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 {UNITED STATES OF AMERICA. 
 
THE 
 
 HOMOEOPATHIC TREATMENT 
 
 SYPHILIS, G0N0RRH(EA, 
 
 SPERMATORRHEA, 
 
 AND 
 
 URINARY DISEASES. 
 
 
 COMPILED BT 
 
 J. PH. BEKJEAU, 
 
 AUTHOR OF 'PHYSIOLOGICAL SYNOPSIS OF HOMCEOPATH Y.' 
 
 ^rngtH, with gtuttwrmttf ^fldiftms, 
 By J. H. P. FROST, M. D., 
 
 LATE PROFESSOR OP PHYSIOLOGY AND PATHOLOGY IN THE 
 HOM. MED. COLLEGE OF PENNSYLVANIA. 
 
 ^ PHILADELPHIA : 
 PUBLISHED BY A. J. TAFEL. 
 1870. 
 
Entered according to Act of Congress, in the year 1869, by 
 
 A. J. TAFEL, 
 
 In the Clerk's Office of the District Conrt of the United States in and for 
 the Eastern District of Pennsylvania. 
 
 STEREOTYPED BY J. FAGAN & SON. 
 
 CAXTON PRESS OF 
 SHERMAN & CO., PHILADELPHIA. 
 
PREFACE TO THE FIRST ENGLISH EDITION. 
 
 The acknowledged want of a Homoeopathic treatise 
 on Urinary and Syphilitic Diseases has induced me to 
 compile the present volume from the few authorities 
 (homoeopathic) who have given the results of their ex- 
 perience to the world. I have endeavored to render 
 the descriptions and treatment of the diseases as con- 
 cise and as intelligible as possible, without being ob- 
 scure, and have consequently rejected (as much as 
 possible) the use of technical phraseology, which is. 
 in treatises of this kind, almost unavoidable. 
 
 The principal authors to whom I am indebted for 
 much of the practical information, are Drs. Laurie, of 
 London; Gollmann, of Vienna; and Humphrey, of 
 Philadelphia, U. S,; to whom I tender my best ac- 
 knowledgments. 
 
 J. Ph. Berjeau. 
 
 London, December, 1856. 
 
 vii 
 
PREFACE 
 
 TO THE FIRST AMERICAN EDITION. 
 
 Having been requested to revise Dr. Berjeau's 
 excellent treatise, for republication in this country, it 
 is proper to mention the alterations and additions 
 which have been made to the Second English Edition. 
 
 [The principal additions made by the American 
 Editor will be found enclosed in brackets, like this 
 sentence.] 
 
 The repeated dose-directions have been omitted as 
 unnecessary, and the whole work condensed in va- 
 rious ways (without omitting anything else), in order 
 to introduce new matter, and, at the same time, avoid 
 increasing too much the size of the book, or enhancing 
 its price. 
 
 The full discussion of the dose, added by the Editor, 
 will, it is believed, be found to contain directions 
 amply sufficient for the junior practitioner. Those 
 more experienced will need no such guidance. 
 
 The treatment of acute and chronic Gonorrhoea, as 
 well in the female as in the male, and of Gleet, has been 
 much more fully set forth. Here will now be found, 
 
X PREFACE TO THE 
 
 in addition to the system advised by our author, the 
 various methods recommended by particular physicians 
 of eminence; and also that which corresponds with 
 our own experience, and which is believed to be most 
 strictly in accordance with Homoeopathic principles. 
 We refer here more especially to what we have said 
 of intercurrent anti-psoric treatment in venereal cases. 
 
 The entire chapter on Venereal Rheumatism has 
 been added to the work in this edition. Important 
 additions will be found under Condylomata; Hema- 
 turia; Orchitis; Prostatitis; Chancre, and numerous 
 other headings. 
 
 Similar additions also appear, in connection with 
 Syphilis, and Syphilitic disorders. And in every part 
 of the work numerous minute additions occur, — which 
 it would not have been deemed worth while to enclose 
 in brackets, but from an unwillingness to make the 
 Author responsible for what he had not_ written. 
 
 The chapter on Cerebrospinal Meningitis, ori- 
 ginally published in the fourth volume of the Hahne- 
 mannian Monthly, has been inserted as necessary to 
 cover the vacant ground between the Spinal Irritation, 
 and Tabes Dorsalis of Berjeau. 
 
 Some important New Remedies have also been in- 
 troduced ; such as Copaiba and Occimum canum, in 
 Hematuria and Renal Colic; Tussilago petasites, in 
 Gonorrhoea ; Nat mur. and Mezereum, in Gleet ; Eu- 
 phrasia, Nitric acid, and Sabina, in Condylomata; 
 and Jacaranda caroba and Phytolacca decandra, in 
 Syphilis. 
 
FIRST AMERICAN EDITION. XI 
 
 From the larger work of Jahr (translated, with ad- 
 ditions, by Dr. Hempel) many important items have 
 been gleaned. From Professor Heme's Pathology 
 and Therapeutics w r e have taken some valuable indi- 
 cations. Some interesting matter has also been de- 
 rived from American Horn. Periodical Literature — 
 neither of these three sources having been accessible 
 to Berjeau in preparing the work; and while we have 
 thus sought in all directions for w T hatever would 
 tend to enhance the practical utility of the present 
 edition, or to confirm the treatment recommended, 
 due credit has been given in every instance. And in 
 regard to what we have ourselves advised, it is proper 
 to state, that the conclusions we have reached on the 
 subjects contained in the present work, and the cor- 
 responding suggestions which it offers, are the results 
 of twenty years' experience in our own practice, and 
 of a still larger observation of that of others. 
 
 J. H. P. Feost, M.D. 
 
 Bethlehem, Pa., July, 1869. 
 
INTRODUCTION. 
 
 SYPHILITIC diseases arise either directly or in- 
 directly from an impure coition, and may be trans- 
 mitted to other persons in a similar manner to the inocu- 
 lation of the small-pox. After breaking out at first on 
 the sexual organs, the disease is carried through the 
 whole organism by means of the lymphatic system ; 
 this, at least, is Bjcord's opinion, who holds that the 
 disease (syphilis) is at first only local, although by Ho- 
 moeopaths it is held (and I believe justly) that the in- 
 fection at once pervades the whole system, and being 
 gradually matured, shows itself at first on the genera- 
 tive organs, and afterwards in the throat, (secondary 
 syphilis,) the character of the ulcers being the same, and 
 therefore is not to be treated by caustics aud other 
 repellent remedies. The true venereal disease develops 
 itself at the spot where the infectious matter is first 
 communicated to the organism ; at this stage the disease 
 yields readily to appropriate treatment. But if the 
 parts round the ulcer become hard, the disease becomes 
 more obstinate, and a course of medicine is requisite for 
 its removal. Secondary syphilis, or that stage when 
 other symptoms begin to show the action of the virus 
 on the system, is still contagious, though in a remoter 
 2 13 
 
14 INTRODUCTION. 
 
 degree, whilst the latter stages are non-contagious ; 
 hence the denominations of primary and constitutional 
 syphilis, and the subdivision of the latter into secondary 
 and tertiary syphilis. 
 
 Primary Syphilis. — In the majority of cases, pri- 
 mary symptoms affect the mucous membrane of the gen- 
 ital organs, the anus, the mouth, and nipples. It may 
 likewise occur, but accidentally, in the eye, nose, or in 
 excoriated wounds, in consequence of the pus getting at 
 these parts. Infection may likewise take place in dress- 
 ing syphilitic ulcers, and may be communicated to the 
 infant by the nursing mother, as by the infant to the 
 wet-nurse. The infectious matter may also be trans- 
 mitted by means of glasses, spoons, tobacco-pipes, sur- 
 gical instruments, &c, which have been used by diseased 
 persons, and not properly washed from the matter which 
 may accidentally have adhered to them. 
 
 Constitutional Syphilis. — This form develops itself 
 sooner or later after the appearance of the chancre ; the 
 first signs are cutaneous eruptions, accompanied with 
 ulceration of the tonsils, and even by pains in the bones; 
 the laryngeal and nasal membranes are later invaded. 
 It is only, however, manifested in certain organs, or 
 parts of organs, as the mucous membranes of the mouth, 
 fauces, nose, rectum, and sexual organs, the skin and its 
 appendages, the lymphatic system, the muscles and ten- 
 dons, the brain and its membranes, the periosteum and 
 bones, the iris, testicles and ovaries, and the liver. The 
 eruptions are generally copper-colored and rounded. 
 The disease seldom affects more than one organ at once, 
 
INTRODUCTION. 15 
 
 but gradually develops itself, according to Ricord, in 
 two successive periods, termed secondary and tertiary 
 syphilis — the two forms sometimes co-existing at the 
 same period. 
 
 Secondary syphilis manifests itself by a feverish re- 
 action, termed syphilitic eruptive fever ;' the mucous 
 membranes are first invaded by the specific inflamma- 
 tion, succeeded by morbid growths and indurations, and 
 alterations of structure ; the mouth, fauces, and adjoin- 
 ing parts are attacked before the mucous membrane 
 of the genital organs ; afterwards cutaneous eruptions, 
 termed " syphilides," supervene, and finally syphilitic 
 iritis. The first sign of secondary syphilis is a feeling 
 of malaise throughout the body : afterwards the patient 
 experiences violent headache, heaviness, and tearing in 
 the shoulders, forearms, small of the back, legs, and knees, 
 excessive languor, restlessness, sleeplessness, thirst, con- 
 stipation, and hot, slightly moist skin. The glands of 
 the neck begin to swell, the cicatrices of the primary 
 ulcers become darker, sensitive, swell, and grow larger 
 and harder. 
 
 Tertiary syphilis differs from secondary syphilis in 
 this, that it is no longer transmissible to the foetus and 
 is no more contagious ; the older the disease is, and the 
 longer it lasts, the more it becomes divested of its spe- 
 cific character, and takes the form of a dyscrasia, sim- 
 ulating the scrofulous diathesis. It is always preceded 
 by the two former stages, and shows itself not sooner 
 than six months after the disappearance of the chancre ; 
 sometimes it breaks out ten or twenty years after the 
 
16 INTRODUCTION. 
 
 first infection ; tertiary symptoms affect particularly the 
 subcutaneous and submucous cellular tissue, the fibrous, 
 osseous, and cartilaginous tissues, and, lastly, the nerves, 
 parenchymatous (fleshy) organs, and, in short, the whole 
 organism. 
 
 Hygiene. — Highly-seasoned food, tea, coffee, spices, 
 wine, malt and spirituous liquors, not only antidoting 
 the effects of the attenuated remedies, but by their al- 
 most immediate injurious action on the urinary organs, 
 should be avoided with the utmost care. Fat, heavy, 
 indigestible food is likewise to be rejected. Besides rest 
 of mind, which is essential, complete rest of body will be 
 found most advantageous in most cases, and the patient 
 should be kept in a rather elevated temperature. His 
 habitual beverage should be water, toast-, barley-, or rice- 
 water, and cocoa. He should be careful also not to ex- 
 pose the sexual parts to cold or damp, to avoid all violent 
 exertion, and even all bodily exercise in the inflamma- 
 tory stage of the disease. 
 
 Selection of the Medicines. — It will always be ad- 
 visable, particularly when the disease is complicated, to 
 write down on paper the symptoms as enumerated by 
 the patient himself, or revealed to the practitioner by 
 the pathological signs of the morbid alteration. When 
 every particular is ascertained, and not till then, should 
 reference be made to the therapeutical indications for 
 the remedy, and especially to the alphabetic repertory 
 given at the end of most of the varieties. With a little 
 trouble, the remedy which occurs the most frequently in 
 the collation of the symptoms will be found the suitable 
 
INTRODUCTION. 17 
 
 one, and is to be given according to the urgency of the 
 case, in the manner described below, unless otherwise 
 specially directed. It will be especially advisable to 
 note the state of the patient's disposition at that time, 
 as that exercises a most important influence in the selec- 
 tion. For instance, should a case of chancre, for which Mer- 
 curius appears the most suitable, be accompanied with 
 great depression and tendency to suicide, Aurtjm would 
 be the appropriate medicine ; other intermediate ones 
 are also occasionally required, as Veratrum for reli- 
 gious melancholy, Pulsatilla for a weeping mood, Cof- 
 fea for a nervous state, Bryonia, or Nux for irritable 
 persons ; these, however, are not curative to the syphilitic 
 affection, but only remove certain abnormal symptoms 
 which are apt to retard the cure. Those medicines 
 which are curative in syphilis will be found to be espe- 
 cially noticed in the indications for that disease. 
 
 Doses. — A new dose is never to be given so long as 
 a good action continues, and particularly when low at- 
 tenuations are given, it being necessary to watch the 
 effect of the medicine, and to change it, if improvement 
 does not speedily follow the first few doses. 
 
 [Berjeau, the author of this book, gave after each 
 medicine, in every form of disease treated herein, pre- 
 cise directions as to the size and repetition of the dose. 
 These repeated dose-directions it has been thought best 
 to omit ; since it is evident that practitioners will be- 
 come far more successful in treating their patients if 
 they accustom themselves to the exercise of a sound 
 2* 
 
18 INTKODUCTIOJST. 
 
 judgment in the application of the best principles to 
 each individual case. 
 
 Still, it is but just to the author to indicate, once for 
 all, his particular method. He advised, altogether, the 
 lower preparations ; usually five drops of the mother 
 tincture of plants, or five grains of the second decimal 
 (or centesimal) trituration of minerals ; or five drops of 
 the first, second, third, fourth, fifth, or sixth dilution, to be 
 given for a single dose. This dose he usually advised 
 to be dissolved in a wine-glass of water, and repeated 
 once an hour ; once in three or four hours ; or three or 
 four times a day, according to circumstances. In other 
 respects he avoids all empiricism ; and seeks to cure his 
 patients by administering the remedy homoeopathically 
 suited to the actual condition. 
 
 Every experienced physician will of course continue 
 the system of medication, as to potency and repetition 
 of dose, which he has found most advantageous. But, 
 having thus indicated the method pursued by our au- 
 thor, as well in justice to himself as for the considera- 
 tion of less experienced practitioners, we subjoin also 
 our own views, and those adopted by others, whose 
 abilities and successful experience entitle them to re- 
 spect. 
 
 Pure homoeopathy points out the best way (it may be 
 a " narrow way," — for there is no " broad " or " royal 
 road" in the art of medicine, any more than in the sci- 
 ence of knowledge) to heal the sick. The method of 
 finding specifics for special diseases (the " philosopher's 
 stone " of doctors) is just plausible enough to be falla- 
 cious, and just apparently successful enough to prove a 
 delusion and a snare. The venereal disease, gonorrhoea 
 
INTKODUCTIOIST. 19 
 
 especially, has long been regarded as the opprobrium 
 medicorum ; very much like " fever and ague." But the 
 result of allopathic modes of medication — i. e., massive 
 doses empirically prescribed — has thus far been, if pos- 
 sible, less satisfactory in the former kind of disorder than 
 in the latter. 
 
 Chronic cases of venereal disease, like chronic cases 
 of intermittent, we think may be best cured by rare doses 
 of the* higher Homoeopathic preparations* If there is 
 any exception to this, it arises from the apparent neces- 
 sity of antidoting, with lower forms of the appropriate 
 medicines, the mercurial poisons which may be still 
 actually present in the system even in massive quanti- 
 ties ; while chronic cases of mercurial and mercurio- 
 syphilitic disease have been found to yield to the higher 
 and highest potencies of Mercurius itself. But even in 
 these chronic cases, especially of syphilitic disease, very 
 many, perhaps the great majority, of our physicians 
 have more confidence in the lower Homoeopathic prepa- 
 rations. 
 
 Recent cases of venereal disease, both gonorrhoea! and 
 syphilitic, may also be cured — have been very promptly 
 cured — by the higher and highest potencies. But to 
 make such cures requires a more profound mastery of 
 the Materia Meclica, a greater amount of experience, 
 and a more absolute control of the patient's confidence 
 than many, especially the junior, members of the pro- 
 fession can command. Few, indeed, ever attempt it. 
 
 The comparative failure to cure venereal disease, like 
 
 * Numerous cases of such cures may be found recorded in the 
 periodical literature of our school. See Am. Horn. Review, Vol. 
 III. p. 211. 
 
20 INTRODUCTION. 
 
 that of intermittent, has not therefore resulted from 
 using too little medicine. The real cause of ill-success, 
 in the one case as in the other, is to be found in prescrib- 
 ing for the disease rather than for the patient. Let the 
 remedy be carefully adapted to the particular symptoms 
 and constitution of the individual patient, and we believe 
 he can be as readily and as speedily cured in venereal 
 as in other forms of disease; and that too without his 
 system being salivated by mercury, or sickened by 
 copaiba. 
 
 The ordinary low Homoeopathic preparations, such as 
 the third dilution of the plants, and the sixth of min- 
 erals, may answer very well in recent cases of gonor- 
 rhoea. Of these the dose need not be larger, or oftener 
 repeated than is customary for inflammatory affections 
 of a corresponding grade. Some physicians may prefer 
 to administer the larger, five-drop, doses advised by 
 Berjeau. 
 
