diarrhoea, 55, 166, 370, 553, 642 diphtheria, no. 213, 558 dropsy, 66, 104, 164, 337, 445, 558 drunkards, complaints of, 55, 187 dysentery, 488, 553 dyspepsia, 54, 55, 185, 350, 351, 487 eczema, 559 endocarditis, 558 enteritis, 553 epilepsy, 561 eyes, 397 face, 44 fatty degeneration of the heart, 572 fever, 320, 467, 556 fever blisters, 705 gangrena oris, 47 gangrene, 156, 552, 560 gastric catarrh, 378, 379 gastric symptoms, 54, 55, 350, 378, 487 gastritis, 54, 185, 324, 553 general action, 551 haemorrhages, 482 haemorrhoids, 487, 551 hay fever, 332, 557 headache, 701 heart, 111, 164, 239, 514, 558 hectic fever, 373 hemicrania, 129, 561 herpes zoster, 332 hiccough, 203 hydrocephaloid, 102 hydropericardium, 111. 559 hydrothorax, 559 hypertrophy of the heart, 239 hysteria, 614 inflammation of the brain, 94 inflammations, 96, 552 74 8 INDEX OF REMEDIES. ARESNICUM ALBUM (Continued) intermittent fever, 69, 372, 555 jaundice, 187 kidneys, 67, 559 laryngismus stridulus, 504 lead colic, 621 lungs, 374 marasmus, 553 meningitis, 102 menorrhagia, 482 mental symptoms, 443, 551, 612 metrorrhagia, 65, 482 mucous membranes, 557 mumps, 245 muscular exertion, 230, 521 nervous system, 79 neuralgia, 467, 555 . oesophagitis, 414 ovaries, 65 ovaritis, 552 pericarditis, 558 phlyctenular ophthalmia, 397 poisoning by, 550 prosopalgia, 614 psoriasis, 707 puerperal mania. 328 retention of urine, 271 scarlatina, 528, 558, 560 scrofulous ophthalmia, 494, 495, 702 skin, 559 syncope, 37 throat, 95, 596 tongue, 333, 553, 698 tuberculosis, 552 typhoid fever, 227, 252, 430, 467, 537, 552, 555 ulcers, 62, 63, 156, 445, 561 uraemia, 94 urine, 66 urticaria, 107, 560 vertigo, 37, 82 vomiting, 565, 672 wine, aggravation from, 632 ARSENICUM IODATUM cancer, 561 coryza, 557 crusta lactea. 168 diphtheria, 558 hay fever, 557 psoriasis, 125, 707 throat, 596 ARSENICUM MET. tongue, 454 ARTEMISIA ABROTANUM, 244 haemorrhoids, 245 marasmus, 245 mumps, 245 myelitis, 244 rheumatism, 245 stomach, 341 ARTEMISIA TRIDENTATA, 237 biliousness, 244 ARTEMISIA VULGARIS, 242 asthenopia, 243 convulsions, 624 emotions, 242 epilepsy, 30, 242, 420, 676 ARTEMISIA VULGARIS (Continued), eyes, 243 worms, 624 ARTICULATA, 31 ARUM MACULATUM skin, 85 ARUM TRIPHYLLUM, 208 aphonia, 210, 462 diphtheria, 233, 444, 535 inflammation of the brain, 210 larynx, 210 mental symptoms, 209 nasal catarrh, 498 scarlatina, 208, 233, 535 skin, 85 sore mouth, 711 throat, 95, 209 uraemia, 209 ARUNDO MAUR. catarrh, 661 ASAFOETIDA, 449 antidotal relations, 450, 587 bones, 119, 450, 545 eyes, 450 hysteria, 119, 120, 198. 449 iritis, 450, 602 nervous system, 79, 119, 120, 449 periostitis, 450 reaction, lack of, 121 syphilis, 602 ulcers, 62, 119, 450, 545, 602 ASARUM EUROPAEUM nervous symptoms, 7g, 195 ASCLEPIAS TUB. pleurodynia, 296 ASPARAGUS - heart 111 ATROPINE, 405 AURUM METALLICUM, 600 albuminuria, 603 antidotal relations, 586, 600 bones, 604 cervix uteri, 139 cirrhosis of the liver, 36, 603 congestions, 599 congestion of the head, 601 congestion of the liver, 603 diplopia, 601 ears, 43, 491, 602 eyes, 601 face, 599 fatty degeneration of the liver, 603 female genital organs, 603, 615 general action, 139 glaucoma, 601 heart, 600, 656 hemiopia, 601, 702 hyperaemia, 599 hypertrophy of the heart, 323, 601 iritis, 450, 601 kidneys, 559, 603 lungs, 603 mastoid process, caries of, 435. 49*> 602 mental symptoms, 139, 603 nasal catarrh, 602 orchitis, 603 otorrhoea, 602 INDEX OF REMEDIES. 749 AURUM METALLICUM (Continued) ozaena, 49, 602 pannus, 601 prolapsus uteri, 139, 603, 613 retinal congestion, 602 scrofulous, 599 scrofulous ophthalmia, 599, 601 swelling of, 43 syphilis, 601, 602 testicles, 352 throat, 602 uterus, 139, 603, 615 AURUM MURIATICUM cervix uteri, 139 AURUM ' MURIATICUM NATRONATUM cervix uteri, 139 prolapsus uteri, 603 BADIAGA buboes, 31, 490 enlarged lymphatics, 31 heart 31 syphilis, 491 BALSAM OF PERU bronchitis, 215 lungs, 627 phthisis, 627 BAPTISIA TINCTORIA, 398 aphthae, 47 diphtheria, 212, 403 dysentery, 403 enteritis, 59 face, 44 mental symptoms, 398, 437 peritonitis, 59 phthisis, 403 relationships, 403 scarlatina, 212 typhoid fever, 40, 228, 239, 272, 399, 467, 523 BARYTA CARBONICA, 649 amblyopia, 652 aneurism, 650 apoplexy, 268, 650 asthma, 652 brain, 651 capillary bronchitis, 582 cataract, 575 complementary relations, 582, 649 constitution, 649 cough, 652 drunkards, 268, 650 cretinism, 679 ears, 652 enlarged tonsils, 651 fatty tumors, 652 glossoplegia, 650 headache, 652 herpes circinatus, 125, 705 mental symptoms, 650, 679 multiple sclerosis of brain and spinal cord, 650 ophthalmia, scrofulous, 652 paralysis, 650, 731 paralysis of the lungs, 650 poisoning by, 649 BARYTA CARBONICA (Continued). post-nasal catarrh, 652, 656 scrofulosis, 649, 652 senility, 649 sweat, 653 tabes mesenterica, 652 throat, 651 tonsillitis, 651 BARYTA MURIATICA brain, 650 multiple sclerosis of brain and spinal cord, 650 BELLADONNA, 405 abscess, 419, 592 amenorrhoea, 674 antidotal relations, 516, 600, 628 apoplexy, 268, 269 asthenopia, 449 anus, 60 biliary calculi, 192 blepharospasm, 189 boils, 419 brain, 235, 320, 335, 407 cancer, 561 cholera infantum, 411, 419 chorea, 77 climaxis, 233 colic, 419, 621 coma, 409 complementary relations, 406, 419, 422 congestions, 407, 591 conjunctivitis, 412 convulsions, 201, 408, 420 coryza, 326 cough, in, 421, 570 delirium, 355, 429 dentition, 249 diarrhoea, 419 diphtheria, 214, 413 dysentery, 419 enteritis, 59, 419 enuresis, 416, 734 epilepsy, 420 erysipelas, 45, 106, 407, 416 erythema, 416 eyes, 397, 412, 449 face, 44, 409, 411 female genital organs, 420, 615 fever, 292, 319, 409 gastralgia, 414 gastric symptoms, 350, 414 general character, 406 glands, 233 haemorrhage, 368, 421 headache, 82, 27 7, 408, 411 heart, 11 1 hemicrania, 128 hydrophobia, 94 hysteria, 77, 199 inflammation, 99, 407, 591 labor, 421 laryngismus stridulus, 504 lead colic, 621 lungs, 627 mammary abscess, 301, 419, 569 measles, 174 meningitis, 94, 101, 105, 294, 407, 409, 591 75° INDKX OF RKMKDIKS. BELLADONNA (Continued) mental symptoms, 218, 294, 682 menses, 421, 613 metritis. 415 metrorrhagia, 272, 421 nervous system, 408 neuralgia, 419, 613, 682 oesophagitis, 414 otalgia, 683, 708 otitis media, 348, 411 parotitis, 412 peritonitis, 59, 415 poisoning by, 405 puerperal convulsions, 420 puerperal metritis, 415 puerperal peritonitis, 415 pulse, 317 pupil, 405 quinsy, 414 retinal congestion, 602 rectum and anus, 60 relationships, 419, 422 renal colic, 191 rheumatism, 407, 422 scarlatina, 71, 100, 109, 233, 302, 417, 443, 634, 660 sciatica, 419 scleritis, 412 skin, 416 sleep, 109, 454 soreness, 36 speech, 591 sphincters, 406 strabismus, 617 sunstroke, 38, 320 temperament, 406 tetanus, 181 throat, 95, 173, 412, 596 tonsillitis, 414, 592 torticollis, 194, 422 typhlitis, 59 typhoid fever, 292, 410 urine, 416 vomiting, 266, 417 BENZOIC ACID dysuria, 711 enuresis, 247 gout, 453, 656 heart, 656 joints, 656 rheumatism, 453 urine, 66, 534 BERBERIDACEAE, 451 BERBERINE 451 BERBERIS VULGARIS, 451 alkaloids of, 151 backache, 361 biliary calculi, 192, 452 eyes, 619 female genitals, 452 fistula in ano, 452 gout, 453 joints. 453 kidneys, 93, 451 leucorrhoea, 452 liver, 299, 452 menses, 452 BERBERIS VULG. (Continued) metritis, 452 peritonitis, 452 renal colic, 93, 192 rheumatism, 453 stools, 452 urinary organs, 93, 452 urine, 452 BISMUTH gastralgia, 185, 415, 608 vomiting, 565 BLATTA, 32 dropsy, 32 BOMBUS, 98 BORAX VENETA, 708 aphthous stomatitis, 710 colic, 710 constitution, 708 cough, 710 diarrhoea, 710 dysuria, 711 erysipelas, 711 eyes, 710 leucorrhoea, 710 lungs, 710 mucous membranes, 710 nervous system, 708 nose, 710 otalgia, 708 otorrhoea, 708 phthisis, 711 skin, 711 throat, 710 trichiasis, 710 ulcers 125, 711 BOTHROPS LANCIOLATUS aphasia, 33 BO VISTA, 157 asphyxia, 158, 273, 659 awkwardness, 102 circulation, 157 colic, 287 epistaxis, 157 headache, 158 heart, 158 herpes, 157 menses, 158 mental symptoms, 102 metrorrhagia, 157 oedema, 159 speech, 425 wine, aggravation from, 632 urticaria, 107 BROMINE, 502 asthma, 507 brain, 502 cancer, 503 conjunctivitis, 507 coryza, 504 croup, 504, 684 dentition, 504 epistaxis, 502, 507 glands, 503 goitre, 503 headache, 504 hypertrophy of the heart, 225, 239, 507 laryngismus stridulus, 504 INDEX OF REMEDIES. 751 BROMINE (Continued). mammae, 503 mental symptoms, 502 mucous membranes, 503 nasal catarrh, 504 pneumonia, 507 scrofulous, 503 testicles, 503 thymus, 504 tonsillitis, 503 tuberculosis, 507 ulcers, 510 vertigo, 502 BRUCIA, 177 BRUCIA ANTTDYSENTERICA, 180 BRYONIA ALBA, 289 alimentary canal, 298 antidotal relations, 303, 617 blood, 289 bronchitis, 296, 570 complementary relations, 303, 617 constipation, 186, 271, 298, 461, 617, coryza, 294 cough, in, 296, 693, 703 diarrhoea, 114, 299, 453, 474, 724 dyspepsia, 298 epistaxis, 291 eyes, 300 face, 246 female genital organs, 301 fever, 289, 317 gastric catarrh, 378, 578 gastric fever, 290 gastro-enteric symptoms, 248 glaucoma, 300 headache, 40, 82, 289, 300, 701 heart, 298 hypochondriasis, 618 intermittent fever, 229 jaundice, 187, 299 joints, 453 liver, 207, 282, 298 mammary abscess, 301 measles, 302 meningitis, 101, 105, 294, 407 menses, 301 mental symptoms, 299, 619 milk fever, 301 nasal cararrh, 294 ophthalmia, 300 peritonitis, 293 pleurisy, 293, 295 pleurodynia, 295, 570 pneumonia, 295, 323 rheumatism, 297, 353 scarlatina, 302, 418 serous membranes, 293 sore mouth, 301, 710 suppressed eruptions, 101, 294, 302 sweat, 300 synovitis, 103, 296, 353 tongue, 568, 578 toothache, 300 torticollis, 422 typhilitis, 59 typhoid fever, 261, 290, 523 whooping cough, 296 686 BRYONIA ALBA (Continued) urine, 301 BUFO epilepsy, 30, 547, 676 face, 44 peritonitis, 30 skin, 30 ulcers, 30, 63 CACTUS GRANDIFLORUS asthma, 633 diaphragmitis, 331 haemoptysis, 324 heart, 225, 239 hypertrophy of the heart, 239, 323 neuralgia, 419, 555 uterus, 133 CADMIUM SULPH. asthma, 633 indigestion, 55 vomiting, 554 yellow fever, 555 CAFFEINE general action, 383 CALADIUM SEGUINUM asthma, 214 masturbation, 247 nymphomania, 613 seminual emissions, 175, 215 sexual excesses. 175, 339 spermatorrhoea, 175, 215 worms, 247 CAJUPUTUM, 203 CALCAREA ACETICA vomiting, 450 CALCAREA CAUSTICA skin, 85 CALCAREA FLUORICA bones, 519 lumbago, 677 osteoma, 519, 666 CALCAREA HYPOPHOSPHORICA, 667 debility, 738 CALCAREA IOD. enlarged tonsils, 651 CALCAREA OSTREARUM, 668 amenorrhoea, 673 bones, 676 cataract, 575 cholera infantum, 671 complementary relations, 672 conjunctivitis, 235 constitution, 493, 668, 677 corneal opacity, 669 corneal ulcers, 669 convulsions, 669 cough, 421 delirium, 269 delirium tremens, 269, 675 dentition, 669 diarrhoea, 671, 687 eczema, 670 enuresis, 416, 734 epilepsy, 676, 734 epistaxis, 671 face, 668 female genital organs, 145, 673 gastric symptoms, 415 752 INDEX OF RKMEDIKS. CALCAREA OSTREARUM (Continued) glands, 671 gout, 453, 656, 677 headache, 701 herpes circinatus, 125 hip-joint disease, 676 hydrocephalus, 672 hysteria, 614 insomnia, 675 joints, 652, 676 leucorrhoea, 674 lumbago, 677 lungs, 627, 673 marasmus, 569, 645 meningitis, 409 menorrhagia, 673 menses, 672, 673 mental symptoms, 293, 617 nasal catarrh, 498, 671 nervous system, 195, 675 neurasthenia, 624 opacities of the cornea, 669 otitis externa, 670 otitis media, 670 otorrhoea, 670 parotitis, 443 phthisis, 536, 673 polypi, 570 post-nasal catarrh, 656 prolapsus uteri, 145 puerperal mania, 328 rheumatism, 453, 656, 677 scarlatina, 233, 418, 635 scrofulosis, 494, 495, 545, 591, 669 scrofulous ophthalmia, 494, 495, 669 seminal emissions, 175, 192 sexual excesses, 192, 339, 477, 674 sprains, 229 stomach, 132 sweat, 663 temperament, 406 throat, 498 tonsillitis, 651 tuberculosis, 470, 672 typhoid fever, 293, 442, 675 ulcers, 534 ulcers of cornea, 669 urine, 453 urticaria, 107, 667, 705 vomiting, 450, 671 CALCAREA PHOSPHORICA, 678 bones, 241, 680 chlorosis, 680 cholera infantum, 380, 679 complementary relations, 678 constitution, 678 cretinism, 679 diarrhoea, 672 female genital organs, 145, 679 fistula in ano, 452 fractures, 241, 680 hydrocephaloid, 367, 380, 636, 680 joints, 679, 680 laryngismus stridulus, 504 leucorrhoea, 145 lungs, 627, 673 marasmus, 680 CALCAREA PHOSPHORICA (Continued). polypi, 570 prolapsus uteri, 145, 146, 625 rachitis, 679 rheumatism, 679 tabes mesenterica, 653 tonsillitis, 651 tuberculosis, 670 CALCAREA SULPHURICA boils, 667 croup, 667 CALENDULA injuries, 241 CALTHA pemphigus, 87 skin, 85 CAMPHOR antidotal relations, 116, 481, 658 cholera Asiatica, 156, 256, 484, 629 cholera morbus, 156, 380 convulsions, 45, 94 collapse, 69, 484, 629 diphtheria, 481 epistaxis, 481 erysipelas, 86 face, 44, 45 inflammation, 94 inflammation of the brain, 94 intermittent fever, 69 reaction, defective, 121 scarlatina, 635 seminal emissions, 175 skin, 85, 86 strangury, 93 sexual mania, 94 sunstroke, 38 syncope, 37, 38 tetanus, 183 urinary organs, 93 vertigo, 37 CANCHALAGUA intermittent fever, 372 CANNABIS INDICA backache, 361 chordee, 90 delirium tremens, 269 gonorrhoea, 90 headache, 90 kidneys, 90 mental symptoms, 89, 269 paralysis, 322 uraemia, 90 urinary organs, 90 CANNABIS SATIVA chordee, 89 gonorrhoea, 89 leucorrhoea, 674 nephritis, 89 CANTHARIS, 84 alimentary canal, 95 antidotal relations, 93 bladder, 88 brain, 93 Bright's disease, 88 burns, 97 chordee, 96 cystitis, 88, 89, 351 INDEX OF REMEDIES. 753 CANTHARIS (Continued) diphtheria, 95, 435 dysentery, 95, 253 dysuria, 711 eclampsia, 94, erysipelas, 97, 106 female genital organs, 97 gastritis, 95 genital organs, 96 gonorrhoea, 96 gravel, 89 haematuria, 89 hydrophobia, 94 inflammation of the brain, 93 labor, 97 mucous membranes, 94 nephritis, 88 nymphomania, 97 pemphigus, 87 penis, irritation of glans, 88 priapism, 96 renal colic, 88, 191 retained placenta, 97, 355 skin, 84 throat, 95 uraemia, 94 urethritis, 88 urinary organs, 87 urine, 306 CANTHARIS STRYGOSA skin, 84 CAPSICUM, 434 asthma, 435 bronchitis, 374, 546 diphtheria, 435, 524 dyspepsia, 434 dysentery, 96, 435 dysuria, 434 ears, 43, 435, 49* elongation of the uvula, 435 general action, 434 gonorrhoea, 91 home sickness, 435, 528 intermittent fever, 201, 372, 435 mastoiditis, 43, 435, 602 modalities, 231, 434 neuralgia, 614 reaction, defective, 150, 629 skin, 85, 86, 404 throat, 95, 435. 596 vesicle irritability, 92 CARBO ANIMALIS, 489 acne, 141 ankle-joint, 676 brain, 235 bronchitis, 490 buboes, 31, 489 cancer, 490 cervix uteri, 140 constitution, 489 cough, 490 deafness, 491 debility, 489, 490 ears, 491 eyes, 491 female genital organs, 140 gastric symptoms, 490, 496 4-S CARBO ANIMALIS (Continued) glands, 489, 503 gonorrhoea, 489 haemorrhoids, 490 headache, 141, 354 heart, 134, 499 lactation, 165, 490 menses, 140 otorrhoea, 491 phthisis, 490 pneumonia, 490 relationships, 489 stomach, 132, 166, 490 syphilis, 489, 491 uterus 490 CARBO VEG., 481 abscess, 483 antidotal relationships, 481 aortitis, 486 aphonia, 210, 462, 484, 733 aphthous sore mouth, 47 asthma, 191, 485 blood, 481 boils, 483 bronchorrhagia, 481 cancer, 483 carbuncle, 232, 483, 561 catarrhs, 484, 662 cholera, 156, 380, 484 collapse, 156, 373, 484, 566 complementary relations, 481 constipation, 186, 486 constitution, 481 cough, 112, 491 deafness, 491 debility, 481, 491 diphtheria, 481 dysentery, 488 dyspepsia, 56, 185, 486, 532 ears, 491, 498 emphysema, 485 epistaxis, 157, 481 eyes, 492 face, 44 female genital organs, 141 fever, 483 gangrene, 483 gastric symptoms, 56, 350, 486 gastro-enteric symptoms, 554 glands, 484 haemoptysis, 481 haemorrhages, 157, 368, 481 haemorrhoids, 57, 486 headache, 300, 486 hectic fever, 373, 483 hernia, 56 hip-joint disease, 483 inimical relations, 481 intermittent fever, 68, 372, 483 leucorrhoea, 141 menorrhagia, 482 menses, 141 metrorrhagia, 482 mumps, 245 otorrhoea, 491 paralysis of the lungs, 485, 582 reaction, defective, 150, 270, 465, 629 754 INDEX OF REMEDIES. CARBO VZG. (Continued) sweat, 653 syphilis, 491 throat, 740 tympanites, 253, 261, 271, 487 typhoid fever, 228, 253, 261, 483, 566 ulcers, 63, 482 urine, 66 varicose veins, 141, 441, 482 vertebral caries, 483 yellow fever, 483 wine, aggravation from, 632 CARBOLIC ACID diphtheria, 721 headache, 581 skin, 85 urine, 66 CARBON BISULPHIDE, 480 Meniere's disease, 733 CARBONEUM OXYGENISATUM herpes zoster, 87 pemphigus, 87 skin, 87 CARBONIC OXIDE, 497, 480 CARBONS general characteristics of, 479 CARDUUS MARIANUS jaundice, 187 liver, 187 CASCARILLA abdominal symptoms, 312 constipation, 312, 497 haemorrhage, 312 haemorrhoids, 312 CASTOR EQUI sore nipples, 28 CASTOREUM, 27 amenorrhoea, 117 colic, 117 convalescence, tardy, 117 diarrhoea, 117 menses, 121 nervous system, 117, 195 reaction defective, 121, 465 typhoid fever, 27, 117 CAULOPHYLLUM after pains, 356 dysmenorrhoea, 176, 648 labor, 357 leucorrhoea, 674 pregnancy, 357 prolapsus uteri, 146 rheumatism, 297 CAUSTICUM, 729 agalactia, 356, 734 anger, effects of, 286 ankle-joint, 698 anus, 60 aphonia, 462, 485, 732 apoplexy, 731 bladder, 271 brain, 651 catarrh, 662 chorea, 77, 734 colic, 735 constitution, 729 cough, 421, 703, 732 CAUSTICUM (Continued) dysmenorrhoea, 735 ears, 733 enuresis, 416, 734 epilepsy, 734 gout, 288 headache, 702, 724 heels, 663 inimical relations, 481, 729 locomotor ataxia, 730 Meniere's disease, 733 menses, 735 mental symptoms, 126, 288, 729 nature of, 729 nervous system, 77 paralysis, 322, 650, 729, 730 paralysis of tongue, 731 pemphigus, 87 ptosis, 170, 235, 398, 731 rectum and anus, 60 . retention of urine, 271, 735 rheumatism, 288, 735 scabies, 476 scrofulosis, 731 skin, 87, 702, 735 tongue, 731 torticollis, 194 urine, 737 vertigo, 730 warts, 735 CEDRON ciliary neuralgia, 206 intermittent fever, 80 neuralgia, 288, 328, 374, 555 CEPA antidotal relations, 380 complementary relations, 555 coryza, 380, 398 cough, 421 flatulence, 445 neuralgia after amputations, 241, 663 ulceration of heel, 663 CHAMOMILLA, 248 abortion, 250 after-pains, 356 anger, effects of, 286, 339 antidotal relations, 616, 644 biliousness, 249, 2qc\ colic, 339 convulsions, 201 coryza, 249 cough, in, 249 dentition, 249 diarrhoea, 243, 342, 645 dysmenorrhoea, 202, 263 emotions, 248 face, 248 gastric symptoms, 249 insomnia, 248 jaundice, 187, 248 labor, 250 lungs, 627 menses, 263, 613 mental symptoms, 248, 288, 344 nervous system, 248 neuralgia, 288, 644 otalgia, 349, 384, 683, 708 INDEX OF REMEDIES. 755 CHAMOMILLA (Continued) relationships, 250 rheumatism, 249. 353 skin, 688 sweat, 566 teeth, 340, 645 temperament. 248 CHELIDONIUM, 281 capillary bronchitis, 283 gastralgia, 497 jaundice, 207 liver, 207, 281, 299 mental symptoms, 281 neuralgia, 282 relationships, 281 pneumonia, 282, 295 scapular pains, 281 skin, 85 vertigo, 82 CHENOPODIUM liver, 282 scapular pains, 282 CHIMAPHILA bladder, 27, 92 follicular pharyngitis, 722 skin, 85 CHININUM ARSEXICOSUM gastralgia, 415 CHININUM SULPH., 365 blood, 365 enlarged spleen, 80, 365 infusoria, 365 intermittent fever, 80, 371, 467 neuralgia, 467, 555 pemphigus, 87 reflex action, 365 rheumatism, 374 skin, 85, 87, 363 tissue waste, 365 CHLORAL skin, 85, 87 CHLORIDE OF GOLD AXD PLATINUM caries and necrosis, 341 CHLORINE, 511 antidotal relations, 511 aphthous sore mouth, 511 catarrh, 511 coryza, 511 impotence, 511 laryngismus stridulus, 504 nervous system, 511 scurvy, 511 typhoid fever. 511 CHOLOS TERRAPINAE cramps in muscles, 288 CHROMIC ACID ulcers, 723 CICUTA VIROSA cancer, 451 convulsions, 44, 182, 451 epilepsy, 182, 428, 451 face, 44, 45 injuries, 451 nervous system, 79 puerperal convulsions, 451 skin, 451, 677 tetanus, 178, 181, 182, 537 worms, 451 CICUTINA, 181 CICUTOXINE, 182 CIMEX LECTULARIUS cough, 152 intermittent fever, 32 CINA, 246 asthenopia, 247 bladder, 247 convulsions, 246, 629 dentition, 420 enuresis, 247 eyes, 247, 619 face, 246 intermittent fever, 247 modalities, 247 strabismus, 246, 617 temperament, 247 whooping cough, 247, 382 worms, 246, 624 CINCHONA, 363 abdominal symptoms, 488 abscesses, 484 alkaloids of, 365 anaemia, 366 antidotal relations, 372, 375, 551, 586 asthenopia, 369 biliary calculi, 192 bowels, 370 brain, 235 cholera infantum, 366, 380 colic, 272 complementary relations, 555 coryza, 295, 326 debility, 367, 487 diarrhoea, 53, 166, 370, 429, 488, 642 dysentery, 53, 488 dyspepsia, 53, 350, 369, 487 enlarged spleen, 80 face, 44 gastric symptoms, 370, 553 haemorrhages, 293, 367, 482, 643 headache, 40, 369, 701 hectic fever, 373 hydrocephaloid, 366, 380, 680 inimical relationships, 375, 462 intermittent fever, 80, 229, 371 jaundice, 374 lungs, 374 malarial neuralgia, 374 marasmus, 554, 680 Meniere's disease, 733 mental symptoms, 293, 369 nervous symptoms, 369 neuralgia, 369. 374 poisoning from, 366 reaction, defective, 121, 150 retained placenta, 368 rheumatism, 374 seminal emissions, 367, 529 tympanites, 252, 261, 370, 4 8 7 typhoid fever, 252, 556 ulcers, 63 CINNABARIS condylomata, 311 eyes, 394 nasal catarrh, 595 scarlatina, 95, 596 756 INDEX OF REMEDIES. CINNABARIS (Continued) skin, 311 sycosis, 311 syphilis, 311, 595 throat, 95, 595 CINNAMON haemorrhage, 369 CISTUS CANAD., 463 nasal catarrh, 656 CITRIC ACID, 516 CITRULLUS, 285 CLEMATIS CRISPA, 86, 314 CLEMATIS ERECT A cancer, 561 cystitis, 90 gonorrhoea, 91 orchitis, 352 skin, 85, 86, 560 urethra, 86, 90 CLEMATIS VIORNA skin, 314 COBALT backache, 193, 361, 636 seminal emissions, 193 spinal irritation, 303, 636 COCA muscular fatigue, 521 reaction, defective, 121 COCCULUS INDICUS, 259 anus, 60 cerebro-spinal meningitis, 263 convulsions, 262 debility, 260, 624 dysmenorrhoea, 202, 263 general action, 259 headache, 262, 354 hernia, 189 hysteria, 199 menses, 262 mental symptoms, 199 nervous system, 195, 259 neurasthenia, 624, paralysis, 315, 624 rectum and anus, 60, 61 sleeplessness, 361 spinal cord, 260 spinal irritation, 330 stomach, 132 tympanites, 252 typhoid fever, 260 COCCUS CACTI phthisis, 627 whooping cough, 32, 627 COCHLEARIA ARMORACEA skin, 85 urinary organs, 92 CODEIN ' muscular twitchings, 265 • phthisis, 265 COFFEA ARABICUM, 383 alkaloids of, 383 apoplectic congestion, 384 circulation, 385 diarrhoea, 385 fatigue, 385 general action, 383 heart, 31 COFFEA ARABICUM (Continued) mental symptoms, 322, 384 skin, 384 reaction, defective, 121 special senses, 385 teeth, 340 toothache, 301, 384 COLCHICUM AUTUMN ALE, 251 abdominal symptoms, 253 antidotal relations, 254 Bright's disease, 254 cholera, 59, 253 convulsions, 59 debility, 251 dentition, 420 diarrhoea, 59 dropsy, 67, 254 dysentery, 96, 253 gastric symptoms, 58, 350 gastritis, 324 glossoplegia, 650 gout, 253, 353 heart, 254, 298 hydrothorax, 254 indigestion, 58 paralysis, 731 pericarditis, 254 peritonitis, 60 prosopalgia, 322 rheumatism, 231, 232, 253, 298 tympanites, 251, 261, 271, 370 typhoid fever, 251, 271, 556 urine, 66 COLEOPTERA, 32 COLLINSONIA constipation, 188 haemorrhoids, 188 neurasthenia, 624 paralysis, 624 prolapsus uteri, 188 COLOCYNTH, 285 abdomen, 286 antidotal relation, 288 arthritic ophthalmia, 288, 341 bladder, 287 ciliary neuralgia, 288 colic, 285, 324, 339, 419, 644 constipation, 195 cramps of muscles, 288 diarrhoea, 248, 285, 644 dysentery, 96, 286, 287 dysmenorrhoea, 286, 287 enteritis, 285 glaucoma, 287 gout, 287 headache, 287 hip disease, 288 iritis, 287 lead colic, 621 mental symptoms, 288 neuralgia, 285 ovarian tumor, 285, 510 paraphimosis, 288, 394 rheumatism, 288, 735 sciatica, 288 COMOCLADIA DENTATA erysipelas, 217 INDKX OF REMEDIES. 757 COMOCLADIA DENTATA (Continued) eyes, 217 skin, 217 COMPOSITAE, 237 CONCHIOLIN osteitis, 680 CONIFERAE, 304 CONIINE. 181 CONIUM MACULATUM, 447 bladder, 91 cancer, 449, 561 ' cancer of the stomach, 449 cataract, 575 complementary relations, 449 constipation, 449 cough, 361, 448 cystitis, 450 debility, 447 ears, 448 eyes, 360, 619 glands, 448 heart, 392, 448, 656 hypochondriasis, 448, 638 impotence, 564 injuries, 449, 532 muscular exhaustion, 336 mental symptoms, 448 nervous system, 447 noma, 449 paralysis, 318, 447 poisoning by, 447 post-diphtheritic paralysis, 447 prosopalgia, 448 rheumatism, 231 scrofulous, 448 seminal emissions, 175 sexual excesses, 448, 564 testicles, 352 tonsils, enlargement of the, 651 urethra, 91 urethritis, 91 vertigo, 448 wine, aggravation from, 632, 634 CONVALLARIA MAJALIS heart, 393 pruritus vulvae, 393 uterus, 393 COPAIVA gonorrhoea, 91 lungs, 91, 627 pemphigus, 87 skin, 87 urine, 306 urticaria, 87, 107 vesicle irritability, 92 COPTIS ROOT, 451 CORALLIUM RUBRUM chancre, 311 nasal catarrh, 656 psora, 30 syphilis, 30 whooping cough, 27, 31 CORNUS FLORIDA intermittent fever, 371 COTURA MATURA skin, 85 CRABRO, 98 CROCUS chorea, 76, 79 eyes, 619 hysteria, 76, 79 menses, 613 muscular twitchings, 265 CROTAuers horridus apoplexy of retina, 43 ciliary neuralgia, 43 cough, in diphtheria, 35, 50 ears, 43 erysipelas, 45, 417 haematuria, 66 keratitis, 43 retinal apoplexy, 43 CROTON TIGLIUM antidotal relations, 222 cholera infantum, 285 colic, 287, 312 diarrhoea, 256, 285, 287, 312, 453 mammary gland, 302, 503 rhus poisoning, 222 skin, 85, 313, 688 CUBEBS gonorrhoea, 91 leucorrhoea, 674 CUCURBITA tape-worm, 285 CUCURBITACEAE, 284 CUPRUM ARSENICOSUM skin, 85 visceral neupalgia, 630 CUPRUM METALLICUM, 628 after-pains, 356 antidotal relations, 628 aortitis, 486 asthma. 381 chlorosis, 629 cholera Asiatica, 628 colic, 629 collapse, 70, 629 complementary relations, 628 convulsions, 201, 629, 630, 634 epilepsy, 630 erysipelas, 417, 630 * face, 44 fever, 629 hysteria, 198 intermittent fever, 70 laryngismus stridulus, 504 meningitis, 101, 630 neuralgia, 630 paralyisis, 537, 630 pneumonia, 630 reaction, defective, 464, 629 scarlatina, 302, 443, 630, 634 skin, 688 sleep, 443 suppressed eruptions, 101, 302, 424, 630, 634 uraemia, 629 whooping cough, 382 CURARE, 206 catalepsy, 179 eczema, 179 758 INDEX OF REMEDIES. CURARE (Continued) emphysema, 207 liver spots, 125, 179 muscular exhaustion, 336 nervous system, 179, 206 paralysis, 1 79 tetanus, 179 CURARINE, 179 CYANOGEN, 501 CYCLAMEN asthenopia, 130 chlorosis, 359 colic, 263, 360 dysmenorrhoea, 263 eyes, 360 gastric symptoms, 359 haemorrhages, 369 headache, 130 nasal catarrh, 348 neurasthenia, 359 strabismus, 617 CYPRIPEDIUM reaction, defective, 121 sleep, 384 DIFFENBACHIA stomacace, 208 throat, 95 DIGITALIN, 387 DIGITOXIN, 387 DIGITALIS PURPUREA, 387 abortion, 388 alkaloids of, 387 balanorrhoea, 394 brain, 393 cerebro-spinal meningitis, 393 chordee, 394 collapse, 69 cyanosis neonatorum, 389 cystitis, 393 dropsy, 66, 164, 396 face, 389 gonorrhoea, 394 heart, 69, 111, 171, 388 hydrocele, 390 hydrocephalus, 337, 393 hydropericardium, 1 1 1 hydrothorax, 390 jaundice, 391 kidneys, 559 liver, 391 meningitis, 337, 393 mental symptoms, 387 paraphimosis, 394 seminal emissions, 174, 394 sleep, 389 syncope, 37, 38 urinary organs, 92 vertigo, 37 vesical irritation, 92 vomiting, 388 vomiting of pregnancy, 388 DIOSCOREA diarrhoea, 453, 473 seminal emissions, 174 sexual excesses, 339, 674 visceral neuralgia, 285 DITAINE, 168 DOLICHOS dentition, 420 DORYPHORA gonorrhoea, 32 urethritis, 91 DRACONTIUM bronchitis, 215 DROSERA asthma, 27 cough, 273, 395, 732 phthisis, 27, 273 skin, 85 whooping cough, 27 DULCAMARA, 433 antidotal relations, 586 bladder, 434 colic, 434 complementary relations, 434 coryza, 434 cystitis, 351, 434 diarrhoea, 434, 652 lungs, 434 mental symptoms, 683 myelitis, 236 nervous system, 434 otalgia, 434 paralysis, 434, 731 paralysis of the lungs, 434 poisoning by, 433 rheumatism, 433 skin, 434 spinal cord, 434 throat, 434 tongue, 434 twitching of muscles, 433 urticaria, 434 EL APS diarrhoea, 58 ears, 43 gastro-intestinal symptoms, 58 haemoptysis, 35 lungs, 51 phthisis, 51 pneumonia, 51 stomach, 58, 324 ELATERIUM cholera infantum, 284 diarrhoea, 34, 257, 284, 395 EPIGEA vesical irritation, 92 EQUISETUM HYEMALE albuminuria, 90 cystitis, 90, 351 enuresis, 90 haematuria, 90 ERGOT, iS3 convulsions, 153 ERIGERON CANADENSIS uterine haemorrhage, 159, 368 vesical irritability, 92, 159 ERYODICTION CAL. See Yerba Santa ESERINE, 178 EUCALYPTUS intermittent fever, 372 INDEX OF REMEDIES. 759 EUPATORIUM PERFOLIATUM, 244 aphonia, 485, 733 influenza, 244 intermittent fever, 299, 244, 372 EUPATORIUM PURPUREUM intermittent fever, 244 vesical irritation, 90, 145 EUPHORBIA COROLLATA cholera morbus, 312 diarrhoea, 312 skin, 85 ulcers, 63 EUPHORBIA CYPARISblAS skin, 86 EUPHORBIA PEPLUS skin, 86 EUPHORBIACEAE, 312 EUPHORBIUM bones, 313 erysipelas, 46 skin, 85, 217, 313 ulcers, 63 EUPHRASIA, 396 blepharitis, 396 condylomata, 311, 398 conjunctivitis, 397 coryza, 380, 397 eyes, 396, 683 granular lids, 609 heart, 718 iritis, 397 nasal catarrh, 380 ophthalmia, 189, 683 phlyctenular ophthalmia, 496 ptosis, 396 FEL TAURI constipation, 29 FEL VULPI constipation, 29 FERRUM CARBONICUM neuralgia, 420 FERRUM IOD. female genital organs, 143 prolapsus uteri, 643 FERRUM METALLICUM, 639 anaemia, 367, 493, 640 antidotal relations, 639 asthma, 639 circulation, 639 chlorosis, 493, 640 cholera infantum, 642 complementary relations, 493, 639 constitution, 639 cough, 641 diarrhoea, 166, 370, 642 epistaxis, 639 face, 640 female genital organs, 615 gastralgia, 640 gastric symptoms, 496 haemoptysis, 639, 641 haemorrhages, 643 headache, 639, 641 intermittent fever, 643 menses, 641 neuralgia, 640 FERRUM METALLICUM (Continued) phthisis florida, 639, 641 prolapsus uteri, 643 rheumatism, 231, 249, 281, 735 tuberculosis, 641 uterine haemorrhage, 642 vertigo, 641 FERRUM PHOS. bladder, 92 cholera infantum, 159, 270, 642 enuresis, 734 diarrhoea, 159, 642 dysentery, 642 fever, 320 hydroa, 159 inflammation, 159, 642 lungs, 159 phthisis, 642 pneumonia, 159, 642 pulmonary congestion, 159, 642 vesical irritation, 92 FLUORIC ACID, 519 bones, 519 caries, 519 cicatrices, 520 dental fistula, 519 felons, 520 gastric symptoms, 704 liver, 187 mental symptoms, 440 muscular fatigue, 520 naevi, 441, 521 nails, 520 skin, 520 sleep, 521 speech, 440 syphilis, 519 teeth, 46 tonsillitis, 414 varicose veins, 521 wine, aggravation from, 632 FORMICA, 98 albuminuria, 86 skin, 85, 86 FORMIC ACID. 98 GAMBIER, 363 GAMBOGE diarrhoea, 165, 380 GAULTHERIA pleurodynia, 295 GELSEMINE. 169 GELSEMIUM, 169 abortion, 176 amenorrhoea, 674 antidotal relations, 176 aphonia, 170 bilious fever, 173 catarrh, 173 cerebro-spinal meningitis, 172 cervix uteri, 139, 175 circulation, 168 coryza, 173 cough, 173, 174 diarrhoea, 176, 255, 272 diplopia, 170 dysmenorrhoea, 176 76o INDEX OF REMEDIES. GELSEMIUM (Continued) dysphagia, 170, 173 emotions, 176 epididymitis, 175 face, 171 female genital organs, 175 fever, 173, 317 genital organs, 174, 175 gonorrhoea, 175 headache, 40, 171, 172, 200, 262, 300, 581, 701 heart, 170, 276 hemicrania, 128 intermittent fever, 66, 172, 229 labor, 175, 328 measles, 174, 326 muscular fatigue, 336 nervous system, 169 orchitis, 513 paralysis, 166, 170, 448, 606 passive congestion, 169 poisoning by, 168 polyuria, 171 post-diphtheritic paralysis, 171, 448,. 606 prosopalgia, 174 ptosis, 170, 235, 619 puerperal convulsions, 175, 257 remittent fever, 172, 317 rheumatism, gonorrhoeal, 175 seminal emissions, 174 sexual excesses, 174, 339 skin, 174 strabismus, 171 throat, 173 tonsillitis, 173 typhoid fever, 173, 261, 401 uterus, 175, 176 GERANIUM MACULATUM diarrhoea, 379 GETTYSBURG SPRING WATER bones, 545 nip-joint disease, 341, 545, 656 vertebral caries, 341, 656 GLONOIN, 4^5 albuminuria, 437 amenorrhoea", 673 antidotal relations, 438 apoplexy, 537 apoplexy of the retina, 436 brain, 320 circulation, 278, 435 congestion of the retina, 436, 602 convulsions, 201, 437 eyes, 436 headache, 436, 701 heart, 466 inflammation of the brain, 437 injuries, 437 meningitis, 101, 320, 438 mental symptoms, 437, 500 metrorrhagia, 278 puerperal convulsions, 437, 438 retinal congestion, 436, 602 speech, 437 sun, ill effects of the, 38, 436, 437 wine, aggravation from, 632, 634 GNAPHALIUM cholera infantum, 379 GNAPHALIUM (Continued) diarrhoea, 379, 725 sciatica, 288, 614 GOSSYPIUM retained placenta, 355 GRAPHITES, 492 antidotal relations, 492 aphonia, 210, 733 blepharitis, 130, 494, 619 cervix, 142 chlorosis, 493 cicatrices, 141, 496, 544 complementary relations, 492 constipation, 497 constitution, 493 cough, 498 crusta lactea, 168 deafness, 59 diarrhoea, 498 ears, 498 eczema, 234, 495 erysipelas, 97, 496 eyes, 130, 494, 580, 619, 710 female genital organs, 498 fissure in ano, 497 flatulence, 497 gastralgia, 57, 497 gastric symptoms, 57, 496 glands, 494 haemorrhoids, a^i heart, 499, 718 heels, 663 impotence, 498 indigestion, 57 leucorrhoea, 141, 493 male genital organs, 498 liver, 497 menses, 141, 493 mental symptoms, 57, 493 nasal catarrh, 497 nipples, 141 nose, 86 obesity, 493 ophthalmia, 347 ovaries, 65, 498 prolapsus uteri, 141 scrofulosis, 494 scrofulous ophthalmia, 494, 702 skin, 141, 493, 494, 495, 560, 702 styes, 40* sweat, 653 tarsal cysts, 340 throat, 498 trichiasis, 710 GRATIOLA diarrhoea, 395 GRINDELIA ROBUSTA heart, 171, 466 lungs, 171, 633 pneumogastric nerves, 222 skin, 222 GUAIACUM chest pains, 306 gout, 288 growing pains, 530 phthisis, 215, 298, 329 pleurodynia, 329 rheumatism, 288, 298, 735 INDEX OF REMEDIES. 761 GUAIACUM (Continued) torticollis, 422 HALOGENS, 501 HAMAMELIS abortion, 328 ecchymoses of the sclerotic, 190 haematemesis, 301 haemorrhage, 158, 369, 537 haemorrhoids, 188 metrorrhagia, 159, 369 milk leg, 356 orchitis, 352, 512 pregnancy, 346 retinal apoplexy, 43 typhoid fever, 537 varicocele, 346 varicose veins, 366, 521 vesical irritation, 146 vicarious menstruation, 301 HEDEOMA female genitals, 146 HELLEBORUS, 334 alkaloids of, 334 aphthae, 48 apoplexy, 269 convulsions, 45 dropsy, 66, 164, 337 heart, 392 hydrocephalus, 105, 337 intermittent fever, 69 kidneys, 559 meningitis, 101, 336 nephritis, 337 scarlatina, 66, 302 sensorium, 334 shock, 337 skin, 85 tubercular meningitis, 337 typhoid fever, 39, 335 urine, 66 HELONIAS DIOICA albuminuria, 358 debility, 135 female genital organs, 134, 357, 616 leucorrhoea, 358 lying-in, 357 mental symptoms, 134 neurasthenia, 357 prolapsus uteri, 146, 358 uterine disease, 134, 615 vaginitis, 357 HEPAR SULPHURIS CALC, 6S2 abscess, 592, 684 antidotal relations, 536, 543, 585, 600, 688, 712 bladder, 687 boils, 684 Bright's disease, 685 buboes, 686 capillary bronchitis, 686 catarrhs, 685 constipation, 53, 686 coryza, 684, 685 cough, 234, 513, 683 croup, 324, 506, 684 diarrhoea, 687 HEPAR SULPH. CALC. (Continued) dysDepsia, 53, 686 dysuria, 687 ears, 43, 412, 683 eczema, 688 enuresis, 687 erysipelas, 106 eyes, 496, 683 fever blisters, 705 gastric symptoms, 460, 686, 704 glands, 686 jaundice, 187 inflammation, 683 liver, 687 lungs, 627, 685 mania, 683 marasmus, 687 mental symptoms, 127, 682 mercury, abuse of, 536 nervous system, 248, 682 neuralgia, 682 ophthalmia, 683 otalgia, 683 otitis externa, 683 otitis media, 412, 683 ovarian tumor, 62 periodontitis, 46 pneumonia, 685 scrofulous ophthalmia, 496 skin, 687 styes, 496, 683 throat, 619, 685, 740 tonsilitis, 414, 592, 684, 685 tonsils, 651 tuberculosis, 513, 685 ulcers, 62, 63, 687 HIPPOMANE MANC. scarlatina, 313 skin, 86 HURA BRAS. skin, 85 HYDRASTIS CANADENSIS. cancer, 510, 561 cancer of the uterus, 510 mucous membranes, 360 post-nasal catarrh, 348, 656, 722 stomach, 132 uterus, 360 HYDRANGEA vesical calculus, 92 HYDROCOTYLE pruritus vaginae, 145 skin, 560 vesical irritation, 145 HYDROCYANIC ACID, 537 asphyxia, 433 cholera, 538 collapse, 69, 538 convulsions, 433, 538 cough, 538 dyspepsia, 517 epilepsy, 537, 676 face, 44, 45 heart, 514, 538 intermittent fever, 69 nervous system, 537 paralysis of brain and lungs, 336, 538 762 INDEX OF REMEDIES. HYDROCYANIC ACID (Continued) phthisis, 538 scarlatina, 524, 538, 635 syncope, 37 tetanus, 181, 537 uraemia, 433 vertigo, 37 HYMENOPTERA, 32, 93 HYOSCYAMUS, 426 apoplexy, 269 bladder, 271 brain, 268, 427, 442 chorea, 77, 428 convulsions, 44, 45, 201, 428 cough, in, 361, 247 delirium, 426, 429 elongated uvula, 427 enuresis, 416 epilepsy, 428 face, 44, 45 fever, 428 headache, 427 hiccough, 203 hysteria, 77, 198 insomnia, 428 intermittent fever, 69 mania, 426, 430, 714 meningitis, 427 mental symptoms, 102, 198, 426, 427, 437, 612 metrorrhagia, 272 multiple sclerosis of the brain and spinal cord, 650 nervous system, 77, 79 nymphomania, 563 paralysis, 426 puerperal mania, 430 retention of urine, 271 scarlatina, 418, 428 sleep, 428 typhoid fever, 39, 228, 268 urethritis, 91 urine, 442 HYPERICUM injuries, 241 spine, 241 tetanus, 181 IGNATIA AMARA, 197 antidotal relations, 204, 631 chorea, 74, 77 constipation, 220 convulsions, 200 cough, in, 201 deafness, 575 emotions, 197, 200 diphtheria, 203 dislocation of jaw, 235 dysmenorrhoea, 202, 263 dyspepsia, 202 eyes, 203 fistula, 452 follicular pharyngitis, 722 gastralgia, 202 grief, effects of, 197, 198, 528 headache, 78, 171, 199 hiccough, 203 IGNATIA AMARA (Continued) hysteria, 77, 116, 198, 200, 276 intermittent fever, 201, 372 joints, 235 laryngismus stridulus, 504 mental symptoms, 103, 197, 344, 528 neuralgia, 203 neurasthenia, 624 nose, 276 paralysis, 624 phlyctenular ophthalmia, 203 polyuria, 171, 200, 460 proctalgia, 60 prolapsus ani, 203 rectum and anus, 60, 203 stomach, 132 temperament, 197 throat, 201, 203 tonsils, 201, 651 toothache, 203 worms, 203, 246 ILLICIUM ANISATUM lungs, 627 INDIGO epilepsy, 30 worms, 203 247 INDIUM gastric symptoms, 636 INULA female genital organs, 146 vesical irritation, 146 IODINE, 508 abuse of, 508 antidotal relations, 508, 587 aphthae, 47 cancer, 510 cough, 509 croup, 506 diarrhoea, 510 diphtheria, 214 glands, 509 heart, 509 hypertrophy of the heart, 509 joints, 103 laryngismus stridulus, 50/1 marasmus, 703 mental symptoms, 502, 617 ovarian tumor, 510 ovaries, 510 pancreas, 510 phthisis, 509 pneumonia, 508 rheumatism, 510 scrofulosis, 509 synovitis, 103 tabes mesenterica, 502, 507, 653 ulcers, 510 IPECACUANHA, 376 abortion, 328 alkaloids, 376 asthma, 380, 558 capillary bronchitis, 381, 582 cholera infantum, 378 colic, 378 conjunctivitis, 383 convulsions, 378 coryza, 380 INDEX OF REMEDIES. 763 IPECACUANHA (Continued) diarrhoea, 379 emphysema, 558 gastric symptoms, 350, 351, 377 general action of, 376 haematuria, 383 haemorrhage, 368, 482, 643 headache, 377 intermittent fever, 372, 382 laryngismus stridulus, 504 lungs, 627 measles, 303 mental symptoms, 377 stomach, 132, 341 suppressed eruption, 303 temperament, 377, 383 vomiting, 579, 672 whooping- cough, 382 IPECACUANHIC ACID, 376 IPOMEA NIL renal colic, 92 IRIS VERSICOLOR cholera morbus, 256, 351, 396 diarrhoea, 351, 371, 396 headache, 277, 702, 784 hemicrania, 129 JABORANDI asthenopia, 130 bronchitis, 686 eyes, 619 JACARANDA chancroid, 311 condylomata, 311 JATROPHA CURCAS cholera Asiatica, 256, 312 JUGLANDACEAE, 207 JUGLANS CATHARTICA See Juglans Cinerea JUGLANS CINEREA headache, 207, 262, 300 hydrothorax, 207 jaundice, 207, 262 liver, 207 JUGLANS REGIA menses, 207 KALI BICHROMICUM, 720 acne, 724 anus, 60 asthma, 727 bronchiectasia, 727 bronchitis, 727 constitution, 720 corneal opacities, 669 corneal ulcers, 726 cough, 662, 727 croup, 595, 723 diarrhoea, 724 diphtheria, 214, 524, 595, 721 dysentery, 61, 97, 725 eyes, 113, 360, 726 face, 724 flushes of heat, 466 follicular pharyngitis, 722 gastric catarrh, 720 gastric symptoms, 724 KALI BICHROMICUM (Continued) gastritis, 754 gonorrhoea, 722 headache, 702, 724 heart, 134, 499, 718 iritis, 726 laryngitis, 721 leucorrhoea, 720 lupus, 725 measles, 361, 725 mucous membranes, 720 nasal catarrh, 656, 661, 722 otalgia, 721 otitis media, 720 otorrhoea, 721 ozaena, 49, 310, 722 pharyngitis, 721 post-nasal catarrh, 656, 722 rectum and anus, 60, 61 rheumatism, 35^, 728 scrofulous ophthalmia. 113, 726 skin, 87, 725 sycosis, 310, 726 syphilis, 723 throat, 722 tongue, 725 ulcers, 63, 722 whooping-cough, 32 KALI BROMATUM, 713 acne, 716 antidotal relations, 713 brain-fag, 714 cholera infantum, 380 convulsions, 76, 713 diarrhoea, 380 eczema, 716 epilepsy, 715 locomotor ataxia, 715 mental symptoms, 437, 606, 612, 715 nervous system, 76, 606, 713, 715 night terrors, 430, 714 sexual excesses, 76, 606, 713, 715 skin, 87, 715 urticaria, 107 KALI CARB., 736 abortion, 737 aphonia, 739 asthenopia, 130 backache, 738, 739 blood, 736 capillary bronchitis, 740 chest pains, 306 complementary relations, 736 coryza, 739 cough, 732, 740 debility, 738 face, 44 heart, 111, 145. 737, 74* hydropericardium, 111 liver, 299 lumbago, 230, 741 menses, 700 mental symptoms, 443, 738 muscular fatigue, 336 nasal catarrh, 739 nervous system, 195, 738 phthisis, 536, 740, 741 764 INDEX OF REMEDIES. KALI CARB. (Continued) pleurodynia, 296 pneumonia, 283, 740 puerperal convulsions, 738 spinal irritation, 738 stomach, 132 sweat, 653 throat, 739, 740 urine, 66, 737 vertigo, 736 KALI CHLORICUM antidotal relations, 586 asthma, 633 aphthae, 47 follicular pharyngitis, 722 heart, 134, 499 KALI FERROCYANICUM female genual oigans, 144 heart, J44 metrorrhagia. 144 KALI HYDRIODICUM, 716 antidotal relations, 586, 716, 719 bones, 341 Bright's disease, 718 catarrh, 717 chemosis, 717 coryza, 717 endocarditis, 718 eyes, 716 general symptoms, 716 gummatous tumors, 719 headache, 716 heart, 717, 718 iritis, 716 joints, 103 keratitis, 717 kidneys, 719 lungs, 717 ozaena, 64, 717 paralysis of the lungs, 582 pericarditis, 718 phthisis, 718 pneumonia, 717 pulmonary oedema, 718 rheumatism, 719 sciatica, 719 skin, 87, 719 spinal cord, 719 synovitis, 103 syphilis, 64, 716, 719 KALI HYDROSULPHURICUM skin, 85, 87 KALI NITRICUM heart, 499 kidneys, 93 skin, 87 KALI PERMANGAN. diphtheria, no, 214, 524, 721 KALI SULPHURATUM skin, 87 KALI SULPHURICUM nasal catarrh, 594 KALMIA headache, 171, 200 heart, no, 214, 534, 721 hypertrophy of the heart, 323 neuralgia, 328, 555, 625 KALMIA (Continued) ptosis, 170, 235 rheumatism, 231, 392 KAOLIN croup, 505, 506, 723 KOUMYSS, 28 KREOSOTUM acne, 196 blepharitis, 609 cancer, 136 enuresis, 247, 416, 734 female genital organs, 136, 615 gastric symptoms, 185, 350 leucorrhoea, 136 menses, 136 neuralgia, 301, 555 skin, 560 teeth, 48, 301, 340 urinary symptoms, 136 vomiting, 136, 565, 671 LAC CANINUM, 28 constipation, 28 diphtheria, 28, 50 ozaena, 49 rheumatism, 353 LAC DEFLORATUM diabetes, 28 headache, 28 • prolapsus uteri, 146 LACHESIS, 36 abscess, 592 acne, 196 albuminuria, 65, 66 antidotal relations, 62, 587 aortitis, 486 aphthae, 47, 48 apoplexy, 268, 269 asthma, 51 bladder, 416 brain, paralysis of the, 268 Bright's disease, 65 bronchitis, 50 cancer, 71 carbuncle, 71, 8o, 561 chancre, 62 cholera, 59 circulation, 65 climaxis, 37, 65, 466 constipation, 52, 54 coryza, 49, 294 cough, in, 152, 421 croup, 723 cystitis, 66 delirium, 38 delirium tremens, 269 diarrhoea, 52 diphtheria, 214, 444, 502 dropsy, 65, 66 drunkards, complaints of, 55, 58, 65, 187, 268, 477 dysentery, 61 dyspepsia, 561, 687 ears, 43 enteritis, 59 erysipelas, 41, 45, 106, 416 eyes, 42 INDEX OF REMEDIES. 765 LACHESIS (Continued) face, 43 female genitals, 62 flushes of heat, 466 gastric symptoms, 52, 56, 704 general action, 35 haematuria, 66 haemophilia, 575 haemorrhoids, 52 headache, 40, 41 heart, 65, in, 718 hernia, 57 hydropericardium, in inimical relation, 659 intermittent fever, 68, 202, 372 jaundice, 52 ' laryngismus stridulus, 504 liver, 52, 187, 444, 477 loquacity, 39, 423 lungs, 374 male genital organs, 62 malignant pustule, 71 meningitis, 42 menses, 62 mental symptoms, 36, 38, 102, 218, 437, 617 metrorrhagia, 278 modalities, 71 nasal catarrh, 49, 294 nose, 49, 51 ovaralgia, 62 ovarian tumors, 62 ovaries, 62 ovaritis, 62, 613 ozaena, 49, 51 paralysis of the lungs, 582 parotitis, 443 periproctitis, 60 peritonitis, 59 pneumonia, 51, 474 post-scarlatinal dropsy, 66 prosopalgia, 46 puerperal mania, 328 rectum and anus, 52 retinal apoplexy, 43, 66 scarlatina, 42, 70, 233, 418, 661 scrofulous ophthalmia, 42 sexual symptoms, 62 skin, 86 sleep, 36 sore mouth, 47 speech, 440 stomach, 52, 58 sunstroke, 38 jyncope, 37 syphilis, 62 teeth, 46 tetanus, 44, 181 throat, 49 tonsillitis, 49, 592 tuberculosis, 52 typhlitis, 54, 59 typhoid fever, 39, 108, 268, 402, 430 ulcers, 62 universal symptoms, 35 urine, 66 vertigo, 36, 82 LACHESIS (Continued) yellow fever, 55 LACHNANTHES intermittent fever, 69 torticollis, 194 LACTIC ACID, 517 diabetes mellitus, 518 sweat, 653 LACTUCA heart, 718 LAC VACCINUM, 28 LAMIUM ALBUM haemorrhoids, 220 headache, 220 LAPIS ALBUS cancer, 510 tuberculosis, 510 LATHYRUS, 162 LAUROCERASUS asphyxia neonatorum, 583 catarrhs, 662 cough, 361, 538, 732 liver, 477 phthisis, 538 reaction, defective, 464, 629 scarlatina, 38 syncope, 37, 38 vertigo, 37 LEDUM acne, 195 antidotal relations, 114 drunkards' complaints, 195, 324 ecchymoses of the sclerotic, 191 gout, 232, 297 haemorrhages, 369 haemoptysis, 324 heart, 656 heels, 663 injuries, 241 lumbago, 230 polypi, 369 rheumatism, 232, 297, 353, 392, 548 wine, aggravation from, 632 LEPTANDRA VIRGINICA, 395 diarrhoea, 396, 598 liver, 395. 598 typhoid fever, 537 LILIUM TIGRINUM asthenopia, 130 chest, 134, 346 circulation, 127, 346 diarrhoea, 134 ' female genitals, 133, 616 heart, 134 leticorrhoea, 134 mental symptoms, 127 poisoning by, 133 ovaries, 133 prolapsus uteri, 133 retroversion, 133 subinvolution of the uterus, 133 uterine symptoms, 133, 360 LIME preparations of, 666 LINARIA, 394 enuresis, 90, 395 fainting, 394 766 INDEX OF REMEDIES. LITHIUM CARB., 654 asthenopia, 655 bladder, 655 cough, 655 debility, 654 diarrhoea, 655 eyes, 655 gastralgia, 655 gout, 453, 654 headache, -55 heart, 656 hemiopia, 655, 702 joints, 654, 656 menses, 655 mucous membranes, 655 nasal catarrh, 655 rheumatism, 453, 655, 656 skin, 655, 677 wine, 655 LOBELIA INFLATA asthma, 381 hay fever, 557 gastric symptoms, 377 vomiting, 265 LOBELIA SYPHILITICA scapular pain, 282 LYCOPODIUM, 439 abortion, 328 amenorrhoea, 674 aphthous sore mouth, 48 asthma, 191 bladder, 416 brain, paralysis of the, 442 blood, 441 bronchial catarrh, 445 capillary bronchitis, 382 cataract, 443 cirrhosis of the liver, 444 colic, J22 complementary relations, 446 constipation, 186, 444 constitution, 440 convulsions, 44 cough, 546 diphtheria, 50, 211, 413, 443 dropsy, 445 dyspepsia, 131, 487 dysuria, 443, 711 erectile tumors, 441 face, 44, 440 feet, 692 fever, 440 flatulence, 284, 445, 497 gastric symptoms, 444, 553, 724 gout, 453, 056 gravel, 443 haemorrhoids, 441 hectic fever, 446 hemiopia, 702 hernia, 189 hydropericardium, 445 intermittent fever, 70, 441 joints, 656 kidneys, 446 labor, 328 liver, 282, 444 liver spots, 125 LYCOPODIUM (Continued) lungs, 445, 627 mental symptoms, 37, 440 modalities, 440 mucous membranes, 445 naevi, 441 nasal catarrh, 445 ovaries, 65 parotitis, 442 pneumonia, 446 pregnancy, 441 preparation of, 440 pulse, 441 renal colic, 191, 446 retinitis, 443 rheumatism, 231, 446, 453 scarlatina, 211, 418, 442, 446 scrofulosis, 545 seminal emissions, 175, 192 sensitiveness, 36 sexual excesses, 192, 339 skin, 688 sleep, 443 stomach, 131 styes, 443 temperament, 440 tongue, 442 tonsillitis, 414, 454, 651 tympanites, 261, 271, 487 typhoid fever, 430, 441, 446, 675 ulcers, 62, 63, 445 urine, 271, 442, 710 varicose veins, 441 wine, aggravation from, 632 LYTTA VITATA skin, 84 MAGNESIA CARBONICA, 643 abuse of, 144 antidotal relations, 644 cataract, 646 colic, 644 constitution, 644 diarrhoea, 644, 687 dyspepsia, 645 marasmus, 644 menses, 645 neuralgia, 120, 644 pregnancy, 645 rheumatism, 646 teeth, 645 vomiting, 672 MAGNESIA MURIATICA, 646 crrtaraclu-575-. constipation, 647 constitution, 646 dysmenorrhoea, 202, 647 dysuria, 648 headache, 120, 646 heart, 120, 647 hysteria, 120, 646 liver, 186, 647 menses, 120, 647 nervous system, 120, 121, 648 ozaena, 647 rachitis, 647 scirrhus, 202 INDEX OF REMEDIES. 