 In recent cases of Syphilis, we think the great majority 
 of experienced physicians prefer to depend on the first or 
 second centesimal (or even decimal) triturations, in doses 
 of one or two grains, repeated two, three, or four times 
 a day. Some more precise indications, in this respect, 
 will appear in the subsequent pages, — such as may be 
 gleaned from the particular prescriptions of individual 
 physicians. 
 
 As to the repetition of the dose, and to the change of 
 medicine, " a new dose is never to be given as long as a 
 good action continues." But, the medicine being care- 
 fully chosen, suited to the existing state as exactly as 
 possible, be sure and not change it for another, except 
 under one of the three following conditions : 
 
INTRODUCTION. 21 
 
 I. When no further improvement can be seen to ac- 
 company or to follow its use. 
 
 II. When some new forms of the disease appear, — 
 some of the old symptoms being removed, or others aris- 
 ing into greater prominence, — which render the whole 
 case different, and the original remedy no longer Ho- 
 moeopathic to it. 
 
 III. When satisfied that the remedy itself was not, 
 even in the first instance, Homoeopathic to the case. 
 
 In either of these contingencies a new prescription 
 should be made to suit the existing condition. 
 
 Finally, a single word may be given on the vexed ques- 
 tion of alternation. As a matter of fact, it must be ac- 
 knowledged that the greater number of Homoeopathic 
 physicians do alternate. As a matter of principle, it is, we 
 think, pretty generally acknowledged, even by those who 
 practise it, that alternation is not to be defended. To 
 this there may be some exceptions ; of these exceptions, 
 and of the reasons for them, an ably written statement 
 may be found in the June number of the Hahnemannian 
 Monthly, 1867.* But we are thoroughly satisfied, that, 
 in most of venereal as of other kinds of disease, the 
 physician will much more rapidly and thoroughly cure 
 his patients, if he will give them but one remedy at a 
 time ; and it is obvious that he will in this way acquire 
 a much more complete knowledge of what can be done 
 with each single drug. He who practises in this way 
 will soon learn how to give his doses so as not to aggra- 
 vate his patient's symptoms, that is, not to make them 
 too large or to repeat them too often. The law of the 
 
 * Report on Alternation. By Dr. Win. E. Payne. Hah. Monthly, 
 Vol. II. p. 781. 
 
22 INTRODUCTION. 
 
 single remedy proves an excellent " schoolmaster " to 
 those who will faithfully follow it. What is here said, 
 however, is not intended to apply to the careful adminis- 
 tration of an intercurrent (anti-psoric) rerned} r , as after- 
 wards recommended ; a method which, so far from con- 
 tradicting Homoeopathic principles, seems to be in strict 
 accordance with them.] 
 
SYPHILIS, GONORRHOEA, 
 
 THEIR CONCOMITANTS. 
 
 GONORRHEA. 
 
 THIS is a violent inflammation of the mucous mem- 
 brane of the urethra, with purulent discharge. It 
 manifests itself from two to seven days after an impure 
 connection, when the patient experiences at the end of 
 the penis a peculiar itching, which increases to a real pain 
 during erection : the pain is also greatly aggravated by 
 urinating, and sometimes becomes intolerable as the dis- 
 ease progresses. Two or three days after the first symp- 
 toms the orifice of the urethra becomes red, swollen, 
 and moist ; tensive and drawing pain invades the sper- 
 matic cord, the testes, and inguinal region ; the patient 
 experiences a burning pain after micturition, which in- 
 creases daily, as well as the swelling and redness of the 
 urethra ; and the discharge, at first inconsiderable, clear, 
 and viscid, causes the sides of the orifice to adhere, and 
 stains the linen. The glans becomes hot, red, swollen, 
 and painful, whilst frequent erections at night produce 
 distressing pain and disturb the sleep. After a week 
 
 23 
 
24: GONORRHOEA. 
 
 the discharge is much increased, becomes thicker, of a 
 yellowish-white color, w T hilst the pain during urination 
 and during erection is extremely violent, and extends 
 the whole length of the penis. With the inflammation 
 the urethra becomes contracted, and the stream of urine 
 is divided. This second stage continues for another 
 Aveek or fortnight. 
 
 When the inflammatory symptoms begin to decline, 
 the emission of urine and the erections become less pain- 
 ful, and occasionally altogether painless, yet nevertheless 
 the discharge continues, but changes to a whitish, viscid, 
 stringy secretion. 
 
 If these last symptoms remain unaltered for a while, 
 the disease is called gleet, or secondary gonorrhoea. 
 
 Numerous causes besides impure coition give rise to a 
 gonorrheal discharge, running the same course as vene- 
 real gonorrhoea. Such are the use of new wine, unfer- 
 mented beer, the exposure of the parts to a cold wind 
 whilst urinating, mechanical and chemical lesions, na- 
 tural predisposition, constitutional debility, scrofulous 
 diathesis, gout and cutaneous eruptions, and last, not 
 least, from the presence of leucorrhoea (the whites) in 
 the female; gonorrhoea taking its origin in non-syphilitic 
 causes being frequently more intractable than the true 
 one. 
 
 Treatment. — " This disease sometimes proves very 
 intractable, even in homoeopathic practice ; but if the 
 treatment is commenced sufficiently early, it terminates 
 much less frequently in the secondary form of the mala- 
 dy, and the other serious consequences detailed, than it 
 does in allopathic practice."* 
 
 * Laurie, "Elements of Homoeopathic Practice of Physic," 2d 
 edit., p. 468 
 
GONORRHOEA. 25 
 
 The first and important rule is to avoid entirely the 
 use of injections, which have a tendency to suppress the 
 discharge, and to give rise to swelled testicle and 
 other serious complaints. A strict abstemious diet must 
 be enforced, and the patient should remain at home, and 
 recline in a horizontal position. 
 
 When, however, that is impossible, the use of a sus- 
 pensory bandage becomes absolutely necessary. Strict 
 attention to cleanliness should not be neglected, the 
 employment of warm water often giving striking relief, 
 besides being useful in loosening the linen, which fre- 
 quently adheres to the part, and which always should 
 be removed before urinating. 
 
 Prophylactic Treatment. — Well washing the parts 
 with a solution of soap, (or covering them before con- 
 nection with oil,) and voiding urine immediately after a 
 suspicious intercourse has taken place, will prevent the 
 syphilitic virus from adhering to the mucous membrane, 
 and giving rise to an infection. Should, however, these 
 precautions not be taken, the use of medicines will gen- 
 erally prevent, or greatly lessen any mischief that might 
 ensue. 
 
 Should, however, the presence of leucorrhcea in the 
 female be suspected, Tincture of Sulphur is to be sub- 
 stituted for the mercurial preparation. It is also to be 
 noticed that an abstinence from beer or spirits for a few 
 days, and the plentiful use of demulcent drinks, as lin- 
 seed tea, gum-water and barley-water, with cold water 
 ad libitum, (if the others are not easily procurable,) to 
 dilute the urine, may prevent a great deal of unneces- 
 sary suffering. Should, however, the fever and inflam- 
 mation set in severely, animal food must be totally ab- 
 3 
 
26 GONORRHCEA. 
 
 stained from, and the patient subsist on demulcent 
 drinks and slops. 
 
 [We add here the treatment recommended by different 
 physicians. Jahr* advises Sepia, 30 dry, morning and 
 evening, when the patient complains only of titillation 
 at the orifice of the urethra, with slight redness and a 
 scarcely perceptible secretion, barely sufficient to close 
 the orifice by agglutination. In this way he frequently 
 effects a speedy cure, without any inflammation super- 
 vening. In the same circumstances, Grauvogl as strongly 
 recommends Natrum sulph. in the first or incipient stage. 
 But, to return to Jahr's method, if the patient has the 
 secretion already quite copious ; or if the inflammatory 
 period is already more or less advanced ; or if Sepia has 
 failed to diminish the incipient symptoms and cut short 
 the disease, Jahr advises Cannabis* dry, night and morn- 
 ing, " without paying any attention to consensual symp- 
 toms ;" and says that "perseverance in this remedy two, 
 or at most three, weeks will suffice to radically cure every 
 case of gonorrhoea, provided the patient keep a very strict 
 diet and his case is not complicated with any syphilitic 
 taint." 
 
 If the patient presents himself after the inflammation 
 has subsided, with a continual painless more or less pro- 
 fuse discharge, he gives the Cannabis where it has not 
 been used previously ; if the case, nearly cured by Can- 
 nobis, becomes aggravated by errors of diet, he restores 
 the normal condition of things by means of a few doses 
 of Cannabis, If Cannabis, in either of these two cases, 
 
 * Jahr's Venereal Diseases, Translated by Dr. C. J. HempeJ, 
 New York, 1868. 
 
GONORRHOEA. 27 
 
 prove of no avail, he gives half-grain doses of the second 
 trituration of Mercurius vivus once in three or four days. 
 
 As showing the contrast of modes of treating this dis- 
 ease, we subjoin Dr. Wni. H. Holcombe's " Usual Treat- 
 ment of Acute Gonorrhoea." * " Put one or two drops 
 of Copaiba into an ounce of alcohol, succuss thoroughly, 
 and give ten drops three times a day. Inject every six 
 hours a small glass syringe of the following solution: 
 Acetate of lead, four grains ; Acetate of morphine, four 
 grains ; water, four ounces. Enjoin rest and low diet 
 for one week." 
 
 In cases where a few, scarcely perceptible drops are 
 still secreted, (gleet,) which are quite unmanageable and 
 resist all treatment, Jahr advises Sepia, Sulphur, or 
 Pulsatilla ; or if the secretion is of a milky whiteness, 
 Capsicum and Ferrum. In- some cases, he says, Tus- 
 silago and Natrum mur. have rendered excellent service. 
 
 It is well known that, while many cases of gonorrhoea 
 are readily cured, (some patients even curing themselves 
 by mild remedies and gently astringent injections,) nu- 
 merous others have proved so intractable as to wear out 
 the patience of the sufferer, and exhaust in vain the skill 
 of able and eminent physicians. In the greater number 
 of such cases, the failure must be attributed to the pres- 
 ence of psomc (or it may be even an unsuspected syphi- 
 litic or sycotic) miasm in the system. Which miasm the 
 physician fails to antidote by his direct method of treat- 
 ing the gonorrhoea or gleet; that is, of prescribing for the 
 disease instead of for the patient himself! By this latter 
 and only true, Homoeopathic, and really curative method, 
 
 * U. S. Med. and Surg. Journal, Vol. I. p. 231. April, 1866. 
 
28 GONORRHOEA. 
 
 the physician will discover the evidences or symptoms 
 which represent the latent miasm, and thus adapting his 
 prescription to the actual conditions, or interior patho- 
 logical state which they indicate, will often effect cures 
 which to the uninitiated seem like magic. It is thus 
 that we have seen a single dose of Sulphur zo remove in 
 a few days, and forever, a gleety discharge which had 
 resisted all other treatment for months. 
 
 But, to return to the treatment of recent and fully 
 established cases of gonorrhoea, with Berjeau's advice 
 to use Aconite at first, to remove the severe inflamma- 
 tion, we entirely coincide. Then Cannabis, Cantharis, 
 Argenti nitras, or whatever other remedy corresponds 
 most nearly to all the symptoms of the patient, should 
 be given. The selected remedy is variously given in 
 five-drop doses of the mother tincture, (especially Can- 
 nobis, by Berjeau almost despised, of which Dr. Hempel * 
 advises from five to thirty drops a day; Dr. Yeldam,f 
 " five to ten, or even fifteen drops of the mother tincture, 
 three or four times a day;" and of which Ruekert J says, 
 "large doses are preferable in gonorrhoea,") or in five- 
 drop doses of any one of the first six dilutions, repeated 
 three or four times a day ; or in doses of the pellets, 
 either dry or in solution, according to the severity and 
 intensity of the symptoms, the susceptibility of the patient, 
 and the judgment of the attending physician. 
 
 In our opinion, the ordinary doses of the third and 
 sixth potencies, repeated once in three or four hours, or 
 once or twice a day only, according to circumstances, 
 
 * Jahr's Venereal Diseases, p. 65. 
 
 f Marcy and Hunt, Practice, II. p. 379. 
 
 J Therapeutics, p. 195. 
 
GONORRHCEA. 29 
 
 are abundantly capable of curing persons suffering with 
 acute gonorrhoea ; provided they keep perfectly quiet, and 
 observe a strict regimen in all respects. And to the too 
 common plan of attempting to make the quantity of 
 medicine compensate as well for want of scientific accu- 
 racy on the part of the physician, as for neglect of the 
 necessary regimen on the part of the patient, must often 
 be attributed the disappointment which not unfrequently 
 occurs to both. The Cannabis may sometimes prove 
 an exception, and act more promptly and favorably in 
 the mother tincture. 
 
 But in most cases of gonorrhoea, even in the first in- 
 stance, it will be well for the physician to consider with 
 the utmost care what kind, if any, of psoric or other 
 miasm may be latent in his patient's system, and admin- 
 ister an occasional intercurrent dose of Sulphur, Sepia, 
 Nat. mur., Merc, Thuja* or whatever other anti-psoric, 
 anti-miasmic, anti-syphilitic, or anti-sycosic, he may think 
 required by the subjective symptoms, present condition, 
 and previous history. Nat. mur., for instance, will 
 often be needed, and prove curative in recent as in 
 chronic cases, where the patient has been exposed or 
 subject to intermittents. According to Jahr, however, 
 ''it is only where intense inflammations threaten danger- 
 ous results, such as gangrene, where Jr. seme would 
 have to be used, that intercurrent remedies become neces- 
 sary." 
 
 The indications given here for the various remedies 
 are unavoidably scanty and meagre ; they must be re- 
 garded only as hints towards their thorough study in 
 
 * On the great importance of Thuja, for example, as an inter- 
 current remedy, consult Am. Horn. Review, Vol. III. p. 117. 
 
 3* 
 
30 GONORRH(EA. 
 
 the Materia Medica itself. And the more closely the 
 practitioner assimilates his prescription to the actual 
 condition of the individual patient, so much the more 
 rapidly and perfectly will he cure him.] 
 
 Aconite. This remedy is always to be employed as 
 soon as the first symptoms arise, and is to be very fre- 
 quently repeated, being extremely efficacious in conjunc- 
 tion with Cannabis and Petroselinum in allaying the 
 inflammation and subduing the discharge. 
 
 Cannabis. Dr. Curie states that this remedy is only 
 useful in the premonitory stage, when the discharge is 
 thin, and not partaking of the purulent character, and 
 also at the termination of the complaint when the secre- 
 tion has lost its distinctive features. In gonorrhoea 
 proper it is perfectly useless* Dr. Hempel gives the 
 following indications: Discharge of pus from the urethra; 
 ulcerative soreness of the urethra when^ touching it; diffi- 
 culty of urinating, with constant urging ; sensation of 
 tearing in the fibres of the urethra ; the urethra feels as 
 if drawn up into knots. The glans may be sore, swollen, 
 and inflamed. These symptoms may be accompanied 
 with symptoms of vascular excitement, rush of blood to 
 the head, frontal headache, &c. 
 
 [The German Homoeopathic physician, Muller,f finds 
 this remedy useful only in strong doses, the first or 
 mother tincture ; and declares its value in gonorrhoea 
 
 [* This opinion of Berjeau I prefer to let stand as he left it; 
 the reader can compare it with the opinions and advice of other 
 physicians as here given. — F.] 
 
 f U. S. Med. and Surg. Journal, Vol. I. p. 160. 
 
GOINTORRHCEA. 31 
 
 to be uncertain and trifling, — in which Dr. Holcornbe 
 agrees. In my own experience, and in that of other 
 physicians of my acquaintance, this remedy has proved 
 very valuable, — not when prescribed by rote, but when 
 homoeopathically indicated, which it so often is, that 
 Jahr came to regard it as almost a specific in gonorrhoea. 
 But we have no such general specifics ; what answers 
 in one country or person, may not in another.] 
 
 Argenti Nitras. This valuable remedy in purulent 
 inflammations is indicated when the emission of urine is 
 accompanied by burning, and sensation as if the urethra 
 were closed, the last portion of urine remaining behind; 
 with dragging pain and feeling of soreness in the ure- 
 thra, cutting pain extending to the anus, haemorrhage, 
 and discharge of pus from the urethra, and painful ten- 
 sive erections. Also, when severe inflammatory symp- 
 toms are present, with priapism, chordee, swelling of 
 the penis, great febrile irritation, and sensation as if the 
 urethra were drawn into knots. 
 
 Petroselinum is very efficacious when there is tingling 
 and pressure at the root of the penis, especially early 
 in the morning whilst in bed, abating when standing 
 or sitting, a milky fluid being secreted which can be 
 pressed out, afterwards changing to a yellow glutinous 
 matter. 
 
 [Drs. Miiller and Holcornbe pronounce this remedy 
 worthless in gonorrhoea, It has disappointed many 
 others who have used it.*] 
 
 * U. S. Med. and Surg. Journal, Vol. I. p. 167. 
 
32 GONORRHOEA. 
 
 Mercurius corrosivus. When the orifice of the ure- 
 thra is inflamed, and the fore part swollen with sup- 
 puration between the glans and prepuce ; the glans 
 being red, hot, and painful when touched, accompanied 
 with burning pain, and itching, stinging, and throbbing 
 in the urethra, the urine passing with a feeble stream ; 
 the discharge is greenish, often painless, especially at 
 night. 
 