767 MAGNESIA MURIATICA (Continued) scrofulous, 648 skin, 647 sweat, 647 tongue, 647 uterus, 202, 647 MAGNESIA PHOSPHORICA nervous system, 648 neuralgia, 120, 555 MAGNOLIA GRANDIFLORA heart, 393 MALARIA OFFICINALIS intermittent fever, 373 MAMMALIA, 27 MANCINELLA scarlatina, 86, 313 skin, 85, 86, 313 MANGANUM anaemia, 641 cough, 609 heels, 663 larynx, 609 liver, 633 marasmus, 633 paralysis, 633 rheumatism, 663 MEDORRHINUM mental symptoms, 37 MEDUSA urticaria, 31 MELANTHACEAE, 250 MEL CUM SALE metritis, 415 uterus and ovaries, 112 MELILOTUS headache, 200, 217 MENISPERMACEAE, 259 MENTHA PIPERITA cough, 428 MENYANTHES headache, 354, 547 intermittent fever, 68, 372, 483 MEPHITIS asthma, 27 loquacity, 39 nervous system, 27, 79 sleep, 521 whooping-cough, 27, 31 MERCURIUS ACETICUS vesical irritation, 92 MERCURIUS BINIOD. diphtheria, 214, 594 eyes, 593 syphilis, 491, 597 MERCURIUS COkROS. balanorrhoea, 394 corneal ulcers, 593 diphtheria, 596 eyes, 593 gonorrhoea, 91, 394 iritis, 593, 602, 716 ophthalmia neonatorum, 347 retinitis albuminurica, 593 syphilis, 593, 596, 602 syphilitic nasal disease, 596 throat, 95, 596 typhlitis, 60 MERCURIUS CORROS. (Continued) ulcers, 597 urinary organs, 91 MERCURIUS CYANATUS croup, 723 diphtheria, 214, 481, 524, 595 epistaxis, 451 MERCURIUS DULCIS eyes, 593 scrofulous ophthalmia, 593 MERCURIUS PROTOIOD. diphtheria, 595 eyes, 593 syphilis, 597 ulcers of the cornea, 593 MERCURIUS SULPHURICUS hydrothorax, 390, 559 MERCURIUS VIVUS AfcD SOLUBILIS, 590 abscess, 592 abscess of teeth, 46 antidotal relation, 589 aphthous sore mouth, 47, 710 balanorrhoea, 311 blepharitis, 397, 593, 609 bones, 341 catarrhal fever, 591 catarrh of the bowels, 591 chancroid, 596 congestions, 591 conjunctivitis, 397 constipation, 54 corneal ulcers, 593 coryza, 190, 594 diarrhoea, 250, 396, 591 diphtheria, 594 dysentery, 54, 188, 253, 296,' 324, 357 dyspepsia, 54 epistaxis, 591 eyes, 397, 495, 593 fever, 410 felon, 592 gastric fever, 591 glands, 590, 596 glans, irritation of, 88 gonorrhoea, 91, 311, 352, 394 haemorrhages, 591 headache, 4T, 591 inimical relations, 543 iritis, 311, 593 jaundice, 187 leucorrhoea, 674 liver, 395, 597, 647 male genital organs, 88 meningitis, 591 menorrhagia, 592 nasal catarrh, 594 nostalgia, 590 orchitis, 513 ovarian tumor, 62 otitis media, 349 ozaena, 49 periodonitis, 46 peritonitis, 592 phimosis, 352 pneumonia, 283, 592 rheumatism, 311 768 INDEX OF REMEDIES. MERCURIUS VIV. AND SOL. (Continued) scabies, 476 scrofulosis, 590 scrofulous ophthalmia, 496, 593 ~ skin, 85, 688 sweat, 591 syphilis, 591, 593, 596 throat, 190, 594, 685 tongue, 454 tonsillitis, 414, 592, 685 toothache, 47, 81 typhlitis, 54, 59 typhoid fever, 226 ulcers, 62, 63, 534 urinary organs, qo, 91 MERCURY antidotes, 189, 536, 585, 600 poisoning by, 588 preparations of, 584 MEZEREUM anus, 60 antidotal relation, 587 ciliary neuralgia, 205 cough, 234 crusta lactea, 168 eczema, 233 herpes zoster, 332 neuralgia, 308, 555 rectum and anus, 60 skin, 85, 86, 168 ulcers, 125, 677 MILLEFOLIUM, 243 haematemesis, 301 haemoptysis, 324 haemorrhages, 243, 368 menses, 301, 613 MINERAL 'KINGDOM, 4 5S MITCHELLA cervix uteri, 145 metrorrhagia, 158 vesical irritability, 145, 158 MOMORDICA BALSAMUM flatulence, 284, 445 MORPHIA cancer, 265 tympanites, 265 MOSCHUS, 27, 115 antidotal relations, 79, 116 convulsions, 116 headache, 116 hysteria, 79, 116, 198, 614 menses, 65 mental symptoms, 79, 116 nervous system, 115 paralysis of the lungs, 485, 582 pneumonia, 121 poisoning by, 115 reaction, defective, 121, 150 vertigo, 37 MUREX PURPUREA leucorrhoea, 135 menses, 135 polyuria, 136 uterus, 135 MURIATIC ACID, 521 antidotal relations, 525 aphthous sore mouth, 47 MURIATIC ACID (Continued) cirrhosis of the liver, 525 diphtheria, 211, 524 dropsy, 525 gastric symptoms, 525 general symptoms, 521 mental symptoms, 521 muscular exhaustion, 736, 525 nervous system, 521 scarlatina, 211, 524 typhoid fever, 40, 108, 228, 403, 430, 522 ulcers, 63 MYGALE, 73 chordee, 75 chorea, 75 mental symptoms, 75 nervous system, 73 MYLABIS CICHORII ET PHALATERII, 80 MYOSOTIS lungs, 627 MYRICA CERIFERA jaundice, 391 MYRTUS COMMUNIS phthisis, 83, 306 NAJA diphtheria, 50, 213 NAPHTHALIN emphysema, 558 NATRUM ARSENICOSUM (or Arseni- catum), 706 bronchitis, 707 catarrh, 706 coryza, 706 cough, 707 diphtheria, no, 214, 254 face, 43 psoriasis, 707 scarlatina, 524 throat, 706 tuberculosis, 707 NATRUM CARBONICUM, 689 ankle-joint, 676, 692 burns, 689 catarrhs, 693 cervix uteri, 142, 693 constipation, 690 corneal ulcers, 693 cough, 693 debility, 692 diarrhoea, 690 dyspepsia, 690 eczema, 693 eyes, 619 feet, 692 female genital organs, 142, 693 headache, 692 heat, ill effects of, 691 heels, 663, 692 hypochondriasis, 689 labor, 694 marasmus, 645 mental symptoms, 689 mucous membranes, 693 nasal catarrh, 693 nervous system, 691 INDEX OF REMEDIES. 769 NATRUM CARBONICUM (Continued) ozaena, 693 pregnancy, 691 phlyctenular ophthalmia, 693 prolapsus uteri, 142 seminal emissions, 703 skin, 689 sunstroke, 38, 691 NATRUM HYPOCHLOROSUM, 142 ankle-joint, 692 aphthous sore mouth, 48 enuresis, 692 female genitals, 143 headache, 143 otorrhoea, 692 prolapsus uteri, 143 pruritus vulvae, 143 NATRUM MURIATICUM, 696 anaemia, 698 antidotal relation, 696 anus, 60, 705 asthenopia, 130, 702 awkwardness, 102 brain-fag, 128 blepharospasm, 189 cataract, 575, 697 catarrhs, 648, 702 chlorosis, 700 chorea, 699 ciliary neuralgia, 701 conjunctivitis, 131 constipation, 704 coryza, 702 cough, 427, 703, 732 diarrhoea, 705 dyspepsia, 704 eczema, 705 elongated uvula, 427, 703 eyes, 130, 619, 702 headache, 128, 300, 699, 701, 702, 724 female genital organs, 142, 615, 700 fever blisters, 705 fright, ill effects of, 272 gonorrhoea, 703 gout, 656 grief, chronic effects of, 197, 528 headache, 128, 300, 699, 701, 702, 724 heart, 134, 499 hemiopia, 702 herpes, 705 hypochondriasis, 699, 704 intermittent fever, 108, 229, 706 leucorrhoea, 142 marasmus, 703 menses, 700 mental symptoms, 102, 126, 344, 624, 699 nervous system, 29, 606, 691 neuralgia, 625 paralysis, 170, 624, 627 prolapsus ani, 704 prolapsus uteri, 142, 146, 700 ptosis, 131 rectum and anus, 61, 705 scrofulous ophthalmia, 702 scurvy, 698 seminal emissions, 703 skin, 688, 698, 702, 705 49 NATRUM MURIATICUM (Continued) spinal irritation, 329, 700, 739 sunstroke, 38 sweat, 300 throat, 702 tongue, 333, 698 urine, 06 urticaria, 705 NATRUM PHOSPHORICUM seminal emissions, 703 NATRUM SULPHURICUM, 694 asthma, 694 constitution, 694 corneal opacities, 699 diarrhoea, 453, 474, 695, 724 eyes, 619 flatulence, 695 hip-joint disease, 695 injuries, 434, 694 jaundice, 187 phthisis, 694 sycosis, 694 NICCOLUM stomach, 132 NICOTINUM tetanus, 181, 182 NITRI SPIRITUS DULCIS See Sweet Spirits of INitre NITRIC ACID, 533 abscess of the mastoid process, 435, 591 antidotal relations, 535, 536, 586 anus, 60, 534 aphonia, 536 aphthous sore mouth, 47, 48 balanorrhoea, 310 caries of the mastoid process, 43, 435, 491, 535. 602 catarrh, 534 chancre, 63, 535 condylomata, 310 corneal ulcers, 535, 670 cough, 536 diarrhoea, 534 diphtheria, 210, 444, 534 ears, 43, 535 fissure in ano, 497, 534 iritis, 602 leucorrhoea, 510, 534 local effects of, 533 mastoid, caries of, 43, 435, 602 mental symptoms, 219, 535 mercury, abuse of, 535 mucous membranes, 533, 534 ozaena, 49 pemphigus, 87 phthisis, 536 ptyalism, 534 rectum and anus, 60 renal colic, 610 scarlatina, 210, 534 scrofulosis, 670 skin, 85 stomacace, 534 sweat, 653 syphilis, 63, 491, 534, 535, 602 throat, 535, 609, 619, 685 77o INDEX OF REMEDIES. NITRIC ACID (Continued) tuberculosis, 670 typhoid fever, 522, 536 ulcers, 63, 310, 534, 535 urine, 534 warts, 310, 535 NITRITE OF AMYL cerebral congestion, 320 climacteric, 31, 466 eyes, 412 flushes of heat, 31, 466 heart, 31 metrorrhagia, 278 neuralgia, 322, 419 prosopalgia, 322 NITRO-MURIATIC ACID gastric symptoms, 525 NOBLE METALS, 599 NOSODES, 147 NUPHAR LUTEUM diarrhoea, 380 NUX JUGLANS crusta lactea, 168 skin, 85 tinea favosa, 168, 234 NUX MOSCHAfA eyes, 619 face, 44 hysteria, 11 8, 199 mental symptoms, 118 nervous system, 118, 121, 248 rheumatism, 646 NUX VOMICA, 177 abdominal symptoms, 136 acne, 195 amblyopia, 189 antidotal relations, 136, 266, 492, 562 apoplexy, 269 arthritic headache, 128 asthma, 190 atrophy of the retina, 189 backache, 194 bladder, 192 blepharospasm, 189 brain-fag, 128, 540 brain, softening of the, 184, 564 catarrh, 190 colic, 186, 272, 621 complementary relations, 183 composition of, 177 conjunctivitis, 189 constipation, 184, 186, 220, 445, 686 coryza, 190, 249, 326, 594 cough, in, 196 cramps in muscles, 288 debility, 252 diarrhoea, 188, 287 drunkards, complaints of, 186, 187, 189, 191, 195 dysentery, 96, 188, 597 dysmenorrhoea, 263 dyspepsia, 184, 185, 350, 477, 487, 704 dysuria, 192 ears, 190 ecchymoses of the sclerotic, 189 epilepsy, 30, 547-676 NUX VOMICA (Continued) epistaxis, 190 Eustachian catarrh, 190 eyes, 131, 189 face, 44 female genitals, 136, 193 follicular tonsillitis, 722 gastric catarrh, 378 gastric irritability, 184 gastric symptoms, 445 gonorrhoea, 192 haematuria, 192 haemoptysis, 191 haemorrhoids, 186, 187 headache, 129, 183, 184, 300 hemicrania, 129 hernia, 189 hypochondriasis, 618, 691 hysteria, 276 inimical relation, 196, 631 intermittent fever, 196 jaundice, 187 labor, 193, 355 lead colic, 621 liver, 130, 136, 186 liver spots, 125 locomotor ataxia, 194 lumbago, 194, 677 marasmus, 554 masturbation, 192 menses, 193 mental symptoms, 102, 344, 619 metrorrhagia, 194 modalities, 196, 440 myelitis, 194 nasal catarrh, 594 nose, 276 paralysis, 315, 731 pregnancy, 193, 691 prolapsus uteri, 193, 454, 625 renal colic, 182, 191 rheumatism, 195, 677 scrofulous ophthalmia, 189 seminal emissions, 175, 192 sensitiveness, 36 sexual excesses, 192, 339, 477 sleep, 184, 196, 361 spinal cord, 194, 620 spinal irritation, 194, 330, 620 stomacace, 190 stomach, 59, 136 temperament, 183 tetanus, 537 throat, 190 torticollis, 194, 422 typhoid fever, 196 uterus, 136 vomiting of pregnancy, 193, 220, 691 wine, aggravation from, 632, 634 OCINUM renal calculi, 92 OENANTHE CROCATA convulsions, 428 OENOTHERA BIENNIS diarrhoea, 379 INDEX OF REMEDIES. 771 OLEANDER, 165 abdominal organs, 165 antidotal relations, 167 crusta lactea, 167 diarrhoea, 166, 371, 642 headache, 165 lactation, 165, 490 mental symptoms, 165 paralysis, 165, 166 poisoning by, 165 skin, 85, 166 stomach, 132, 165 vertigo, 165 OLEUM ANIMALE, 28 headache, 171 polyuria, 171 OLEUM JECORIS ASELLI general symptoms of, 29 tuberculosis, 29 OLEUM RICINI COMMLNIS See Ricinus Communis OPHIDIA, 33 antidotes, 35 general effects, 34 OPIUM, 264 abortion, 176 alkaloids of', 264 antidotal relations, 266, 268, 272 anus, 60 apoplexy, 100, 268 asphyxia from charcoal vapor, 273 bladder, 271 brain, paralysis of the, 268 cholera infantum, 270 colic, 272, 621 constipation, 186, 271, 461 convulsions, 200, 201, 270 cough, 270 delirium tremens, 269 diarrhoea, 176, 255 drunkards, complaints of, 268, 269, 270, 650 face, 44, 420 fever, 272 fright, ill effects of, 270, 272 general action of, 266 haemoptysis, 270 hernia, 272 lead colic, 621 marasmus, 271 mental symptoms, 268 metrorrhagia, 272 muscular exhaustion, 336 poisoning by, 266, 267 puerperal fever, 272 reaction, defective, 150, 270 rectum and anus, 60, 61 retention of urine, 271 suppression of urine, 271 suppuration of the lungs, 270 tympanites, 267, 270 typhlitis, 2-2 typhoid fever, 39, 268, 272, 335, 336, 528 OPUNiIA VULGARIS diarrhoea, 379 ORTHOPTERA, 32 OSMIUM urine, 306 OXALIC ACID spinal softening, 540 testicles, 352 OZONE, 458 PAEONIA fissure in ano, 497 haemorrhoids, 497 PALLADIUM, 615 female genital organs, 615 headache, 615 hysteria, 78 mental symptoms, 64, 78, 615 ovaritis, 64, 616 uterus, 79, 615 PAPAVERACEAE, 264 PAREIRA BRAVA cystic calculus, 93 urinary symptoms, 93, 453 PARIS QUADRIFOLIA eyes, 412 headache, 547 larynx, 610 loquacity, 39 mammae, 503 PASSIFLORA INCARNATA tetanus, 179 PAULLINIA SORBILIS diarrhoea, 379 headache, 278 PENTHORUM SEDOIDES coryza, 348 PETROLEUM, 498 antidotal relations, 500 blepharitis, 499 cough, 499 dacryo-cystitis, 499 diarrhoea, 499, 500 eczema, 311, 495, 499 eyes, 499 dislocation of the jaw, 235 fistula, 499 gastralgia, 497 gastric symptoms, 500 headache, 172, 300 heart, 134, 499 lumbago, 230 mental symptoms, 437, 500 nervous system, 500 ozaena, 499 periodontitis, 46 rheumatism, 499 sea-sickness, 499 skin, 31, 495, 498 sprains, 499 sweat, 499, 544 sycosis, 398 teeth, 46 typhoid fever, 500 vertigo, 82 vomiting of pregnancy, 499 PETROSELINUM gonorrhoea, 90, 394, 450, 710 dysuria, 710 772 INDEX OF REMEDIES. PETROSELINUM (Continued) vesical irritation, 90 PHELLANDRIUM headache, 354, 450 mammary glands, 302, 450 phthisis, 546 PHOSPHORIC ACID, 526 bones, 530 cough, 530 debility, 367, 526, 624 diabetes, 518 diarrhoea, 370, 530 enuresis, 247 epistaxis, 527 face, 44 fright, ill effects of, 272 grief, ill effects of, 197, 528 growing pains, 530 headache, 530 hip-joint disease, 530 home-sickness, 528 kidneys, 530 masturbation, 529 mental symptoms, 197, 471, 526, 738 mucous membranes, 529 neurasthenia, 367, 541, 624 ovaries, 528 rheumatism, 735 seminal emissions, 529 sensorial depression, 335, 526 sleep, 529 tuberculosis, 530 typhoid fever, 228, 335, 430, 523, 527 ulcers, 63 uterus, 528 vertebral caries, 530 PHOSPHORUS, 562 alimentary tract, 567 amblyopia, 574 amenorrhoea, 569 antidotal relations, 562 aphonia, 462, 485, 570 asthenopia, 574 blood, 575 bones, 545, 573 brain fag, 540 brain, softening of the, 184 Bright's disease, 569 bronchitis, 190, 570, 571 cancer of the stomach, 568 capillary bronchitis, 381 cataract, 575 chest pains, 306 chorea, 565 choroiditis, 574 complementary relations, 562 constipation, 566 coryza, 380 cough, 151, 421, 546, 570, 571 croup, 570 deafness, 574 debility, 367 delirium, 563 diabetes, 568 diarrhoea, 166, 475, 565, 568 dyspepsia, 568 PHOSPHORUS (Continued) endocarditis, 572 eyes, 574, 683 face, 44, 45 fatty degeneration, 540, 566, 569 fatty degeneration of the heart, 572 fatty degeneration of the liver, 567 fistulae, 573 gastric symptoms, 565, 568, 636 grief, ill effects of, 198 haematemesis, 301, 575 haemophilia, 575 haemoptysis, 301, 569 haemorrhages, 369, 569 headache, 563 heart, 31, 514, 572 hip-joint disease, 573 hysteria, 276 impotence, 564 inimical relation, 729 jaundice, 567 kidneys, 559, 569 laryngismus stridulus, 504 larynx, 462, 570 leucorrhoea, 674 liver, 477, 565, 567 locomotor ataxia, 564 lungs, 627 mammary abscess, 569 marasmus, 469 menses, 301, 569 mental symptoms, 562 myocarditis, 572 nasal catarrh, 569 necrosis of the lower jaw, 573 nervous system, 562, 691 neurasthenia, 367, 540 nose, 276 nymphomania, 562, 563, 569 ozaena, 569 pancreas, 568 paralysis, 564, 569, 624, 636 paralysis of the lungs, 485 phthisis, 509, 626 pneumonia, 279, 381, 571 polypi, 369, 569 retinal apoplexy, 43 retinitis, 574 retinitis albuminurica, 574 rose-cold, 276 scrofulosis, 669 seminal emissions, 175, 540, 563 sexual excesses, 564 spasmodic oesophageal stricture, 568 spinal cord, 564 spinal irritation, 195, 563 sweat, 566 throat, 567 tongue, 567 tracheitis, 570 tuberculosis, 470, 564, 571, 669, 673 typhoid fever, ulcers, 62, 568, 574, 683 vertebral caries, 573 vomiting, 672 waxy degeneration of the liver, 567 INDEX OF REMEDIES. 773 PHOSPHORUS (Continued) white swelling, 573 yellow atrophy of the liver, 567 PHYSOSTIGMA paralysis, 178 spinal irritation, 195, 329 tetanus, 178, 195 PHYTOLACCA aphthous sore mouth, 48 carbuncle, 561 cicatrices, 141, 544 convulsions, 179 diphtheria, 213, 444 face, 44 heart, 225 mammary abscess, 302 tetanus, 179 PICRIC ACID, 538 back, 134, 361, 539 brain-fag, 128, 538 brain, softening of the, 184 general symptoms of, 538 headache, 128, 194 locomotor ataxia, 97 meningitis, 97 myelitis, 97 neurasthenia, 539 poisoning by, 538 priapism, 97, 194, 539 seminal emissions, 539 skin, 85 spinal irritation, 194 vertigo, 539 PICROTOXINE, 259 tetanus, 178 PINUS SYLVESTRIS joints, 676, 692 PIPER METHYSTICUM nervous system, 385 vertigo, 82 PIPER NIGRUM skin, 58, 86 PISCES, 29 PIX LIQUIDA, 306 bronchial catarrh, 215 lungs, 306, 627 phthisis, 83, 215, 306 skin, 85, 86, 87, 306 PLANTAGO MAJOR enuresis, 416, 734 otalgia, 349 relation to tobacco, 433 PLANTAIN antidotal relation, 433 PLATINA, 612 constipation, 614 convulsions, 339, 614 female genital organs, 65, 140, 613 headache, 78 hysteria, 78, 198, 613, 614 lead colic, 614, 621 masturbation, 339, 614 menses, 65, 613 mental symptoms, 127, 140, 612, 615 neuralgia, 420, 613, 625 nymphomania, 64, 140, 612 PLATINA (Continued) ovaritis, 64, 613 prolapsus uteri, 613 puerperal convulsions, 614 sexual excesses, 339, 614 uterus, 140 PLATINUM MUR. bones, 545, 614 PLUMBUM, 621 abortion, 622 antidotal relations, 621 cerebral sclerosis, 622 colic, 621 constipation, 271, 461, 614, 622 delirium, 622 epilepsy, 622 granular kidneys, 603, 623 kidney, 623 multiple cerebro-spinal sc^rosis, 622 muscles, 621 paralysis, 621, 622, 636 progressive muscular atrophy, 622 rectum and anus, 60, 61 ulcers, 63 PODOPHYLLJM PELTATUM, 453 abdominal symptoms, 453 biliary calculi, 454 bilious remittent fever, 454 cholera infantum, 59, 285 cholera morbus, 256 constipation, 454 convulsions, 59 dentition, 59, 454 diarrhoea, 188, 250, 371, 395, 453, 474 fever, 454 liver, 137, 138, 453 marasmus, 645 prolapsus recti, 138, 454, 625 prolapsus uteri, 138, 188, 454, 625 skin, 85, 453 stomach, 138 tongue, 454 tonsillitis, 454 POTASH SALTS remarks on the, 712 POTHOS FOETIDA asthma, 216 hysteria, 216 PSORINUM, 148 boils, 150 cholera infantum, 149 constitution, 148 debility, 738 diarrhoea, 149 eczema, 234 headache, 49, 150, 724 herpes, 149 night sweats, 374 otr.irhoea, 149 pregnancy, 150 reaction, defective, 149, 150, 270, 464 scabies, 150 scarlatina, 148 sebaceous glands, 149 skin, 149, 688 tinea capitis, 149 774 INDEX OF REMEDIES. PSORINUM (Continued) typhoid fever, 150 ulcers, 149 PSEUuO-ACONITINE, 315 PTELEA headache, 377 liver, 648 PULMO VULPIS asthma, 29 PULSATILLA NUTTALLIANA, 343 chest-pains, 306, 361 PULSATILLA PRATENSIS, 343 after-pains, 356 agalactia, 356 amenorrhoea, 355 anaemia, 344 antidotal relations, 343, 644 asthenopia, 130 backache, 361 bronchitis, 361 chest, 331, 345 chlorosis, 344, 494 circulation, 345 complementary relations, 343 conjunctivitis, 130, 347 constipation, 351 corneal ulcers, 347 coryza, 190, 348 cough, 234, 536, 732 cystitis, 92, 351 dacryo-cystitis, 347 diarrhoea, 176, 256, 272, 351, 355 dysmenorrhoea, 202, 263 dyspepsia, 185, 370 ears, 348, 708 epistaxis, 346, 354, 355 eyes, 130, 347 face, 44 female genital organs, 138, 354 fever, 360 fright, ill effects of, 272 gastric catarrh, 349, 579 gastric symptoms, 377, 496 general character of, 343 gonorrhoea, 310, 352 gout, 353 haematemesis, 301 haemoptysis, 301, 361 headache, 41, 353 heart, 225, 345 heels, 663 hemicrania, 129 hiccough, 203 hydrocele, 353 intermittent fever, 360 jaundice, 187 joints, 221 labor, 193, 3ss leucorrhoea, 674 lungs, 740 mammary giands, 356 measles, 174, 326, 361 menses, 138, 301, 355 mental symptoms, 126, 197, 343, 344, 617, 627, 700 milk leg, 356 PULSATILLA PRATENSIS (Continued) mucous membranes, 347 mumps, 245 nasal catarrh, 348, 594 neuralgia, 361 ophthalmia neonatorum, 347, 608 orchitis, 310, 352 otalgia, 348, 683, 708 otitis externa, 348, 354 otitis media, 348, 349 ozaena, 310 pregnancy, 351, 355 prostate gland, enlargement of the, 352 prostatitis, 310 purulent ophthalmia, 608 retained placenta, 355, 356, 368 rheumatism, 231, 310, 353 skin, 85 sleep, 362 spinal irritation, 361 sycosis, 310, 726 synovial membranes, 353 synovitis, 353 temperament, 197, 344 testicles, 352 throat, 349 tuberculosis, 345, 355 urine, suppression of, 271 urticaria, 107 uterus, 138, 625 varicocele, 346 varicose veins, 346 vesical irritation, 92 vicarious menstruation, 301 wine, aggravation from, 632 QUASSIA worms, 247 QUILLAYA SAPONARIA, 627 coryza, 174 QUININE See Chinin. sulph. RADIATA, 30 RADIX COPTIDIS, 314 RANUNCULACEAE, 314 RANUNCULUS BULBOSUS, 330 alcoholism, 332 diaphragmitis, 321 eczema, 332 epilepsy, 332 hay fever, 332 headache, 354 herpes zoster, 332 hiccough, 332 pemphigus, 87, 332 peritonitis, 331 pleurisy, 331 pleurodynia, 295, 331 pneumonia, 331 rheumatism, 331 serous membranes, 331 skin, 85, 86, 330, 332 ulcers, 332 RANUNCULUS SCELERATUS, 333 coryza, 333 INDEX OF REMEDIES. 775 RANUNCULUS SCEL. (Continued) diphtheria, 333 headache, 354 influenza, 87 pemphigus, 86 skin, 86, 87, 330, 333 stomacace, 333 tongue, 333 typhoid fever, 333 ulcers, 333 RAPHANUS flatulence, 271, 445 RATANHIA fissure in ano, 497 toothache, 645 RHEUM antidotal relation, 644 diarrhoea, 644, 687 RHODODENDRON nervous system, 691 orchitis, 352 rheumatism, 231 wine, aggravation from, 632 RHUS GLABRA headache, 217 RHUS RADICANS headache, 222 pleurodynia, 231, 296 rheumatism, 231 RHUS TOXICODENDRON, 223 antidotal relations, 223, 224 aphonia, 733 apoplexy, 269 blepharospasm, 235 brain, 235 carbuncles, 232 cellulitis, 232, 234 chemosis, 113 circulation, 223 colic, 234 conjunctivitis, 113, 235, 397 coryza, 234 cough, 234, 546 diarrhoea, 234 diphtheria, 213, 225, 232 dislocation of the jaw, 235 dropsy, 445 dysentery, 225, 234 eczema, 232 enteritis, 59, 234 erysipelas, 46, 106, 113, 221, 232 eyes, 113, 235, 397, 609, 619 face, 41 fever blisters, 705 glaucoma, 235 granular lids, 609 haemoptysis, 229 heart, 223, 225, 323 herpes zoster, 332 hypertrophy of the heart, 223, 239, 323, 508 influenza, 234 inimical relation, 114 injuries, 240 intermittent fever, 229 iritis, 235, 397 RHUS TOXICODENDRON (Continued) lumbago, 230, 677 meningitis, 102 mental symptoms, 226, 437 metritis, 234 muscular exertion, ill effects of, 229, 521 oesophagus, 414 otalgia, 235 palpitation of the heart, 225 paralysis, 236, 322, 731 parotitis, 443 pemphigus, 87 periproctitis, 60 peritonitis, 59, 225, 234 perityphlitis, 234 phlyctenular ophthalmia, 235 pneumonia, 225, 227 ptosis, 170, 235, 398 pulse, 225 scarlatina, 102, 109, 225, 233 rheumatism, 230, 249, 297, 677, 735 scrofulous opnthalmia, 235 skin, 85, 232, 560 sprains, 229 sweat, 545, 566 tongue, 226, 333, 567 toothache, 236 torticollis, 230 typhlitis, 60, 234 typhoid fever, 40, 225, 226, 292, 402, 410, 430, 523, 527, 552 typhoid pneumonia, 227 ulcers, 445 urticaria, 107 variola, 233, 234 vertigo, 234 vomiting, 265, 417 RHUS VENENATA, 217 RICINUS COMMUNIS agalactia, 313, 356 antidote to, 313 ROBIN I A neuralgia, 555 ROSA DAMASCENA hay fever, 557 RUBIACEAE, 363 RUMEX CRISPUS asthma, 27 cough, in, 421, 427, 546, 570 diarrhoea, 474, 724 pleurodynia, 296 urticaria, 107 RUTA asthenopia, 449 complementary relations, 681 eyes, 449, 619 injuries, 532, 654 lumbago, 230 sprains, 654 SABADILLA, 258 influenza, 258 intermittent fever, 229 mental symptoms, 258 modalities, 440 tonsillitis, 258 776 INDEX OF REMEDIES. SABADILLA (Continued) worms, 258 SABINA, 305 abortion, 305 condylomata, 311 gastric symptoms, 350 gout, 298 menses, 613 metrorrhagia, 305, 368 retained placenta, 356 rheumatism, 298, 663 SACCHARUM OFFICINALE corneal opacity, 669 mental symptoms, 669 SALICYLIC ACID aphthae, 48 Meniere's disease, 733 SAMBUCUS coryza, 249 laryngismus stridulus, 324, 504 laryngitis, 513 SANGULNARIA CANADENSIS, 275 acne, 280 aphonia, 280 bronchitis, 374 circulation, 276, 278 conjunctivitis, 280 coryza, 280 cough, 152, 234, 278, 279, 374 ears, 276 general action of, 276 haemorrhages, 278 headache, 82, 171, 200, 276 hemicrania, 128 hysteria, 276 larynx, 290 menses, 278 mental symptoms, 275 metrorrhagia, 278 nose, 276 phthisis, 278 pneumonia, 278 polypi, 280, 570 polyuria, 171 rheumatism, 280, 646, 735 rose-cold, 276 skin, 275 vertigo, 276 SANTONINE, 246 eyes, 247, 360 SAPONIN, 627 muscular exhaustion, 336 SARSAPARILLA antidotal relations, 272 chest pains, 306 gravel, 92, 443 headache, 311 marasmus, 272 skin, 311 stomach, 132 sycosis, 311, 726 tinea capitis, 311 urine, 710 SCILLA MARITIMA cough, 546, 703, 732 lungs, 627 SCOPARIUS dropsy, 163 SCROPHULARIACEAE, 387 SCUTELLARIA reaction, defective, 121 SCROPHULARIACEAE, 387 abortion, 154 blood, 154 bloodvessels, 154, 650 cataract, 575 cholera Asiatica, 155, 554 cholera infantum, 155 cholera morbus, 155 circulation, 154 collapse, 69, 156 constitution, 154 convulsions, 153, 201, 437 enuresis, 247 epistaxis, 1 5 7 face, 44 female genital organs, 145 follicular pharyngitis, 722 gangrene, 154, 156, 560 gastro-enteric symptoms, 155, 554 haemorrhages, 154, 368 intermittent fever, 69 labor, 154 lumbago, 677 lungs, 374 metrorrhagia, 145, 155, 368 paralysis, 650 poisoning by, 153 prolapsus uteri, 145 retained placenta, 154, 356 ulcers, 63, 156 uterus, 154 SELENIUM, 459 aphonia, 210, 462, 733 constipation, 460 debility, 459 gastric symptoms, 460 headache, 460 heat, ill effects of, 38, 459 impotence, 459 inimical relation, 462 larynx, 461, 610 liver, 461 nervous system, 459 prostatorrhoea, 459 seminal emissions, 175, 459 skin, 461 sleep, 461 sun, ill effects of, 38 typhoid fever, 459 urinary organs, 306 urine, aggravation from, 462, 632 SENECIO AUREUS catarrh, 359 cough, 359 haemoptysis, 301 menses, 301, 359 uterus, 359 SENEGA aphonia, 296 cough, 296 phthisis, 626 INDEX OF REMEDIES. 777 SENEGA (Continued) pleurodynia, 296 whooping cough, 32 SENNA debility, 737 urine, 737 SEPIA, 122 abortion, 146 anaemia, 347 ankle joint, 676 antidotal relation. 125, 432 arthritic headache, 128 asthenopia, 129, 130 backache, 361, 636 brain fag, 128 cataract, 130 chlorosis, 124, 347 chorea, 146 circulation, 123, 124 complementary relations, 135, 142 circulation, 123, 124 complexion, 123 conjunctivitis, 130 connective tissue, 125 constipation, 220, 705 constitution, 122 cough, 732 discovery of medicinal virtues of, 122 dyspepsia. 131, 432 eczema, 693 enuresis, 734 epistaxis, 124 eyes, 129, 619 female genital organs, 133, 420, 615 gastric symptoms, 350, 490, 623 general action of, 122 gonorrhoea. 394 haemorrhoids, 131 headache, 128, 176, 701 hemicrania, 128 herpes, 125, 705 herpes circinatus, 125, 705 hypochondriasis. 690 intermittent fever, 372 joints, 125 leucorrhoea, 134, 674 liver, 131, 186 liver spots, 125 marasmus, 645 menses, 133 mental symptoms, 125, 344, 347, 617. 624, 690, 700 neuralgia. 432 os, induration of the, 139 pannus, 130 psoriasis, 125 post-nasal catarrh, 656 prolapsus uteri. 193, 454 ptosis, 170. 235 rhus poisoning, 125 scabies, 125, 476 seminal emissions, 175 skin, 123, 125, 560, 688 sphincters, 123 spinal irritation, 136, 739 stomach, 131 SEPIA (Continued) time, 124 trachoma, 130 ulcers, 125, 711 urticaria, 107 uterus, 133, 615 venous congestion, 123 vertigo, 82 SILICEA, 542 abscesses, 543, 592 ankle-joint, 676, 732 antidotal relation, 543 boils, 543 bones, 519, 544 carbuncle, 80, 543 cataract, 575 cellulitis, 543 chest pains, 306 cicatrices, 543 complementary relation, 542 constipation, 546 constitution, 542, 677 corneal ulcers, 545 cough, 546 diarrhoea, 546 ears, 43, 435, 545 enuresis, 416 epilepsy, 547, 676 erysipelas, 106 fissure in ano, 497, 573 fistula in ano, 452 fright, ill effects of, 272 chest pains, 306 glands, 544 hay fever, 332, 546, 557 headache, 171, 200 hemicrania, 128, 129 hip-joint disease, 544, 573 inimical relation, 543 keratitis, 545 knee-joint disease, 544 lungs, 546 mammary abscess, 569 mastoid process, affections of the, 43, 545, 602 mental symptoms, 272, 440 mucous membranes, 545 nasal catarrh, 546 nervous system, 547, 691 neuralgia, 683 neurasthenia, 541 otitis media, 349, 435 otorrhoea, 43, 349, 545, 670 ozaena, 647 paralysis, 547 periodontitis, 46 phthisis, 546, 626 polyuria, 171 rachitis, 542, 647 rhetunatism, 548 scrofulosis, 494, 544, 561, 648 skin, 688 spinal cord, 547, 548 speech, 440 sweat, 544, 647, 653 tabes mesenterica, 653 778 INDEX OF REMEDIES. SILICEA (Continued) tetanus, 181 tonsillitis, 414, 546, 592 tuberculosis, 546 ulcers, 62, 63, 520, 544, 574 vaccination, ill effects from, 307, 542 vertebral caries, 544 vertigo, 548 wine, aggravation from, 632 wine, aggravation irom, 632 SINAPIS NIGRA, 558 hay fever, 558 skin, 85 SODA salts of, 689 SOLANACEAE, 404 SOLANINE, 162 SPIGELIA, 205 brain, 235 ciliary neuralgia, 205, 701 eyes, 205, 321, 412, 701 headache, 82, 205, 354, 392, 701 heart, in, 206, 254, 392, 509, 741 mental symptoms, 205 neuralgia, 205, 288, 308, 321, 327, 625 post-nasal catarrh, 348, 722 prosopalgia, 322 retinitis, 205 worms, 206 SPONGIA, 512 constitution, 512 cough, 395, 506, 513 croup, 323, 506, 684 glands, 512 goitre, 512 heart, 514 hoarseness, 462 laryngeal phthisis, 513 laryngitis, 462, 513 orchitis, 512 testicles, 352, 512 tuberculosis, 513, 686 SQUILLA MARITIMA See Scilla STANNUM METALLICUM, 623 complementary relation, 623 debility, 624 dyspepsia, 624 epilepsy, 625 gastric symptoms, 624 hypochondriasis, 624 hysteria, 625 mental symptoms, 344, 623 mucous membranes, 626 neuralgia, 607, 625 neurasthenia, 623 paralysis, 170, 624, 627 phthisis, 623, 626, 706 pleurisy, 627 prolapsus uteri, 136, 624 stomach, 132 tongue, 624 worms, 624, 625 STAPHISAGRIA, 338 anger, ill effects of, 286, 339 antidotal relation, 340, 587 STAPHISAGRIA (Continued) aphtkous sore mouth, 47 arthritic ophthalmia, 341 bones, 340 colic, 248, 339, 341 condylomata, 311, 340 crusta lactea, 168, 340 diarrhoea, 342 eczema, 340 eyes, 340 gastric symptoms, 341, 377, 460 gout, 341 hypochondriasis, 338 injuries, 241 laparotomy, 241 lumbago, 230 mental symptoms, 248, 338, 339 mouth, 46, 340 ovaries, 339 paralysis, 170, 322, 627 pediculi, 340 prolapsus uteri, 342 sexual excesses, 193, 338 skin, 339 stomacace, 342 stomach, 132, 341, 460 styes, 340 sycosis, 340 syphilis, 340 teeth, 340 temperament, 338 testicles, 352 STICTA PULMONARIA asthma, 27 coryza, 249 nervous system, 79 STILLINGIA antidotal relations, 587 bones, 341 hip-joint disease, 695 ozaena, 341 syphilis, 341, 695 STRAMONIUM, 423, 628 antidotal relation, 425 asthma, 424 chorea, 74, 428 convulsions, 45, 183, 200, 423, 714 delirium, 39, 255, 423, 439 delirium tremens, 269 diarrhoea, 425 erysipelas, 425 exanthemata, 424, 425 face, 44, 45 hiccough, 203 hip-joint disease, 425 hydrophobia, 423 locomotor ataxia, 424 loquacity, 39 mania, 429 measles, 424 mental symptoms, 218, 255, 423, 424, 429 nervous system, 79. nymphomania, 425. scarlatina, 302, 418, 425, 428, 443 sleep, 443 stuttering, 425 INDEX OF REMEDIES. 779 STRAMONIUM (Continued) tetanus, 183 tongue, 425, 454 typhoid fever, 272, 431 urine, suppression of, 271 STRONTIANA CARBONICA, 653 apoplexy, 653 bones, 341, 546, 654 caries of the femur, 545 circulation, 653 climacteric, 654 diarrhoea, 341, 654 headache, 548 neuralgia, 625 osteitis, 341 skin, 654 sprains, 654 STRYCHNIA, 177 tetanus, 177 SULPHUR, 463 abscess, 592 acne, 195, 468, 475 ankle-joints, 692, 732 antidotal relations, 272, 712 aphonia, 473, 485, 733 atelectasis, 382 boils, 468 brain-fag, 128 brain, softening of the, 184 bronchitis, 473 capillary bronchitis, 382 cholera Asiatica, 478 cholera infantum, 471, 672 cicatrices, 544 circulation, 135, 465 climaxis, 466 congestion of the chest, 465 congestion of the head, 465 conjunctivitis, 321, 473 constipation, 220, 476 constitution, 464 continued fever, 557 coryza, 473 cough, 395 crusta lactea, 167, 468 debility, 460, 624 diarrhoea, 250, 453, 474, 500, 685, 695 dropsy, 104 dysentery, 96, 466, 474, 598 dyspepsia, 132, 476 eczema, 464 enuresis, 416 epilepsy, 676 erysipelas, 106, 417 eyes, 321, 473, 494, 670 face, 44, 132, 465 female genital organs, 134, 478 fever, 320, 466, 557 fistulae, 452 flatulence, 445 flushes of heat, 466 gastric symptoms, 185, 445, 636 glands, 468 gonorrhoea, 394, 478 haemorrhoids, 187, 465, 476 haemoptysis, 465 SULPHUR (Continued) headache, 128, 581 heart, in, 465 hip- joint disease, 470 hydrocephaloid, 471 hydrocephalus, 104, 469 hysteria, 471 intermittent fever, 229, 467 keratitis, 473 laryngitis, 473 liver, 186, 461, 476 liver spots, 125 lumbago, 230 lungs, 469, 627, 740 marasmus, 272, 468, 554, 645 meningitis, 101, 104, 294, 409 mental symptoms, 37, 471, 683 mucous membranes, 473 nasal catarrh, 473 nervous system, 195, 471 neuralgia, 467, 683 neurasthenia, 624 panaritium, 114 paralysis, 236, 322, 472, 541 peritonitis, 472 pleurisy, 103, 472 pneumonia, 51, 279, 466, 473 prostatorrhoea, 459 psora, 463 rachitis, 468 reaction, defective, 270, 463, 629 retinal congestion, 602 rheumatism, 353, 472 scabies, 125, 475 scarlatina, 418, 466, 524 scrofula, 468, 494, 545, 591 scrofulous ophthalmia, 473, 494, 495 seminal emissions, 477 septic infection, 467 sexual excesses, 192, 339, 477 sleep, 361, 461 speech, 440 spinal congestion, 471, 541 spinal cord, 472, 541, 620 spinal irritation, 471 spinal weakness, 472 stomach, 132 suppressed eruptions, 101, 105, 464, 470 synovitis, 297, 472 tabes mesenterica, 470 throat, 498 tongue, 293 tonsillitis, 414, 592 tubercular meningitis, 104, 469 tympanites, 261 typhoid fever, 467 ulcers, 62 uterine diseases, 135 vertebral caries, 573 vomiting, 672 white swelling, 470 SULPHURIC ACID, 531 alcoholism, 531 ankle-joint, 698, 732 aphthous sore mouth, 47, 532 brain, 235 780 INDEX OF REMEDIES. SULPHURIC ACID (Continued) climaxis, 466 cough, 152, 531 diarrhoea, 532 diphtheria, 532 drunkards, complaints of, 58 dyspepsia, 58, 532 flushes of heat, 466 general symptoms, 531 haemorrhages, 532 haemorrhoids, 58, 531 injuries, 532, 662 marasmus, 532 mental symptoms, 531 pemphigus, 87 scarlatina, 524 skin, 85, 87 sprains, 662 typhoid fever, 531 SUMBUL heart, 225 SWEET SPIRITS OF NITRE sensorial depression, 335, 527 typhoid fever, 335, 336, 527 SYMPHYTUM fractures, 241, 680 injuries, 241 TABACUM, 432 antidotal relation, 432, 433 apoplexy, 430 asphyxia, 182, 433 cholera, 432 dyspepsia, 432 gastric symptoms, 377, 432 general symptoms of, 432 heart, 432 neuralgia, 432 relation to Gelsemium, 176 renal colic, 182, 433 strangulated hernia, 433 tetanus, 182 vomiting, 387 TARAXACUM, 244 liver, 244 tongue, 229, 244, 333 typhoid fever, 228, 244 TARANTULA, 75 chorea, 74 hysteria, 75, 78 nervous system, 75, 714 poisoning by, 75 reaction, defective, 121 uterus and ovaries, 76 TARANTULA CUBENSIS, 80 carbuncle, 80 TELLURIUM herpes circinatus, 125, 705 otitis media, 349, 412 otorrhoea, 349, 412 TEREBINTHINA, 305 albuminuria, 66 antidotal relations, 562 Bright's disease, 254, 306 bronchitis, 306 capillary bronchitis, 382 TEREBINTHINA (Continued) cough, 306 dropsy, 66, 337 haematuria, 66, 305 hydrocephalus, 305 kidneys and bladder, 92, 305, 559 metritis, 305, 306 peritonitis, 305, 306 pneumonia, 305, 306 post-scarlatinal dropsy, 66 puerperal metritis, 415 scarlatina, 305 skin, 85, 86, 87 tympanites, 271, 370 typhoid fever, 66, 305 urticaria, 107 worms, 306 TEUCRIUM MARUM VERUM hiccough, 203 polypi, 570 post-nasal catarrh, 656 worms, 203 THAPSIA GARGANICA skin, 85, 86 THEA stomach, 132, 377 THEBAINE tetanus, 178 THERIDION, 81 antidotal relations, 81 bones, 83 headache, 82 head symptoms, 81 hemicrania, 129 hysteria, 82 neuralgia, 82 ozaena, 83 phthisis, 83 post-nasal catarrh, 348 sea-sickness, 82 spinal irritation, 82 sun, ill effects of the, 38 syncope, 37 vertigo, 37, 82 THUJA OCCIDENTALS, 307 balanorrhoea, 309 blepharitis, 131 ciliary neuralgia, 206 circulation, 308, 309 complementary relations, 311, 543 condjdomata, 309, 340 cough, 310 diarrhoea, 310 eyes, 131 female genital organs, 309, 615 gastric symptoms, 350 gonorrhoea, 91, 309 headache, 308 history of, 307 iritis, 310 marasmus, 310 mental symptoms, 258, 308, 424 nails, 310, 520 nervous system, 307 neuralgia, 308 orchitis, 310 ozaena, 310 INDEX OF REMEDIES. 7 8l THUJA OCCIDENTALIS (Continued) prostatitis, 309 pseudo-cyesis, 308 rheumatism, 309 sclerotitis, 310 scrofula, 310 skin, 85, 688 sun stroke, 38 sweat, 653 sycosis, 307, 309, 694, 726 teeth, 48, 340 tarsal tumors, 130 urinary organs, 91 vaccination, bad effects of, 307, 542 variola, 308 vertigo, 82 warts, 309, 310 TILIA EUROPEA puerperal metritis, 415 TITANIUM hemiopia, 702 TRIFOLIUM PRATENSE cough, 296 torticollis, 296 TRILLIUM PENDULUM epistaxis, 159 menorrhagia. 673 haemorrhages, 158, 159, 368 UMBELLIFERAE, 447 URTICA URENS agalactia, 313, 356 urticaria, 31, 107 USTILAGO crusta lactea, 168 female genital organs, 145, 157 haemoptysis, 301 haemorrhages, 145, 157 menses, 301 metrorrhagia, 157, 158 prolapsus uteri, 145 testes, 352 UVA URSI cystic calculus, 93 cystitis, 93 VALERIANA hysteria, 118, 199, 276 lumbago, 230 nervous system, 118, 121, 248 nose, 276 reaction, defective, 121, 270, 465, 629 sciatica, 230 VEGETABLE KINGDOM, 161 VERATRIA, 178 tetanus, 178 VERATRUM ALBUM, 254 abdominal organs, 254 antidotal relation, 541 cardiac debility, 257 cholera Asiatica, 255 cholera infantum, 156, 255, 285, 380 cholera morbus, 255, 396, 554 colic, 272, 287 collapse, 69, 484, 315 convulsions, 183, 201 VERATRUM ALBUM (Continued) cough, 151 cramps, 288 delirium, 255 V diarrhoea, 176, 255, 272, 371 face, 44 fright, ill effects of, 272 headache, 200, 354, 377, 701 heart, 257 hemicrania, 128 hiccough, 203 intermittent fever, 69 intestinal symptoms, 583 intussusception, 255, 287 mental symptoms, 255, 272 nervous system, 195, 248 neurasthenia, 624 nymphomania, 254, 429 poisoning by, 254 rheumatism, 249 scarlatina, 635 skin, 85 syncope, 37, 38 tetanus, 182 typhoid fever, 252 vertigo, 37 whooping cough, 704 VERATRUM VIRIDE, 257 chorea, 257 fever, 319 heart, 257 lungs, 257 oesophagitis, 257, 414 pneumonia, 257, 279, 319, 323 puerperal convulsions, 257 tetanus, 181 VERBASCUM THAPSUS cough, 395 neuralgia, 395, 419 prosopalgia, 614 VESPA, 97 os uteri, ulceration of, 145 VIBURNUM OPULUS abortion, 250 female genital organs, 146 VINCA MINOR, 167 crusta lactea, 167 haemorrhages, 167, 369 menorrhagia, 167 plica polonica, 167 VIOLA ODORATA rheumatism, 297 VIOLA TRICOLOR crusta lactea, 167 polypi, 369 urine, 167 WYETHIA hay fever, 558 XANTHOXYLUM FRAXINEUM after-pains, 356 YERBA SANTA lungs, 627 phthisis, 215, 627, 718 782 INDEX OF REMEDIES. YUCCA FILAMENTOSA asthma, 718 biliousness, 299, 313 gonorrhoea, 313 skin, 313 tongue, 454 ZANTHORRHIZA, 451 ZINCUM METALLICUM, 631 amblyopia, 637 antidotal relations, 631 asthma, 633 backache, 361 brain, 367, 633 brain, softening of the, 636 cholera infantum, 635 chorea, 634 colic, 637 complementary relations, 631 corneal opacity, 637 cough, 638 dentition, 633 dysuria, 638 exanthemata, 424 eyes, 637 female genital organs, 638 gastric symptoms, 637 granular lids, 637 headache, 635 heart, 636, 656 hydrocephaloid, 635, 680 hypochondriasis, 638 inimical relation, 543, 631 liver, 637 locomotor ataxia, 600 measles, 425, 633 meningitis, 102, 337, 633, 634 menses, 633, 638 ZINCUM METALLICUM (Continued) nervous symptoms, 79, 632 neurasthenia, 541 ovaries, 65, 633, 638 paralysis, 636 poisoning by, 631, 632 prosopalgia, 637 pterygium, 637 rheumatism, 634 scarlatina, 302, 633, 634 sexual excesses, 633 sleep, 443 spermatorrhoea, 638 spinal cord, 632, 636 spinal irritation, 330, 633, 636 suppressed eruptions, 101, 302, 367, 443, 633. typhoidal conditions, 102 urine, 637 wine, aggravation from, 632, 634 ZINCUM OXIDATUM hypochondriasis, 44S reaction, defective, 121 typhoid fever, 102 ZINCUM SULPHURICUM corneal opacities, 637 dysentery, 96 granular lids, 637 ZINC, VALERIANATE OF hysteria, 199 ZINGIBER asthma, 191 urine, 271 ZIZIA chorea, 74, 146 female genital organs, 146 mental symptoms, 146 THERAPEUTIC INDEX. ABDOMINAL SYMPTOMS arsenicum, 488 cascarilla, 312 cinchona, 488 colchicum, 253 colocynth, 286 nux vomica, 136 oleander, 165 podophyllum, 453 veratrum album, 254 ABORTION aconite, 325 actea racemosa, 328 chamomilla, 250 digitalis, 388 gelsemium, 176 hamamelis, 328 ipecac, 328 kali carb., 737 lycopodium, 328 opium, 484 plumbum, 622 sabina, 305 secale, 154 sepia, 146 viburnum, 250 ABSCESSES belladonna, 419, 592 carbo veg., 483 cinchona, 484 hepar, 592, 684 lachesis, 492 mercurius, 592 silicea, 543, 592 sulphur, 592 ABSCESS OF LUNGS lachesis, 51 sulphur, 51 ABSCESS OF TEETH hepar, 46 lachesis, 46 mercurius, 46 silicea, 46 ACNE carbo animalis, 141 kali bich., 724 kreosote, 196 lachesis, 196 ledum, 195 nux vomica, 195 sanguinaria, 280 sulphur, 195, 468, 475 ADENOMATA conium, 449 AFTER-PAINS actea racemosa, 328 AFTER-PAINS (Continued) caulophyllum, 356 chamomilla, 356 cuprum, 356 Pulsatilla, 356 xanthoxylum, 356 AGALACTIA agnus castus, 356 causticum, 356, 734 Pulsatilla, 356 ricinis communis, 313, 356 urtica urens, 313, 356 ANGINA PECTORIS actea recemosa, 329 argentum nitricum, 608 arsenicum, 559 tabacum, 432 ANKLE-JOINT carbo animalis, 676 causticum, 692, 698, 732 natrum carb., 676, 692 natrum hypochlor., 692 natrum mur., 692 pinus sylvestris, 692 sepia, 676 silicea, 732 sulphur, 692, 732 sulphuric acid, 692, 698, 732 ANTIDOTAL RELATIONS, 24 aconite, 326 alumina, 616, 620 ammonium carb., 658 anacardium, 222 antimonium tart., 583 apis, 114 argentum nitricum, 272, 579 arnica, 658 arsenicum, 541 asafoetida, 450, 587 aurum, 586, 600 belladonna, 516, 600, 628 bryonia, 303, 617 camphor, 116, 481, 658 cantharis, 93 carbo veg., 481 castor oil, 313 cepa,' 380 chamomilla, 266, 616, 644 chlorine, 511 cicuta, 433 cinchona, 372, 375, 55*. 586 colchicum, 254 colocynth, 288 croton tiglium, 222 cuprum, 628 dulcamara, 586 7 8 4 THERAPEUTIC INDEX. ANTIDOTAL RELATIONS (Continued) ferrum, 639 gelsemium, 176 glonoin, 438 graphites, 492 hepar, 536, 543, 585, 600, 631, 688, 712 ignatia, 200, 631 iodine, 508, 587 kali brom., 713 kali chlor., 586 kali hydr., 556, 716, 719 lachesis, 62, 587 ledum, 114 magnesia carb., 644 mercury, 536, 585, 589, 600 mezereum, 587 moscnus, 116 muriatic acid, 272, 525 natrum mur., 696 nitric acid, 535, 536, 586 nux vomica, 136, 266, 492, 562 oleander, 167 ophidia, 35 opium, 266, 268, 272 petroleum, 311, 500 phosphorus, 562, 569 plantago, 433, 644 plumbum, 614, 620, 621 Pulsatilla, 343, 644 rheum, 644 rhus tox., 222, 224 sarsaparilla, 272 selenium, 462 sepia, 125, 432 silicea, 543 staphisagria, 340, 586 stillingia sylvatica, 587 . stramonium, 425, 628 sulphur, 272, 712 sulphuric acid, 532 tabacum, 432, 433 terebinthina, 562 theridion, 81 veratrum alb., 541 zinc, 631 ALBUMINURIA apis, 66 arsenicum, 67, 559 aurum, 603 equisetum, 90 formica, 86 glonoin, 437 helonias, 358 lachesis, 65, 66 terebinthina, 66 ALCOHOLISM {See also drunkards, complaints of.) ranunculus bulbosus, 332 sulphuric acid, 531 ALIMENTARY CANAL aloes, 478 bryonia, 298 cantharis, 95 lachesis, 51 nux vomica, 189 phosphorus, 567 ALOPECIA selenium, 461 AMBLYOPIA baryta carb., 652 phosphorus, 574 zincum, 637 AMENORRHOEA aconite, 674 actea spicata, 674 apis, 112 belladonna, 674 calcarea ostr., 673 castoreum, 117 gelsemium, 674 glonoin, 673 hamamelis, 301 kali carb., 739 lycopodium, 674 natrum mur., 739 phosphorus, 569 Pulsatilla, 355 ANAEMIA (See also Chlorosis.) alumina, 618 cinchona, 366 ferrum, 367, 483, 640 kali carb., 736 manganum, 641 natrum mur., 698 Pulsatilla, 344 sepia, 347 ANALYSIS OF DRUGS, 18 ANASARCA (See Dropsy.) ANEURISM baryta carb., 650 ANGER, ILL EFFECTS OF causticum, 286 chamomilla, 286, 33$ colocynth, 286, 339 staphisagria, 286, 339 ANUS anacardium, 165 belladonna, 60 causticum, 60 cocculus, 60, 61 ignatia, 60, 203 kali bi., 60 mezereum, 60 natrum mur., 60, 705 nitric acid, 60, 534 opium, 60 plumbum, 60 AORTITIS arsenicum, 486 carbo veg., 486 cuprum, 486 lachesis, 486 APHONIA AND HOARSENESS bothrops lanceolatus, 33 APHONIA ammonium caust., 662 aurum triphyl., 210, 462 carbo veg., 210, 462, 484, 733 causticum, 462, 485, 732 eupatorium perf., 485, 733 THERAPEUTIC INDEX. 785 APHONIA (Continued) gelsemium, 170 graphites, 733 kali carb., 739 nitric acid, 536 phosphorus, 462, 485, 570 Pulsatilla, 360 rhus tox., 733 sanguinaria, 280 selenium, 210, 462, 733 senega, 296 spongia, 462 sulphur, 473, 485, 733 APHTHOUS SORE MOUTH apis, 47 arsenicum, 47 arum triphyllum, 710 baptisia, 47 borax, 710 bryonia, 301, 709 carbo veg., 47 chlorine, 511 helleborus, 48 iodine, 47 lachesis, 47, 48 lycopodium, 48 mercurius, 47, 710 muriatic acid, 47 natrum hypochlor., 48 nitric acid, 47, 48 Phytolacca, 48 salicylic acid, 48 staphisagria, 47 sulphuric acid, 47, 532 APOPLECTIC CONGESTION coffea, 384 APOPLEXY apis, 100, 269 arnica, 242, 269 baryta carb., 268, 650 belladonna, 268, 269 causticum, 731 glonoin, 437 helleborus, 269 hyoscyamus, 269 lachesis, 2b6, 269 nux vomica, 269 opium, 100, 268 rhus tox., 269 strontiana carb., 653 tabacum, 430 APOPLEXY OF THE RETINA arnica, 43 crotalus, 43 glonoin, 436 hamamelis, 43 lachesis, 43 phosphorus, 43 ARTHRALGIA argentum met., 599, 611 ARTHRITIC HEADACHE nux vomica, 128 sepia, 128 ARTHRITIS DEFORMANS calcarea carb., 677 50 ASCARIDES ignatia, 203 indigo, 203 spigelia, 206 teucrium, 203 ASCITES acetic acid, 104 apocynum cannab., 104 lycopodium, 444 ASPHYXIA ammonium carb., 661 arnica, 158, 273, 659 bovista, 158, 273, 659 hydrocyanic acid, 433 tabacum, 182, 433 ASPHYXIA NEONATORUM antimonium tart., 582 laurocerasus, 583 ASTHENOPIA alumina, 619, 655 ammoniacum gummi, 449 apis, 114 argentum nitricum, 609 artemisia vulgaris, 243 belladonna, 449 cina, 247 cinchona, 369 cyclamen, 130 jaborandi, 130 kali carb., 130 lilium triginum, 130 lithium carb., 655 natrum mur., 130, 702 phosphorus, 574 Pulsatilla, 130 ruta, 449 sepia, 129, 130 ASTHMA ambra grisea, 152 antimonium tart., 633 apis, no aralia racemosa, 727 argentum nitricum, 608 arsenicum, 381, 558, 727 baryta carb., 652 bromine, 507 cactus, 633 cadmium sulph., 633 caladium seguin., 214 capsicum, 435 carbo veg., 191, 485 cuprum, 381 drosera, 27 ferrum met., 639 grindelia robusta, 633 ipecacuanha, 380, 558 kali bich., 727 kali chlor., 633 lachesis, 51 lobelia, 381 lycopodium, 191 mephitis, 27 natrum sulph., 694 nux vomica, 190 pothos foetida, 215 pulmo vulpis, 29 786 THERAPEUTIC INDEX. ASTHMA (Continued) rumex crispus, 27 sepia, 633 stramonium, 424 sticta, 27 yucca, 718 zincum, 633 zingiber, 191 ATROPHY OF THE RETINA nux vomica, 189 AWKWARDNESS aethusa, 102 apis mellifica, 102 ignatia, 102 natrum mur., 102 nux vomica, 102 BACKACHE aesculus hipp., 'J06 agaricus, 361 berberis, 361 cannabis indica, '61 chelidonium, 281 chenopodium, 282 cobalt, 193, 361, 632, 636 kali carb., 738, 739 lobelia syph., 282 nux vomica, 194 picric acid, 134, 361, 539 Pulsatilla, 361 rhus tox., 361 sepia, 361, 636 valerian, 361 zincum, 361 B ALAin ORRHOEA digitalis, 394 mercurius corrosivus, 394 mercurius vivus, 311 nitric acid, 310 thuja, 309 BILIARY CALCULI belladonna, 192 berberis, 192, 452 cinchona, 192 podophyllum, 454 BILIOUSNESS artemesia tridentata, 244 chamomilla, 249, 299 yucca filamentosa, 299, 313 BILIOUS REMITTENT FEVER gelsemium, 173 podophyllum, 453 BLADDER arsenicum, 271 berberis, 451 cantharis, 88 cina, 247 causticum, 271 colocynth, 287 conium, 91 dulcamara, 434 erigeron, 92 ferrum phos., 92 hepar, 687 hyoscyamus, 271 lachesis, 416 BLADDER (Continued) lithium carb., 655 nux vomica, 192 opium, 271 Pulsatilla, 92 senecio, 359 BLADDER, STONE IN THE (See » esical Calculus.) BLEPHARITIS alumina, 619 argentum nitr., 609 euphrasia, 396 graphites, 130, 494, 619 kreosote, 609 mercurius, 397, 593, 609 petroleum, 499 sepia, 130 thuja, 131 BLEPHAROSPASMUS agaricus, 189 euphrasia, 189 natrum mur., 189 rhus tox., 235 nux vomica, 189 BLOOD alumina, 618 ammonium carb., 658 arsenicum, 552 belladonna, 189 bryonia, 289 carbo veg., 481 chininum sulph., 365 kali carb., 736 lycopodium, 441 phosphorus, 575 quinine, 365 secale, 154 sepia, 124 BLOODVESSELS arnica, 238 secale, 154, 650 BOILS arnica, 242 arsenicum, 561 belladonna, 419 calcarea sulph., 667 carbo veg., 483 hepar, 684 psorinum, 150 silicea, 543 sulphur, 468 BONES angustura, 545 aranea diadema, 81 asafoetida, 119, 450, 545 aurum, 604 calcarea fluorica, 519 calcarea ostrearum, 676 calcarea phosphorica, 241, 680 chloride of gold and platinum, 341 euphorbium, 313 fluoric acid, 519 Gettysburg spring water, 341, 545 kali hydriodicum, 341 mercurius, 341 phosphoric acid, 530 THERAPEUTIC INDEX. 