 Sulphur. When the patient is of a scrofulous consti- 
 tution, or when other remedies apparently well selected 
 do not appear to exercise any beneficial influence on the 
 complaint, this remedy will be generally found very 
 efficacious. Its more especial indications are, when, in 
 addition to the discharge, there are burning pains near 
 the orifice of the urethra, which is red and inflamed, with 
 constant urging to urinate, accompanied with tearing 
 and stinging, the stream of urine being thin and divided ; 
 there is at times itching in the middle of the urethra, 
 with stitches and cutting pains during stool. 
 
 Hep. sulph. ; Silicea. These two remedies are very 
 frequently useful in discharges of white, yellowish, or 
 discolored pus, attended with a fetid smell, particularly 
 when occasjoned by scrofulous leucorrhoea. 
 
 Agnus castus. When the inflammatory symptoms 
 have subsided, but a yellow purulent discharge remains, 
 and there is absence of sexual desire and want of erec- 
 tion, Agnus will render efficient service. 
 
 Cantharis. This medicine, although principally used 
 in secondary gonorrhoea, when the discharge again in- 
 creases, is frequently required in primary cases, partic- 
 ularly should the inflammation threaten to extend to the 
 
GONORRHCEA. 33 
 
 bladder. Burning pains of excoriation, with yellow or 
 sanguineous discharge, which stains the linen, and great 
 difficulty and pain in making water, especially point to 
 this remedy. 
 
 Capsicum. Pricking, burning, cutting pains, with 
 sensation of warmth in the urethra, excessive sensibility 
 of the parts to contact, and thick, purulent, yellow dis- 
 charge, indicate Capsicum. 
 
 Cocculus is useful when there is tensive aching pain 
 in the orifice of the urethra, when not urinating. 
 
 Copaiba. This well-known remedy should be taken 
 when the discharge is purulent, with a painful soreness, 
 and continual smarting, itching pain, with swelling of the 
 urethra. A very characteristic indication for Copaiba 
 is a violet smell of the urine ; or when the discharge is 
 accompanied by a cutaneous eruption like measles or 
 nettle-rash attended with great itching. 
 
 Cubebae is useful when the discharge is dark and red- 
 dish as if mixed with blood, the urine having a violet 
 odor. 
 
 Mezereum. The discharge in this case is watery 
 mucus, increased by exercise, and the pain stinging and 
 titillating, through the whole course of the urethra, ex- 
 tending to the perinaBum, with painful soreness of the 
 urethra when touched. 
 
 Millefolium. In severe eases with swelling of the 
 penis, and discharge of blood and watery slime, this 
 remedy (or in alternation with Cantharis) is indispen- 
 sable. 
 
 Nux vomica. Pressive pains occurring at the orifice 
 of the urethra when not urinating, accompanied with 
 shuddering, and sharp pains as of a cutting instrument 
 
34 GONORRHOEA. 
 
 near the orifice of the passage, the bladder, the perinseuni, 
 or anus as from flatulence, with discharge of mucus, and 
 often accompanied with hemorrhoidal affections. 
 
 Pulsatilla. Suppressed gonorrhoea, -with swelling of 
 the testicles, contraction of the passage, and discharge 
 of dark-colored blood, with tendency to inflammation of 
 the eyes, particularly in mild-disposed persons, with light 
 hair. 
 
 [Tussilago petasites. — Butterbur, Pestilent-wort — 
 First recommended in gonorrhoea by C. H. Rosenberg.* 
 " The remedy, considered by the people of Baden as in- 
 fallible against gonorrhoea, was nothing more than the 
 water containing the plant in a macerated condition." 
 Dr. Rosenberg gave about one teaspoonful of the water 
 for a dose, morning and evening ; and cured twenty-six 
 cases with it in from two to four weeks 7 treatment. The 
 active properties of this plant may not be entirely taken 
 up by alcohol ; water alone dissolving some of the muci- 
 laginous and other elements common to aquatic plants. 
 From this may result the low esteem into which this 
 once celebrated remedy is now fallen. 
 
 Indications : " Acute stage, fixed, stinging pain in the 
 fossa navicularis ; for persons of high living and irregu- 
 lar habits. Chronic stage, with inflammation of the eyes 
 and swelling of the testicles, after suppressed discharge." 
 Raue.f] 
 
 Thuja. Required when the discharge is watery and 
 copious, with drawing, cutting, burning, piercing pains, 
 
 * Homoeopathic Examiner, New Series, Vol. I. p. 251. 
 j- Pathology and Therapeutics, p. 381. 
 
GONORRHCEA. 35 
 
 especially when walking, and stitches in the urethra 
 when not urinating. 
 
 Colchicum is very useful when, with scanty emission 
 of dark albuminous urine, there is continual urging tp- 
 urinate, and burning pains in the urethra; the urine de- 
 positing a whitish, or purulent flocculent sediment. 
 
 Carbo veg. is likely to prove useful, when there are 
 violent burning pains in the urethra, and extremely of- 
 fensive discharge. 
 
 GONORRHOEA. —SYMPTOMATIC INDICATIONS. 
 
 N. B. The symptoms in this list belong to the Urethra, unless 
 specially noticed. 
 
 Aching at the orifice, with shuddering . Nux vomica. 
 
 with pressure, as from matter in the 
 
 fore part .... Cannabis. 
 Biting pains in the fore part . . . Cann., Copaib., Ar- 
 
 senicum. 
 Burning pains ..... Bry., Canth., Con. y 
 
 Thuja. 
 with itching before and after urinating Apis melt., Copaiba. 
 at the orifice .... Capsicum. 
 with soreness of the prepuce . . Cinchona. 
 
 in the middle of the passage when not 
 
 urinating .... Staphysagria. 
 during urination, with feeling of swell- 
 ing . . . . . Argent, nitras. 
 and stitches (also on the glans and ex- 
 ternal part of the prepuce) . . Cannabis. 
 itching, and stitches in the fore part 
 
 when not urinating . . . Bryonia. 
 
 Contraction of the passage . . . Bry., Puis., Sulph. 
 
 Contractive pains extending backwards . Nux vomica. 
 
 Drawing, stitches, and discharge of moisture . Mezereum. 
 Crawling, in the morning in bed . . Petroselinum. 
 
 then aching .... Petroselinum. 
 tickling and itching . . . Cinchona. 
 
36 GONORRHOEA. 
 
 Crawling, when moving, especially in the even- 
 ing .... Thuja. 
 Cutting, when not urinating . . . Capsicum. 
 pains, continual . . . Cantharis. 
 whilst passing the last drops of 
 
 urine .... Arg. nitras. 
 and burning after urinating, with dis- 
 charge of mucus. . . . Natri murias. 
 before and after stool . . . Sulphur. 
 and drawing whilst walking . . Thuja. 
 Drawing pain and tearing in the fore part . Bryonia. 
 
 extending back to the anus. . . Acid, phosph. 
 
 and tearing from perinseum, through 
 
 the whole urethra . . . Mezereum. 
 
 and aching at the root of the penis . Petroselinum. 
 Inflammation of the orifice . . . Merc. , Sulph. 
 
 with throbbing . . . Copaiba. 
 
 and pain in entire course . Sabina, Cannabis. 
 
 with violent pain, increased dis- 
 charge, erections, anddysuria . Argent, nitras. 
 Itching in the fore part of the urethra . . Ign., Am., Merc. 
 
 almost agreeable . . . Cannabis. 
 
 and stinging in the fore part . . Cocculus. 
 
 Pinching when not urinating . . . Jferatrum. 
 
 during urination . . . Argent, nitras. 
 
 Soreness of the orifice .... Copaiba. 
 
 internal, continuing after urination . Arg. nitras. 
 painful, at the orifice . . . Ac. nitricum. 
 
 on pressure .... Natr. mur., Mezer. 
 Stitches, in the urethra .... Apis., Am., Cocc, 
 
 Sulphur. 
 painful at the orifice . . . Acid, phosph. 
 
 in the fore part . . . Sulphur. 
 
 when not urinating . Acid phosph. 
 ending in tearing pain . Ignatia. 
 along the urethra when not urinating Cannabis. 
 from behind forwards . . Thuja. 
 
 back through the urethra . . Mercurius. 
 
 after frequent erections . . Cannabis. 
 
 entering the abdomen . . . Mercurius, 
 
 whilst at stool .... Scilla. 
 dull, during movement, when not uri- 
 nating .... Belladonna. 
 vehement, deep in the urethra, whilst 
 
 walking .... Ignatia. 
 
 strong, when not urinating . . Capsicum. 
 
GONORRHCEA. 37 
 
 Stitches, violent, extending its whole length . Conium. 
 twitching, in the back part when 
 
 standing .... Cannabis. 
 tearing in the fore part of the urethra Thuja. 
 itching and tickling, in the fore part 
 
 of the urethra . . . Cannabis. 
 
 transient, with bleeding . . Arg. nitras. 
 
 Stinging, when not urinating . . . Acid phosph. 
 
 as with a needle . . . Capsicum. 
 
 occasionally dull . . . Mercurius. 
 
 twitching and cutting, when not uri- 
 nating .... Thuja. 
 changing after urinating into a cutting 
 
 and biting .... Petroselinum. 
 corrosive, and burning . . Cannabis. 
 
 Swelling of the urethra .... Rhus., Ac. nitric. 
 with throbbing pain . . . Copaiba. 
 
 with hard and knotty feeling . . Arg. nitras. 
 
 Tearing, or rending, in the fore part . . Antim. tart. 
 
 and drawing when not urinating . Bryonia. 
 
 through the whole urethra to the peri- 
 
 ngeum .... Mezereum. 
 
 in a zigzac form, as if in the fibres of 
 
 the urethra .... Cannabis. 
 and in the rectum, when not urinating Ruta. 
 deep in the urethra . . . Arsenicum. 
 
 with dull stitches . . . Aurum. 
 
 and stinging, when not urinating . Sulphur. 
 Throbbing pain ..... Copaiba, Merc, 
 
 Hepar. 
 in the region of the bladder . Cinchona. 
 
 Twitching pain in the urethra . . . Thuja. 
 
 as in the emission of semen . . Petroleum. 
 
 CHARACTER OF THE DISCHARGE. 
 
 Discharge of bad-smelling moisture . . Pulsatilla. 
 
 bloody slime .... Ac. nitr., Millefol. 
 
 in drops . . Pulsatilla. 
 
 green, and painless during the night Mercurius. 
 increased .... Canth., Argent.nit. 
 of milky moisture . . . Petroselinum. 
 
 mucous, after a chill (milky white- 
 ness) .... Ferr., Capsicum. 
 of pus .... Copaiba. 
 4 
 
38 GONORRHOEA OF THE FEMALE. 
 
 Discharge semen-like, with burning pain after 
 
 urination .... Pulsatilla. 
 slimy without pain . . . Cann., Petroleum. 
 
 thin, mucous, which leaves stiff spots 
 
 on the linen . . . Natri murias. 
 
 thin at first, afterwards thick, with 
 
 biting pain during urinating . Mercurius. 
 varnish-like .... Petroselinum. 
 watery and slimy . . •. Cann., Thuja. 
 
 white, acrid, muddy matter with 
 
 mucus .... Sarsaparilla. 
 yellowish, which stains the linen . Canth., Agnus cast. 
 yellow and thick . . . Capsicum. 
 
 fetid and discolored . . Silie., Carbo veg. 
 
 of whitish or yellowish pus . . Hep. sulph., Gale. 
 
 GONORRHOEA OF THE FEMALE. 
 
 Besides leucorrhcea, which is generally a non-syphilitic 
 disease, women are subject to gonorrhceal inflammation, 
 which, owing to the large extent of mucous membrane of 
 the parts, is generally accompanied with a much greater 
 discharge. This discharge may proceed from the urethra 
 (which, being very short and dilatable, does not produce 
 such distressing effects as in men), the labia majora and 
 minora, or from the vagina or uterus. In order to dis- 
 tinguish the nature of the discharge and the seat of the 
 affection, the speculum is indispensable. If the inflam- 
 mation has its seat in the urethra, it is revealed by itching 
 pain, swelling of the orifice of the urethra, urging to 
 urinate, with scalding pain during micturition, and sym- 
 pathetic inflammation of the. labia and vagina. Drops of 
 pus are seen at the orifice of the urethra, the linen is 
 stained with isolated opaque spots of a yellowish-green 
 
GONORRHCEA OF THE FEMALE. 39 
 
 color, which may be pressed out by introducing the 
 finger into the vagina, and compressing the urethra from 
 behind, forwards and upwards. If the labia are affected, 
 the inflammation is the same as the balanorrhoea of the 
 male, the internal labia constituting a thick, bluish-red, 
 shining, disc-shaped swelling, and covered with erosions, 
 whilst the labia majora are tense, darkish-red, and ver} r 
 prominent ; the urine in its passage causing much pain, 
 the introduction of the speculum being impossible. If 
 the inflammation is great, the warmth of the bed becomes 
 intolerable, febrile symptoms arise, and the patient is 
 tormented by thirst and sleepless nights ; a viscid puru- 
 lent fluid, of a specific odor, is secreted, and often dries 
 up in the hair of the pudendum, forming a thick crust, or 
 else flowing down, excoriates the neighboring parts. Cor- 
 pulent females seem to be more particularly predisposed 
 to this kind of gonorrhoea. 
 
 Vaginitis (inflammation of the vagina) is more fre- 
 quently met with than the affection of the external parts, 
 although it is commonly accompanied with blennorrhea 
 of the labia ; when severe, the whole mucous membrane 
 and the subjacent cellular tissue are involved, the heat 
 in the vagina is intense, and the pain, increased by any 
 exertion, frequently extending to the kidneys ; the sexual 
 desire is also more intense, and mucus or pus is dis- 
 charged profusely. If the follicles of the vagina are 
 principally invaded, a number of miliary granulations 
 may be distinguished with the finger. The mucous 
 membrane is redder than usual, partially denuded of its 
 epithelium, and covered with small superficial ulcers. 
 The discharge is frequently mixed with blood, has an 
 acid reaction, and leaves yellow or yellowish-green 
 
40 GONORRHOEA OF THE FEMALE. 
 
 stains on the linen. When the inflammation extends to 
 the uterus, the disease becomes much more intractable. 
 Then we have violent haemorrhage, with great disturb- 
 ance of the menstrual functions, and if the woman is 
 pregnant, a tendency to miscarriage, or even degenera- 
 tion of the foetus ; in severe cases, complete obliteration 
 of the Fallopian tubes and incurable sterility are pro- 
 duced. This disease can only be properly recognized by 
 means of the speculum, which reveals the neck of the 
 uterus, dry and red, and covered with whitish, thick, 
 adhering mucus, secreted from the neighboring parts ; 
 the patient complains of heaviness and drawing in the 
 pelvis and small of the back, and frequently experiences 
 burning pains when sitting down. The parts around 
 the mouth of the womb are covered with erosions, and 
 the inflammation often spreads to the inner surface of 
 the uterus, the Fallopian tubes, and ovaries, and even 
 to the peritoneum. 
 
 Treatment. — The best remedies for urethritis are 
 Cannabis and Thuja; for vulvitis, Bryonia, Mercurius, 
 Sabina, and Thuja; for vaginitis, Bellad., KreosoL, 
 Lycop., Mercurius, Nux vom., Puis., and Sabina; for 
 uteritis, Ac. nitric, Canth., Ignat., Phos., and Platina. 
 The seat and extent of the disease being ascertained, the 
 selection of one or several of the following medicines, 
 either alone or in alternation, will be greatly facilitated 
 by the comparison between the symptoms of this com- 
 plaint and those of gonorrhoea of the male. 
 
 Aconite is always to be resorted to in cases attended 
 with inflammatory symptoms, with great heat, and 
 scalding in making water. 
 
 Arsenicum should be given when there is smarting, 
 
GONORRH03A OF THE FEMALE. 41 
 
 gnawing discharge, causing soreness of the parts with 
 which it comes in contact ; when standing, the discharge 
 drops down, accompanied with emission of flatulence; or 
 when there is also great redness of the parts. 
 
 Aurum is useful for profuse discharge which excoriates 
 the perineum and inner parts of the thighs, with vesicular 
 eruptions on the parts, or when labor-like pains are present. 
 
 Belladonna is required for discharge of white mucus 
 from the vagina, with violent stitches in the pubic re- 
 gion and the inner parts, with violent dragging- pains, 
 as if everything would issue from the abdomen. 
 
 Bryonia is good when the discharge, which had pre- 
 viously much decreased, again increases, attended with 
 swelling of the labia, and sometimes with black, hard 
 pustules, which arise on the swollen parts. 
 
 Calcis carb. should be given for burning, milky dis- 
 charge, attended w T ith pressure on the vagina, and tuber- 
 cles on the labia. 
 
 Cannabis should be preferred when there is cutting 
 pain between the labia during micturition, the orifice 
 of the urethra also being closed with pus, there being 
 violent sexual desire, with swelling of the vagina. 
 
 Cantharis is to be prescribed when there is copious 
 debilitating discharge, and pains in the kidneys, with 
 distressing sensations in the pelvis, accompanied with 
 a languid, sallow complexion, and depression of spirits. 
 It is also useful in swelling of the neck of the womb, 
 with burning and itching of the genital parts. 
 
 Chamomilla is more especially useful for yellow, smart- 
 ing discharge from the vagina, or for acrid, smarting, 
 watery discharge, with smarting burning, as if the parts 
 were excoriated. 
 4* 
 
42 GONORRHOEA OF THE FEMALE. 
 
 Ignatia is good for violent, cramp-like pressure on the 
 uterus, followed by purulent corrosive discharge, with 
 swelling of the clitoris, and weakness of the remainder 
 of the genital organs, sometimes attended with uterine 
 spasms. 
 
 Kreosofum is of great utility in bloody, salmon-colored, 
 yellow, or yellowish-white discharges, having a foul odor, 
 especially in the morning ; or in acrid discharges, with 
 itching of the parts, or jerking, smarting pain in the ex- 
 ternal parts, with weakness in the legs. 
 
 Lycopodium is of great service in copious bloody and 
 milky discharge, with burning in the vagina. 
 
 Mercurius is of great service when there is discharge 
 of flocks, pus, and mucus, or purulent discharge of a 
 greenish color, which does not drop, causing a smarting 
 in the anterior portions of the genital parts; or when 
 there is corrosive discharge, with long-tasting itching of 
 the labia, especially just before the menses, and swelling 
 of the follicles of the labia, with pressing in the parts, 
 causing the patient to void a quantity of urine. It is 
 also good when the vagina is swollen and inflamed, with 
 a feeling of rawness and soreness. 
 
 Nux vomica is very appropriate for painless discharge 
 of yellow mucus from the vagina ; or for fetid mucus, 
 with burning in the parts, and violent sexual desire ; or 
 for gnawing, itching eruptions on the genitals, and swell- 
 ing of the inner portion of the vagina, with burning pain, 
 the slightest touch causing intolerable distress. 
 
 Nitric acid is invaluable in discharge of flesh-colored 
 mucus, one-half of the vagina being swollen, with flat 
 ulcers on the inner parts, apparently covered with pus, 
 causing burning, itching pain. 
 
GONORRHCEA OF THE FEMALE. 43 
 
 Phosphorus is very useful in mucous or milky dis- 
 charge, with stitches through the whole length of the 
 vagina, and great aversion to sexual intercourse. 
 
 Platina. In mucous discharge, with pinching in the 
 abdomen, followed by pressing downwards in the groins 
 and discharge of blood, this remedy is very useful. . 
 
 Pulsatilla is very efficient in painless discharge of thick- 
 ish. milky mucus, which is especially perceptible on lying 
 down, with burning, stinging pain and swelling of the 
 labia, and cutting pains at the mouth of the uterus. 
 
 Sabina is to be given in discharge of blood and mucus, 
 or yellow, ichorous, fetid secretion, which frequently re- 
 curs, with itching and stitches in the vagina. 
 
 Sepia is requisite w T hen blood is discharged w T hen walk- 
 ing, and with mucous discharge and itching of the genital 
 organs. 
 
 Sulphur. Violent itching of the clitoris, and burn- 
 ing of the exterior parts, accompanied with vesication, 
 attended with smarting, burning, thin discharge, espe- 
 cially in the morning. 
 
 Thuja is of importance when both labia sw T ell and are 
 covered with whitish ulcers, the discharge from the ure- 
 thra being yellow or green mucus or pus, which stains 
 the linen, and attended with smarting and itching, espe- 
 cially when urinating ; walking produces stinging, itch- 
 ing, and smarting pain, with contractive and pressing 
 pain in the genitals. 
 
 [In recent or chronic cases of gonorrhoea, characterized 
 by cauliflower excrescences, or by condylomata, this 
 remedy will be indispensable.] 
 
 Zincum should be preferred when there is a discharge 
 of thick mucus, especially after stool, with constant pinch- 
 
44 GONORRHOEA OF THE FEMALE. 
 
 ing and yawning previous to the discharge. The sexual 
 desire is also very excited, especially at night, but with- 
 out lascivious dreams. 
 
 [In gonorrhoea of the female it is indispensably requi- 
 site that the patient entirely abstain from sexual inter- 
 course, and observe the strictest diet, not only during 
 treatment, but even for some time after the cure is ap- 
 parently complete. Jahr says : " From a single cup of 
 coffee, or from a single coit, I have seen the discharge 
 return worse than ever, even after it was all but stopped." 
 And this is amply confirmed by the experience of others. 
 The greatest difficulty in curing the female patient, as 
 in the male, consists in maintaining, in all respects, the 
 necessarily rigid diet and regimen, — such as is involved 
 in abstinence, from exposure to cold, sexual excitement, 
 walking or other physical exertion, and from every va- 
 riety of hearty food and stimulating drink. The best 
 medical treatment, the most accurate prescriptions, will 
 prove ineffectual, if the patient do not observe these 
 strict rules ; and the physician will be unfaithful alike 
 to his patient and to himself, who does not impress them 
 in all their importance upon the mind of the former. 
 While, if the physician prescribe correctly, he may 
 always take it for granted, when a relapse or aggra- 
 vation of the disease occurs, that the cause for it (and 
 without some particular cause it cannot occur) must be 
 found in some transgression on the part of the patient. 
 And it will be needful, by strictly interrogating the pa- 
 tient, to discover what this transgression has been, in 
 order both to remedy its effects and to prevent its recur- 
 rence in future. 
 
GONORRHCEA OF THE FEMALE. 45 
 
 The medical treatment which may be required in the 
 female suffering from gonorrhoea, is not very different 
 from that indicated in the male ; but the cure is often 
 more readily effected. In the first stage of the acute 
 form, Aconite will be needed ; then Cannabis, or what- 
 ever other remedy is most strongly called for by the 
 prevailing symptoms and conditions. Jahr says : " We 
 depend upon Cannabis as our chief remedy in the treat- 
 ment of simple acute gonorrhoea (in the female) ; this 
 remedy will effect a cure, in most cases, in the space of 
 two or three weeks, provided its use is persisted in and 
 the patient abstains from all improper dietetic indul- 
 gences." 
 
 In the chronic form, or gleet, which greatly resembles 
 ordinary leucorrhcea,* Sepia will often be required. 
 Where there is reason to suspect the presence of syphi- 
 litic virus in the system, Mercurius, or some other anti- 
 syphilitic, will be necessary. If the patient has been 
 mercurialized already, Nitric acid should receive partic- 
 ular attention; also Phytolacca decandra ; — whatever 
 anti-syphilitic and anti-mercurial best corresponds with 
 the prevailing symptoms, should be carefully admin- 
 istered. The most remarkable characteristic indication 
 for Thuja, condylomata, or fig-warts, on vulva or anus, 
 Berjeau has omitted. In addition to the other remedies 
 mentioned by him, the following should be considered : 
 Alumina, Causticum, Conium, Iodium, Lachesis, Sarsa- 
 parilla. Compare also the remedies mentioned for gleet 
 in the male.] 
 
 * See an admirable resume" of Indications for Medicines in 
 Leucorrhcea, by Dr. Guernsey ; Hahnemannian Monthly, March 
 and February, 1869, Vol. IV. p. 293. 
 
46 GONORRHOEA OF THE FEMALE. 
 
 SYMPTOMATIC INDICATIONS. 
 
 Acrid discharge, with itching of the parts . Kreosotum. 
 smarting watery discharge from the 
 
 vagina ..... Chamom'dla. 
 
 Black, hard pustules on the labia . . Bryonia, 
 
 Bloating of the abdomen, followed by contrac- 
 tion ...... Belladonna. 
 
 Burning and itching of the pudendum . . Cantharis. 
 
 in the vagina, with copi- 
 ous bloody or milky dis- 
 charge . . . Lycopodium. 
 stinging pain in the labia and vagina . Pulsatilla 
 Coolness of the body, with uterine spasms . Ignaiia. 
 Cramp-like pressure in the uterus, followed by 
 
 corrosive purulent discharge. . . Ignatia. 
 
 Cutting between the labia during micturition . Cannabis. 
 Cutting pain at the orifice of the womb in va- 
 ginitis ..... Pulsatilla. 
 
 Discharge of white mucus from the vagina . Belladonna. 
 increased, after having decreased . Bryonia. 
 causing smarting of the parts which 
 
 it touches .... Cannabis. 
 
 of blood, with sexual excitement . Sabina. 
 of pus, or flocks, with scalding . Mercurius. 
 acrid, fluid, corroding the parts . Are., Kreos., Aur. 
 milky fluid .... Calc, Lye, Phos., 
 
 Pulsatilla. 
 Dragging towards the sexual parts, with stitches 
 
 in the pubis ..... Belladonna. 
 
 Fetid mucous discharge from the vagina . Nux vomica. 
 
 Gnawing, itching eruption on the pudendum . Nux vomica. 
 soreness on the left side of the puden- 
 dum ..... Platina. 
 
 Greenish discharge, with itching of the parts . Nat. murias. 
 Itching of the labia, with corroding discharge . Mercurius. 
 
 sexual organs . . . Sabina, Sepia. 
 
 vagina, with watery discharge . Sepia. 
 Milky discharge early in the morning . . Phosphorus. 
 
 or opalescent discharge, with smarting . Acid, sulph. 
 Mucous discharge from the urethra and vagina Mezer., Thuja. 
 
 and bloody discharge from the vagina . Sabina. 
 Pale yellow nauseous discharge from the vagina Merc, corros. 
 Painless discharge of yellow mucus from the 
 
 vagina ..... Nux vomica. 
 
GLEET. 
 
 47 
 
 Purulent greenish discharge, causing smarting Mercurius. 
 Redness of the parts, with smarting, gnawing 
 
 discharge ..... Arsenicum. 
 
 Stinging pain in the pudendum when walking . Thuja. 
 Sharp stitches in the posterior part of the va- 
 gina ...... Sabina. 
 
 Smarting, burning, thin discharge . . Sulphur. 
 
 and itching in the urethra, 
 
 when urinating . ' . Thuja. 
 
 Swelling of the labia majora . . . Bryonia. 
 
 vagina, with violent sexual de- 
 sire .... Cannabis. 
 
 and inflammation of the vagina . Mercurius. 
 
 of the neck of the uterus . . Cantharis. 
 
 clitoris .... Ignatia. 
 
 follicles of the labia . . Mercurius. 
 
 vagina, which is excessively 
 
 sensitive . . . Nux vomica. 
 
 of both labiae, with burning pain . Thuja. 
 Thickish milky mucous discharge . . Pulsatilla, 
 
 Transparent mucus, with smarting pain . Stannum. 
 
 Tubercles on the labia .... Cal. carb. 
 
 Vesicular eruption on the parts . . Aurum. 
 
 Violent itching of the clitoris . . . Sulphur. 
 
 Whitish ulcers on the labia majora . . Thuja. 
 
 Yellow, smarting discharge from the vagina . Chamomilla. 
 or yellowish-white fetid discharge . Kreosotum. 
 discharge, with sickly sweetish odor . Mercurius, 
 excoriating discharge . . . Sulphur. 
 
 GLEET. 
 
 This is a morbid discharge of a muco-purulent, serous, 
 or pale-green fluid from the urethra, without inflam- 
 matory symptoms, or rather without pain and heat in 
 urinating, and is generally a sequel to acute or misman- 
 aged gonorrhoea. This discharge arises after the acute 
 symptoms of the former affection have disappeared, 
 
48 GLEET. 
 
 threading between the fingers, staining the linen but 
 slightly, and if neglected continuing for months, or even 
 years, without any other bad symptom than that it sen- 
 sibly weakens the constitution of the patient ; at other 
 times, however, it may produce stricture, or even affec- 
 tions of the prostate gland, bladder, or the kidneys. In 
 particular cases, although the discharge may have ceased 
 for weeks, it will reappear after connection, violent ex- 
 ercise, or excesses of the table. The cause of the com- 
 plaint is either ulceration of the mucous membrane of 
 the urethra, or erosion of the orifices of the ducts of the 
 prostate gland or seminal vessels, or from debility of the 
 membrane itself. In the former case, the discharge is 
 either of pus, or mucus mixed with pus ; in the latter 
 cases, it is limpid, mucous, copious, persistent, and at- 
 tended with a peculiarly nauseous smell. 
 
 Strict attention to diet, for a considerable time after 
 every trace of the complaint has disappeared, is neces- 
 sary, as even slight excesses have a tendency to cause a 
 return of the abnormal symptoms; cleanliness also should 
 be strictly observed. 
 
 Treatment. — When the disease is seated within a 
 short distance of the orifice of the urethra, it is generally 
 easily cured ; but if the seat is in some gland of the ure- 
 thral canal, or there is ulceration of the passage, or ero- 
 sions of the seminal ducts, it is much more intractable, 
 and in such cases considerable quantities of fluid should 
 be taken, in order to dilute the urine, and prevent irri- 
 tation of the part. 
 
 Cannabis is very useful when the discharge is thin and 
 watery, of a greenish or yellow color, and disagreeable 
 odor, 
 
GLEET. 49 
 
 Capsicum is more required when the discharge is muco- 
 purulent, with a tendency to spermatorrhoea, or when it 
 has become yellow, or whitish and thick. White dis- 
 charge, like cream. 
 
 Ferrum. This is a most important remedy in mucous 
 gleet, arising from debility of the vessels after severe 
 gonorrhoea. Painless discharge, like milk. 
 
 Kali bichrom. should be given when the discharge is 
 stringy, or jelly-like, and rather profuse. 
 
 Merc, corros. This medicine is required when ulcer- 
 ation is suspected, and the secretion is purulent or bloody, 
 of a greenish, yellowish, or whitish consistence. 
 
 [Mez. — Gleet. A drop of a gluey, albuminous liquid 
 appears at times at the orifice of the urethra.] 
 
 Acid nitric is useful in similar symptoms, particularly 
 when Mercury has been previously employed without 
 benefit. 
 
 Nux vomica. This remedy can be employed when 
 the patient is subject to piles, and the discharge is prin- 
 cipally clear mucus; it is of great service when the com- 
 plaint has been aggravated by excess in diet, or the use 
 of beer or strong drinks. 
 
 Sepia. In chronic, intractable cases, where the dis- 
 charge is milky, or greenish, attended with pain in the 
 back. 
 
 [As already stated, a few doses, or even a single dose, 
 of the appropriate antipsoric may be made to cure the 
 most inveterate case of gleet. According to Jahr, 
 " Gleet is generally nothing more than a symptom of 
 weakness of the mucous lining, which had been occa- 
 sioned by this disorder,' 7 (Gonorrhoea.) But it seems 
 5 
 
50 GLEET. 
 
 impossible to believe that this simple and apparently 
 trifling difficulty can be all, — when for months, and even 
 years, it bids defiance to mild treatment, to stimulating 
 and tonic treatment, to all sorts of treatment in fact, 
 save and except the minute doses of the true antipsoric 
 which the particular constitution of the patient requires, 
 and under the influence of which it is often seen to fade 
 away, like dew before the sun. 
 
 In order to recover from this disorder, it may be neces- 
 sary for the patient to abstain entirely from malt liquors, 
 as well as from spirits. And it is believed that in some 
 cases the habit of smoking suffices to keep up the irrita- 
 tion and consequent discharge. This discharge, although 
 so minute, when long established, becomes the outlet, or 
 at least the representation, the coefficient, of all that is 
 morbid in the system, or wrong in the person's habitual 
 life. By aiming at the entire system of the patient, the 
 physician will soon cure his gleet ; but by directing his 
 attention to the gleet alone, he will as surely not cure the 
 one or the other ! Yerbum sat. 
 
 Ferrum, Phosph., and Sulphur, are all the remedies 
 mentioned by Jahr in this connection. Each one of 
 these is capable of curing many cases, for it will be 
 indicated in many ; but not in all. 
 
 C. Miiller writes : "In chronic gonorrhoea, I have seen 
 good results from nat. mur. This remedy is recom- 
 mended especially after injections of Nitrate of Silver." 
 
 Sepia will often be called for. " Sepia and Silicea 
 have frequently cured long-lasting gonorrhoea! dis- 
 charges.'' 
 
 Cimicifuga racemosa is said by Hale * to cure old 
 standing oases of gleet and spermatorrhoea. 
 * Materia Medica of New Remedies, 
 
GLEET. 51 
 
 Gelseminum; JErigeron; Phytolacca dec. ; and Podo- 
 phyllin, (the latter in females especially,) and others, 
 have been recommended in gleet. 
 
 Riickert* advises also Cubebs, and Lycopodium, in 
 addition to other medicines. 
 
 From Raue f we glean also the four following reme- 
 dies : — 
 
 Agnus c. Gleet : yellow purulent discharge, impotence. 
 
 Fluoric acid. Gleet : little discharge during the night, 
 which makes a yellowish stain on the linen. 
 
 Phosph. acid. Gleet : every morning a few drops of a 
 white discharge from the urethra, and in the evening 
 discharge of prostatic juice. 
 
 Phosph. Gleet : every morning a drop of watery fluid 
 at the orifice of the urethra, sticking its lips together. 
 Compare Mezereum. 
 