787 BONES (Continued) phosphorus, 545, 573 platinum mur., 545, 614 silicea, 519, 544 staphisagria, 340 stillingia, 341 stroritiana carb., 341, 545, 654 Symphytum, 241 theridion. 83 BOWELS, OBSTRUCTION OF opium, 272 BRAIN aconite, 320 argentum nitricum, 605 baryta carb., 651 baryta mur., 650 belladonna, 235, 320, 335, 407 cantharis, 93 carbo animalis, 235 causticum, 651 cinchona, 235 digitalis, 393 glonoin, 320 hyoscyamus, 427 natrum mur., 129 plumbum, 622 rhus tox., 235 spigelia, 235 stramonium, 425 sulphur, 471 sulphuric acid, 235 zincum, 367, 633 BRAIN, CONGESTION OF THE amyl nitrite, 320 belladonna, 320, 409 glonoin, 320, 437 BRAIN-FAG kali bromatum, 714 natrum mur., 128 nux vomica, 128, 540 phosphoric acid, 540 phosphorus, 540 picric acid, 128, 538 sepia, 128 sulphur, 128 BRAIN, INFLAMMATION OF THE arsenicum, 94 arum triphyllum, 210 belladonna, 94, 409, 437 camphor, 94 cantharis, 93 glonoin. 437 hyoscvamus, 426 BRAiN, PARALYSIS OF THE hydrocyanic acid, 336, 538 hyoscyamus, 268, 442 lachesis, 268 lycopodium, 442 opium, 268 BRAIN, SCLEROSIS OF THE plumbum, 622 BRAIN, SOFTENING OF THE ambra grisea, 151 nux vomica, 564 phosphorus, 184, 564 picric acid, 184 BRAIN, SOFTENING OF (Continued) piper methysticum, 385 sulphur, 184 zincum, 636 BRIGHT'S DISEASE arsenicum, 559 cantharis, 88 colchicum, 254 hepar, 685 kali hydr., 718 lachesis, 65 phosphorus, 569 terebinthina, 254, 306 BRONCHIAL CATARRH AND BRON- CHITIS ammonium carb., 660 ammonium mur., 664 balsam of Peru, 215 bryonia, 296, 570 calcarea pJaos., 680 capsicum, 374, 546 carbo animalis, 490 carbo veg., 490 dracontium, 215 ipecacuanha, 381 jaborandi, 686 kali bichromicum, 727 kali carbonicum, 740 lachesis, 50 lycopodium, 445 natrum arsenicosum, 707 phosphorus, 190, 570, 571 pix liquida, 215 Pulsatilla, 361 sanguinaria, 374 sulphur, 473 terebinthina, 306 yerba santa, 215 BRONCHORRHAGIA carbo veg., 481 BUBOES alumina, 620 badiaga, 31, 490 belladonna, 391 carbo animalis, 31, 489 hepar, 686 BURNS arsenicum, 97 cantharis, 97 carbolic acid, 97 sapo soda, 97 soda bicarbonate, 97, 689 CALLOSITIES antimonium crudum, 2^2, 579 CANCER arsenicum, 552, 561 arsenicum iod., 561 belladonna, 561 bromine, 503 carbo animalis, 490 carbo veg., 483 cicuta virosa, 451 clematis, 561 conium, 449, 561 hydrastis, 510, 561 788 THERAPEUTIC INDEX. CANCER (Continued) iodine, 510 kreosote, 136 lachesis, 71 lapis albus, 510 morphia, 265 phosphorus, 568, 575 CAPILLARY BRONCHITIS antimonium tart., 381, 581, 686 baryta carb., 582 chelidonium, 263 hepar, 686 ipecacuanha, 381, 582 kali carb., 740 lycopodium, 382 phosphorus, 381 sulphur, 382 terebinthina, 382 CARBUNCLE anthracinum, 80, 232, 561 arsenicum, 232, 552, 561 carbo veg., 232, 443, 501 lachesis, 71, 80, 561 Phytolacca, 561 rhus tox., 22,2 silicea, 80, 543 tarantula Cubensis, 80 CARDIAC DEBILITY veratrum album, 257 CARIES OF BONES angustura, 545 aranea diadema, 81 calcarea fluorica, 519 fluoric acid, 519 Gettsysburg salts, 545 nitric acid, 535 phosphorus, 545 platina muriatica, 545 silicea, 544 strontiana carb., 545 sulphur, 468 CATALEPSY curare, 179 piper methysticum, 386 CATARACT baryta carbonica, 575 calcarea ostr., 575 conium, 575 lycopodium, 443 magnesia carb., 646 magnesia mur., 646 natrum mur., 575, 697 phosphorus, 575 secale, 575 sepia, 130 silicea, 575 CATARRHAL FEVER mercurius, 591 CATARRH (See also Mucous Membranes.) arsenicum, 380 arundo maur., 661 bryonia, 294 carbo veg., 484, 662 causticum, 662 chlorine, 511 CATARRH (Continued) gelsemium, 173 hepar, 685 kali hydriodicum, 717 laurocerasus, 662 natrum arsenicosum, 706 natrum carb., 693 natrum mur., 698, 702 nitric acid, 534 ranunculus sceleratus, 333 senecio, 359 CELLULITIS apis, 232 rhus tox., 232, 234 silicea, 543 CEREBRO-SPINAL MENINGITIS ammonium carb., 659 cocculus, 263 digitalis, 393 gelsemium, 172 oxalic acid, 540 CERVIX UTERI aurum metallicum, 139 aurum muriaticum, 139 aurum muriaticum natron., 139 carbo animalis, 140 gelsemium, 139, 175, 421 graphites, 142 kreosote, 136 mitchella, 145 murex, 135 natrum carb., 693 sepia, 139 CHANCRE corallium rubrum, 311 kali hydriodicum, 64 lachesis, 62 lycopodium, 63 mercurius biniod., 597 mercurius protoiod., 597 nitric acid, 63, 535 CHANCROID jacaranda, 311 mercurius, 596 thuja, 309 CHANGE OF LIFE (See Climaxis.) CHARCOAL FUMES, ASPHYXIA FROM ammonium carb., 659 arnica, 158, 273, 659 bovista, 158, 273, 659 opium, 273 CHEMOSIS rhus tox., 113 CHEST PAINS angustura, 282 anisum stellatum, 83, 306 chenopodium, 282 fluoric acid, 306 guaiacum, 306 kali carb., 306 lilium tigrinum, 134, 306, 346 lobelia syphilitica, 282 myrtus com., 306 oxalic acid, 306 phosphorus, 306 THERAPEUTIC INDEX. 789 CHEST PAINS (Continued) pix liquida, 306 Pulsatilla nut., 306, 361 Pulsatilla prat., 331, 34s ranunculus bulbosus, 282 sarsaparilla, 306 silicea, 306 sulphur, 306 sumbul, 306 theridion, 306 CHLOROSIS (See also Anaemia.) alumina, 617, 618 argentum met., 599 calcarea phosphorica, 680 cuprum, 629 cyclamen, 359 ferrum, 493, 640 graphites, 493 manganum, 641 natrum mur., 700 Pulsatilla, 344, 494 sepia, 124, 347 CHOLERA ASIATICA arsenicum, 156, 553 camphor, 156, 256, 484, 629 carbo veg., 156, 380, 484 colchicum, 59, 253 cuprum, 628 hydrocyanic acid, 538 jatropha curcas, 256, 312 lachesis, 59 secale, 155, 554 sulphur, 478 tabacum, 432 veratrum album, 255 CHOLERA INFANTUM aconite, 324 argentum nitr., 610 arnica, 22, 242 arsenicum, 555 belladonna, 411, 419 calcarea ostr., 671 calcarea phos., 300, 679 cinchona, 366, 380 colocynth, 287 croton tiglium, 285 elaterium, 284 ferrum, 642 ferrum phos., 159, 270, 642 gnaphalium, 379 helleborus, 337 ipecacuanha, 378 kali bromatum, 380 opium, 270 podophyllum, 59, 285 psorinum, 149 secale, 155 sulphur, 471, 672 veratrum alb., 156, 255, 285, 380 zincum, 635 CHOLERA MORBUS argentum nitricum, 629 arsenicum, 156 camphor, 156, 380 euphorbia corollata, 312 CHOLERA MORBUS (.Continued) iris versicolor, 256, 351, 396 podophyllum, 256 secale, 155 veratrum alb., 255, 396, 554 CHORDEE agaricus, 541 ambra, 541 cannabis indica, 90 cannabis sativa, 89 cantharis, 89, 96, 541 capsicum, 541 digitalis, 391 mygale, 541 opium, 541 petroselinum, 541 physostigma, 541 platina, 541 zincum, 541 CHOREA actea rac, 74 agaricus muscarius, 74, 79 arsenicum, 79 belladonna, 77 causticum, 77, 734 crocus, 76, 79 hyoscyamus, 77, 428 ignatia, 74, 77 mygale, 73 natrum mur., 699 phosphorus, 565 sepia, 146 stramonium, 74, 428 tarentula, 74 veratrum viride, 257, 428 zincum, 634 zizia, 74, 146 CHOROIDITIS phosphorus, 574 CHOROIDO-RETINITIS nux vomica, 189 CICATRICES fluoric acid, 520 graphites, 141, 496 Phytolacca, 141, 544 silicea, 543 sulphur, 544 CINCHONISM, 366 CIRCULATION ammonium mur., 662 amyl nitrite, 278 bovista, 157 coffea, 385 ferrum, 639 gelsemium, 168 glonoin, 278, 435 graphites, 493 lachesis, 65 lilium tigrinum, 127, 346 Pulsatilla, 345 rhus tox., 223 sanguinaria, 276, 278 secale, 154 sepia, 123, 124 strontiana carb., 643 sulphur, 135, 465 79Q THERAPEUTIC INDEX. CIRCULATION (Continued) thuja, 308 CIRRHOSIS OF THE LIVER aurum, 36, 603 lycopodium, 444 muriatic acid, 525 CLERGYMAN'S SORE THROAT arum triphyllum, 210 CLIMAXIS amyl nitrite, 31, 278, 466 glonoin, 278 lachesis, 36, 65, 278, 466 sanguinaria, 276, 278 strontiana carb., 654 sulphur, 466 sulphuric acid, 466 COLIC aconite, 287, 324 aethusa cynapium, 710 alumina, 620, 621 belladonna, 419, 621 borax, 710 bovista, 287 castoreum, 117 causticum, 735 chamomilla, 339 cinchona, 272 colocynth, 285, 324, 339, 419, 644 croton tiglium, 287, 312 cuprum, 629 cyclamen, 263, 360 dulcamara, 434 ipecacuanha, 378 lycopodium, 272 magnesia carb., 644 nux vomica, 186, 272, 62.1 opium, 272, 621 platina, 621 plumbum, 621 rhus tox., 234 staphisagria, 248, 339, 341 veratrum album, 272, 287 zincum, 637 COLLAPSE aconite, 315 arsenicum, 69 camphor, 69, 484, 629 carbo veg., 156, 373, 484, 566 cuprum, 70, 629 digitalis, 69 hydrocyanic acid, 69, 538 secale, 69, 156 veratrum album, 69, 315, 484 CONCORDANT REMEDIES, 24 CONDYLOMATA cinnabaris, 311 euphrasia, 311, 398 jacaranda, 311 lycopodium, 63 nitric acid, 310 sabina, 311 staphisagria, 311, 340 thuja, 309, 340 CONGESTION OF THE BRAIN (See Brain.) CONGESTION OF THE CHEST ferrum phos., 159, 642 sulphur, 465 CONGESTION OF THE HEAD aurum, 601 sulphur, 465 CONGESTIONS aconite, 320 aurum, 599, 603 belladonna, 407, 591 gelsemium, 169 mercurius, 591 sulphur, 456 CONJUNCTIVITIS aconite, 321, 397 apis, 113, 217 argentum nitricum, 347 arnica, 397 arsenicum, 113, 397 belladonna, 412 bromine, 507 calcarea ostrearum, 235 euphrasia, 397 ipecacuanha, 383 mercurius cor., 347 mercurius viv., 397 natrum mur., 131 nux vomica, 189 Pulsatilla, 130, 347 rhus tox., 113, 235, 397 sanguinaria, 280 sepia, 130 sulphur, 321, 473 CONNECTIVE TISSUE sepia, 125 CONSTIPATION aletris farinosa, 359 alumina, 186, 271, 461, 617 ambra, 152 ammonium mur., 664 anacardium, 219 antimonium crud., 578 bryonia, 186, 271, 298, 461, 617, 686 carbo veg., 186, 486 cascarilla, 312, 497 collinsonia, 188 conium, 449 fel tauri, 29 fel vulpi, 29 graphites, 497 hepar, 53, 686 hydrastis, 360 ignatia, 220 lac caninum, 28 lac defloratum, 28 lachesis, 52, 54 lycopodium, 186, 444 natrum carb., 690 natrum mur., 704 nux vomica, 184, 186, 220, 445, 686 opium, 186, 271, 461 phosphorus, 566 platina, 614 plumbum, 271, 461, 614, 622 podophyllum, 454 Pulsatilla, 351 THERAPEUTIC INDEX. 791 CONSTIPATION (Continued) selenium, 460 sepia, 220, 705 silicea, 546 sulphur, 220, 476 zincum, 637 CONSTITUTION alumina, 617 ammonium carb., 657 ammonium mur., 662, 657 aranea diadema, 80 baryta carb., 649 borax, 708 calcarea ostrearum, 493, 668, 677 calcarea phos., 678 carbo animalis, 489 carbo veg., 481 causticum, 729 colocynth, 195 ferrum, 637 graphites, 493 kali bichromicum, 720 lycopodium, 440 magnesia carb., 644 magnesium mur., 646 mercurius, 54 natrum sulph., 694 nux vomica, 183 phosphorus, 562, 570 psorinum, 148 secale, 154 selenium, 460 sepia, 122 silicea, 542, 677 spongia, 512 sulphur, 464 thuja, 307 CONTINUED FEVER (See also Fever.) . aconite, 316 arsenicum, 316, 557 sulphur, 557 CONVULSIONS arsenicum, 44 artemisia vulg., 624 belladonna, 201, 40S, 420 calcarea ostr., 669 camphor, 45, 94 chamomilla, 201 cicuta, 44, 182, 451 cina, 246, 624 cocculus, 262 colchicum, 59 cuprum, 201, 629, 630, 634 ergot, 153 glonoin, 201, 437 helleborus, 45 hydrocyanic acid, 44, 45, 433, 538 hyoscyamus, 44, 45, 201, 428 ignatia, 378 ipecacuanha, 273, 378 kali bromatum, 761, 713 lycopodium, 44 moschus, 116 oenanthe crocata, 428 opium, 200, 201, 270 CONVULSIONS (Continued) Phytolacca, 179 platina, 339, 614 podophyllum, 59 secale, 153, 201, 437 stannum, 625 stramonium, 45, 93, 200, 423, 714 strychnine, 177 veratrum album, 183, 201 CORNEA, OPACITY OF THE alumen, 669 apis, 669 calcarea ostrearum, 669 cuprum, 669 kali bi., 669 natrum sulph., 699 saccharum offic, 669 zincum, 637 zincum sulph., 637 CORNEA, ULCERS OF THE calcarea ostrearum, 669 kali bichromicum, 726 mercurius corrosivus, 593 mercurius protoiod., 593 mercurius vivus, 593 natrum carb., 693 nitric acid, 535, 670 podophyllum, 453 Pulsatilla, 347 silicea, 545 CORYZA (See also Nasal Catarrh.) aconite, 294, 326 ammonium carb., 661 ammonium caust., 662 ammonium mur., 661, 664 anacardium, 221 arsenicum, 380, 557 arsenicum jod., 557 belladonna, 326 bromine, 294 bryonia, 294 cepa, 380, 398 chamomilla, 249 chlorine, 511 cinchona, 295, 326 dulcamara, 434 euphrasia, 380, 397 gelsemium, 173 hepar, 684, 685 ipecacuanha, 380 kali bichromicum, 726 kali carb., 739 kali hydriodicum, 717 lachesis, 49, 294 mercurius, 190, 594 natrum ars., 706 natrum carb., 693 natrum mur., 702 nitric acid, 534 nux vomica, 190, 249, 326, 594 penthorum sedoides, 348 phosphorus, 380 Pulsatilla, 190, 348 quillaya, 174 ranunculus seel., 333 792 THERAPEUTIC INDEX. CORYZA (Continued) rhus tox., 234 sambucus, 249 sanguinaria, 280 sticta pulmonaria, 249 sulphur, 473 verbascum, 395 COUGH actea racemosa, 308 alumina, 619 ambra grisea, 151, 152, 546, 661 ammonium carb., 661 ammonium mur., 662, 664 anacardium, 513 angustura, 152 antimonium tart., 270, 582, 583 apis, 1 1 1 arnica, 152, 732 arsenicum, in, 152 baryta carb., 652 belladonna, in, 421, 570 borax, 710 bryonia, in, 296, 693, 703 calcarea ostr., 421 capsicum, 374 carbo animalis, 490 carbo veg., 112, 491 causticum, 421, 703, 732 cepa, 422 chamomilla, in, 249 cimex, 152 conium, 361, 448 crotalus horridus, in drosera, 273, 395, 732 ferrum, 641 gelsemium, 173, 174 graphites, 498 hepar, 234, 513, 683 hydrocyanic acid, 538 hyoscyamus, in, 361, 427 ignatia, in, 201 iodine, 509 kali bich., 662, 727 lcali carb., 732, 740 lachesis, in, 152, 421 laurocerasus, 361, 538, 732 lithium carb., 655 lycopodium, 546 manganum, 609 mentha piperita, 428 mezereum, 234 natrum ars., 707 natrum carb., 693 natrum mur., 427, 703, 732 nitric acid, 536 nux vomica, in, 190 oleum jecoris, 29 opium, 270 petroleum, 499 phosphorus, 151, 421, 546, 570, 571 phosphoric acid, 430 Pulsatilla, 234, 536, 732 rhus tox., 234, 546 rumex, in, 421, 427, 546, 570 sanguinaria, 152, 234, 278, 279, 374 scilla, 546, 703, 732 COUGH (Continued) senecio, 359 senega, 296 sepia, 732 silicea, 546 spongia, 395, 506, 513 sulphur, 395 sulphuric acid, 152, 531 terebinthina, 306 thuja, 310 trifolium praetense, 296 veratrum alb., 151 verbascum, 395 zinc, 638 CRAMPS cholos terrapinae, 288 colocynth, 288 nux vomica, 288 veratrum album, 288 CRETINISM baryta carb., 679 calcarea phos., 679 CROUP aconite, 323, 505, 684 antimonium tart., 505 arsenicum, 560 bromine, 504, 684 cf.lcarea sulphurica, 667 hepar, 324, 506, 684, 723 iodine, 506 kali bichromicum, 595 kaolin, 505, 506, 723 lachesis, 723 mercurius cyanatus, 723 phosphorus, 570 sanguinaria, 280 spongia, 323, 506, 684 CRUSTA LACTEA arctium lappa, 168 arsenicum iod., 168 graphites, 168 mezereum, 168 natrum muriaticum, 705 nux juglans, 168 oleander, 167 psorinum, 149 staphisagria, 168, 340 sulphur, 167, 468 ustilago, 168 vinca minor, 167 viola tricolor, 167 CYANOSIS NEONATORUM digitalis, 389 CYSTITIS apis, 93 cantharis, 88, 89, 351 conium, 450 digitalis, 393 dulcamara, 351, 434 equisetum, 90, 351 lachesis, 66 Pulsatilla, 92, 351 DACRYOCYSTITIS petroleum, 499 Pulsatilla, 347 THERAPEUTIC INDEX. 793 DEAFNESS carbo animalis, 491 carbo veg., 491 graphites, 498 ignatia, 575 phosphorus, 574 DEBILITY (See also Defective Reaction.) argentum metallicum, 611 arsenicum, 367, 369 calcarea ostrearum, 624 calcarea hypophos., 738 carbo animalis, 489, 490 carbo veg., 481, 491 cinchona, 367, 487 cocculvts, 260, 624 colchicum, 251 conium, 447 helonias, 135 hypophosphite of lime, 738 kali carb., 738 lithium carb., 135 muriatic acid, 522 natrum carb., 692 nux vomica, 256 phosphoric acid, 367, 526, 624 phosphorus, 367 psorinum, 738 selenium, 459 senna, 737 stannum, 624 sulphur, 460, 624 sulphuric acid, 624 veratrum album, 624 DEFECTIVE REACTION ambra grisea, 121, 150, 270, 465, 629 asafoetida, 121 camphor, 121 capsicum, 150, 629 carbo veg., 150, 270, 465, 629 castoreum, 121, 465 cinchona, 121, 150 coca, 121 coffea, 121 cuprum, 464, 629 cypripedium, 121 laurocerasus, 150, 464, 629 moschus, 121, 150 opium, 150 psorinum, 149, 150, 270, 464 Scutellaria, 121 tarentula, 121 sulphur, 270, 462, 629 valerian, 121, 270, 465, 624 zinc oxide, 121 DELIRIUM absinthium, 243 agaricus, 423 belladonna, 255, 429 bryonia, 290 hyoscyamus, 426, 429 lachesis, 38, 423 calcarea ostr., 269 lycopodium, 442 muriatic acid, 522 phosphorus, 563 DELIRIUM (Continued) plumbum, 622 stramonium, 39, 255, 423, 429 veratrum alb., 255 DELIRIUM TREMENS absinthium, 243 arsenicum, 269, 551 calcarea ostrearum, 269, 675 cannabis indica, 269 lachesis, 269 opium, 269 ranunculus bulb., 332 stramonium, 269 DENTAL FISTULA calcarea fluorica, 519 fluoric acid, 519 DENTITION aethusa, 420 belladonna, 249 bromine, 504 calcarea ostrearum, 669 chamomilla, 249 cina, 420 colchicum, 59, 420 dolichos, 420 kreosotum, 420 podophyllum, 59, 454 zincum, 633 DIABETES lac defloratum, 28 lactic acid, 518 phosphoric acid, 518 phosphorus, 568 DIAPHRAGMITIS cactus grandiflorus, 331 ranunculus bulb., 331 DIARRHOEA aconite, 324 aloes, 137, 165, 166 astonia schol., 168 antimonium crud., 578 apis, 144, 166 apocynum, 164 aranea diadema, 81 argentum nitricum, 166, 176, 253, 610, 643 arnica, 242 arsenicum, 55, 166, 370, 553, 642 belladonna, 419 borax, 710 bryonia, 114, 299, 453, 474, 724 calcarea ostrearum, Cy r, 687 calcarea phosphorica, 672 castoreum, 117 chamomilla, 248, 342, ^ 5 t cinchona, 53, 166, 370, 429, 488, 642 coffea, 385 colchicum, 59 colocynth, 248, 285, 644 croton tiglium, 256, 285, 312, 453 dioscorea, 453, 475 dulcamara, 434, 652 elaps, 58 elaterium, 257, 284, 287, 395 euphorbia corollata, 312 ferrum met., 166, 370, 642 ferrum phos., 159, 642 794 THERAPEUTIC INDEX. DIARRHOEA (Continued) gamboge, 165, 180 gelsemium, 176, 255, 272 geranium, 379 gnaphalium, 374, 725 graphites, 59 gratiola, 395 hepar, 687 iodine, 510 ipecacuanha, 379 iris versicolor, 351, 371, 396 kali bichromicum, 724 kali bromatum, 380 lachesis, 52 leptandra, 396, 598 lilium tig., 134 lithium carb., 655 magnesia carb., 644, 687 mercurius, 250, 396, 591 natrum carb., 690 natrum mur., 705 natrum sulph., 453, 474, 695, 724 nitric acid, 534 nuphar luteum, 380 nux vomica, 188, 287 Oenothera, 379 oleander, 166, 371, 642 opium, 176, 255 opuntia, 379 paullinia sorbilis, 379 petroleum, 499, 500 phosphoric acid, 370, 530 phosphorus, 475, 565, 568 picric acid, 540 podophyllum, 188, 250, 371, 395, 453, 474 psorinum, 149 Pulsatilla, 176, 256, 272, 351 rheum, 644, 687 rhus tox., 234 rumex crispus, 474, 724 silicea, 546 staphisagria, 342 stramonium, 425 strontiana carb., 541, 654 sulphur, 250, 453, 474, 500, 695 sulphuric acid, 532 thuja,. 310 ve rat rum album, 176, 255, 272, 371 DIPHTHERIA ailanthus, 212, 403 alcohol, 211 ammonium caust., 211 amygdala amara, 213, 214 apis, 51, 95, 107, 109 arsenicum, no, 213, 558 arsenicum iod., 558 arum triphyllum, 233, 444, 535 baptisia, 212, 403 belladonna, 214, 412 bromine, 214 camphor, 481 cantharis, 95, 435 capsicum, 435, 524 carbo veg., 481 carbolic acid, 721 • crotalus horr., 35, 50 DIPHTHERIA (Continued) hydrocyanic acid, 524 ignatia, 203 iodine, 214 kali bichromicum, 214, 524, 595, 721 kali permangan., no, 214, 524, 721 lac caninum, 28, 50 lachesis, 50, 214, 444 lycopodium, 50, 211, 413, 443 mercurius biniod., 214, 594 mercurius cor., 596 mercurius cyanatus, 214, 481, 524, 595 mercurius protoiod., 595 mercurius vivus, 594 muriatic acid, 211, 524, 535 naja, 50, 213 natrum arsenicosum, no, 214, 254 nitric acid, 210, 444, 534 Phytolacca, 213, 444 ranunculus seel., 333 rhus tox., 213, 225, 22,2 sulphuric acid, 532 DIPHTHERIA, LARYNGEAL lachesis, 50 DIPLOPIA aurum, 601 gelsemium, 170 DISLOCATION OF JOINTS ignatia, 235 petroleum, 235 rhus tox., 235 DROPSY acetic acid, 104 apis, 66, 67, 102 apocynum can., 104, 163, 337 arsenicum, 66, 104, 164, 337, 445> 5$8 blatta, 32 colchicum, 67, 254 digitalis, 66, 166, 396 helleborus, 66, 164, 337 lachesis, 56, 66 lycopodium, 445 muriatic acid, 525 rhus tox., 445 scoparius, 163 sulphur, 104 terebinthina, 66, 337 DRUNKARDS, COMPLAINTS OF arsenicum, 55, 187 ammonium mur., 187 antimonium tart., 583 baryta carb., 268, 650 carbo veg., 486 cinchona, 374 fluoric acid, 187 lachesis, 477 ledum, 195, 324 nux vomica, 186, 187, 189, 191, 195 opium, 210, 268, 269, 650 selenium, 460 staphisagria, 460' sulphur, 476 sulphuric acid, 58 DYSENTERY aconite, 324 aloes, 188 THERAPEUTIC INDEX. 795 DYSENTERY (Continued) arnica, 242 arsenicum, 488, 553 baptisia, 403 belladonna, 419 cantharis, 95, 253 capsicum, 96, 435 carbo veg., 488 cinchona, 488 colchicum, 96, 253 colocynth, 96, 286, 287 ferrum phos., 642 kali bichrom., 61, 97, 725 lachesis, 61 mercurius, 54, 188, 253, 324, 597 nux vomica, 96, 188, 597 rhus tox., 225, 234 sulphur, 96, 466, 474, 598 zincum sulph., 96 DYSMENORRHOEA aconite, 325 actea racemosa, 202, 648 belladonna, 421 caulophyllum, 176, 648 causticum, 735 chamomilla, 209, 263 cinchona, 53 cocculus, 202, 263 colocynth, 286, 287 cyclamen, 263 gelsemium, 176 ignatia, 202, 263 magnesia mur., 202, 647 nux vomica, 263 Pulsatilla, 202, 263, 355 DYSPEPSIA abies nigra, 305, 350, 370 alumina, 618, 619 arnica, 242 arsenicum, 54, 55, 185, 487, 350, 351 bryonia, 298 cadmium sulph., 55 capsicum, 434 carbo veg., 56, 185, 486, 532 cinchona, 53, 350, 370, 487 graphites, 57 hepar, 53, 686 hydrocyanic acid, 517 ignatia, 202 ipecac, 377 kali bichromicum, 724 kali carb., 739 kreosote, 185 lachesis, 52, 687 lycopodium, 131, 487 magnesia carb., 645 mercurius, 54 • natrum carb., 690 natrum mur., 704 nux vomica, 184, 350, 477, 487, 704 phosphorus, 568 Pulsatilla, 186, 370 sepia, 131, 432 stannum, 624 sulphur, 132, 476 sulphuric acid, 58, 532 DYSPEPSIA (Continued) tabacum, 432 DYSPHAGIA gelsemium, 170, 173 DYSURIA aconite, 710 apis, 145 arnica, 443 belladonna, 416 benzoic acid, 711 camphor, 93 cantharis, 711 capsicum, 434 colocynth, 287 digitalis, 394 hepar, 687 lycopodium, 443, 711 nitric acid, 192 nux vomica, 192 pareira brava, 453 petroselinum, 710 prunus spinosa, 443 Pulsatilla, 443 sarsaparilla, 443 EARS aurum, 43, 491, 602 baryta carb., 652 belladonna, 411, 708 borax, 708 capsicum, 43, 435, 491 carbo animalis, 491 carbo veg., 491, 498 causticum, 733 chamomilla, 708 conium, 448 crotalus, 43 dulcamara, 434 elaps, 43 graphites, 498 hepar, 43, 412, 683 lachesis, 43 nitric acid, 43, 535 nux vomica, 190 Pulsatilla, 348, 708 sanguinaria, 276 silicea, 43, 435, 545 tellurium, 412 ECCHYMOSES OF THE SCLEROTIC arnica, 190 hamamelis, 190 ledum, 191 nux vomica, 189 ECZEMA antimonium crudum, 579 arsenicum, 559 calcarea ostrearum, 670 curare, 179 hepar, 688 hydrocotyle, 560 kali bromatum, 716 mezereum, 233 natrum carb., 693 natrum mur., 705 nux juglans, 233 petroleum, 311, 495, 499 796 THERAPEUTIC INDEX. ECZEMA (Continued) pix liquida, 306 psorinum, 234 ranunculus bulb., 332 rhus tox., 232 selenium, 461 sepia, 693 staphisagria, 340 EMOTIONS, ILL EFFECTS OF (See Grief, Anger, etc.) EMPHYSEMA ammonium carb., 485, 660 antimonium arsen., 558 antimonium tart., 558 arsenicum, 558 carbo veg., 558 curare, 207 ipecac, 558 naphthalin, 558 ENDOCARDITIS arsenicum, 558 kali carb., 741 kali hydriodicum, 718 phosphorus, 572 ENTERITIS arnica, 60 arsenicum, 553 baptisia, 59 belladonna, 59, 419 colocynth, 285 colchicum, 60 lachesis, 59 rhus tox., 59, 234 ENURESIS belladonna, 416, 734 benzoic acid, 247 causticum, 416, 734 calcarea ostrearum, 416, 734 cina, 247 equisetum, 90 hepar, 687 hyoscyamus, 416 kreosote, 247, 416, 734 linaria, 90, 395 natrum hydrochlor., 692 phosphoric acid, 247 plantago major, 416, 734 secale, 247 sepia, 734 silicea, 416 sulphur, 416 EPIDIDYMITIS gelsemium, 175 Pulsatilla, 352 EPILEPSY (See also Convulsions.) absinthium, 420 argentum metallicum, 611 argentum nitricum, 608 arsenicum, 561 artemisia vulgaris, 242, 420, 676 belladonna, 420 bufo, 30, 547, 676 calcarea ostrearum, 676, 734 causticum, 734 cicuta virosa, 182, 428, 451 EPILEPSY (Continued) cuprum, 630 hydrocyanic acid, 537, 676 hyoscyamus, 428 indigo, 30 kali bromatum, 715 nux vomica, 30, 547, 676 oenanthe, 428 plumbum, 622 ranunculus bulb., 332 silicea, 547, 676 sulphur, 676 stannum, 625 EPISTAXIS ambra, 152 bovista, 157 bromine, 502, 507 bryonia, 291 calcarea ostr., 671 camphor, 481 carbo veg., 157, 481 ferrum, 639 ipecac, 380 mercurius, 591 mercurius cyan., 591 nux vomica, 190 phosphorus, 569 phosphoric acid, 527 Pulsatilla, 346, 354, 355 rhus tox., 527 _ secale, 157 sepia, 124 trillium, 159 EPITHELIOMA arsenicum, 561 cicuta, 451 clematis, 561 hydrastis, 510, 561 ERECTILE TUMORS lycopodium, 441 ERGOTISM, 153 ERYSIPELAS anacardium oca, 221 apis, 46, 106, 232, 417 belladonna, 45, 106, 407, 416 borax, 711 camphor, 86 cantharis, 97, 106 comocladia, 217 crotalus, 45, 417 cuprum, 417, 630 euphorbium, 46, 86 graphites, 97, 174, 497 hepar, 106 lachesis, 41, 44, 106, 416 rhus tox., 46, 106, 113, 221, 232 silicea, 106 stramonium, 425 sulphur, 106, 417 EUSTACHIAN CATARRH graphites, 498 nitric acid, 535 nux vomica, 190 silicea, 546 EYES aconite, 321, 397 THERAPEUTIC INDEX. 