 The indications for these and other remedies in this 
 complaint, might be extended almost indefinitely; but 
 we content ourselves with remarking, that, whatever 
 medicine is indicated by the totality of the symptoms of 
 the patient, by his dynamic, constitutional conditions, 
 will prove curative. For not the discharge only, or indeed 
 even principally, but all the accompanying affections and 
 recent or latent complications, must be considered and 
 provided for. This is what we mean by prescribing 
 for the patient, and not for the gleet alone.] 
 
 Sulphur is very efficacious in this complaint, either in 
 the mucous or purulent variety, and is to be employed 
 when the previous remedies seemingly exert no beneficial 
 
 * Therapeutics, p. 196. 
 
 | Pathology and Therapeutics, p. 380. 
 
52 BALANORR(EA. 
 
 influence, or the patient is of an unhealthy, or scrofulous 
 disposition. 
 
 Thuja. This remedy is useful in copious watery dis- 
 charges from the urethra, and particularly when compli- 
 cated with condylomata (warts). 
 
 [For other remedies and indications in gleet, see pre- 
 vious discussion of acute and chronic gonorrhoea.] 
 
 BALANORRHCEA, Balanitis. 
 
 This is an inflammatory disease, accompanied with 
 purulent secretion from the surface of the glans, arising 
 principally from gonorrhceal infection ; however, some 
 irritating and non-contagious cause m&y produce inflam- 
 mation of this part, and even a purulent secretion from 
 the follicular glands which surround the corona glandis. 
 This disease frequently occurs in children. It is neces- 
 sary, however, to observe, that the strong-smelling sub- 
 stance which is secreted and accumulates behind the 
 glans, when the prepuce is not frequently retracted, is 
 not to be confounded with balanorrhcea, as it can easily 
 be cured by a little attention to cleanliness. Contagious 
 balanorrhcea shows itself sometimes in a few hours, or in 
 most cases from three to six days after impure con- 
 nection. 
 
 General Symptoms. — The first symptoms are a slight 
 smarting or burning on the surface of the glans, which 
 becomes hot, and of a bright rosy, or carmine color, 
 
BALANORRHCEA. 53 
 
 somewhat swollen, and sensitive to pressure or the fric- 
 tion of the clothes. The secretion of the follicular glands 
 becomes purulent, thick, greenish or yellow, and is dis- 
 charged on each side the fraenum in large tenacious drops, 
 which dry up, and cause the glans to adhere to the linen : 
 inside the prepuce, its folds are filled with pus, forming, 
 as it dries, small crusts of a dirty yellow color. The 
 surface of the glans, and the skin of the prepuce itself, 
 become covered with erosions, arising from the acrid 
 nature of the secretion ; these erosions form little flat 
 ulcers, which sometimes remain unchanged for a fort- 
 night, after which the cure proceeds rapidly, provided 
 no violent incidental affections, as phimosis or paraphi- 
 mosis, are induced by the extension and spreading of the 
 ulcers. 
 
 Prophylactics. — The use of strong soap and water 
 after sexual intercourse will speedily remove the pus, 
 which has a tendency to attach itself firmly to the cov- 
 ering of the glans, and which water alone is unable to 
 effect. 
 
 Diet. — The same diet is to be observed as in gon- 
 orrhoea. 
 
 Acid nitric, is indicated when small vesicles form at 
 the orifice of the urethra, on the inner surface and 
 margin of the prepuce ; or when brown, painful spots, 
 the size of a pea, arise on the glans or for flat little 
 ulcers, which secrete a fetid matter and bleed when 
 touched, accompanied with sharp stinging pains on the 
 inner surface of the prepuce. 
 
 Cannabis is to be preferred when bright red spots 
 spread all over the glans, which is of a deeper hue than 
 5* 
 
54 BALANORRHCEA. 
 
 the prepuce itself, the back of the glans being red and 
 damp, with itching at the fraenuin and under the pr& 
 puce, the penis being swollen, whilst there is constant 
 burning of the glans and prepuce. 
 
 Capsicum is required when there is constant pressure 
 and prickling in the glans, or when there is stinging and 
 itching, as if the glans were bitten by fleas. 
 
 Cinchona must be given when there is burning in both 
 glans and prepuce, with sensation of creeping in the 
 urethra, and fine prickling near the fraenum; or when 
 there is itching of the glans, especially in bed, walking 
 producing twitching in both glans and prepuce ; or tear- 
 ing pains are also felt in the left side of the prepuce, and 
 in the left testicle. 
 
 Cinnabaris is necessary when, in addition to the burn- 
 ing, stinging, or itching of the glans, there is a secretion 
 of pus, of a nauseous sweetish smell, — or for small red 
 spots on the glans, with little red shining spots or easily 
 bleeding warts on the prepuce. 
 
 Mercurius is more particularly indicated when there is 
 inflammatory swelling of both glans and prepuce, with 
 purulent secretion between the surfaces, and accom- 
 panied with voluptuous itching, tingling, tearing, and 
 shooting in both ; there is often an eruption of vesicles 
 on the inner surface of the prepuce, which give rise to 
 small ulcers, which itch and sting if pressed or rubbed ; 
 the urethra being red, hot, and very painful when 
 pressed. 
 
 Mezereum should be administered when the secretion 
 from the glans is very abundant, with tearing and burn- 
 ing lancinations, soreness and excoriation of the parts, 
 and inflammatory redness of the prepuce. 
 
BALANORRHCEA. 55 
 
 Nux vomica is requisite when there is tickling, smart- 
 ing, and itching of the glans and prepuce, which is re- 
 tracted and excoriated, the secretion behind the glans 
 being very copious, and the irritation being worse to- 
 wards evening. 
 
 Acidum phosphoricum is useful when there is a feeling 
 of heaviness, and shooting pains in the glans, with tin- 
 gling, oozing vesicles round the fraenum. 
 
 Pulsatilla can be given when the tickling and itching 
 of the glans and prepuce become worse towards morn- 
 ing and evening, or when sitting, the irritation being 
 sometimes accompanied with loss of prostatic fluid. 
 
 Sabina. When there is deep redness of the glans, 
 with great sensibility of the prepuce, with swelling and 
 tightness of the frsenurn, continual shootings in the glans, 
 and burning soreness when touched. 
 
 Sulphur is required when there is icy coldness, and 
 swelling, with redness of the glans, the prepuce being 
 stiff and hard, attended with shooting pains, the secre- 
 tion at the same time being very profuse. 
 
 Thuja is needful should there be swelling of the pre- 
 puce, with burning, itching, and feeling of soreness in 
 the glans, which is covered with red spots or erosions, 
 or small red, flat, unclean ulcers, with burning pain, or 
 when there are violent stitches in the glans near the 
 urethra. 
 
 SYMPTOMATIC INDICATIONS. 
 
 Aching and prickling, constant, especially at 
 
 night and morning .... Capsicum. 
 
 Biting ...... Nux vomica. 
 
 and itching under the prepuce . . Pulsatilla. 
 
56 
 
 BALANORRHCEA. 
 
 Burning, with tickling, crawling, and aching 
 in the urethra and anus 
 about the glans in the evening, when 
 small vesicles appear on the inner 
 surface of the prepuce, and break 
 into minute ulcers . . 
 
 and itching at the back of the glans . 
 and feeling of soreness 
 with sore pain, felt continually 
 and numerous stitches 
 prickling, and itching at the end of 
 the glans .... 
 
 cutting, with outward pressing pain 
 in groin .... 
 
 Coldness, icy, of both glans and prepuce 
 Contraction, and constrictive pain, at the back 
 of the glans 
 and wild sensitive pains in left 
 groin, suddenly darting through 
 the whole urethra 
 and spasmodic pain 
 Drawing and tearing at the corona glandis, 
 
 with yellowish secretion 
 Heaviness, feeling of, during micturition - 
 Itching ...... 
 
 in the morning .... 
 
 with biting 
 voluptuous, at the end of the glans 
 
 at the fore part 
 and biting under the prepuce . 
 with crawling on the corona glandis 
 painful, in the furrow at the back of 
 
 the glans 
 frequent . 
 Prickling 
 
 on the side of the glans 
 when pressed . 
 violent, in the morning 
 and fine itching 
 many fine itching stitches on the point 
 of the glans 
 Redness, dark . 
 
 of both glans and prepuce 
 with moisture on the glans 
 Swelling, with moist eruption on the scrotum . 
 bluish -red, of the glans, with fis- 
 sures 
 
 Cinchona. 
 
 Mercurius. 
 Nux vomica. 
 Thuja. 
 Sabina 
 Thuja. 
 
 Cinnabaris. 
 
 A cid phosphoric. 
 Sulphur. 
 
 Pulsatilla. • 
 
 As arum. 
 Ignatia. 
 
 Mezereum. 
 
 A cid phosphoric. 
 
 Mezer., Sulphur. 
 
 Nux vomica. 
 
 Ignatia. 
 
 Spongia, Calc. 
 
 Mercurius. 
 
 Pulsatilla. 
 
 Natr. murias. 
 
 Cinnab. 
 
 Acid nitric. 
 
 Thuja. 
 
 Arsenicum. 
 
 Mercurius. 
 
 Sabina. 
 
 Caps., Acid phos. 
 
 Helleb. niger. 
 
 Cannab., Mercurius. 
 
 Cannabis. 
 
 Rhus tox. 
 
 Arsenicum. 
 
BALANORRHCEA. 
 
 57 
 
 Spots, red ..... Thuja. 
 
 bright red .... Cannabis. 
 
 itching ..... Arnica. 
 petechial (like flea-bites) . . Bryonia. 
 
 brown, and painful (size of lentils) . Acid nitricum. 
 Stitches, dull, tormenting . . . Sulphur. 
 
 stinging and itching . . . Thuja. 
 
 fine, through the glans . . Arsenicum. 
 
 tearing and painful, at the fore part 
 of the glans, drawing through the 
 penis back into the anus, and ex- 
 tending sometimes to the groin 
 Tickling, with discharge of colorless mucus . 
 fleeting, and itching . 
 sensation between the prepuce and 
 glans .... 
 
 in the fore part, like a flea-bite 
 Twitching between the prepuce and glans when 
 
 walking . . 
 
 Vesicles, small, in the orifice of the urethra, or 
 on the inner surface and margins 
 of the glans, which break and form 
 round ulcers, like chancres 
 on the front and side of the glans, 
 which ulcerate and extend on all 
 sides, sinking deep in its substance ; 
 or small vesicles, which break, but 
 heal rapidly 
 
 Mercurius. 
 Pulsatilla. 
 Colocynth. 
 
 Thuja. 
 Belladonna. 
 
 Cinchona. 
 
 . Acid nitricum. 
 
 Mercurius. 
 
 SYMPTOMS OF THE PREPUCE. 
 
 Burning, continuous, in entire prepuce and 
 glans .... 
 
 with vesicles appearing on the inner 
 surface .... 
 and corrosive prickling in the exter- 
 nal parts .... 
 itching, and prickling at the edge . 
 Coldness, icy, of both prepuce and glans 
 Itching relieved by rubbing, but soon return- 
 ing . 
 with moist spots on the inner surface . 
 voluptuous . 
 
 on and within the prepuce . 
 painful, on the inner surface . 
 disagreeable, on the right side and edge 
 
 Cannabis. 
 
 Mercurius. 
 
 Cannabis. 
 
 Bryonia. 
 
 Sulphur. 
 
 Aconitum. 
 
 Acid nitricum. 
 
 Euphrasia. 
 
 Mercurius. 
 
 Cannabis. 
 
 Cannabis. 
 
58 BALANORRHCEA. 
 
 Itching under the prepuce and at the frsenum . Cannabis, 
 with swelling and redness, and also of 
 
 the scrotum . . . Rhus tox. 
 
 and biting on the inner surface, espe- 
 cially towards the evening . . Nux vomica. 
 at the inner and upper part . . Pulsatilla. 
 Prickling and itching under the prepuce . Pulsatilla. 
 whilst sitting or lying . . Pulsatilla. 
 on the inner half . . . Rhus tox. 
 itching at the edge . . . Chamomilla. 
 frsenum . . Mercurius. 
 Redness, the entire surface is dark red, hot, 
 
 and inflamed . . . Cannabis. 
 
 with burning pains . . . Mercurius. 
 
 with thickening . . . Sulphur. 
 
 itching and swelling of both scrotum 
 
 and prepuce . . . Rhus tox. 
 
 and painful sensibility of the inner 
 
 surface .... Mercurius. 
 
 and swelling at its junction with the 
 
 glans .... Rhus tox. 
 
 of both prepuce and fraenum . Sabin., 
 
 of the right and lower side . . Cann., Cham., Cin- 
 
 chona, Verat. 
 Soreness of the edges, especially towards even- 
 ing ..... Nux vomica. 
 
 and ulcerative pains, 
 the edges 
 
 with itching at 
 
 Stitches 
 
 Ignatia. 
 
 as from distention at the extremity . Ignatia. 
 
 . Manganes. 
 side . . Thuja. 
 
 sensitive, in the inner i 
 
 in the extremity . . . Cocculus. 
 
 short . . . . . Acid nitric. 
 
 stinging and burning on the external 
 
 surface .... Cannabis 
 
 when retracted . . . Hepar sulph. 
 
 in the region of the fraenum . . Hepar sulph. 
 
 Tickling . .... Thuja, Calc. 
 
 itching, and biting, alternating with 
 
 transient stinging at the anus . Thuja. 
 
 itching, and biting at the back of the 
 
 glans and frsenum . . . Acid phos., Merc. 
 
 Rending pains on the left side and in the left 
 
 testicle when in bed .... Cinchona. 
 Vesicles, which become moist and itch . Acid phosphoric. 
 
 when handled Acid phosphoric. 
 
GONORRHffiAL ACCESSORY AFFECTIONS. 
 
 SOME accessory affections in direct relation with the 
 gonorrheal discharge may accompany it as well as 
 Balanorrhcea : they are either caused by the disease or 
 induced by some accidental circumstance. The most 
 frequent are, painful erections, satyriasis and priapism, 
 chordee, haemorrhage from the urethra, inflammation of 
 Cowper's glands, prostatitis, dysuria. 
 
 ERECTIONS are present in almost every case of gon- 
 orrhoea, are extremely painful, and always aggravate the 
 inflammatory condition. The- pain is always more severe 
 in the first instance than in those who have been several 
 times affected with the disease. 
 
 Prophylactic Treatment. — Absolute avoidance of 
 all lascivious and moral excitement, abstinence from 
 meat, eggs, or cheese, eating little or no supper, voiding 
 the urine frequently, even at night, will frequently pre- 
 vent or greatly ameliorate this distressing affection. 
 
 Treatment. — The best remedies are Cantharis and 
 Capsicum, although due regard must be had to the 
 totality of the symptoms, for which reference should be 
 made to the symptomatic indications for gonorrhoea. 
 
 Capsicum is more especially indicated when there is 
 
 violent erection constantly recurring through the day, 
 
 without amorous thoughts, and only relieved by the use 
 
 of cold water. 
 
 Cantharis is more useful in very painful erections. 
 
 with discharge of blood and pus, with or without great 
 
 sexual desire, 
 
 59 
 
60 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 SATYRIASIS AND PRIAPISM. — The first dis- 
 ease, which is generally preceded by more or less sexual 
 excitement, consists of an insatiable desire for con- 
 nection, attended with permanent erection; lascivious 
 images are constantly present to the imagination, even 
 in sleep ; there is acute fever with glistening eyes, in- 
 tense thirst, and foaming at the mouth ; raving lascivious 
 madness supervenes, and if the disease is not checked, 
 the organs become inflamed, gangrene rapidly sets in, 
 and death ensues. Priapism is a much less severe form 
 than the preceding, and frequently occurs during the 
 course of gonorrhoea. 
 
 Treatment. — In addition to mental treatment, the 
 use of cold baths, cooling, drinks, total abstinence from 
 animal food, and sleeping at night on a hard mattress, are 
 necessary. 
 
 The following indications for the^most important 
 medicines in these complaints are here given, merely pre- 
 mising, that due regard must be paid to the totality of 
 the symptoms in each particular case. 
 
 Cantharis. Frantic sexual desire, with priapism and 
 excessive pain. 
 
 Digitalis. Sexual excitement, with frequent and pain- 
 ful erections night and day. 
 
 Moschus. Violent sexual desire ; also with nausea 
 and vomiting after an embrace. 
 
 CHORDEE. — Sometimes the penis assumes a curved 
 form, from violent inflammation and consequent exuda- 
 tion into its cellular tissue ; the curvature is almost 
 always downwards, but occasionally in a lateral direc- 
 tion, with a rending sensation in the swollen part, 
 
GONORRHEAL ACCESSORY AFFECTIONS. 61 
 
 especially in the frsanum. If not subdued, it may 
 terminate in chronic disorganization, thickening, or 
 induration. Should these latter supervene, a cure can 
 no longer be expected, chordee remains a normal condi- 
 tion of the parts, connection becomes more or less pain- 
 ful, and sometimes even impossible. 
 
 lodium. The external employment of this remedy, 
 diluted with spirit to the color of sherry wine, will very 
 frequently remove the affection in a clay or two, par- 
 ticularly if the patient is of a scrofulous diathesis. The 
 penis is to be painted with the above by means of a 
 camel-hair brush twice a day. 
 