797 EYES (Continued) actea racemosa, 327 agaricus, 203 alumina, 131, 619 amyl nitrite, 412 antimonium crudum, 580 antimonium tart., 583 apis, 113, 217 argentum nitricum, 608, 019 arnica, 43 arsenicum, 113, 397, 494 artemisia vulgaris, 243 asafoetida, 450 aurum, 601 belladonna, 397, 412, 449 berberis, 619 borax, 710 bryonia, 300 calcarea ostrearum, 494, 669 carbo animalis, 491 carbo veg., 492 cedron, 206 cina, 247, 619 cinnabaris, 594 comocladia, 217 conium, 360, 619 crocus, 619 crotalus horridus, 43 cyclamen, 360 euphrasia, 383, 396, 496, 609, 683 glonoin, 436 graphites, 130, 494, 580, 619, 710 hepar, 496, 683 ignatia, 203 jaborandi, 130, 619 kali bichromicum, 113, 360, 726 kali carb., 130 kali hydriodicum, 716 kreosote, 609 lachesis, 42 lithium carb., 655 mercurius, 397, 495, 593 mercurius biniod., 593 mercurius cor., 593 mercurius dulcis, 593 mercurius protoiod., 593 mezereum, 206 natrum carb., 619 natrum mur., 130, 619, 702 natrum sulph., 619 mix moschata, 619 nux vomica, 130, 189 paris quadrifolia, 412 petroleum, 499 phellandrium, 450 phosphorus, 574, 683 prunus spinosa, 412 Pulsatilla, 130, 347 rhus tox., 113, 235, 397, 609, 619 ruta, 449, 619 saccharum offic, 669 santonine, 274, 360 sepia, 129, 619 spigelia, 205, 321, 412, 701 staphisagria, 340 sulphur, 321, 473, 494, 070 EYES (Continued) thuja, 131 zincum, 637 zincum sulph., 637 FACE aethusa, 377, 450 ammonium mur., 662 antimonium tart., 377 apis, 42, 44 arsenicum, 44 baptisia, 44 belladonna, 44, 409, 411 bryonia, 246 bufo, 44 calcarea ostr., 668 camphor, 44, 45 carbo veg., 44 cicuta, 44, 45 cina, 246 cinchona, 44 cuprum, 44 digitalis, 389 euphorbium, 46 ferrum, 640 gelsemium, 171 hydrocyanic acid, 44, 45 hyoscyamus, 44, 45 ipecacuanha, 246, 377 kali bich., 724 kali carb., 44 lachesis, 43 lycopodium, 44, 440 natrum arsenicosum, 44 nux moschata, 44 nux vomica, 44 opium, 44, 420 phosphoric acid, 44 phosphorus, 44, 45 Phytolacca, 44 Pulsatilla, 44 rhus tox., 44 secale, 44 stramonium, 44, 45 staphisagria, 338 sulphur, 44, 465 veratrum album, 44 FAINTING (See Syncope.) FAMILY RELATION OF DRUGS, 23 FATIGUE coca, 521 coffea, 385 fluoric acid, 521 FATTY DEGENERATIONS apocynum, 164 aurum, 603 manganum, 633 phosphorus, 540 picric acid, 540 FATTY TUMORS baryta carb., 652 FEET lycopodium, 692 natrum carb., 692 79 8 THERAPEUTIC INDEX. FELONS fluoric acid, 520 mercurius, 592 FEMALE GENITAL ORGANS actea racemosa, 143, 328, 356 aletris farinosa, 359 aloes, 137, 478 ambra grisea, 151 ammonium mur., 663 antimonium crud., 580 apis mellifica, 112, 615, 664 argentum metallicum, 616 argentum nitricum, 616 arnica, 664 aurum, 139, 603, 615 belladonna, 420, 615 berberis, 452 bryonia, 301 calcarea ostrearum, 145, 673 calcarea phos., 145, 679 cantharis, 97 carbo animalis, 140 carbo veg., 141 caulophyllum 357 cyclamen, 359 ferrurn, 615 ferrum jod., 143, 643 gelsemium, 175 graphites, 141, 498 hedeoma, 146 helonias, 134, 357, 616 hydrocotyle, 145 inula, 146 kali ferrocyan., 144 kreosote, 136, 615 lachesis, 62 lilium tigrinum, X33, 616 mitchella, 145 murex, 135 natrum carb., 142, 693 natrum hypochlorosum, 143 natrum mur., 142, 615, 700 nux vomica, 136, 193 palladium, 615 platina, 65, 140, 613 podophyllum, 138 Pulsatilla, 138, 354 secale, 145 senecio, 359 sepia, 133, 420, 615 stannum, 138 sulphur, 134, 478 thuja, 309, 615 ustilago, 145, 157 vespa, 145 viburnum opulus, 146, 250 zincum, 638 zizea, 146 FEVER aconite, 291, 316, 318 apis, 317 arsenicum, 320, 467, 552, 556 baptisia, 467 belladonna, 292, 319, 409 bryonia, 289, 317 carbo veg., 483 FEVER (.Continued) cuprum, 629 ferrum phos., 320 gelsemium, 173, 317 hyoscyamus, 428 mercurius, 410 lycopodium, 440 opium, 272 podophyllum, 454 Pulsatilla, 360 sulphur, 320, 466, 557 veratrum viride, 319 FEVER BLISTERS arsenicum, 705 hepar, 705 natrum mur., 705 rhus tox., 705 FIBROUS TISSUES rhus tox., 235 FISTULAE ignatia, 542 petroleum, 499 phosphorus, 573 silicea, 497, 573 sulphur, 452 FISTULA IN ANO berberis, 452 calcarea phos., 452. graphites, 497 lycopodium, 497 nitric acid, 497, 534 paeonia, 497 petroleum, 499 ratanhia, 497 silicea, 542 FLATULENCE cepa, 445 fel tauri, 29 fel vulpi, 29 graphites, 497 lycopodium, 284, 445, 497 momordica balsamica, 284, 445 natrum sulph., 695 raphanus, 271, 445 sulphur, 445 FLUSHES OF HEAT . amyl nitrite, 31, 466 kali bichromicum, 466 lachesis, 466 sulphur, 466 sulphuric acid, 466 FRACTURES calcarea phos., 680 Symphytum off., 241, 680 FRIGHT, ILL EFFECTS OF gelsemium, 272 glonoin, 437 natrum mur., 272 opium, 270, 272 phosphoric acid, 272 Pulsatilla, 272 silicea, 272 veratrum, 272 GALL-STONES (See Biliary Colic.) THERAPEUTIC INDEX. 799 GANGRENE arsenicum, 47, 156, 483, 552, 560 carbo veg., 483 cinchona, 561 iodine, 511 lachesis, 560 secale, 154, 156, 560 GASTRALGIA anacardium, 221 argentum nitricum, 607 belladonna, 414 bismuth, 185, 415, 608 chamomilla, 249 chelidonium, 497 chininum ars., 415 ferrum, 640 graphites, 57, 497 ignatia, 202 lithium carb., 655 nux vomica, 184 petroleum, 497 stannum, 624 GASTRIC CATARRH aconite, 324 antimonium crud., 351, 378, 578 arsenicum, 378, 379 bryonia, 378, 578 ipecacuanha, 378 kali bichromicum, 720 nux vomica, 378 Pulsatilla, 49, 579 GASTRIC FEVER aconite, 291 bryonia, 289 mercurius, 591 GASTRIC SYMPTOMS (See also Gastritis, etc.) aconite, 324 alumina, 619 anacardium, 219 antimonium crudum, 378 antimonium tart., 583 arsenicum, 54, 55, 350, 378, 487, 553 belladonna, 350, 414 bryonia, 248 calcarea ostr., 415 carbo animalis, 490 carbo veg., 56, 350, 486, 554 chamomilla, 249 chelidonium, 481 cinchona, 370, 553 colchicum, 58, 350 cyclamen, 359 ferrum, 496 fluoric acid. 704 graphites, 57, 496 hepar, 460, 686, 704 indium, 636 ipecacuanha, 350, 351, 377 kali bichromicum, 724 kreosote, 185, 350 lachesis, 52, 56, 704 lobelia, 377 lycopodium, 444, 553, 724 muriatic acid, 525 natrum mur., 697 GASTRIC SYMPTOMS (Continued) nitro-muriatic acid, 525 nux vomica, 184, 445 petroleum, 500 phosphorus, 565, 568, 636 Pulsatilla, 377, 496 raphanus, 445 sabina, 350 selenium, 460 sepia, 350, 490, 623 stannum, 624 staphisagria, 341, 377, 460 sulphur, 195, 445, 636 tabacum, 377, 432 thein, 132, 377 thuja, 350 zincum, 637 GASTRITIS aconite, 324 arsenicum, 54, 185, 324, 553 cantharis, 95 colchicum, 324 kali bichromicum, 726 GASTRO-ENTERIC SYMPTOMS argentum nitricum, 554 cadmium sulph., 554 carbo veg., 554 elaps, 58 magnesia carb., 644 secale cornutum, 155, 554 veratrum album, 554 GENITAL ORGANS (See also Female Genital Organs.) apis, 112 cantharis, 96 croton tiglium, 86 gelsemium, 174 graphites, 498 lachesis, 62 picric acid, 97 GLANDS alumina, 620 badiagia, 31 belladonna, 233 bromine, 503 calcarea ostr., 671 carbo animalis, 31, 489, 503 carbo veg., 484 conium, 448 graphites, 494 hepar, 686 iodine, 509 mercurius, 590, 596 silicea, 544 spongia, 512 sulphur, 468 GLAUCOMA aconite, 321 aurum, 601 bryonia, 300 colocynth, 287 rhus tox., 235 GLOSSOPLEGIA baryta carb., 650 colchicum, 650 8oo THERAPEUTIC INDEX. GOITRE bromine, 503 lapis albus, 510 spongia, 512 GONORRHOEA argentum nitricum, 91 cannabis indica, 90 cannabis sativa, 89 cantharis, 89, 96 capsicum, 91 carbo animalis, 489 chimaphila, 91 clematis, 91 copaiva, 91, 627 cubeba, 91 digitalis, 394 doryphora, 32 gelsemium, 175 kali bichromicum, 72.2 mercurius corrosivus, 91, 394 mercurius solubilis, 91, 311, 352, 394 natrum mur., 703 nux vomica, 192 petroselinum, 90, 394, 450, 710 Pulsatilla, 310, 352 sepia, 394 sulphur, 394, 478 thuja, 91, 309 yucca, 313 GOUT ammonium phos., 656, 665 antimonium crudum, 580 arnica, 369 benzoic acid, 453, 656 berberis vulgaris, 453 calcarea ostrearum, 453, 656, 077 causticum, 288 colchicum, 253, 353 colocynth, 288 guaiacum, 288 ledum, 232, 297 lithium carb., 453, 654 lycopodium, 453, 656 natrum mur., 656 Pulsatilla, 353 sabina, 298 staphisagria, 341 GRANULAR LIDS alumina, 619 argentum nitricum, 609 euphrasia, 609 lycopodium, 443 rhus tox., 609 zincum, 637 zincum sulph., 637 GRAVEL cantharis, 89 lycopodium, 443 sarsaparilla, 92, 443 GRTEF, BAD EFFECTS OF ignatia, 197, 198, 528 natrum mur., 197, 528 phosphoric acid, 197, 528 GROWING PAINS guaiacum, 530 phosphoric acid, 530 GUMMATA kali hydriodicum, 719 HAEMATEMESIS hamamelis, 301 millefolium, 301 phosphorus, 575 Pulsatilla, 301 ustilago, 301, 575 HAEMATURIA cantharis, 89 crotalus, 66 equisetum, 90 ipecacuanha, 383 lachesis, 66 nux vomica, 192 terebinthina, 66, 305 HAEMAPHILLIA bovista, 157 lachesis, 575 phosphorus, 575 HAEMOPTYSIS acalypha indica, 369 aconite, 324 cactus, 324 carbo veg., 481 elaps, 35 ferrum, 639, 641 ledum, 324 millefolium, 324 nux vomica, 191 opium, 270 phosphorus, 301, 569 Pulsatilla, 301, 361 rhus tox., 229 senecio, 301 sulphur, 465 HAEMORRHAGES acalypha indica, 369 aconite, 243 ammonium carb., 658 aranea diadema, 80 arsenicum, 482, 487 belladonna, 368, 421 bovista, 157 carbo veg., 151, 368, 481 cascarilla, 312 cinchona, 293, 367, 482 cinnamomum, 369 cyclamen, 369 erigeron, 159, 368 ferrum, 643 ferrum phos., 159 hamamelis, 158, 369, 537 ipecacuanha, 368, 482, 643 ledum, 369 leptandra, 537 mercurius, 591 millefolium, 343, 368 mitchella, 158 phosphorus, 369, 569 sabina, 305, 368 sanguinaria, 278 secale, 154, 368 sulphuric acid, 532 trillium, 158, 159, 368 THERAPEUTIC INDEX. 801 HAEMORRHAGES \Continued) vinca minor, 167, 369 HAEMORRHOIDS abrotanum, 245 aesculus hip., 187 aloes, 137, 187, 478 anacardium, 220 apocynum, 165 arsenicum, 55, 487 carbo animalis, 490 carbo veg., 57, 486 cascarilla, 321 collinsonia, 188 graphites, 497 hamamelis, 188 lachesis, 52 lamium album, 220 lycopodium, 441 nux vomica, 186, 187 paeonia, 497 sepia, 131 sulphur, 187, 465, 476 sulph. ac, 58, 531 HAY-FEVER ailanthus, 557 ambrosia, 332 arsenicum, 332, 557 arsenicum jod., 557 lobelia inflata. 557 rosa damascena, 557 ranunculus bulbosus, 332 silicea, 332, 546, 557 sinapis nigra, 558 wyethia, 558 HEADACHE (See also Hemicrania.) aconite, 200 actea racemosa, 176, 328 aloes, 137, 187 anacardium, 219 antimonium tart., 581 aranea, 81 argentum nitricum, 605, 606 arsenicum, 701 baryta carb., 652 belladonna, 82, 277, 408, 411 bovista, 158 bromine, 504 bryonia, 40, 82, 289, 300, 701 calcarea ostrearum, 701 cannabis indica, 90 carbo animalis, 141, 354 carbo veg., 300, 486 carbolic acid, 481 castoreum, 195 causticum, 702, 724 chamomilla, 287 chelidonium, 281 cinchona, 40, 369, 701 cocculus, 262, 354 colocynth, 287 cyclamen, 130 ferrum, 639, 641 gelsemium, 40, 171, 172, 200, 262, 300. 581, 701 glonoin, 436, 701 51 HAEMORRHAGES (Continued) hyoscyamus, 427 ignatia, 78, 171, 199 ipecacuanha, 377 iris versicolor, 277, 702, 784 juglans cinerea, 207, 262, 300 kali bichromicum, 702, 727 kali hydriodicum, 716 kalmia, 171, 200 lac defloratum, 28 lachesis, 40, 41 lamium album, 220 lithium carb., 655 magnesia mur., 120, 656 melilotus, 200, 277 men3'anthes, 354, 547 mercurius, 41, 591 moschus, 116 natrum carb., 692 natrum mur., 128, 300, 699, 701, 724 nux vomica, 128, 183, 184, 300 oleander, 165 oleum animale, 171 palladium, 615 paris quadrifolia, 547 paullinia, 278 petroleum, 172, 300 phellandrium, 354, 450 phosphoric acid, 530 phosphorus, 563 picric acid, 128, 194 platina, 78 psorinum, 149, 150, 724 ptelea, 377 Pulsatilla, 41, 353 ranunculus bulb., 354 ranunculus seel., 354 rhus glabra, 217 rhus radicans, 222 sanguinaria, 82, 171, 200, 276 sarsaparilla, 311 selenium, 460 sepia, 176, 701 silicea, 171, 200, 547, 653, 724 spigelia, 82, 205, 354, 392, 701 strontiana carb., 548 sulphur, 128, 581 theridion, 82 thuja, 308 veratrum alb., 200, 354, 377, 701 zincum, 635 HEART aconite, 225, 322, 507, 514 actea racemosa, 225 ammonium carb., 601, 659 anacardium, 221 apis, 103, no apocynum, in, 164 argentum metallicum, 611 arnica, 225, 239, 323 arsenicum, in, 164, 239, 314 asparagus, 111 aurum, 323, 600, 656 aurum mur. natr., 601 belladonna, 11 1 benzoic acid, 656 802 THERAPEUTIC INDEX. HEART (Continued) bovista, 158 bromine, 225, 239, 507 bryonia, 298 cactus, 225, 239 carbo animalis, 134, 499 colchicum, 254, 298 conium, 392, 448, 656 convallaria, 393 digitalis, 69, in, 171. 3^3 euphrasia, 718 gelsemium, 170, 276 glonoin, 466 graphites, 499, 718. grindelia, 171, 466 helleborus, 392 hydrocyanic acid, 514, 538 iodine, 509 kali bichromicum. 134, 499, 718 kali carb., in, 145, 737, 74* kali chloricum, 134. 449 kali hydriodicum, 717, ;i8 kali nitricum, 499 kalmia, 225, 323, 392, 656 lachesis, 65, in, 514, 718 lactuca, 718 ledum, 656 lilium tig., 134 lithium carb., 656 magnesia mur., 120, 647 natrum mur., 134, 499 petroleum, 134, 499 phosphorus, 31, 514, 572 Phytolacca, 225 Pulsatilla, 225 quinine, 36-; rhus tox., 223, 225, 323 spigelia, in, 206, 254, 392, 509, 741 spongia, 514 sulphur, in, 465 sumbul, 225 tabacum, 432 veratrum alb., 257 veratrum viride, 257 zincum, 636, 656 HEART, FATTY DEGENERATION OF THE apocynum, 164 arsenicum, 572 phosphorus, 572 HEART, HYPERTROPHY OF THE aconite, 323, 508 arnica, 225, 239, 323, 507 arsenicum, 239 aurum, 323, 601 bromine, 225, 239, 507 cactus, 239, 323 iodine, 509 kalmia, 323 rhus tox., 223, 239, 323, 508 HEART, PALPITATION OF TEE badiaga, 31 coffea, 31 nitrite of amyl, 31 phosphorus, 31 rhus tox., 225 HEAT, ILL-EFFECTS OF natrum carb., 691 selenium, 38, 459 HECTIC FEVER arsenicum, 373 carbo veg., 373, 483 cinchona, 373 lycopodium, 446 stannum, 626, 706 HEELS ammonium mur., 663 antimonium crudum, 663 causticum, 663 cepa, 663 graphites, 663 ignatia, 663 ledum, 663 manganum, 663 natrum carb., 663, 692 Pulsatilla, 663 sepia, 663 HEMICRANIA argentum nitricum, 606 arsenicum, 129, 561 belladonna, 128 gelsemium, 128 iris versicolor, 129 nux vomica, 129 oleum animale, 171 Pulsatilla, 129 sanguinaria, 128 sepia, 128 silicea, 128, 129 theridion, 129 veratrum album, 128 HEMIOPIA aurum, 601 lithium carb., 655, 702 lycopodium, 702 natrum mur., 702 titanium, 702 HEMIPLEGIA arnica, 242 HEPATITIS phosphorus, 567 HERNIA aconite, 325 carbo veg., 56 cocculus, 189 lachesis, 57 lycopodium, 189 nux vomica, 189 opium, 272 tabacum, 433 HERPES bovista, 157 psorinum, 149 natrum mur., 705 sepia, 125, 70s HERPES CIRCINATUS baryta carb., 125, 705 calcarea ostrearum, 125 natrum mur., 705 sepia, 125, 705 tellurium, 125, 705 THERAPEUTIC INDEX. 803 HERPES LABIALIS (See Fever Blisters.) HERPES ZOSTER arsenicum, 332 carboneum oxygen., 87 mezereum, 332 ranunculus bulb., 332 rhus tox., 332 HICCOUGH arsenicum, 203 cajuputum, 203 hyoscyamus, 203 ignatia, 202 Pulsatilla, 203 ranunculus bulb., 372 stramonium, 203 sulphuric acid, 203 teucrium marum verum, 203 veratrum album, 203 HIP-JOINT DISEASE calcarea ostrearum, 676 carbo veg., 483 colocynth, 288 Gettysburg spring water, 341, 545, 656 natrum sulph., 695 phosphoric acid, 530 phosphorus, 573 silicea, 544, 573 stillingia, 695 stramonium, 425 sulphur, 470 HOARSENESS (See Aphonia.) HOMESICKNESS capsicum, 435, 528 mercurius, 590 phosphoric acid, 528 HYDRARTHROSIS apis, 511 iodine, 510 sulphur, 511 HYDROCELE digitalis, 390 Pulsatilla, 353 HYDROCEPHALOID apis, 114 arsenicum, 102 calcarea phos., 367, 380, 636, 680 cinchona, 366, 380, 680 ferrum phos., 159 Oenothera bien., 379 sulphur, 471 zinc, 635, 680 HYDROCEPHALUS apis, 103 apocynum, 164 baryta carb., 649 calcarea ostr., 672 digitalis, 164, 337, 393 helleborus, 101, 105, 337 staphisagria, 338 sulphur, 104, 469 terebinth., 305 HYDROPERICARDIUM apis, no arsenicum, in, 559 HYDROPERICARDIUM (Continued) digitalis, 390 kali carb., in lachesis, 65 lycopodium, 445 HYDROPHOBIA belladonna, 94 cantharis, 94 stramonium, 423 HYDROTHORAX apis, 103, no apocynum cannabinum, 104 arsenicum, 559 colchicum, 254 digitalis, 390 juglans cinerea, 207 lachesis, 65 mercurius sulph., 390, 559 HYPEROPIA caibo an., 492 HYPOCHONDRIASIS alumina, 618 anacardium, 219 bryonia, 618 conium, 448, 638 natrum carb., 689 natrum mur., 699, 704 nux vomica, 618, 691 sepia, 690 stannum, 624 staphisagria, 338 zincum, 638 zincum ox., 448 HYSTERIA actea racemosa, 76 ammoniacum gummi, 116, 120 apis, 100, 112 arsenicum, 614 asafoetida, 119, 120, 198, 449 belladonna, 77, 199 calcarea ostrearum, 614 cocculus, 199 crocus, 76, 79 cuprum, 198 hyoscyamus, 77, 198 ignatia, 77, 116, 198, 200, 276 magnesia mur., 120, 646 moschus, 79, 116, 198, 614 nux moschata, 118, 199 nux vomica, 276 palladium, 78 phosphorus, 276 platina, 78, 198, 613, 614 sanguinaria, 276 sepia, 124 stannum, 625 sulphur, 471 tarantula, 757 theridion, 82 Valeriana, 118, 119, 276 valerinate of zinc, 199 ILEUS opium, 272 IMPETIGO sepia, 476 804 THERAPEUTIC INDEX. IMPOTENCE agnus castus, 674 calcarea ostr., 674 chlorine, 511 conium, 564 graphites, 498 phosphorus, 564 selenium, 459 INFLAMMATIONS aconite, 36, 99, 316 apis, 99 arsenicum, 94, 96, 552 belladonna, 99, 407, 591 camphor, 94 cantharis, 94 ferrum phos., 159, 642 hepar, 687 mercurius, 591 INFLAMMATORY FEVER arsenicum, 467 INFLUENZA eupatorium perf., 244 ranunculus sceleratus, 333 rhus tox., 234 sabadilla, 298 INIMICAL DRUGS ammonium carb. and lachesis, 659 apis and rhus, 114 carbo veg. and causticum, 481 cinchona and belladonna or morphia, 375 cinchona and digitalis, 393 nux and zinc, 196, 631 phos. and caust., 729 psorin. and lach., 151 ranunculus bulb, and sulph., 332 rhus tox. and apis, 1 14, 223 selenium and cinchona, 462 silicea and mercurius, 543, 631 INIMICAL RELATION OF DRUGS, 24 INJURIES angustura, 180 arnica, 242, 532 calcarea phos., 241 calendula, 241 cicuta, 451 conium, 449, 532 glonoin, 437 hypericum, 241 ledum, 241 natrum sulph., 437, 694 rhus tox., 240 rut'a, 532, 654 staphisagria, 241 sulphuric acid, 532 Symphytum, 241 INSOMNIA (See also Sleep.) ambra grisea, 151 calcarea ostrearum, 675 chamomilla, 248 cocculus, 361 hyoscyamus, 428 INTERMITTENT FEVER alstonia schoJ., 168 ammonium mur., 66fe apis mellifica, 70, 107 INTERMITTENT FEVER (Continued) aranea diadema, 80, 373 arsenicum, 69, 555 camphor, 69 canchalagua, 372 capsicum, 68, 201, 372, 435 carbo veg., 68, 372, 483 cedron, 80 chininum sulph., 80, 371, 467 cimex, 32 cina, 247 cinchona, 80, 229, 371 cornus florida, 371 cuprum, 70 digitalis, 69 eucalyptus, 372 eupatorium perf., 229, 244, 372 eupatorium purp., 244 ferrum, 372, 643 gelsemium, 68, 172, 229 helleborus, 69 hydrocyanic acid, 69 hyoscyamus, 69 ignatia, 201, 372 ipecacuanha, 372, 382 malaria offic, 373 lachesis, 68, 202, 372 lachnanthes, 69 lycopodium, 70, 441 menyanthes, 68, 372, 483 natrum mur., 108, 229, 706 nux vomica, 196 Pulsatilla, 360 rhus tox., 229 sabadilla, 229 secale, 69 sepia, 372 sulphur, 229, 467 veratrum album, 69 IRITIS asafoetida, 450, 602 aurum, 450, 601 colocynth, 287 euphrasia, 397 kali bichromicum, 726 kali hydriodicum, 716 . mercurius, 311, 593 mercurius corros., 593, 602, 716 nitric acid, 602 rhus tox., 235, 397 thuja, 310 JAUNDICE arsenicum, 187 bryonia, 187, 299 carduus marianus, 187 chamomilla, 187, 248 chelidonium, 207 cinchona, 374 digitalis, 391 hepar, 187 juglans cin., 207, 262 lachesis, 52 mercurius, 187, 597 myrica, 391 natrum sulph., 187 THERAPEUTIC INDEX. 805 JAUNDICE (Continued) nux vomica, 187 phosphorus, 569 podophyllum, 453 Pulsatilla, 187 JOINTS ammonium mur., 663 ammonium phos., 656 anacardium, 221 apocynum, 164 argentum met., 611 benzoic acid, 453, 656 berberis, 453 bryonia, 453 calcarea ostr., 453, 656 calcarea phos., 679, 680 Gettysburg spring water, 656, 676 ignatia, 235 iodine, 103 kali hydriodicum, 103 lithium carb., 654, 656 petroleum, 235 lycopodium, 656 pinus sylvestris, 676, 692 Pulsatilla, 221 rhus tox., 235, 240 sepia, 125 KERATITIS apis, 383 crotalus, 43 kali hydriodicum, 717 silicea, 545 sulphur, 473 KIDNEYS ammonium benz., 66 apis, 66, 559 argentum nitricum, 610 arsenicum, 67, 559 aurum, 559, 603 berberis, 93, 451 cannabis indica, 90 cantharis, 87 carbolic acid, 66 colchicum, 67 digitalis, 66, 559 helleborus, 66, 559 kali carb., 66 kali hydriodicum, 719 lachesis, 66 \ lycopodium, 446 natrum mur., 66 phosphoric acid, 530 phosphorus, 559, 569 plumbum, 603, 623 terebinthina, 66, 92, 305, '59 KNEE-JOINT DISEASE silicea, 544 LABOR * aconite, 321 actea racemosa, 328 belladonna, 421 cantharis, 97 caulophyllum, 357 chamomilla, 250 LABOR (Continued) gelsemium, 175, 328 ipecacuanha, 328 lycopodium, 328 natrum carb., 694 nux vomica, 193, 355 Pulsatilla, 193, 355 secale, 154 LACTATION (See also Agalactia.) carbo animalis, 165, 490 oleander, 165 LAPAROTOMY staphysagria, 241 LARYNGEAL PHTHISIS selenium, 462 spongia, 513 LARYNGISMUS STRIDULUS antimonium tart., 504 arsenicum, 504 belladonna, 504 bromine, 504 calcarea phos., 504 chlorine, 504 cuprum, 504 ignatia, 504 iodine, 504 ipecacuanha, 504 lachesis, 504 phosphorus, 504 sambucus, 324, 504 LARYNGITIS apis, no kali bichromicum, 721 sambucus, 513 spongia, 462, 513 sulphur, 473 LARYNX (See also Laryngeal Phthisis.) apis, no argentum metallicum, 611 argentum nitricum, 609 arum triphyllum, " 210 causticum, 732 eupatorium perf., 485 manganum, 609 phosphorus, 462, 570 paris quadrifolia, 610 sanguinaria, selenium, 461, 610 LEAD-COLIC alum, 621 alumina, 620, 621 arsenicum, 621 belladonna, 621 colocynth, 621 nux vomica, 621 opium, 621 platina, 614, 621 sulphuric acid, 621 LEUCORRHOEA alumina, 618 ambra grisea, 152 ammonium mur., 664 berberis, 452 borax, 710 8o6 THERAPEUTIC INDEX. LEUCORRHOEA (Continued) calcarea ostrearum, 674 calcarea phosphorica, 145 cannabis sat, 674 carbo veg., 141 caulophyilum, 674 cubeba, 674 graphites, 141, 493 helonias, 358 hydrastis, 360 kali bichromicum, 720 kreosote, 136 lilium tigrinum, 134 mercurius, 674 murex purpurea, 135 natrum carb., 693 natrum mur., 142 nitric acid, 310, 354 palladium, 616 phosphorus, 674 podophyllum, 454 Pulsatilla, 674 rhus tox., 134 sepia, 133, 674 stannum, 625 thuja, 309 LIVER (See also Hepatitis and Gall Stones.) aloe, 137 ammonium mur., 187, 664 angustura, 282 aurum, 603 berberis, 299, 452 bryonia, 207, 282, 298 carduus mar., 187 chelidonium, 207, 281, 299 chenopodium, 282 digitalis, 391 fluoric acid, 187 graphites, 497 hepar, 687 juglans cin., 207 kali carb., 299 lachesis, 52, 187, 444, 477 laurocerasus, 477 leptandra, 395, 598 lobelia syph., 282 lycopodium, 282, 444 magnesia mur., 186, 647 manganum, 633 mercurius, 395, 597, 647 myrica cerifera, 391 nux vomica, 130, 136, 186 phosphorus, 477, 565, 567 podophyllum, 137, 138, 453 ptelea, 648 ranunculus bulb., 282 selenium, 461 sepia, 136, 186 sulphur, 186, 461, 476 taraxacum, 244 zincum, 637 LIVER SPOTS curare, 125, 179 lycopodium, 125 nux vomica, 125 LIVER SPOTS (Continued) sepia, 125 sulphur, 125 LOCOMOTOR ATAXIA alumina, 541, 618 aluminium met., 618 argentum nitricum, 606 belladonna, 419 causticum, 730 cocculus, 261 kali bromatum, 715 nux vomica, 194 phosphorus, 564 picric acid, 97 stramonium, 424 zincum, 606 LUMBAGO calcarea fluorica, 677 calcarea ostrearum, 677 kali carb., 230, 741 ledum, 230 nux vomica, 194, 677 petroleum, 230 rhus tox., 230, 677 ruta, 230 secale, 677 staphisagria, 230 sulphur, 230 Valeriana, 230 LUNGS ammonium carb., 659 antimonium crud., 627 antimonium tart., 627 arsenicum, 374 aurum, 603 balsam of Peru, 627 borax, 710 calcarea ostr., 627, 673 calcarea phos., 627, 673 chamomilla, 627 cinchona, 374 copaiva, 627 .dulcamara, 434 elaps, 51 ferrum phos., 159, 642 grindelia, 171, 633 hepar, 627, 685 illicium anisatum, 627 ipecacuanha, 627 kali bichromicum, 740 kali carb., 740 kali hyd., 717 lachesis, 374 lycopodium, 445, 627 myosotis, 627 opium, 270 phosphorus, 027 pix liquida, 306, 327 Pulsatilla, 740 scilla, 627 secale, 374 selenium, 461 senega, 673 sepia, 673 silicea, 546 spongia, 513 THERAPEUTIC INDEX. 807 LUNGS (Continued) sulphur, 469, 627, 740 veratrum viride, 257 yerba santa, 627 LUNGS, ABSCESS OF THE lachesis, 51 LUNGS, PARALYSIS OF THE ammonium carb., 582, 659 ammonium mur., 664 antimonium tart., 485, 582, 650 baryta carb., 650 carbo veg., 485, 582 dulcamara, 434 hydrocyanic acid, 336, 538 kali hydr., 582 lachesis, 582 moschus, 485, 582 phosphorus, 480 LUNGS, SPASMS OF THE moschus, 273 ipecac, 273 opium, 273 LYING-IN aconite, 325 ambra grisea, 152 arnica, 242 arsenicum, 271 bryonia, 301 causticum, 250 chamomilla, 250 croton tiglinum, 302 helonias, 257 hyoscyamus, 271 opium, 271 phellandrium, 302 Phytolacca, 302 Pulsatilla, 355 LYMPHATIC GLANDS (See Glands.) MALIGNANT PUSTULE lachesis, 71 MAMMARY GLAND, AFFECTIONS OF THE apis, 574 belladonna, 301, 419, 569, 574 bromine, 503 bryonia, 301 carbo veg., 484 croton tiglium, 302, 503 paris quad., 503 phellandrium, 302, 450 phosphorus, 545, 569, 574 Phytolacca, 302 Pulsatilla, 356 silicea, 569, 574 MANIA hepar, 683 hyoscyamus, 246, 430, 714 kali bromatum, 430, 714 stramonium, 429 sulphur, 471 MARASMUS abrotanum, 245 antimonium crud., 645 argentum nitricum, 272, 554 MARASMUS (Continued) arsenicum, 553 calcarea ostrearum, 469, 645 calcarea phosphorica, 680 cinchona, 554, 680 hepar, 687 iodine, 703 magnesia carb., 644 manganum, 663 natrum carb., 645 natrum mur., 703 nux vomica, 554 opium, 271 phosphorus, 469 podophyllum, 045 rheum, 645 sarsaparilla, 272 sepia, 645 sulphur, 272, 468, 554, 645 sulphuric acid, 532 thuja, 310 MASTOID PROCESS, DISEASES OF aurum, 43, 435, 491, 602 capsicum, 43, 435, 602 carbo an., 491 fluoric acid, 519 nitric acid, 43, 435, 491, 602 silicea, 43, 545, 602 MASTURBATION (See Sexual Excesses.) MEASLES aconite, 174, 326, 361 antimonium tart., 581, 583 belladonna, 174 bryonia, 302 cuprum, 424 gelsemium, 174, 326 ipecac, 303 kali bichromicum, 361, 725 Pulsatilla, 174, 326, 361 stramonium, 424 zincum, 425, 633 MENIERE'S DISEASE carbon bisulphide, 733 causticum, 733 cinchona, 733 salicylic acid, 733 MENINGITIS aconite, 294, 320, 407 apis, 100, 294 arsenicum, 102 arum tri., 210 belladonna, 42, 94, 101, 105, 294, 407, 403, 59i bryonia, 101, 105, 294, 407 calcarea ostr., 409 cuprum, 101, 630 digitalis, 337, 393 glonoin, 101 helleborus, 101, 336. hyoscyamus, 427 lachesis, 42 mercurius, 591 picric acid, 97 rhus tox., 102 sulphur, 101, 104, 294, 409 8o8 THERAPEUTIC INDEX. MENINGITIS (Continued) zinc, 102, 337. 633, 634 MENINGITIS, TUBERCULAR (See Meningitis.) MENORRHAGIA arsenicum, 482 calcarea ostrearum, 673 carbo veg., 482 cinchona, 482 ipecacuanha, 482 mercurius, 592 trillium pendulum, 673 vinca minor, 167 MENSES ambra grisea, 152, 158 ammonium carb., 65 belladonna, 613 berberis, 452 bovista, 158 bryonia, 301 calcarea ostrearum, 672, 673 carbo an., 140 carbo veg., 141 castoreum, 121 causticum, 735 chamomilla, 263 cocculus, 262 crocus, 613 ferrum, 641 graphites, 141, 493 hamamelis, 301 juglans regia, 207 kali carb., 700 kreosote, 136 lachesis, 62 lithium carb., 655 magnesium carb., 645 magnesium mur., 120, 647 millefolium, 301^ 613 moschus, 65 murex, 135 natrum mur., 700 nux vomica, 193 phosphorus, 301, 569 platina, 65, 613 Pulsatilla, 138, 301, 355 sabina, 613 senecio, 301, 359 sepia, 133 ustilago, 301 zincum, 633, 638 MENTAL FATIGUE anacardium, 219 MENTAL SYMPTOMS abies nigra, 305 aconite, 316, 321, 409 actea racemosa, 39 agaricus, 39, 423 alumina, 617 anacardium, 218, 219, 302 antimonium crudum, 219, 308, 577 antimonium tart., 581 apis, 99 argentum nitricum, 605, 612 arsenicum, 443, 551 arum tri., 209 MENTAL SYMPTOMS (Continued) aurum, 139, 603 baptisia, 398, 437 baryta carb., 650, 679 belladonna, 218, 294 bovista, 102 bromine, 502 bryonia, 299, 619 calcarea ostrearum, 293, 617 calcarea phosphorica, 679 cannabis indica, 89, 269 causticum, 126, 288, 729 chamomilla, 248, 288, 344 chelidonium, 281 cinchona, 293, 369 cocculus, 199 coffea, 322, 384 colocynth, 288 conium, 448 cypripedium, 384 digitalis, 389 dulcamara, 683 fluoric acid, 440 gelsemium, 232, 272 glonoin, 427, 500 graphites, 57, 493 helonias, 134 hepar, 127, 682 hyoscyamus, 102, 198, 420, 427, 437, 612 ignatia, 102, 197, 344, 528 ipecac, 377 iodine, 502, 614 kali bromatum, 437, 606, 612, 715 kali carb., 443, 748 lachesis, 36, 38, 102, 218, 437, 617, 683 lilium tigrinum, 127 lycopodium, 37, 440, 613 mercurius, 590 moschus, 79, 116 muriatic acid, 521 mygale, 75 natrum carb., 689 natrum mur., 102, 126, 142, 198, 344, 624, 699 nitric acid, 219, 535 nux moschata, 118 nux vomica, 102, 344, 618 oleander, 165 opium, 272 palladium, 64, 78, 615 paris quad., 39 petroleum, 424, 437, 500 phosphoric acid, 197, 272, 471, 526, 738 phosphorus, 562 platina, 78, 127, 612, 615 Pulsatilla, 126, 197, 343, 344, 617, 623, 700 rhus tox., 226, 437 sabadilla, 258 saccharum alb., 669 sanguinaria, 275 sepia, 121, 244, 347, 617, 624, 690, 700 silicea, 272 spigelia, 205 stannum, 344, 623 staphisagria, 248, 338, 339 stramonium, 218, 255, 423, 424, 429 THERAPEUTIC INDEX. 809 MENTAL SYMPTOMS (Continued) sulphur, 37, 471, 683 sulphuric acid, 531 thuja, 258, 308, 424 valerian, 118 veratrum album, 255, 272 zizia, 146 METRITIS belladonna, 414 berberis, 452 kali carb., 741 mel cum sale, 112, 415 rhus tox., 234 terebinthina, 305, 306 METRITIS, PUERPERAL (See Puerperal Metritis.) METRORRHAGIA ambra, 152 arsenicum, 65, 482 belladonna, 272, 368, 421 bovista, 157 cantharis, 355 carbo an., 490 carbo veg., 368, 482 cinchona, 368, 482 cinnamon, 369 erygeron, 159, 368 ferrum, 642 glonoin, 278 gossypium, 355 hamamelis, 159, 369 hyoscyamus, 272 ipecacuanha, 482 lachesis, 278 kali ferrocyan., 144 mercurius, 592 millefolium, 368 mitchella, 159 nitrite of amyl, 278 nux vomica, 194 opium, 272 Pulsatilla, 355 sabina, 305, 368 sanguinaria, 278 secale, 145, 155, 368 trillium pend., 158, 368 ustilago, 157, 158 MILK FEVER aconite, 325 bryonia, 301 MILK LEG hamamelis, 356 Pulsatilla, 356 MISCARRIAGE (See Abortion.) MORBUS BRIGHTII (See Bright's Disease.) MOUTH apis, 47 argentum nitricum, 609 arsenicum, 47 arum triphyllum, 710 baptisia, 47 borax, 709 bryonia, 709 carbo veg., 47 MOUTH (Continued) iodine, 47 kali chloricum, 47 lachesis, 46, 47 mercurius, 709 muriatic acid, 47 nitric acid, 47 staphisagria, 47, 340 sulphuric acid, 47 MUCOUS MEMBRANES (See also Catarrhs.) alumina, 618 ammonium carb., 658 arsenicum, 557 borax, 710 bromine, 503 cantharis, 94 graphites, 497 hydrastis, 360 ipecacuanha, 376 kali bichromicum, 720 lithium carb., 655 lycopodium, 445 natrum carb., 693 natrum mur., 142, 702 nitric acid, 533 petroleum, 499 phosphoric acid, 529 Pulsatilla, 347 senecio, 359 silicea, 545 stannum, 626 MULTIPLE CEREBRO-SPINAL SCLE- ROSIS baryta carb., 650 baryta mur., 650 hyoscyamus, 650 plumbum, 622 MUSCULAR EXERTION, ILL-EFFECTS OF arnica, 229, 239 arsenicum, 230, 521 coca, 521 fluoric acid, 520 rhus tox., 229, 521 MUSCULAR EXHAUSTION conium, 336 curare, 336 gelesmium, 336 kali carb., 336 muriatic acid, 336, 525 opium, 336 saponin, 336 MYALGIA actea rac, 143, 327 arnica, 240 MYELITIS artemisia abrotaum, 244 dulcamara, 236 nux vomica, 194 picric acid, 97 MYOCARDITIS phosphorus, 572 NAEVI fluoric acid, 441, 521 8io THKRAPKUTIC INDEX. NAEVI (Continued) lycopodium, 441 NAILo antimonium crudum, 579 fluoric acid, 520 thuja, 310, 520 NASAL CATARRH alumina, 617, 619 ambra, 661 ammonium carb., 661 ammonium mur., 661 antimonium crudum, 497 arum triphyllum, 498 aurum, 602 bromine, 504 bryonia, 294 calcarea ostrearum, 498, 671 cinnabaris, 595 cistus canad., 656 corallium rubrum, 656 cyclamen, 348 euphrasia, 380 graphites, 497 hydrastis, 360 kali bichromicum, 656, 661, 722 kali carb., 739 kali sulph., 594 lachesis, 49, 294 lithium carb., 655 lycopodium, 445 mercurius, 594 natrum carb., 693 nux vomica, 594 phosphorus, 569 Pulsatilla, 348, 594 sepia, 656 silicea, 546 sulphur, 473 teucrium, 656 NECROSIS OF THE LOWER JAW angustura, 180 calcarea fluor., 666 phosphorus, 573 NEPHRALGIA argentum nitr., 613 NEPHRITIS aconite, 325 cannabis sativa, 89 cantharis, 88 helleborus, 337 kali carb., 741 NERVOUS SYSTEM actea racemosa, 76, 143, 3:7 agaricus muse, 79 alumina, 145 ambra grisea, 151, 195, 715 ammonium carb., 79 ammonium mur., 662 aranea, 81 argentum nitricum, 606 arnica, 369 arsenicum, 79 asafoetida, 79, 119, 120, 449 asarum, 79, 195 belladonna, 77, 408 borax, 708 NERVOUS SYSTEM (Continued) bryonia, 691 calcarea ostrearum, 195, 675 castoreum, 117, 195 causticum, 77 chamomilla, 248 cicuta, 79 cinchona, 369 cocculus, 195, 259 colocynth, 287 crocus, 71 curare, 179, 206 dulcamara, 434 gelsemium, 169 hepar, 248, 682 hydrocyanic acid, 537 hyoscyamus, 77, 79 ignatia, 78 kali bromatum, 76, 606, 713, 715 kali carb., 195, 738 magnesia mur., 120, 121, 648 magnesia phos., 648 mephitis, 27, 79 moschus, 79, 115 muriatic acid, 521 mygale, 73 natrum carb., 691 natrum mur., 79, 606, 691 nitric acid, 691 nux moschata, 118, 121, 248 opium, 267 palladium, 78 petroleum, 500, 691 phosphorus, 562, 691 piper methysticum, 82, 385 platina, 78 rhododendron, 691 selenium, 459 sepia, 123, 691 silicea, 547, 691 spigelia, 369 sticta, 79 stramonium, 79 sulphur, 195, 471 tarantula, 75, 714 thuja, 307 Valeriana, 118, 121, 248 veratrum alb., 195, 248 zincum, 79, 632 NEURALGIA (See also Prosopalgia.) aconite, 321, 322 actea racemosa, 327, 356 ammonium carb., 663 ammonium mur., 662 amyl nitrite, 322, 419 argentum met., 611 arsenicum, 467, 555 belladonna, 419, 613, 682 cactus, 419, 555 capsicum, 614 cedron, 288, 328, 374, 555 cepa, 241, 663 chamomilla, 288, 644 chelidonium, 282 chininum sulph., 467, 555 THERAPEUTIC INDEX. 8ll NEURALGIA (Continued) cinchona, 369, 37+, 467 colchicum, 322 colocynth, 285 cuprum, 630 cuprum arsenicosum, 630 dioscorea, 285 ferrum, 640 ferrum carb., 420 hamamelis, 352 hepar, 582 ignatia, 203 kalmia, 328, 555, 625 kreosote, 301, 555 magnesia carb., 120, 644 magnesia phos., 120, 555 mezereum, 308, 555 natrum mur., 625 platina, 420, 613, 625 prunus spinosa, 288 Pulsatilla, 361 robinia, 555 sepia, 432 silicea, 683 spigelia, 205, 288, 308, 321, 327. stannum, 607, 625 staphysagria, 663 strontiana carb., 625 sulphur, 467, 683 tabacum, 432 theridion, 82 thuja, 308 valerian, 555 verbascum, 395, 419 NEURALGIA, CILIARY actea racemosa, 137 cedron, 206 colocynth, 288 crotalus horr., 43 mezereum, 205 natium mur., 701 spigelia, 205, 701 thuja, 206 NEURASTHENIA aletris farinosa, 359 alumina, 541 argentum nitricum, 541 calcarea ostrearum, 624 cocculus indicus, 624 collinsonia, 624 cyclamen, 359 helonias, 357 ignatia, 624 natrum mur., 624 phosphoric acid, 367, 541, 6;?4 phosphorus. 367, 541, 624 picric acid, 539 silicea, 541 stannum, 623 sulphur, 624 veratrum alb., 624 zincum, 541 NIGHT TERRORS kali bromatum, 413, 714 NIPPLES, SORE castor equi, 28 NIPPLES, CORE (Continued) graphites, 141 Phytolacca, 141 sepia, 141 NOMA conium, 449 NOSE aurum, 602 borax, 710 graphites, 86 ignatia, 276 lithium carb., 655 natrum carb., 693 nux vomica, 276 phosphorus, 276 sanguinaria, 276 Valeriana, 276 NOSTALGIA mercurius, 590 NYMPHOMANIA caladium, 613 camphor, 94 cantharis, 97 hyoscyamus, 563 phosphorus, 562, 569 platina, 64, 140, 612 stramonium, 425 veraturm alb., 255, 429 OBESITY graphites, 493 OBJECTIVE SYMPTOMS, 19 OEDEMA bovista, 158 OEDEMA GLOTTIDIS apis, no OEDEMA PULMONUM apis, no OESOPHAGITIS arsenic, 414 belladonna, 414 rhus tox., 414 veratrum viride, 257, 414 OESOPHAGUS, SPASMODIC STRICTURE OF THE phosphorus, 568 OPHTHALMIA antimonium crudum, 217 antimonium tart., 300 argentum nitricum, 217, 234 bryonia, 300 OPHTHALMIA, ARTHRITIS antimonium tart., 300 bryonia, 300 colocynth, 288, 341 euphrasia, 189, 683 staphysagria, 341 OPHTHALMIA NEONATORUM argentum nitricum, 347, 608 mercurius corrosivus, 347 Pulsatilla, 347, 608 OPHTHALMIA, PURULENT argentum nitricum, 60S graphites, 347 hepar, 683 Pulsatilla, 608 8l2 THERAPEUTIC INDEX. OPHTHALMIA, SCROFULOUS apis, 113 argentum nitricum, 702 arsenicum, 494, 495, 702 aurum, 601, 602 baryta carb., 652 calcarea ostrearum, 494, 495, 669 conium, 448 euphrasia, 496 graphites, 494, 702 hepar, 486 kali bichromicum, 113, 72^ lachesis, 42 mercurius, 496, 593 mercurius, 593 natrum mur., 702 nux vomica, 189 vhns tox., 235 sulphur, 473, 494, 495 ORCHITIS aurum, 603 clematis, 352 gelsemium, 513 hamamelis, 352, 512 mercurius, 513 Pulsatilla, 310, 352 rhododendron, 352 spongia, 512 thuja, 310 OSTEOMA calcarea fluorica, 519, 666 OSTEITIS conchiolin, 680 stillingia, 341 strontiana carb., 341 OTALGIA belladonna, 683, 708 borax, 708 chamomilla, 349, 384, 683, 708 dulcamara, 434 hepar, 683 kali bichromicum, 721 plantago major, 349 Pulsatilla, 348, 683, 708 rhus tox., 235 OTITIS EXTERNA calcarea ostrearum, 670 hepar, 683 Pulsatilla, 348, 354 OTITIS MEDIA belladonna, 348, 411 calcarea ostrearum, 670 hepar, 412, 683 kali bichromicum, 720 mercurius, 349 Pulsatilla, 348, 349 silicea, 349, 435 tellurium, 349, 412 OTORRHOEA aurum, 43, 602 borax, 708 calcarea ostrearum, 670 capsicum, 43 carbo animalis, 491 carbo veg., 491 elaps, 43 OTORRHOEA (Continued) he par, 43, 671 kali bichromicum, 721 lachesis, 43 mercurius, 671 natrum hypochlor., 692 nitric acid, 43 psorinum, 149 Pulsatilla, 348 silicea, 43, 349, 545, 670 tellurium, 349, 412 OVARALGIA. colocynth, 286 lachesis, 62 OVARIAN TUMORS apis, 64, 112, 510 colocynth, 285, 510 hepar, 62 iodine, 510 lachesis, 62 mercurius, 62 OVARIES f.pis, 64, 112 argentum metallicum, 611, 616 argentum nitricum, 605 arsenicum, 65 graphites, 65, 498 iodine, 510 lachesis, 62 iilium tig., 133 lycopodium, 65 palladium, 65 phosphoric acid, 528 platina, 64 staphisagria, 339 tarentula, 76 zincum, 65, 633, 638 OVARITIS apis, 112 arsenicum, 552 lachesis, 62, 613 palladium, 64, 66, 613 platina, 64, 613 OZAENA alumina, 617 aurum, 49, 602 kali bichromicum, 49, 310, 722 kali hyd., 64, 717 lac caninum, 49 lachesis, 49, 51 magnesium mur., 647 mercurius corr., 596 mercurius vivus, 49 natrum carb., 693 nitric acid, 49 petroleum, 499 phosphorus, 569 Pulsatilla, 310 silicea, 647 stillingia, 341 theridion, 83 thuja, 310 PANARITIUM apis, 114 sulphur, 114 THERAPEUTIC INDEX. 813 PANCREAS, AFFECTIONS OF THE iodine, 510 phosphorus, =;68 PANNUS aurum, 601 PARALYSIS aconite, 315, 322, 731 antimonium tart., 537 apis, 107 arsenicum, 537 baryta carb., 650, 731 cannabis indica, 322 causticum, 322, 650, 729, 731 cocculus ind., 315, 624 colchicum, 731 collinsonia, 624 ccnium, 315, 447 cuprum, 537, 630 curare, 179 dulcamara, 34. 731 gelsemium, 166, 170, 315, 448, 606 hyoscyamus, 426 ignatia, 624 manganum, 663 muriatic acid, 731 natrum mur., 170, 624, 627 nitric acid, 537 nux vomica, 315, 731 oleander, 165, 166 phosphorus, 537, 564, 569, 624 plumbum, 621, 622, 632 rhus tox., 236, 322, 632 secale, 650 silicea, 547 stannum, 170, 624, 672 staphisagria, 170, 332, 627 sulphur, 107, 236, 322, 472, 541 zincum, 636 PARALYSIS, POST-DIPHTHERITIC argentum nitricum, 606 cocculus, 448 conium, 448 gelsemium, 171, 448, 606 physostigma, 178 rhus tox., 236 sulphur, 236 PARAPHIMOSIS colocynth, 288, 394 digitalis, 394 PAROTITIS abrotanum, 245 arsenicum, 245 belladonna, 412 calcarea ostr., 443 carbo veg., 245 lachesis, 443 lycopodium, 442 Pulsatilla, 245 rhus tox., 443 PEDICULI staphisagria, 340 PEMPHIGUS caltha, 87 cantharis, 87 carboneum oxygenisatum, 87 causticum, 87 PEMPHIGUS (Continued) chi-tinum sulph., 87 copaiva, 87 nitric acid, 87 ranunculus bulbcsus, 87, 332 ranunculus sceleratus, 87 rhus tox., 87 sulphuric acid, 87 PERICARDITIS anacardium, 221 arsenicum, 558 colchicum, 254 kali carb., 741 kali hydr., 718 PERIODONTITIS hepar, 46 lachesis, 46 mercurius, 46 silicea, 46 PERIOSTEUM, INURIES TO THE angustura, 180 ruta, 180 PERIOSTITIS aranea diadema, 81 asafoetida, 450 stillingea, 341 PERIPROCTITIS lachesis, 60 rhus tox., 60 PERITONITIS arnica, 60 baptisia, 59 belladonna, 59, 415 berberis, 452 bryonia, 293 bufo, 30 carbo veg., 57 colchicum, 60 lachesis, 55, 59 lycopodium, 271 mercurius, 592 opium, 271 ranunculus bulb., 331 raphanus, 271 rhus tox., 59, 225, 234 sulphur, 472 terebinth., 271, 305 PERITYPHLITIS rhus tox., 234 PETIT MAL absinthium, 420 artemesia vulgaris, 243 causticum, 734 PHARYNGITIS kali bicarbonicum, 721 kali carbonicum, 740 Pulsatilla. 349 PHARYNGITIS FOLLICULAR aesculus hippocastanus, 722 hepar, 722 kali bichromicum 722 kali chloricum, 722 mercurius jodatus, 722 nux vomica, 722 secale, 722 814 THERAPEUTIC INDEX. PHIMOSIS mercurius, 352 sulphur, 478 PHLEBITIS lachesis, 63 PHLYCTENULAR OPHTHALMIA arsenicum, 397 euphrasia, 397, 496 graphites, 495 ignatia, 203 natrum carb., 693 rhus tox., 235 PHTHISIS (See also Tuberculosis.) actea racemosa, 328 ammonium mur., 664 anisum stellatum, 83, 306 balsam of Peru, 627 baptisia, 403 calcarea ostrearum, 536, 673 carba animalis, 490 carbo veg., 490 coccus cacti, 627 codein, 265 conium, 448 drosera, 27, 273 elaps., 51 eyrodiction, 215 ferrum, 639, 641 ferrum phos., 642 guaiacum, 215, 298, 329 hydrocyanic acid, 538 iodine, 509 kali carb., 536, 740 kali hydriodicum, 718 laurocerasus, 538 myrtus communis, 83, 306 natrum sulph., 694 nitric acid, 536 phellandrium, 546 phosphorus, 509, 626 pix liquida, 83, 306 rumex, 296 sanguinaria, 278 senega, 626 silicea, 546, 626 spongia, 513 stannum, 623, 626, 706 sulphur, 474 theridion, 83 yerba santa, 215, 627, 718 PLEURISY aconite, 293, 323 apis, 103, 472 bryonia, 293, 295 ranunculus bulbosus, 331 stannum, 627 sulphur, 103, 472 PLEURODYNIA aconite, 331 actea racemosa, 296, 329 arnica, 296 asclepias tuberosa, 296 bryonia, 295, 570 gaultheria, 295 guaiacum, 329 PLEURODYNIA (Continued) kali carb., 296 ranunculus bulb., 295, 331 rhus radicans, 231, 296 rumex crispus, 296 senega, 296 PLICA POLONICA vinca minor, 167 PNEUMONIA aconite, 295, 323 ammonium carb., 659 antimonium tart., 279, 283, 295, 583 bromine, 567 bryonia, 295, 323 carbo animalis, 490 carbo veg., 484, 485 chelidonium, 282 cuprum, 630 elaps, 51 ferrum phos., 159, 642 hepar, 685 iodine, 508 kali carb., 283, 740 kali hydriodicum, 717 lachesis, 51, 474 lycopodium, 446 mercurius, 283, 592 moschus, 121 phosphorus, 279, 381, 571 ranunculus bulb., 331 rhus tox., 225, 227 sanguinaria, 278 sulphur, 51, 279, 466, 473 terebinth., 305, 306 veratrum viride, 257, 279, 319, 3r POLYPI calcarea ostrearum, 570 calcarea phosphorica, 570 ledum, 369, phosphorus, 36, 570 sanguinaria, 280 teucrium marum verum, vinca minor, 369 POLYURIA arctium lappa, 168 gelsemium, 460 ignatia, 171, 460 kalmia, 171 lac defloratum, 460 moschus, 136, 460 oleum animale, 171 phosphoric acid., 530 sanguinaria, 171 selenium, 460 silicea, 171 POST-NASAL CATARRH baryta carb., 652, 656 calcarea ostrearum, 656 hydrastis, 349, 656, 722 kali bichromicum, 656, 722 lithium carb., 656 natrum carb., 693 petroleum, 499 sepia, 656 spigelia, 348, 722 teucrium marum verum, 656 THERAPEUTIC INDEX. 815 POST-NASAL CATARRH (Continued) theridion, 348 POTT'S DISEASE (See Vertebral Caries.) PREGNANCY actea racemosa, 328 aconite, 325 anacardium, 220 apis, 112 caulophyllum, 357 digitalis, 388 hamamelis, 346, 355 lycopodium, 441 magnesia carb., 64.5 natrum carb., 691 mix vomica, 193, 691 psorinum, 150 Pulsatilla, 351, 355 zincum, 637 PRIAPISM agaricus, 541 ambra grisea, 541 cantharis, 96, 541 capsicum, 541 mygale, 541 opium, 541 petroselinum, 541 phosphorus, 541 physostigma, 541 picric acid, 97, 194, 539 platina, 541 Pulsatilla, 541 PROCTALGIA ignatia, 60 PROCTITIS aesculus, 705 collinsonia, 705 natrum mur., 704 PROFANITY anacardium, 219 nitric acid, 219 PROGRESSIVE MUSCULAR ATROPHY plumbum, 622 PROLAPSUS ANI ignatia, 203 natrum mur., 704 podophyllum, 138, 454, 625 PROLAPSUS UTERI abies canadensis, 146 aletris farinosa, 146 aloes, 137 antimonium crudum, 580 apis, 64, 113 argentum met., 599, 616 aurum, 139, 603, 613 aurum muriat. natr., 603 calcarea ostr., 145 calcarea phos., 145, 625 caulophyllum, 146 collinsonia, 188 ferrum, 643 ferrum jod., 643 graphites, 141 helonias, 146, 358 hydrastis, 360 lac denoratum, 146 PROLAPSUS UTERI (Continued) lilium tigrinum, 133 mel cum sale, 112 melilotus, 2.-]"] natrum hypochlorosum, 143, 146 natrum mur., 142, 146, 700 nux vomica, 193, 454, 625 platina, 613 podophyllum, 138, 188, 454, 625 Pulsatilla, 625 secale, 145 t sepia, 193, 454 stannum, 136, 624 staphisagria, 342 ustilago, 145 PROSOPALGIA (See also Neuralgia.) aconite, 321 amyl nitrite, 322 argentum nitricum, 607 arsenicum, 614 belladonna, 419 capsicum, 614 colchicum, 322 ccnium, 449 gelsemium, 1/4 hepar, 684 kreosote, 301 lachesis, 46 spigelia, 322 stannum, 625 verbascimi 614 zinc, 637 PROSTATE GLAND, ENLARGEMENT OF THE conium, 450 Pulsatilla, 352 PROSTATITIS Pulsatilla, 310 thuja, 309 PROSTATORRHOEA selenium, 459 sulphur, 459 PRURITIS VULVAE caladium, 337 convallaria, 393 hydrocotyle, 145 natrum hypochlor., 143 PSEUDO-CYESIS thuja, 308 PSORA corallium rubrum, 30 psorinum, 149 sulphur, 463 PSORIASIS arsenicum, 707 arsenicum iod., 125, 707 natrum ars., 707 sepia, 125 PTERYGIUM zincum, 637 PTOSIS alumina, 131, 170, 618 causticum, 170, 235, 398, 731 euphrasia, 398 gelsemium, 170, 235, 619 8i6 THERAPEUTIC INDEX. PTOSIS (Continued) kalmia, 170, 235 natrum mur., 131 rhus tox., 170, 235, 398 sepia, 170, 235 PTYALISM nitric acid, 534 PUERPERAL CONVULSIONS argentum nitricum, 608 belladonna, 420 cantharis, 94 cicuta, 451 gelsemium, 175, 257 glonoin, 43/, 438 kali bromatum, 713 kali carb., 738 platina, 614 secale, 437 veratrum viride, 257 PUERPERAL FEVER aconite, 325 kali carb., 738, 741 opium, 2T2. PUERPERAL MANIA actea racemosa, 328 arsenicum 328 calcarea ostrearum, 328 hyoscyamus, 430 .kali carb., 738 lachesis, 328 PUERPERAL METRITIS belladonna, 415 kali carb., 741 lachesis, 62 mel cum sale, 415 tilia curopea, 415 terebinthina, 305 PUERPERAL PERITONITIS belladonna, 415 PULSE aconite, 317 apis, 317 belladonna, 317 lycopodium, 441 rhus, 225 PYAEMIA arnica, 241 QUINSY belladonna, 414 fluoric acid, 414 hepar, 414, 592 lachesis, 592 mercurius, 414, 592 silicea, 414, 592 sulphur, 414, 592 RACHITIS calcarea phos., 679 magnesia mur., 447 phosphorus, 679 silicea, 542, 647, 679 sulphur, 468 REACTION, DEFECTIVE (See Defective Reaction.) RECTUM aesculus, 705 alumina, 705 belladonna, 60 causticum, 60 cocculus, 60, 61 graphites, 705 ignatia, 50, 203 kali bich., 60, 61 lachesis, 52, 60 magnesium mur., 705 mezereum, 60 natrum mur., 61, 705 nitric acid, 60 opium, 61 plumbum, 60, 6t ratanhia, 705 REMITTENT FEVEU. gelsemium, 172 sulphur, 467 RENAL CALCULI argentum nitricum, 610 belladonna, 191 berberis, 93, 192 cantharis, 88, 191 ipomea nil., 92 lycopodium, 191, ,146 nitric acid, 610 nux vomica, 182, 191 ocimum, 92 tabacum, 182, 433 RETAINED PLACENTA cantharis, 97, 355 cinchona, 368 gossypium, 355 Pulsatilla, 355, 356, 368 sabina, 356 secale, 154, 356 sepia, 356 RETENTION OF URINE (See Urine, Retention of.) RETINA, ATROPHY OF THE (see Atrophy of the Retina.) RETINAL APOPLEXY (See Apoplexy of the Retina.) RETINAL CONGESTION aurum, 602 belladonna, 602 glonoin, 436, 602 sulphur, 602 RETINAL HYPERAESTHESIA actea racemosa, 144 nux vomica, 189 RETINITIS lycopodium, 443 mercurius cor., 593 phosphorus, 574 spigelia, 205 RETINITIS ALBUMINURIA mercurius cor., 593 phosphorus, 574 RETINITIS PIGMENTOSA lycopodium, 443 RHEUMATISM abrotanum, 244 actea spicata, 297, 327 THERAPEUTIC INDEX. 