 Capsicum is required w T hen chordee is associated with 
 thick, purulent, yellow discharge, with excessive sensi- 
 bility of the parts. 
 
 Cantharis is to be preferred when, with yellow dis- 
 charge and excessive burning pain, there is great and 
 painful difficulty in making water, often followed by dis- 
 charge of blood. 
 
 Pulsatilla is requisite in chordee arising from sup- 
 pressed gonorrhoea, or in case of venous congestion of 
 the penis. 
 
 [Lupulin, freely given at night, has been found effec- 
 tual in some extreme cases.] 
 
 H/EMORRHAGE FROM THE URETHRA. — This is 
 
 of frequent occurrence when the inflammation is excessive, 
 and is of no particular moment, if in slight quantity; 
 but should the loss be great, the patient must be con- 
 fined to the horizontal position, and cold water or ice 
 must be applied to the penis. 
 6 
 
62 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 Aconite, when there is strong inflammation, with 
 hot, dry skin, and thirst, the penis being very hot and 
 tense. 
 
 Argenti nitras is very useful in discharge of blood and 
 mucus, with painful tensive erections. 
 
 Cantharis is indispensable in acute inflammation of the 
 urethra, with extreme sensitiveness of the parts, dis- 
 charge of blood and pus, and frequently bloody urine, 
 with sharp pains in the back, and strangury. 
 
 Millefolium. In discharges of blood and slime, with 
 swelling of the penis. This medicine is often required in 
 alternation with Argent, nit., or Canth. 
 
 INFLAMMATION OF COWPER'S GLANDS, recog- 
 nized by pain and swelling of the perinseum ; if not 
 speedily arrested, inflammation and suppuration super- 
 vene, frequently terminating in urinary fistula. 
 
 Treatment. — In the inflammatory stage, Aconitum, 
 Cinnabaris, and Mercurius corrosivus, are principally 
 required ; in the suppurative stage, Hepar sulphuris, 
 Silicea, and Thuja. 
 
 Aconitum ; Mercurius corr. These two remedies 
 should be given directly the premonitory symptoms 
 appear, in alternate doses of five drops, each, every two 
 hours. 
 
 Cinnabaris is preferable to Merc. corr. if the patient 
 is of a scrofulous or unhealthy constitution. 
 
 Hepar sulph. When suppuration threatens, attended 
 with throbbing in the perinaeum, and the Mercurius hav- 
 ing proved ineffective, Hepar must be immediately re- 
 sorted to. 
 
 Silicea is preferable to Hepar when the abscess has 
 
GONORRHEAL ACCESSORY AFFECTIONS. 63 
 
 broken, and the discharge is either clear and gelatinous, 
 or thick and discolored. 
 
 PROSTATITIS. — The prostate gland is conglomerate, 
 of the size of a walnut, situated at the neck of the blad- 
 der, and secreting a milky or colorless fluid, which serves 
 to promote the emission of the semen during copulation. 
 When this gland becomes inflamed, there is a sensation 
 of heat and pressure in the perinaeum, towards the neck 
 of the bladder and the rectum, with a sensation as if 
 some foreign body were lodged there ; there is constant 
 and painful urging to pass water, or stool, which in- 
 creases with every attempt to satisfy the inclination, 
 and is either fruitless or followed by a very scanty dis- 
 charge. Suppuration generally ensues, if the disease be 
 not checked by appropriate treatment, the pus being dis- 
 charged either through the urethra, or through fistulous 
 openings in the perinaeum. 
 
 Treatment. — In acute cases, the principal remedies 
 are Aeon., Bell, Bryon., Cann., Here, corros., Phosph., 
 and Thuja. In chronic cases, Pulsatilla and Thuja. 
 
 Aconite is required at the commencement, when there 
 is hot, dry skin, full, bounding pulse, thirst, great rest- 
 lessness, with burning and tenesmus at the neck of the 
 bladder, with painful, anxious urging to urinate, the 
 urine being very dark, acrid, and frequently depositing 
 a red sediment. 
 
 Cannabis is to be preferred when the urine is mixed 
 with thready mucus or filaments, as if pus were present, 
 with darting stitches at the posterior part of the urethra 
 when standing ; and aching pain, with great desire to 
 urinate. 
 
64 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 Mercurius, when the gland has become indurated, the 
 feeling of pressure great, with heat and heavy aching 
 in the perinaeum, and discharge of urine with white fila- 
 ments and flocks, the sediment being white and thick. 
 
 Pulsatilla is extremely useful in this complaint, par- 
 ticularly in fair-complexioned persons, more particularly 
 when there is great heat and pressure in the perinseum, 
 accompanied with frequent erections and loss of pros- 
 tatic fluid, constrictive pain extending to the bladder, 
 with pressure as from a stone, and frequent and almost 
 ineffectual urging to urinate. 
 
 Thuja, when the symptoms are similar, the urine being 
 bloody or depositing a brick-dust sediment. 
 
 Phosphorus; Hep. sulph. ", Silicea. These remedies 
 are required when suppuration is imminent, particularly 
 when the patient is in ill health. 
 
 CHRONIC INFLAMMATION OF THE PROSTATE 
 GLAND, is generally the result of a neglected or ill-treated 
 case of the acute form. The patients first complain of 
 painful pressure in the perinaeum, only felt at first during 
 an emission of urine or semen, but afterwards becoming 
 continuous, and latterly increasing to a burning, extend- 
 ing to the glans, testicles, and thighs ; an albuminous, 
 colorless, rqpy fluid flows from the urethra, sometimes 
 closing its orifice ; this fluid is more copiously secreted 
 after an emission of semen, urine, or after stool, and is 
 particularly aggravated by costiveness, excesses in drink- 
 ing, or physical exertion. The pain now increases, the 
 urging to urinate more violent, and the urine is expelled 
 by fits and starts, the stream being sometimes divided, 
 
GONORRHOEAE. ACCESSORY AFFECTIONS. 65 
 
 and mixed with mucous flocks, and a little urine, often 
 of a dark color and ammoniacal odor, remains constantly 
 behind in the bladder, causing an increased irritation of 
 that organ. The existence of suppuration may be in- 
 ferred from a constant desire to urinate, pain during 
 micturition, and the presence of tenacious mucus or pus 
 in the urine. In the perineal region the patient expe- 
 riences a dull throbbing pain, with frequent chills, feb- 
 rile symptoms, and even delirium. Whilst the suppu- 
 rative process is going on, the abscess generally opens 
 into the urethra, and its contents may be sometimes re- 
 moved by means of the catheter. It may also be dis- 
 charged into the bladder or rectum ; but, in whatever 
 direction the abscess may break, the morbid symptoms 
 subside, and recovery soon takes place. 
 
 Arsenicum may be resorted to if the patient is much 
 debilitated by the disease, particularly if it threatens to 
 assume a malignant form, foul ichor being discharged 
 from the urethra, with fetid colliquative diarrhoea and 
 foul urine. 
 
 Kali iodidum has been lately reported as an important 
 remedy in suppuration of the prostate, particularly in 
 scrofulous subjects, with fair complexion and bloated 
 appearance. - 
 
 lodium may prove serviceable in induration, or subse- 
 quent atrophy of the gland. 
 
 Mercurius may be required when the urine contains 
 threads of mucus, or deposits a chalk-like purulent sedi- 
 ment, and a heavy, aching pain is experienced in the 
 perinaeal region. 
 
 Silicea is useful in chronic suppuration of the gland, 
 with heat and soreness, urging to urinate, and discharge 
 6* 
 
66 GONORRHCEAL ACCESSORY AFFECTIONS. 
 
 of fetid, discolored pus with the urine, the bowels being 
 very costive. 
 
 The following medicines may also be consulted: Acid, 
 nitric, Argenti nitr., Aurum, Cannabis, Capsicum, Co- 
 nium, Lycopodium, Nux vomica, Pulsatilla, Rhododen- 
 dron, Spongia, Sulphur, Thuja, and Uva ursi. Vide 
 Characteristic Effects. 
 
 [For acute and chronic inflammation, hypertrophy, and 
 tumors of the prostate gland, the following remedies are 
 mentioned by Dr. Lippe.* (The indications which he 
 suggests may be more readily found in Raue's Pathology 
 and Therapeutics, page 405.) Pulsatilla, Thuja, Digi- 
 talis, Cyclamen, Selenium, Causticum, Lycopodium, Se~ 
 cale c, Copaiba, Zinc, Agnus c, Alumina, Hepar, Apis, 
 and Sulph. acid. To these may be added Tussilago p., 
 recommended by Rosenberg and Jahr.] -t 
 
 PRURITUS GLANDIS; Itching of the Glans. — This 
 
 complaint frequently occurs without any apparent reason, 
 although it often accompanies the gonorrheal discharge. 
 The patients complain of an intolerable itching of the 
 glans, which induces such violent scratching that excori- 
 ations of the parts are very frequently produced. This 
 itching may likewise affect the genital parts of females 
 suffering from leucorrhcea, or during and after the menses 
 in perfectly healthy women. 
 
 The principal remedies are, Sulphur, Calc, Caust., 
 Antimonium crud., Arsenic. The particular indications 
 which should lead to the selection of each respectively 
 
 * Am. Horn. Review, Vol. III. p. 150. This article will well 
 repay a careful study by all who have cases of this kind to treat. 
 
GONORRHEAL ACCESSORY AFFECTIONS. 67 
 
 may be gathered from the article on Characteristic 
 Effects. 
 
 HERPES PRiCPUTIALIS ; Eczema Praeputialis. — 
 
 This troublesome vesicular eruption, sometimes mistaken 
 for incipient chancre, may affect both sexes, either with or 
 without a syphilitic taint. In the male, the vesicles, of 
 the size of a pin's head when fully developed, are seated 
 on the prepuce and glans ; in the female, on the labia 
 majora and minora. The patients are not aware of the 
 disease until their attention is directed to it by the itch- 
 ing of the red and swollen parts. The vesicles are 
 generally clustered together, and sometimes coalesce. 
 
 Treatment. — The most useful remedies are Acid, 
 phos.y Petroleum, Thuja, and Veratrum ; \_Merc. corr.'] 
 Vide Characteristic Effects. 
 
 PHIMOSIS. — This is caused by the infiltration of 
 fluid into the cellular tissue of the prepuce, forming a 
 large, long, dark, reddish-brown, bulbous swelling at 
 the extremity of the penis, its borders being enlarged, 
 cracked, and so narrow that but a small portion of the 
 secreted pus can make its escape, and rendering the 
 retraction of the prepuce behind the glans impossible, 
 the remainder collecting underneath, forming a fluctuat- 
 ing swelling. Persons with a long and narrow prepuce are 
 the most subject to it, and balanorrhcea is always present. 
 
 Treatment. — If the remedies are selected with care, 
 the disease is generally easily subdued, and it is only in 
 very severe cases, and when gangrene threatens, that 
 the knife becomes necessary. Should the apparently 
 appropriate remedies be of no avail, slight incisions in 
 
68 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 the prepuce will allow much of the fluid to escape, and 
 pave the way to speedy relief. 
 
 Merc, corros. is indicated when there is violent swell- 
 ing of the prepuce, like a bladder, with burning, biting 
 redness, and painful sensibility, with cracks and fissures 
 on the inner surface. 
 
 Rhus tox. is required when there is puffy swelling of 
 both prepuce and glans, with itching and moist eruption 
 on the scrotum. 
 
 Cannabis should be given when there is dark-red, hot, 
 and inflamed prepuce, which is swollen in connection 
 with the fraenum. 
 
 Cinnabaris is useful when there is swelling, redness, 
 and soreness of the prepuce, with itching pain. 
 
 Sulphur. When the patient is of a scrofulous habit, 
 and no relief is afforded by other remedies, although 
 apparently well indicated, a few doses ~6f Sulphur will 
 frequently produce striking amendment. 
 
 Note. — In this, as in other affections complicated 
 with another disease, a reference to the indications for 
 both will materially aid in the selecting the appropriate 
 medicine. 
 
 PARAPHIMOSIS.— Retraction of the prepuce behind 
 the glans is termed paraphimosis, and is much more 
 dangerous, as, should the constriction be not speedily 
 removed, strangulation of the part ensues, and the whole 
 penis is likely to be destroyed by gangrene. In these 
 severe cases there is no remedy but the knife. The 
 remedies are the same as used for phimosis. 
 
 Colocynth has lately been employed with success in 
 obstinate cases, and has been recommended in prefer- 
 
GONORRHEAL ACCESSORY AFFECTIONS. 69 
 
 ence to all other medicines for effecting or facilitating 
 reduction.* 
 
 CYSTITIS; Inflammation of the Bladder. — This is 
 
 characterized by burning pain in the region of the blad- 
 der, with tension, heat, pain on pressure, and external 
 tumefaction. The pain and anguish are increased by 
 the violent urging to urinate, which is often ineffectual, 
 or the urine can only be discharged by drops ; great 
 thirst and fever are always present, sleep vanishes, and 
 the patient rapidly emaciates. The disease in question 
 (cystitis from acute or suppressed gonorrhoea) generally 
 involves the prostate gland and the surrounding parts, 
 and in very severe cases extends even to the kidneys. 
 
 Treatment. — Absolute rest, and a diet of linseed-tea, 
 barley-water, or some mucilaginous drink, are the chief 
 accessories in bringing this complaint to a successful 
 issue. Animal food, spices, or spirits, are positive poi- 
 sons in this disease. It is also advisable to dissolve the 
 medicines in a large quantity of water, as it serves to 
 dilute the urine, which is always very acrid. Distilled 
 or boiled and filtered rain-water are preferable for drink- 
 ing to ordinary pump-water. 
 
 Aconitum is ever requisite in the initiatory treatment 
 of this disease, if there is hot, dry skin, and quick 
 hard pulse. 
 
 Cantharis is indispensable in this complaint, and should 
 be given singly or in alternation with Aconite. It can 
 even precede it, should the accompanying fever be only 
 moderate. 
 
 Hyoscyamus is useful when urination is difficult, and 
 * Laurie's "Elements of the Practice of Physic," p. 495. 
 
70 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 the inflammation not far advanced, or when these symp- 
 toms appear to be more spasmodic than inflammatory. 
 
 Digitalis is useful when, in addition to the suppression 
 of urine, constrictive pains are felt in the bladder. 
 
 Acid phosph. can be given for paleness of the face, 
 heat, and intense thirst, milky urine, with cramp-like 
 constriction of the bladder. 
 
 Arsenicum cannot be dispensed with, when intense 
 thirst, distressing anxiety and restlessness, great fear of 
 death, and rapid sinking of the vital powers prevail. 
 
 Sulphur, Silicea, will frequently be required at the 
 termination of the disease, should it threaten to end in 
 suppuration or perforation. The selection must be made 
 in conformity with the detailed indications in the Char- 
 acteristic Effects. 
 
 CHRONIC INFLAMMATION OF TH£ BLADDER.— 
 
 This complaint is accompanied by a very irritable state of 
 the organ, and profuse secretion of mucus, which passes 
 off with the urine. Hence it is often termed Catarrh of 
 the Bladder. 
 
 The principal remedies are, Pulsatilla, Dulcamara, 
 Sulphur, Hepar sulph., Mercurius, Phosphorus, Can- 
 nobis, Kali carb. 
 
 The selection to be made in conformity with the char- 
 acteristic action of each. 
 
 Vide Catarrh of the Bladder. 
 
 EPIDIDYMITIS.— The epididymis is a small, oblon- 
 gated, grayish body, about the size of a goose-quill, rolled 
 on the superior part of each testicle, and formed by the 
 windings of all the seminal ducts united into one canal. 
 
GONORRHEAL ACCESSORY AFFECTIONS. 71 
 
 It is liable to be affected with acute inflammation, in 
 severe cases of gonorrhoea, when all the surrounding 
 parts are implicated. 
 
 Treatment. — This disease running a rapid course, the 
 appropriate remedies must be sought for immediately on 
 its invasion. At the same time, all sexual excitement 
 must be avoided, and a suspensory bandage worn for 
 some weeks, even after all disappearance of the gonor- 
 rhoea. There is always some fever when the disease is 
 acute, particularly when the spermatic cord is implicated, 
 and the parts are so sensitive that the least pressure will 
 frequently induce fainting. 
 
 It will be necessary to compare the indications here 
 presented with those for gonorrhoea, as we cannot hope 
 to allay the inflammation in the epididymis whilst the 
 gonorrhoea! affection is still unchecked. 
 
 Argent, nit. Contusive pains, with enlargement and 
 hardness of the right testicle. 
 
 Arsenicum. Cramp-like, cutting colic, darting through 
 the abdominal ring and perinaeum, considerable swelling 
 of the testicles, and phenomena resembling those of in- 
 carcerated hernia. 
 
 Aurum. Swelling of the testicles, with pressive pain 
 on contact, and aching tensive pains in the right testicle, 
 which is swollen in the lower part. 
 
 Belladonna. Repeated tearing in the left spermatic 
 cord, from below upwards, in the evening, or when 
 falling asleep ; lancinations in the testicles, which are 
 drawn up. 
 
 Cannabis. Tensive pains in the spermatic cord, and 
 contraction of the scrotum; sensations of pulling or 
 pressure in the testicles, 
 
72 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 Capsicum. Drawing pains in the spermatic cord, and 
 cramp-like pains in the testicles, during and sometimes 
 after urination. 
 
 Cinchona. Painful swelling of the spermatic cord and 
 testicle, but especially of the epididymis ; tearing pains 
 in the left testicle and the left side of the prepuce ; 
 cramp-like, contractive pains in the testicles and urethra, 
 especially in the evening. 
 
 Clematis. Painful inflammation, and swelling of 
 both testicles ; ascending pains in the testicles and sper- 
 matic cord ; induration of the testicles. 
 
 Cocculus. Stitching pains in one or the other tes- 
 ticle, and violent pains, as if bruised, or drawing pains, 
 especially on pressure or even contact. 
 
 Ignatia. Strangling sensation and aching sensation 
 in the testicles, especially after lying down at night. 
 
 Mercurius. Sensation of coldness in the testicles ; or 
 they are hard and swollen, with shining redness of the 
 scrotum, with dragging pains, itching, tingling, and 
 shooting, both in the testicles and spermatic cord. 
 
 Acid nitric. Inflammatory swelling and relaxation of 
 the testicles, with painful swelling of the spermatic cord. 
 
 Acid phosph. Gnawing pains in the testicles, which 
 are swollen, whilst the spermatic cord is enlarged, hard, 
 and tightened. 
 
 Pulsatilla. Inflammatory swelling of the testicles and 
 spermatic cord, with pressive and tensive pains extend- 
 ing into the abdomen; the right testicle is drawn up 
 and swollen, whereas the left is hanging down relaxed ; 
 or the testicles hang down very loosely, with drawing 
 tensive pains passing out of the abdomen through the 
 spermatic cord. 
 
 Rhododendron. Distressing pains in the epididymis, 
 
GONORRHEAL accessory affections. 73 
 
 worse when touched, whilst the testicles are swollen and 
 retracted. It is also useful when they are indurated. 
 
 Spongia. Squeezing, strangulating pain in the tes- 
 ticles, or aching swelling, with dull, darting stitches, 
 affecting also the spermatic cord. 
 
 Staphysagria. Violent drawing, burning stitches from 
 the right abdominal ring, apparently in the spermatic 
 cord, as far as the right testicle ; or drawing with pres- 
 sure in the right testicle, as if it were violently com- 
 pressed, and aching pains in the outside of the left tes- 
 ticle when walking, increased by touching the part. 
 
 Sulphur. Testicles relaxed and hanging down, with 
 pressure a\id tension in the spermatic cord; vibrating 
 sensation in the testicles and neighboring parts. It is 
 also useful when induration has set in. 
 
 Teucrium. Descent of the right spermatic cord 
 towards the abdominal ring, with great sensation of 
 pressure ; crampy sensation deep in the abdomen, which 
 extends to the testicles, as if they had been violently 
 squeezed ; the integuments of the left testicle feel sore 
 when touched. 
 
 Thuja. Aching pain in the testicles as if crushed, 
 aggravated by walking, with repeated sharp stitches, 
 extending to the spermatic cord. 
 
 EPIDIDYMITIS. — SYMPTOMATIC INDICATIONS. 
 
 Aching in the testicles .... Ignat., Scilla. 
 
 in both testicles .... Aconitum* 
 Constrictive pain in the left testicle . . Argent, nitras. 
 
 in the right testicle . . Digit., Spongia. 
 
 very violent in both . . Cocculus. 
 
 Contractive pain .... Nux vom., Merc. 
 
 spasmodic pain . . . Cinchona. 
 
 Drawing and violent continued pain in the left 
 
 testicle ..... Colocynth. 
 
 7 
 
74 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 Painful sensibility . . . . Acid nit. , Rhod. 
 
 Pressive pain in both testicles . . . Ac.phosph.,Canth. 9 
 
 Thuja. 
 in the left testicle . . Staphysagria. 
 
 Rending pain ..... Pulsatilla. 
 spasmodic pains, with itching . Mercurius. 
 
 in the left testicle . . . Ac. phosphoric. 
 
 Strangling pain ..... Ignatia. 
 Swelling of the epididymis, which is painful to 
 
 touch .... Cinchona. 
 
 violent, after a previous diminution . Baryta carb. 
 
 [Orchitis; Swelling of the Testicles and Scro- 
 tum. — Swelling of the testicles forms one of the most 
 painful complications of gonorrhoea. It may be confined 
 to the convolutions of the epididymis, {epididymitis;) or 
 involve also the surrounding cellular tissue of the scro- 
 tum. It results from exposure to the wet and cold; from 
 being too much on the feet ; and from suppression of the 
 gonorrhoeal discharge by injections. In the latter case, 
 the symptoms are well covered by Pulsatilla, which 
 will often relieve the swelling by restoring the discharge. 
 In some cases, Mercurius may be needed ; in others, 
 Aurum, or Clematis. 
 
 In phlegmonous inflammation of the testicles, Aconite 
 is highly recommended by Hempel, who has cured such 
 cases with the thirtieth potency. If the inflammation 
 is extensive, involving the spermatic cord, and is, more- 
 over, attended with cerebral symptoms, torpor, slight 
 delirium, Belladonna, says Dr. Hempel, will be found 
 indispensable. Rhus will be required, if the swelling 
 of the scrotum (right side) have been induced by ex- 
 posure to wet, or aggravated by too much standing. A 
 case of this kind occurred to us some years ago of a 
 tailor, who, from being constantly on his feet, cutting 
 
GONORRHEAL ACCESSORY AFFECTIONS. 75 
 
 out garments, got one testicle and side of the scrotum 
 larger than his two fists, without abatement of the dis- 
 charge. 
 
 Induration of the Testicle, often of years' stand- 
 ing, the result of mismanaged gonorrhoea, requires Au- 
 rum or Clematis, according to the prevailing conditions; 
 Aurum especially, if the patient has been mercurialized. 
 In these old cases, seldom repeated doses of the thirtieth 
 or some still higher potency have been found efficacious. 
 Conium should be considered, if the induration seems 
 to have been (even partially) consequent upon a local 
 contusion.] 
 
 STRICTURE OF THE URETHRA. — Diminution of 
 the transverse diameter of the canal is one of the most fre- 
 quent disorganizations resulting from gonorrhoea. There 
 are several varieties of the complaint, some of w^hich 
 are much more intractable than the rest. Inflamma- 
 tory strictures develop themselves during the course 
 of, or after, acute gonorrhoea, and are generally cured in 
 two or three weeks ; membranous strictures arise 
 from the formation of folds or valves in the mucous 
 membrane ; fleshy strictures, from partial swelling 
 of the lining membrane; fibrous or cartilaginous 
 strictures are caused by cicatrized wounds or ulcers; 
 varicose strictures, by engorgement of the blood- 
 vessels ; and by mixed strictures is understood a spas- 
 modic condition, with an alteration of the tissues. 
 Spasmodic strictures affect only the membranous por- 
 tion of the urethra, and may involve the whole length 
 of the canal, so as to form a very narrow tube ; whilst 
 organic strictures are generally deeply seated, usually 
 
76 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 under the symphysis pubis, at the junction of the 
 spongy with the membranous portion. The following 
 symptoms indicate the invasion of the disease : Soon 
 after the termination of an improperly treated gonor- 
 rhoea, the orifice of the urethra is found in the morning 
 closed with mucus, leaving dirty-yellow stains on the 
 linen. This discharge is not infectious, but it indicates 
 the commencement of stricture : the stream of urine be- 
 comes thinner, slower, and falls more perpendicularly ; 
 at first it is flat, but becomes twisted or divided into 
 several branches, and at last the urine passes off very 
 slowly, and in drops. The constant urging to urinate is 
 particularly troublesome at night, and the difficulty of 
 passing water is equally annoying. Great care must be 
 taken not to force the discharge of urine, as serious 
 consequences, such as hernia, or prolapsus of the rectum, 
 may ultimately ensue. Patients often endeavor to avoid 
 the necessity of frequent urination, and therefore abstain 
 from drinking to a great extent: this only aggravates 
 the evil, as the urine, being more concentrated, is con- 
 sequently more corrosive and irritating than it was 
 before, the urging is more frequent and excessively 
 painful, the urine can only be discharged in drops, and 
 strangury frequently is the result. The urine also con- 
 tains more azote in its composition, is mixed with pus 
 and mucus, depositing a dirty-white, cloudy precipitate 
 on standing, and exhales a pungent, disagreeable, am- 
 moniacal odor. Partial or complete incontinence may 
 set in, in the course of the disease, causing an enlarge- 
 ment of the urethra, extending to the neck of the blad- 
 der. If partial, a small quantity of urine is involun- 
 tarily discharged drop by drop after every emission, 
 
GONORRHEAL ACCESSORY AFFECTIONS. 77 
 
 the clothes get wet, and exhale a fetid odor in spite of 
 the greatest cleanliness. In complete incontinence the 
 inconvenience is very distressing, the urine passing off 
 continually, and necessitates the use of a caoutchouc 
 bag. The diagnosis of the various kinds of stricture 
 and their mechanical management, should be confided, 
 if possible, to an experienced surgeon, as no written de- 
 scription would enable patients to distinguish their cases 
 with certainty. 
 
 Owing to the fact that a stricture always tends to 
 increase even to the complete closure of the passage, the 
 prognosis is generally doubtful ; the nearer it is to the 
 outer portion of the urethra, the more recent and dilat- 
 able, and the less extensive and contracted, the sooner 
 it is removed. Complications and constitutional de- 
 rangements increase the difficulty, and often render it 
 incurable. 
 
 Treatment. — For spasmodic stricture, and the lighter 
 forms of swelling in the mucous membrane of the ure- 
 thra, the annexed list of medicines w T ill be worthy of 
 study. Agaricus, Clematis, Conium, Cantharis, Iodium, 
 Kali iod., Mercurius, Acid nitric, Silicea, Stramonium, 
 Sulphur. 
 
 The principal remedies for spasmodic strictures are : 
 
 Aconite: required when there is inflammatory fever; 
 constant and distressing urging to urinate, with inability 
 to pass any urine. 
 
 Cantharis. Similar symptoms, with discharge of a 
 few drops of blood instead of urine. 
 
 Belladonna is requisite when there is frequent urging, 
 the urine being natural, or gold-colored. 
 
78 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 Camphora, when strangury is present, the urine pass- 
 ing in a thin stream, and is very acrid. 
 
 Dose. — Two drops of the concentrated tincture, on a lump of 
 sugar, every twenty minutes till relieved. 
 
 Digitalis is very useful when there is continual desire 
 to urinate, but emitting only a few drops each time, with 
 sensation as if the bladder were too full; or when there 
 is pressing and burning in the middle of the urethra, as 
 if it were too narrow. 
 
 Argenti nitras is requisite when there is burning urine, 
 and pain in the urethra, as if swollen and closed. 
 
 Nux Vomica, for painful, ineffectual desire to urinate. 
 
 Opium. Spontaneous interruption of the stream when 
 urinating, or sometimes complete suppression for the time 
 being. 
 
 Thuja. Difficult micturition; the stream is arrested 
 half a dozen times, before the urine is entirely voided. 
 
 In organic strictures, however, a surgical operation 
 is unavoidable ; the use of bougies is the first step to be 
 taken, commencing with a very small-sized one, and pro- 
 portioned to the size of the stream. Having well oiled 
 it, we introduce it carefully into the urethra, and pass it 
 gradually towards the stricture, turning it irregularly in 
 various directions, should the course of the stricture 
 prove to be irregular ; this is very frequently a delicate 
 and troublesome operation, the bougie sometimes being 
 arrested by a fold of the mucous membrane, or one of 
 the mucous follicles, situated along the lower wall of 
 the urethra, or (in old offenders) by false passages. In 
 such cases the bougie is to be drawn back, and the penis 
 
GONORRHEAL ACCESSORY AFFECTIONS. 79 
 
 pulled forward for the purpose of removing the obstacle, 
 which sometimes interposes such difficulties that an 
 hour or so is frequently required to accomplish the ob- 
 ject. It is therefore necessary to observe, that great 
 care, caution, and patience be exercised, and that no 
 rash forcing of the instrument be resorted to, as serious 
 mischief would inevitably follow. The bougie may be 
 introduced once or twice a day, and may be gradually 
 increased in size, always taking care to insert the 
 smaller-sized one first, and allow it to remain a few 
 minutes, before employing the larger one. As to the 
 length of time it may be allowed to remain, that depends 
 upon the feelings of the patient, some bearing it much 
 better than others. The good effects of the bougie are 
 generally quickly manifested, the urging to urinate 
 being much lessened, and the stream increasing in size ; 
 at first the mucous discharge is increased, but as the 
 stricture dilates, it decreases, and finally entirely ceases ; 
 the patient now, with appropriate treatment and the use 
 of the instrument, rapidly progresses, the symptoms 
 yield one by one, and in general perfect recovery takes 
 place. 
 
 As the introduction of the bougie often causes great 
 faintness and trembling, a dose or two of the Tincture 
 of Aconite (1), five drops, in a wine-glass of water, at 
 ten minutes' interval, will generally speedily remove the 
 abnormal symptoms. 
 
 In severe disorganizations, however, the cure is not so 
 easily accomplished, and it is often requisite to leave the 
 instrument in the passage for many days or weeks, with- 
 drawing it every day to clean it, or to substitute one of 
 a larger size. Should there be a valvular stricture, the 
 
80 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 knife is necessaiy to remove it, although cauterization is 
 sometimes employed, which has the merit of obviating 
 the severe haemorrhage which often follows the use of 
 the bistoury, but not of preventing the contraction of 
 the cicatrix, which calls for the continual employment 
 of the bougie. 
 
 GONORRHCEAL OPHTHALMIA. — This extremely 
 severe disease requires the promptest attention, disor- 
 ganization and bursting of the eye not unfrequently 
 taking place within even twenty-four hours from its first 
 invasion. It therefore behoves patients troubled with gon- 
 orrhoea to take especial care that none of the discharge 
 be jerked into the eye through carelessness, and that 
 towels or sponges used for washing the penis be kept 
 entirely separate from everything else ; also that they 
 be either destroyed when done with* {always advisable 
 with sponges), or thoroughly cleansed with a strong solu- 
 tion of potash afterwards, before using. These precau- 
 tions cannot be too strictly attended to, as many inno- 
 cent persons have entirely lost their sight and been 
 disfigured for life, by the carelessness of patients troubled 
 with gonorrhoeal discharge. In fact, inflammation of 
 the eyes, occurring during this complaint, should be 
 always regarded as malignant, and treated accordingly. 
 
 There are three distinct stages in this complaint: The 
 first generally sets in with a violent burning itching, 
 especially at the edges of the eyelids and the corners of 
 the eyes, accompanied with a profuse flow of acrid tears, 
 and considerable intolerance of light ; the conjunctiva is 
 uniformly injected, and the upper lid is much swollen, 
 the tears becoming turbid towards the end of this stage : 
 
GONORRHEAL ACCESSORY AFFECTIONS. 81 
 
 there are also fever, dull heavy headache, coated tongue, 
 and violent thirst. The second stage now commences 
 by the conjunctiva becoming more swollen, the tears are 
 mixed with yellowish- white pus, which speedily increases 
 in quantity and thickness, gradually assuming a greenish 
 tint, and inflaming and corroding the cheeks in flowing 
 down. Sometimes the upper lid swells to the size of 
 a hen's egg, the lower lid being always less swollen. 
 The pains now become extremely acute and spread over 
 the whole head, the conjunctiva more and more injected, 
 forming a pad-shaped elevation round the cornea, cover- 
 ing its margin, and ultimately projecting beyond the lids 
 as a dark red mass (chymosis). The pus now pours 
 down profusely, and in a few hours the cornea assumes 
 a uniformly grayish or yellowish appearance. If these 
 alarming symptoms are not speedily checked, the cornea 
 ulcerates and in a few hours bursts, discharging the 
 whole contents of the eye, which speedily collapses, and 
 total and irrecoverable loss of vision, staphyloma, and 
 other unsightly disorganizations, are the result. The 
 pains now decrease, the discharge becomes less, more 
 fluid, and less corrosive, the fever entirely ceases, but 
 the disorganizations remain, and require a special treat- 
 ment (generally surgical), according to their nature. 
 
 Absolute rest, a darkened apartment, un stimulating 
 diet, are indispensable to a favorable recovery. 
 . Prophylactic Treatment. — No time should be lost, 
 after the gonorrhceal discharge has entered the eyelids, 
 in thoroughly syringing the eyes with warm water to 
 dilute and remove the pus. 
 
 In order, however, to prevent any ill effects arising, 
 the alternate administration of Aconite, and Sulphur, 
 
82 GONORRHEAL ACCESSORY AFFECTIONS. 
 
 five drops of the tincture in a wine-glassful of water 
 every hour, is especially recommended. 
 
 Treatment. — Aconite ; Sulphur. These two reme- 
 dies, taken alternately, will generally serve to arrest the 
 complaint if taken when the burning, irritation, and red- 
 ness first make their appearance. 
 