8l 7 RHEUMATISM (Continued) anacardium, 221, 231 apis, 107 apocynum, 164 arctium lappa, 298 arnica, 240 bellauonna, 407, 422 benzoic acid, 453 berberis, 453 bryonia, 297, 353 calcarea fluorica, 677 calcarea ostrearum, 453, 656, 677 calcarea phos., 679 caulophyllum, 297 causticum, 288, 735 chamomilla, 249, 353 chininum sulph., 374 cinchona, 374 colchicum, 231, 232, 253, 298 colocynth, 288, 735 conium, 231 dulcamara, 434 ferrum, 231, 249, 281, 735 gelsemium, 175 guaiacum, 288, 289, 735 iodine, 510 kali bichromicum, 353, 728 kali carb., 741 kali hydriodicum, 719 kalmia, 231, 392 lac caninum, 353 ledum, 232, 297. 353, 392, 548 lithium carb., 463, 655, 656 lycopodium, 231, 446, 453 magnesia carb., 646 manganum, 663 mercurius, 311 nux moschata, 646 nux vomica, 195, 677 petroleum, 499 phosphoric acid, 735 Pulsatilla, 231, 310, 353 ranunculus bulb., 331 rhododendron, 231 rhus radicans, 231 rhus tox., 230, 249, 297, 677, 735 sabina, 298, 663 sanguinaria, 280, 646, 735 secale, 677 silicea, 548 sulphur, 353, 472 thuja, 309 valerian, 230 veratrum album, 249 viola odorata, 297 RHUS POISONING ammonium carb., 222 anacardium, 221 croton tiglium, 222 sepia, 125 zincum, 634 RIGIDITY OF THE OS UTERI belladonna, 421 gelsemium, 139, 175, 421 ROSE-COLD phosphorus, 276 52 ROSE-COLD (Continued) sanguinaria, 276 SCABIES causticum, 476 mercurius, 476 oil of lavender, 150, 476 psorinum, 150 sepia, 125, 476 sulphur, 125, 475 SCARLATINA aconite, 325 ailanthus, 212, 223, 403 ammonium carb., 659, 660 ammonium mur., 664 anacardium, 302 antimonium tart., 581, 583 apis, 100, 104, 109, 524, 660 arsenicum, 524, 558, 560 arum triphyllum, 208, 233, 535 baptisia, 212 belladonna, 71, 100, 109, 233, 302, 417, 428, 443, 634, 660 bryonia, 302, 418 calcarea ostrearum, 23s, 418, 635 camphor, 635 cinnabaris, 95, 596 cuprum, 302, 443, 630, 634 helleborus, 66, 302 hydrocyanic acid, 524, 538, 635 hyoscyamus, 418, 428 lachesis, 42, 70, 233, 418, 660 laurocerasus, 38 lycopodium, 211, 418, 442, 446 mancinella, 86, 313 muriatic acid, 211, 524 natrum ars., 524 nitric acid, 210, 534 psorinum, 148 rhus tox., 102, 109, 225, 233 stramonium, 302, 418, 425, 428, 443 sulphur, 418, 466, 524 suphuric acid, 524 terebinthina, 66, 303 veratrum alb., 635 zincum, 302, 633, 634 SCIATICA ammonium mur., 663 colocynth, 288 gnaphalium, 288, 614 kali hydriodicum, 719 valerian, 230 SCIRRHUS ammonium carb., 659 conium, 449 lapis albus, 510 magnesia mur., 202 SCLEROTITIS aconite, 321 belladonna, 412 thuja, 310 SCROFULOUS aurum, 599 baryta carb., 649, 652 bromine, 503 calcarea ostrearum, 494, 497, 545, 591, 66g 8i8 THERAPEUTIC INDEX. SCROFULOUS (Continued) causticum, 731 conium, 449 fluoric acid, 519 graphites, 494 iodine, 509 lycopodium, 445 magnesia mur., 048 mercurius, 590 nitric acid, 670 oleum jecoris, 29 phosphorus, 669 silicea, 494, 544, 561, 648 sulphur, 409, 494, 545, 591 theridion, 83 thuja, 310 SCROFULOUS OPHTHALMIA (See Ophthalmia, Scrofulous.) SCURVY ammonium carb., 659 chlorine, 511 natrum mur., 698 SEA-SICKNESS apomorphia, 265 petroleum, 499 theridion, 82 SEBACEOUS GLA-.^S psorinum, 149 SEMINAL EMISSIONS agnus castus, 175 caladium seg., 175, 215 calcarea ostr., 175, 192 camphor, 175 cinchona, 367, 529 cobalt, 193 conium, 175 digitalis, 174, 394 dioscorea, 174 gelsemium, 175 lycopodium, 175, 192 natrum carb., 703 natrum mur., 703 natrum phos., 703 nux vomica, 175, 192 phosphoric acid, 529 phosphorus, 175, 540, 503 picric acid, 539 selenium, 175, 459 sepia, 175 sulphur, 477 SENILITY baryta carb., 649 SEROUS MEMBRANES aconite, 293 bryonia, 293 ranunculus bulb., 331 SEXUAL EXCESSES agnus castus, 674 caladium, 175, 247, 339 calcarea ostr., 192, 339, 477, 674 cinchona, 367 cobalt, 192 conium, 448, 564 dioscorea, 339 gelsemium, 174, 339 kali bromatum, 339 SEXUAL EXCESSES (Continued) kali carb., 736 lycopodium, 192, 339 nux vomica, 192, 339, 477 phosphorus, 564 phosphoric acid, 529 platina, 339, 614 stannum, 627 staphisagria, 193, 338 sulphur, 192, 339, 477 zincum, 633 SHOCK helleborus, 337 SKIN aconite, 326 alumina, 620 ammonium caust., 85 anacardium occid., 85, 221 anacardium orientale, 85, 220 antimonium crudum, 86, 579, 702 antimonium tart., 85, 581 argemone mex., 274 arnica, 242 arsenicum, 559 arum, tri., 185 belladonna, 416 borax, 711 bufo, 30 calcarea caustica, 85 caltha, 85 camphor, 85, 586 cantharis, 84 cantharis strygosa, 84 capsicum, 85, 86, 404 carbolic acid, 85 carbo animalis, 688 carboneum oxyg., 87 causticum, 87, 702, 735 chamomilla, 688 chelidoneum, 85 chininum sulph., 87 chloral, 87 cicuta, 451, 677 clematis erecta, 85, 86, 560 clematis viorna, 314 cochlearia, 85 coffea, 384 comocladia, 217 copaiva, 87 cotura, 85 croton tiglium, 85, 313, 688 cuprum ars., 85 cuprum met., 85 drosera, 85 dulcamara, 434 euphorbia cyparissias, 86 euphorbia peplus, 86 euphorbium off., 46, 85, 217, 313 fluoric acid, 520 tormica, 85, 86 gelsemium, 174 graphites, 141, 493, 494, 495, 560, 688, 702 grindelia robusta, 222 hepar, 687 hydrocotyle, 560 hura brasiliensis, 85 THERAPEUTIC INDEX. 819 SKIN (Continued) iuglans cinerea, 207 kali bichromicum, 87, 725 kali bromatum, 87, 715 kali hydriodicum, 87, 7/9 kali nitricum, 87 kali sulph., 87 kreosote, 560 lachesis, 85 lithium carb., 655, 677 lycopodium, 688 lytta vitata, 84 magnesia mur., 647 ir.ancinella, 86, 313 rvercurius, 85, 688 mezereum, 85, 86, 168 natrum carb., 689 natrum mur., 688, 698, 702, 705 n-tric acid, 85 nux vomica, 85, 168, 234 cleander, 166 j,e'troleum, 311, 49:;, 408 picric acid, 85 piper nigrum, 85, 86 pix liquida, 85, 86, 87, 306 podophyllum, 85 psorinum, 149, 688 Pulsatilla, 85 ranunculus bulb., 85, 86, 330, 332 ranunculus sceleratus, 60, 87, 330, 333 rhus tox., 85, 232, 560 sanguinaria, 276 sarsaparilla, 311 selenium, 461 sepia, 123, 125, 560, 688 silicea, 688 sinapis nigra, 85 staphisagria, 339 strontiana carb., 654 sulphur, 166, 461, 475 sulphuric acid, 85, 87 terebinthina, 85. 86, 87 thapsia garganica, 85, 86 thuja, 688 veratrum alb., 85 viola tricolor, 167 yucca filamentosa, 313 zincum, 638 SLEEP belladonna. 109, 454 cocculus, 361 cuprum, 443 cypripedium, 384 digitalis, 389 fluoric acid, 521 hyoscyamus, 428 kali bromatum, 714 lachesis, 36 lycopodium, 443 mephitis, 521 nux vomica, 184, 196, 361 phosphoric acid, 529 Pulsatilla, 362 selenium, 461 stramonium, 443 sulphur, 361, 461 SLEEP (Continued) zincum. 443 SPEECH bovista, 425 fluoric acid, 440 glonoin, 437 lachesis, 440 lycopodium, 440 stramonium, 425 sulphur, 440 SPERMATORRHOEA agnus castus, 175 caladium, 175, 215 conium, 638 discorea, 174 gelsemium, 1 74 zincum, 638 SPINAL CONGESTION sulphur, 471, 541 SriNAL CORD alumina, 541 anacarium, 221 argentum nitricum, 605, 620 cocculus, 260 dulcamara, 434 hypericum, 241 kali hydriodicum, 719 nux vomica, 194, 620 phosphorus, 564 picric acid, 538 silicea, 547, 548 sulphur, 472, 541, 620 zincum, 632, 636 SPIinAL CORD, SOFTENING OF THE ambra grisea, 151 oxalic acid, 540 SPINAL IRRITATION actea racemosa, 329, 739 agaricus, 329 cobalt, 193, 361, 636 cocculus, 330 kali carb., 738 natrum mur., 329, 700, 739 nux vomica, 194, 330, 620 ' phosphorus, 195, 563 physostigma, 195, 320 picric acid, 194 Pulsatilla, 361 sepia, 636, 739 sulphur, 471 theridion, 82 zincum, 330, 633, 636 SPINAL WEAKNESS sulphur, 472 SPLEEN aranea diadema, 80 chininum sulph., 80, 365 cinchona, 80 SPOTTED FEVER (See Cerebro-Spinal Meningitis.) SPRAINS ammonium carb., 662 ammonium mur., 663 arnica, 654, 662 calcarea carb., 229 petroleum, 499 820 THERAPEUTIC INDEX. SPRAINS (Continued) rhus tox., 229 ruta, 654 strontiana carb., 654 sulphuric acid. 662 STAPHYLOMA apis, 113 STOMACACE nitric acid, 534 nux vomica, 190 ranunculus sceleratus, 333 STOMACH abrotanum, 341 actea racemosa, 132 calcarea ostrearum, 132 cantharis, 95 carbo animalis, 132, 166, 490 cocculus, 132 colchicum, 58 elaps, 58, 324 hydrastis, 132 ignatia, 132 ipecacuanha, 132, 341 kali carb., 132 lachesis, 52, 58 lycopodium, 131 niccolum, 132 nux vomica, 59, 132 oleander, 132, 165 podophyllum, 138 sarsaparilla, 132 sepia, 131 stannum, 132 staphisagria, 132, 341, 460 sulphur, 132 thea, 132, 377 veratrum alb., 59 STOMACH, CANCER OF THE conium, 449 phosphorus, 568, 575 STOMACH, ULCER OF THE phosphorus, 568 STOMATETIS (See also Sore Mouth.) apis, 95 _ arum tri., 710 STRABISMUS alumina, 617, 618 belladonna, 617, cina, 246, 617 cyclamen, 617 gelsemium, 171 STUTTERING bovista, 425 causticum, 731 staphysagria, 342 stramonium, 425 STYES graphites, 494 hepar, 687 lycopodium, 443 staphisagria, 340 SUBINVOLUTION OF THE UTERUS lilium tigrinum, 133 mel cum sale, 112 SUICIDAL TENDENCY anacardium, 219 antimonium crudum, 219 SUN, ILL EFFECTS OF THE aconite, 320 belladonna, 320 camphor, 38 glonoin, 426, 437 lachesis, 38 natrum carb., 38, 691 natrum mur., 38 theridion, 38 thuja, 38 SUPPRESSED ERUPTIONS, ILL EFFECTS OF antimonium tart., 303, 581 apis, 100, 470 bryonia, 101, 290, 302 cuprum, 101, 302, 434, 630, 634 helleborus, 101 ipecacuanha, 303 sulphur, 101, 105, 464, 470 thuja, 308 zinc, 101, 302, 367, 443, 633 SWEAT baryta carb., 653 bryonia, 300 calcarea carb., 668 carbo veg., 653 chamomilla, 566 cinchona, 373 graphites, 653 kali carb., 653 lactic acid, 653 magnesia mur., 647 mercurius, 591 natrum mur., 300 nitric acid, 653 petroleum, 499 phosphorus, 566 psorinum, 374 rhus tox., 545, 566 silicea, 544, 647, 653 sulphur, 374 thuja, 653 SYCOSIS cinnabaris, 311 euphrasia, 398 kali bichromicum, 310, 726 natrum sulph., 694 nitric acid, 310 petroleum, 398 Pulsatilla, 310, 726 sabina, 311 sarsaparilla, 311, 726 staphisagria, 340 thuja, 307, 309, 694, 726 SYNCOPE arsenicum, 37 camphor, 37, 38 digitalis, 37, 38 hydrocyanic acid, 37 lachesis, 37 laurocerasus, 37, 38 linaria, 394 theridion, 37 THERAPEUTIC INDEX. 821 SYNCOPE (Continued) veratrum album, 37, 38 SYNOVITIS apis, 103, 296, 353 bryonia, 103, 296, 353 iodine, 103 kali hyd., 103 Pulsatilla, 353 sulphur, 297, 472 SYPHILIS asafoetida, 602 aurum, 601, 602 badiaga, 491 carbo animalis, 498, 491 carbo veg., 491 cinnabaris, 311, 595 corallium rubrum, 30 fluoric acid, 519 kali bichromicum, 723 kali hydriodicum, 64, 716, 719 lachesis, 62 lycopodium, 63 mercurius biniod., 491, 597 mercurius cor., 593, 596, 602 mercurius prot., 597 mercurius vivus, 591, 593, 596 nitric acid, 63, 491, 534, 535, 602 platina mur., 614 staphisagria, 340 stillingea, 341, 695 TABES MESENTERICA baryta carb., 652 calcarea phos., 653 iodine, 502, 509, 653 silicea, 653 sulphur, 470 TAPE WORM argemone mexicana, 274 cucurbita, 285 pumpkin seeds, 285 TARSAL CYSTS graphites, 340 thuja, 130 TEETH antimonium crudum, 340 chamomilla, 340, 645 coffea, 340 fluoric acid, 46 kreosote, 48, 301, 340 lachesis, 46 magnesia carb., 645 petroleum, 46 staphisagria, 340 thuja, 48, 340 TEMPERAMENT belladonna, 406 calcarea ostrearum, 406 capsicum, 434 chamomilla, 248 cina, 247 ignatia, 197 ipecacuanha, 377, 383 lycopodium, 440 nux vomica, 183 Pulsatilla, 194, 344 TEMPERAMENT (Continued) staphisagria, 338 TESTICLES arnica, 352 aurum, 352 bromine, 503 conium, 352 oxalic acid, 352 phosphorus, 352 Pulsatilla, 352 spongia, 352, 512 staphisagria, 352 ustilago, 352 TETANUS aconite, 180 angustura, 180 belladonna, 181 camphor, 183 cicuta, 178, 181, 182, 537 curare, 179 hydrocyanic acid, 181, 537 hypericum, 181 lachesis, 44, 81 nicotinum, 181, 182 passiflora, 179 physostigma, 178, 195 Phytolacca, 179 picrotoxin, 178 pothos foetida, 216 silicea, 181 stramonium, 183 strychnia, 177 tabacum, 182 thebaine, 178 veratria, 1 78 veratrum album, 182 veratrum viride, x8i THROAT (See also Tonsillitis.) alumina, 619, 685, 740 apis, 740 argentum nitricum, 609, 619, 685, 740 arsenicum album, 95, 596 arsenicum iod., 596 arum triphyllum, 95, 209 aurum, 602 baryta carb., 651 belladonna, 95, 172, 412, 596 borax, 710 calcarea ostrearum, 498 cantharis, 95 capsicum, 95, 435, 596 carbo veg., 740 cinnabaris, 595 diffenbachia, 95 dulcamara, 434 gelsemium, 173 graphites, 498 hepar, 619, 685, 740 ignatia, 201, 203 kali bichromicum, 722 kali carb., 739, 740 lachesis, 49 mercurius, 190, 594, 685 mercurius cor., 95, 596 natrum ars., 706 822 THERAPEUTIC INDEX, THROAT (Continued) natrum mur., 702 nitric acid, 535, 609, 619, 685 nux vomica, 190 phosphorus, 567 Pulsatilla, 349 sulphur, 498 TIC DOULOUDEUX aconite, 321 TINEA CAPITIS sarsaparilla, 311 TINEA CILIARIS thuja, 310 TINEA FAVOSA nux juglans, 168, 234 TONGUE antimonium crudum, 377. 578 arsenicum album, 333, 353, 698 arsenicum metallicum, 454 baryta carb., 649 bryonia, 568, 570 causticum, 731 colchicum, 650 dulcamara, 434 kali bichromicum, 725 lycopodium, 442 magnesia mur., 647 mercurius, 226, 454 natrum mur., 333, 698 nux vomica, 377 phosphorus, 567 podophyllum, 454 ranunculus sceleratus, 333 rhus tox., 226, 333, 454, 567 stannum, 624 stramonium, 425, 454 sulphur, 293 taraxacum, 229, 244, 333 yucca filamentosa, 454 TONSILLITIS ammonium mur., 664 amygdala persica, 414 baryta carb., 651 belladonna, 414, 592 bromine, 503 calcarea ostr., 651 calcarea phos., 651 fluoric acid, 414 gelsemium, 173 hepar, 414, 592, 684, 685 ignatia, 201, 651 lachesis, 49, 592 lycopodium, 414, 454, 651 mercurius, 414, 592, 685 nux vomica, 722 sabadilla, 258 silicea, 414, 546, 5:92 sulphur, 414, 592 TONSILS, ENLARGEMENT OF THE baryta carb., 651 bromine, 503 calcarea iod., 651 conium, 651 hepar, 651 ignatia, 651 lycopodium, 651 TOOTHACHE aranea diadema, 81 bryonia, 300 chamomilla, 645 coffea, 301, 384 ignatia, 203 magnesia carb., 645 mercurius, 47, 81 ratanhia, 645 rhus tox., 236 TORTICOLLIS agaricus, 194 anacardium, 231 belladonna, 192, 422 bryonia, 422 causticum, 194 guaiacum, 422 lachnanthes, 194 nux vomica, 194, 422 trifolium prat., 296 TRACHEITIS phosphorus, 570 TRACHOMA sepia, 130 TRICHIASIS borax, 710 graphites, 710 TUBERCULAR MENINGITIS apis, 100, 103, 327, 470 helleborus, 337 sulphur, 104, 469 TUBERCULOSIS (See also Phthisis.) arsenicum, 558 bromine, 507 calcarea ostrearum, 470, 672 calcarea phos., 670 conium, 448 ferrum, 641 guaiacum, 215 hepar, 513, 685 lachesis, 52 lapis albus, 510 natrum ars., 707 nitric acid, 670 oleum jecoris aselli, 29 phosphoric acid, 530 phosphorus, 470, 564, 571, 669, 673 Pulsatilla, 345, 3S5 silicea, 546 spongia, 513, 686 sulphur, 469, 470, 474, 572 TYMPANITES carbo veg., 253, 261, 271, 487 cinchona, 252, 261, 370, 487 cocculus, 252 colchicum, 251, 261, 271, 370 lycopodium, 261, 271, 487 morphia, 265 opium, 261, 270 raphanus, 261 sulphur, 261 terebinthina, 271, 370 TYPHLITIS belladonna, 60 bryonia, 60 THERAPEUTIC INDEX. 823 TYPHLITIS (Continued) lachesis, 54, 60 mercurius, 54, 59 mercurius cor., 60 opium, 272 rhus tox., 60, 234 TYPHOID FEVER AND TYPHOID CON- DITIONS absinthium, 243 aconite, 317 ailanthus, 403 alumen, 537 anacardium, 218 apis, 100, 107, 108, 268, 523 arnica, 40, 228, 239, 336, 402, 527, 659 arsenicum, 227, 252, 430, 467, 537, 552. 555 baptisia, 40, 228, 239, 272, 399, 467, 523 belladonna, 292, 410 bryonia, 261, 290, 523 calcarea ostr., 293, 442, 675 carbo veg., 228, 253, 261, 483, 566 castoreum, 27, 117 chlorine, 511 cinchona, 252, 556 cocculus, 260 colchicum, 251, 271, 556 gelsemium, 173, 261, 401 hamamelis, 537 helleborus, 39, 335 hydrocyanic acid, 336 hyoscyamus, 39, 228, 268, 410, 430 lachesis, 39, 108, 268, 402, 430 leptandra, 537 lycopodium, 430, 441, 446, 675 mercurius, 226 muriatic acid, 40, 108, 228, 403, 430, 522 nitric acid, 522, 536 nux vomica, 196 opium, 39, 268, 272, 335, 336, 528 petroleum, 500 phosphoric acid, 228, 334, 430, 523, 527 phosphorus, 227, 336, 527, 565, 571 psorinum, 150 sulphuric acid, 531 ranunculus sceleratus, 333 rhus tox., 40, 225, 226, 292, 402, 410, 430, 523, 527, 552 selenium, 459 stramonium, 272, 431 sulphur, 467 sweet spirits of nitre, 335, 336, 527 taraxacum, 228, 244 terebinthina, 66, 305 veratrum album, 252 zincum, 102 zincum oxid., 102 ULCERS arsenicum, 62, 63, 156, 445, 561 asafoetida, 62, 119, 450, 545, 602 borax, 125, 711 bromine, 510 bufo, 30, 63 calcarea ostrearum, 534 carbo veg., 63, 482 ULCERS (Continued) chromic acid, 723 cinchona, 63 euphorbia corrollata, 63 euphorbium, 63 fluoric acid,. 520 hepar, 62, 63, 687 iodine, 510 kali bichromicum, 63, 722 lachesis, 62 lycopodium, 62, 63, 445 mercurius, 62, 63, 534 mercurius corr., 597 mezereum, 125, 677 muriatic acid, 63 nitric acid, 63, 310, 534, 535 phosphoric acid, 03 phosphorus, 62, 568, 574, 683 plumbum, 63 psorinum, 149 ranunculus bulb., 332 ranunculus sceleratus, 333 rhus tox., 445 secale, 63, 156 sepia, 125, 711 silicea, 62, 63, 520, 544, 574 sulphur, 62 thuja, 309 vespa, 145 URAEMIA ammonium carb., 659 arsenicum, 94 arum triphyllum, 209 cannabis indica, 00 cantharis, 94 cuprum, 629 hydrocyanic acid, 433 plumbum, 623 URETHRA cantharis, 86, 90 capsicum, 91 clematis erecta, «;0, 97 conium, 91 doryphora, 97 URETHRITIS cannabis sativa, 89 cantharis, 88 conium, 91 doryphora, 91 hyoscyamus, 91 URINARY ORGANS apis, 92, 93 apocynum, 163 argentum nitricum, 91 berberis, 93, 452 camphor, 93 cannabis indica, 90 cannabis sativa, 89 cantharis, 87 capsicum, 92 chimaphila, 92 clematis, 90 cochlearia, 92 conium, 91 copaiva, 92 cubebs, 91 824 THKRAPKUTIC INDEX. URINARY ORGANS (Continued) digitalis, 92 doryphora, 91 equisetum, 90 erigeron, 92 eupatorium purp., 90 ferrum phos., 92 hydrocotyle, 145 hyoscyamus, 91 kali nitricum, 93 kreosotum, 136 linaria, 90 mercurius, 90, 91 mercurius aceticus, 92 mercurius cor., 91 pareira brava, 93, 453 petroselinum, 90 ' ■ Pulsatilla, 92, 271 selenium, 306 thuja, 91 uva ursi, 93 URINE aconite, 710 ammonium benz., 66 apis, 66 apocynum can.^ 163 argentum nitricum, 610 arnica, 66 arsenicum, 66 belladonna, 416 benzoic acid, 66, 534 berberis, 452 borax, 710 bryonia, 301 calcarea ostr., 453 cantharis, 306 carbolic acid, 66 carbo veg., 66 causticum, 271, 737 colchicum, 66 copaiva, 306 digitalis, 66 helleborus, 66 hyoscyamus, 442 kali carb., 66, 737 lachesis, 66 lithium carb., 655 lycopodium, 271, 442, 710 natrum mur., 66 nitric acid., 534 opium, 66, 271 osmium, 306 Pulsatilla, 271 sarsaparilla, 710 senna, 737 stramonium, 271 terebinthina, 66, 306. zincum, 637 zingiber, 271 URINE, RETENTION OF arsenicum, 271 cantharis, 89 causticum, 271, 734 hyoscyamus, 271 opium, 271 URINE, SUPPRESSION OF THE lycopodium, 271 Pulsatilla, 271 stramonium, 271 zingiber, 271 URTICARIA apis, 106, 705 arsenicum, 107, 560 bovista, 107 calcarea ostrearum, 107, 705 copaiva, 87, 107 dulcamara, 434 kali bromatum, 107 medusa, 31 natrum mur., 705 Pulsatilla, 107 rhus tox., 107 rumex, 107 sepia, 107 terebinthina, 107 urtica urens, 107 UTERINE HAEMORRHAGE (See Metrorrhagia.) UTERUS actea rac, 143, 327, 356 aletris, 359 aloe, 137 apis, 112 argentum nitr., 615 aurum, 139, 603, 615 aurum mur., 139 aurum mur. natr., 139 bovista, 157 cactus, 133 carbo an., 490 caulophyllum, 146, 356 convallaria, 393 gelsemium, 175, 176 helonias, 134, 357, 615 hydrastis, 360 kreosote, 136 lilium tigrinum, 133, 360 magnesia mur., 202, 647 mel cum sale, 112, 415 murex, 135 mix vomica, 136 palladium, 79, 615 platina, 140 podophyllum, 138 Pulsatilla, 138, 625 secale, 154 senecio, 359 sepia, 133, 615 stannum, 136 sulphur, 135 tarentula, 76 ustilago, 157 UTERUS, INDURATION OF THE magnesia mur., 202 UVULA ELONGATED capsicum, 435 hyoscyamus, 427 mentha piperita, 428 natrum mur., 427, 703 THERAPEUTIC INDEX. 825 VACCINATION, ILL EFFECTS OF silicea, 307, 542 thuja, 307, 542 VAGINITIS helonias, 357 VARICOCELE hamamelis, 346 Pulsatilla, 346 VARICOSE \EINS ambra, 152 carbo veg., 141, 441, 482 fluoric acid, 521 hamamelis, 346, 521 lycopodium, 441 Pulsatilla, 346 VARIOLA anacardium, 218 antimonium tart., 303, 581, 583 apis, 107 rhus tox., 233, ^34 thuja, 308 VERTEBRAL CARIES carbo veg., 483 Gettysburg water, 341, 545, 656 phosphoric acid, 530 phosphorus, 573 silicea, 544 sulphur, 573 VERTIGO ambra grisea, 151 apis, 82 argentum nitr., 608 arsenicum, 37, 82 bromine, 502 camphor, 37 causticum, 730 chelidonium, 85 conium, 448 digitalis, 37 ferrum, 641 hydrocyanic acid, 37 kali carb., 736 lachesis, 36 laurocerasus, 37 moschus, 37 oleander, 165 petroleum, 82 picric acid, 539 piper meth., 82, 385 rhus tox., 234 sanguinaria, 276 sepia, 82 silicea, 548 theridion, 37, 82 thuja, 82 veratrum alb., 37 VESICAL CALCULUS hydrangea, 92 pareira brava, 93 VESICAL IRRITATION capsicum, 92 capaiva, 92 curare, 206 digitalis, 92 epigea, 92 erigeron, 92, 139 VESICAL IRRITATION (Continued) eupatorium, purp., 90, 145 ferrum phos., 92 inula, 146 mitchella repens, 145, 158 petroselinum, 90 Pulsatilla, 92 VOMITING aethusa cynap., 420, 578, 671 antimonium crud., 450, 578, 671 antimonium tart., 265, 387 apomorphia, 265, 436 arsenicum, 565, 672 belladonna, 226, 417 bismuth, 565 cadmium sulph., 555 calcarea acetica, 450 calcarea ostr., 450, 671 colchicum, 59 digitalis, 388 glonoin, 266, 436 ipecacuanha, 579, 672 kreosote, 136, 565, 671 lachesis, 55 lobelia, 265, 387 magnesia carb., 672 nux vomica, 184 phosphorus, 672 rhus tox., 265, 417 sulphur, 672 tabacum, 387 veratrum alb., 59 VOMITING OF PREGNANCY anacardium, 220 argentum nitricum, 607 digitalis, 388 nux vomica, 193, 220, 691 petroleum, 499 WARTS causticum, 694 nitric acid, 535 thuja, 310 WAXY LIVER phosphorus, 567 WHITE-SWELLING phosphorus, 573 sulphur, 470 WINE, AGGRAVATION FROM antimonium crud., 632 bovista, 632 carbo veg., 632 conium, 632, 634 fluoric acid, 632 glonoin, 632, 634 ledum, 032 lycopodium, 632 nux vomica, 632, 634 Pulsatilla, 632 rhododendron, 632, 634 selenium, 462, 632 silicea, 632 zincum, 632, 634 WHOOPING-COUGH ambra grisea, 152 826 THERAPEUTIC INDEX. WHOOPING-COUGH (Continued) antimonium tart., 581 arnica, 242 bryonia, 296 cina, 247, 382 coccus cacti,* 32, 627 corallium rubrum, 27, 31 cuprum, 682 drosera, 27 ipecacuanha, 382 kali bichromicum, 32 kali carb., 741 mephitis, 27, 31 senega, 32 veratrum album, 704 WORMS aconite, 246 argemone mex., 274 arsenicum, 632 WORMS (Continued) artemesia, 624 caladium seguinum, 247 cicuta, 451 cina, 246, 624 ignatia, 203, 256 indigo, 203, 247 quassia, 247 sabadilla, 258 spigelia, 206 stannum, 624, 625 teucrium, 203 YELLOW ATROPHY OF THE LIVER phosphorus, 567 YELLOW FEVER cadmium sulph., 555 carbo veg., 483 lachesis, 55 .- cy » ^ * o G°Vd •^ ,\, >> _ * n Z 7 #% 'W <<3 ^« p-tf A ** "**c. ^ ^% .:*> .^ % ^ J, -^ ^0* H °x !k'' * %