 Arsenicum is necessary when the redness of the eyes 
 is very considerable, the tears being very profuse and 
 acrid, with violent burning pains in the part. 
 
 Argenti nitras is generally the sheet-anchor in this 
 disease, and must be resorted to immediately if pus has 
 already formed ; the redness, intolerance of light, pains 
 in the head, and swelling of the eyelids, showing but too 
 clearly the malignant nature of the complaint. 
 
 In very severe cases, a lotion composed of one grain of 
 crystallized Nitrate of silver in one ounce of distilled 
 water, must be dropped into the eye -every hour. In 
 many cases the internal use of Tincture of Aconite (1) 
 in alternation will be very efficacious. 
 
 Mercurius corrosivus is very effectual when the disease 
 does not assume such a malignant form, but the redness, 
 burning, and discharge of pus are still very great, or 
 when symptoms of iritis (known by discoloration of the 
 iris, irregular shape of the pupil, which often rapidly 
 contracts and sometimes irrecoverably closes, the pres- 
 ence of a radiated ring of blood-vessels around the 
 cornea, and pain across the temples) make their ap- 
 pearance. 
 
[VENEREAL RHEUMATISM. 
 
 T^ HEUMATISM may arise in connection with gonor- 
 -LV rhcea, or with syphilis, or with both occurring toge- 
 ther. In cases of gonorrhoea, rheumatism may appear while 
 the discharge still continues ; when it has been apparently 
 but only partially and imperfectly cured, or when it has 
 been suppressed by injections. In persons predisposed 
 to rheumatism, it may make its appearance while the 
 discharge still continues. Or if, soon after being cured of 
 gonorrhoea, the patient goes in bathing while yet the 
 water is quite cool, the original discharge may return and 
 become more difficult of removal than before ; or an in- 
 veterate gonorrheal rheumatism may be established. In 
 cases of syphilis, the rheumatism seems to be developed 
 principally as a consequence of excessive mercurializa- 
 tion. 
 
 The joints most frequently affected in venereal rheuma- 
 tism, are those of the knee, the elbow, the wrist and the 
 ankle. The pains are very severe; worse on motion, and 
 usually much Avorse at night. In addition to the local 
 inflammation, some general fever will often be developed. 
 The irritable bladder, and incontinence of urine, which so 
 often appear in connection with gonorrhoea, may result 
 from this kind of rheumatism affecting the neck of the 
 bladder. 
 
 The several forms and complications of rheumatism 
 with venereal affections, may thus be summed up : 
 
 I. Rheumatism with present gonorrhoea. 
 
 II. Rheumatism in imperfectly cured gonorrhoea. 
 
84 VENEREAL RHEUMATISM. 
 
 III. Rheumatism in gonorrhoea suppressed by injec- 
 tions ; (either of these forms may be again complicated by 
 a mercurialized condition of the patient's system, whether 
 acquired formerly or more recently.) 
 
 IV. Rheumatism with Syphilis. 
 
 Y. Rheumatism with Syphilis and Gonorrhoea. — 
 These two latter forms will almost invariably be found 
 complicated by a strongly mercurialized condition of the 
 system ; while the gonorrhoea! discharge, suppressed by 
 injections, may still further increase the difficulty, if it 
 do not obscure the case. Each of these forms and com- 
 plications I have seen, and treated successfully with 
 Homoeopathic Medicines. 
 
 Aconite. Often indispensable in the early treatment 
 of venereal rheumatism ; especially when there are both 
 local inflammation and considerable general fever. 
 
 Rhus may be required when the rheumatism has been 
 induced by exposure to the wet, as in bathing. 
 
 Pulsatilla. Especially indicated where the discharge 
 has been suppressed by injections. Wandering rheu- 
 matic pains characterize this remedy in a remarkable 
 manner. Other indications may be found in its well- 
 known constitutional symptoms. 
 
 Kalmia latifolia may be called for when Pulsatilla is 
 indicated by the wandering pains, but fails on account 
 of not being able to overcome the mercurial influence 
 present in the system. 
 
 Kalmia has been used with much benefit in the cure 
 of syphilis ; the pains are most severe while moving, and 
 disappear while lying. Frequent pains here and there in 
 the limbs, continually changing from one place to another. 
 Pains go from the upper to lower parts. The rheumatic 
 
VEXEREAL RHEUMATISM. 85 
 
 pains are mostly in the upper arms and lower parts of 
 the legs ; and are worse on going to sleep. Suitable for 
 gonorrheal (and even syphilitic) rheumatism in mercu- 
 rialized patients. 
 
 Daphne indica. Articular rheumatism consequent upon 
 suppressed gonorrhoea. Pains worse at night. Violent, 
 crampy pains at night, (all night,) about the joints. 
 Pains in the bones. Darting pains, like shocks, in vari- 
 ous parts, frequently and suddenly wandering from one 
 part to another. Remarkably adapted to gonorrheeal 
 rheumatism occurring in mercurialized syphilitic persons. 
 
 Kali iod. Most important in venereal rheumatism, — 
 especially syphilitic, — where the patient has been mer- 
 curialized. In recently mercurialized cases it may re- 
 quire to be given in substantial or massive doses. 
 Rosenberg prescribed one grain in six ounces of water, 
 curing with this dose more rapidly than Lobethal with 
 doses ten times as large.* The wonderful complemen- 
 tary relation of Kali iod. to Mercury is such that, 
 while by itself it can never cure a case of pure syphilis, 
 it acts like a charm in those which have been modified 
 by mercurial treatment, curing them rapidly and 
 thoroughly. 
 
 Phytolacca decandra. One of the most powerful, 
 valuable, and least known of the indigenous plants of 
 America. Of all the vegetable antidotes of mercury this 
 is one of the most efficacious ; while it is both useful in 
 rheumatism and said to be specific against syphilis. 
 Hence it will be indicated in the rheumatic complica- 
 tions of mercurio-syphilitic affections. In syphilitic 
 rheumatism it may be considered almost a specific. 
 
 * Jahr's Venereal Diseases, p. 423. 
 
86 VENEREAL RHEUMATISM. 
 
 And the additional presence of a gonorrheal complication 
 in such cases — particularly if they have been previously 
 mercurialized — would by no means counterindicate this 
 remedy ; provided, always, that the other symptoms cor- 
 respond. Pains, neuralgic, (mostly on right side,) worse 
 at night, after midnight ; increased by motion and by 
 pressure ; rendered endurable only by energetic walking ; 
 coming on in the hip, tibia and fibula, from 1 to 5 A. m.* 
 
 Asafcetida must also be studied in this connection. 
 With the thirtieth of this remedy I once cured a case of 
 syphilitic rheumatism of the wrists and ankles of long 
 standing, which had been the rounds of some half a 
 dozen Allopathic physicians. The patient, who had 
 taken Mercury, Kali tod., and Ferri iod. in all forms 
 and in any quantity, was a barber, and his wrists were 
 so stiff and lame that he could scarcely work at his 
 trade. But in a few weeks a great improvement was 
 effected, (by the Asa/. 30 ,) which continued till he was 
 as well as could be expected. 
 
 Sarsaparilla should be carefully studied. 
 
 Thuja oc. combines all the elements of these compli- 
 cated forms of disease, and will often be found indis- 
 pensable, especially if condylomata or fig-warts appear.] 
 
 * Bost. Horn. Quarterly, I. p. 436, 1849. 
 
TRUE SYPHILIS. 
 
 CHANCRE. — We have now to treat of a disease less 
 painful than the preceding affection, but infinitely 
 more dangerous, on account of its tendency to progress 
 (unless arrested) to a fatal termination, in contradistinc- 
 tion to gonorrhoea, which often wears itself out without 
 any treatment. 
 
 The disease in question makes its appearance from 
 three to six days after infection, in the form of a small 
 red spot or vesicle, with inflammation of the part and 
 itching. The centre of the spot rises rapidly, becomes 
 whitish and transparent, a reddish and corrosive serum is 
 discharged, and an ulcer is formed, its malignant nature 
 being shown by its circular form. The ulceration ex- 
 tends both laterally and into the substance of the penis, 
 its margins become hard and cartilaginous, and the 
 inner surface assumes a grayish or lardaceous appear- 
 ance, which cannot be detached, the opening of the ul- 
 cer being narrower than at its base. In man, the glans 
 and prepuce are principally affected ; in women, the 
 labia, clitoris, and orifice of the vagina. Chancres are 
 distinguished according to their nature : — 1st, the super- 
 ficial chancre ; 2d, the indurated chancre ; and 3d, the 
 phagedenic, gangrenous, or sloughing chancre. 
 
 The superficial ulcer has its margins, which are con- 
 siderably elevated, sometimes spongy, but is not accom- 
 panied with induration. The edges are never jagged, 
 but always sharply circumscribed ; the sore looks clean, 
 of a flesh-red color ; the discharge is thin, copious, and 
 
88 TRUE SYPHILIS. 
 
 generally mixed with blood ; this form usually heals 
 quickly. 
 
 The indurated chancre has its edges more or less 
 jagged, elevated, slightly painful, with a copper-colored 
 circumference ; its base is indurated and lardaceous, the 
 ichor adhering very firmly, which washing will not re- 
 move. The discharge is of a light-yellow color, viscid, 
 and glutinous, occasionally acrid and offensive, staining 
 the linen ; this variety extends far more in depth than 
 breadth. 
 
 The phagedenic chancre develops itself principally in 
 scrofulous individuals ; there is little induration, but its 
 edges are thin, shaggy, or rolled up, of a brown or violet 
 color, the secretion thin and fetid. The ulcer is usually 
 covered with a gray layer of false membrane, beneath 
 which the destruction of the tissues proceeds alarm- 
 ingly, particularly when badly treated. It is very sub- 
 ject to dangerous haemorrhage, and, in severe cases, 
 becomes gangrenous. 
 
 The sloughing chancre commences as a black spot, 
 which extends, breaks, and discloses a corroded surface ; 
 the ulcer now presents a dark blue or livid crimson mar- 
 gin, is excessively painful, and if not quickly arrested, 
 particularly when occurring under unfavorable circum- 
 stances, sloughs rapidly, destroying the whole of the ex- 
 ternal sexual organs, and even the neighboring parts. 
 
 According to Rauff, chancres in the mouth are gen- 
 erally secondary, being more superficial, and wanting 
 the lardaceous appearance presented by those of the 
 pharynx and palate. Those of the nose are still less 
 frequent, and smaller than either of the others. 
 
 The chancre may pass from the acute to the chronic 
 
TRUE SYPHILIS. 89 
 
 form without ceasing to be primary, but when it loses 
 its syphilitic character, venereal spots make their ap- 
 pearance, with pimples on the forehead and chin, and 
 around the mouth. 
 
 \_Chancre is the name of the primary syphilitic ulcer; 
 that is, of the first form of syphilis itself ; of the existence 
 of which it usually affords the principal if not the only 
 decisive evidence. 
 
 I. Our author's distinction of Superficial and Indu- 
 rated Chancre is itself both superficial and misleading. 
 For every simple Hunterian chancre is first soft and 
 superficial ; and acquires its indurated character usually 
 in five or six days ; although in exceptional cases the 
 induration may be developed in the first twenty-four 
 hours. The characteristic of the regular, simple, Hun- 
 terian Chancre, whether soft or indurated, is its " funnel- 
 shaped, depressed form, with abruptly rising erected 
 edges ; and the fact that the induration invariably appears 
 after a short period." * Thus both the superficial and the 
 indurated chancre of Berjeau belong to the former class, 
 which Jahr, in common with other modern authors, de- 
 scribes as the regular, simple, Hunterian Chancre. 
 This generally locates itself on the fraenulum, corona 
 glandis, or on the glans itself ; and is the mildest form 
 of the terrible syphilitic disease. For this, Merc. sol. 
 is usually the sufficient remedy. 
 
 II. The Elevated Chancre forms Jahr's second class : 
 " When first breaking out, it looks like a small whitish 
 ulcer of the size of a small split pea to that of a dime. In 
 eight or ten days, or even sooner, the edges of the ulcer, 
 
 * Jahr, Yen. Dis. p. 95. 
 8* 
 
90 TKUE SYPHILIS. 
 
 together with its base, become raised, forming an elevated, 
 projecting, whitish gray ulcer, of a spongy appearance. 
 These ulcers generally are of an oval shape ; they secrete 
 a purulent serum, are not very, or even at all painful ; 
 neither the edges nor the base are indurated. 11 — Jahr. 
 "The regular, simple Hunterian Chancre" — continues 
 the same author — "usually forms a single isolated 
 ulcer ; while the Elevated Chancre very frequently con- 
 sists of several ulcers.' 7 
 
 In this elevated form of chancre, (which however can- 
 not be distinguished by the elevation alone from the 
 simple chancre in the first few days,) the principal 
 remedy, according to Jahr, is still Mercurius solubitis, of 
 which (as in a simple chancre) he recommends one half 
 a grain of the first centesimal trituration to be given 
 morning and evening* This remedy, he says, will 
 undoubtedly prove most specifically curative as long as 
 the chancre still presents its ash-colored, lardy appear- 
 ance, and will even surpass in curative power any other 
 agent, in cases where the elevated ulcer has passed into 
 the Hunterian form of chancre. 
 
 Where the lardaceous period has been neglected, 
 and new condylomatous growths appear, Cinnabar may 
 be indicated ; or rather Nitric acid, which Jahr pro- 
 
 *"I use Mercury in all Chancreous Ulcerations. If resembling the 
 simple or Hunterian chancre, I employ Merc. sol. ; in the phagedenic 
 form I prefer Merc, corros., until an improvement sets in, after 
 which I continue the treatment with Merc. sol. Regarding the dose : 
 I never give, in urgent cases, lower than the second trituration 
 of Mercury, in one-half -grain doses, morning and night, giving 
 only one dose every morning on the third or fourth day, and 
 after this period, one dose every other day." — Jahr, Ven. Dis. 
 p. 247. 
 
TRUE SYPHILIS. 91 
 
 nounces superior to Cinnabar in all such cases. But if 
 Merc. sol. is not sufficient in recent cases of elevated 
 chancre, Cinnabar is preferable to Nit. acid. 
 
 If the Elevated Chancre, instead of changing into the 
 milder form of regular, or Hunterian Chancre, assume 
 a phagedenic appearance, Merc, corros. sublimate will be 
 required, as advised in this third Variety of Chancres, viz: 
 
 III. The Phagedenic Chancre. — This is the most 
 malignant and rapidly destructive form of syphilis; 
 the chancre assuming this form, either from the primary 
 intensity of the virus, or from the depraved condition of 
 the system which it attacks, or from both these circum- 
 stances combined. This ulcer, says Jahr, like the ele- 
 vated chancre, has no induration. If the edges or base 
 appear swollen, such swelling is nothing less than a 
 malignant oedema (like most malignant erysipelas). The 
 phagedenic chancre penetrates less into the subjacent 
 tissues than it spreads in circumference. It may pre- 
 serve its round shape ; but in the most cases it spreads 
 about irregularly, assuming a Serpiginous character.* 
 Usually the progress of the phagedenic chancre is 
 marked by putrid disorganization ; but sometimes it be- 
 comes converted into a gangrenous sore. In either case, 
 this form of syphilis is rapidly destructive and dan- 
 gerous. 
 
 This form of syphilis nearly always grows worse under 
 the usual preparations of mercury ; with the exception 
 of the Corrosive sublimate. This, says Jahr, " has never 
 left me in the lurch, although I never give it in larger 
 doses than one half of a grain of the first centesimal 
 trituration, morning and evening. This agent very 
 *Jahr, Venereal Dis. p. 90. 
 
92 TRUE SYPHILIS. 
 
 speedily arrests the ulcerative progress, but should not 
 be repeated too often after symptoms of improvement 
 have begun to set in, lest cicatrization should take place 
 too rapidly and only superficially." When given in solu- 
 tion, this powerful drug acts still more promptly upon 
 the organism. SwainVs Panacea, which is claimed to 
 have caused some wonderful cures, — and which is known 
 to have caused some most f rightful deformities from such 
 phagedenic ulceration, — is principally composed of this 
 active poison. 
 
 " So long as the original spot upon which the chancre 
 has been developed, exhibits a reddish, morbid-looking, 
 red or bluish scar, we may be sure that the internal dis- 
 ease is not completely cured ; whereas, if the chancre has 
 been removed by the internal remedy, the original spot 
 of the chancre can no longer be traced on account of 
 that spot being covered by as healthy colored a skin as 
 the rest of the body." — Hahnemann.^ 
 
 Treatment. — It cannot be too strongly impressed 
 upon the reader, that the practice so frequently adopted 
 of destroying the chancre by lunar caustic is one of 
 the most fatal practices of the present day. It does not 
 by any means follow, that, because we have suppressed 
 the outward manifestation of the disease, we have there- 
 by vanquished it. On the contrary, we have destroyed 
 our most valuable guide, and we cannot possibly tell 
 whether or when the patient is rid of his complaint. 
 When we find the chancre yielding to the internal use 
 of medicines, properly selected, we can be certain that 
 the patient is in a fair way of recovery ; but when 
 caustic or various repellents are employed, the disease 
 
TRUE SYPHILIS. 93 
 
 becomes more intractable and complicated, secondary 
 symptoms arise, or the patient is carried off by con- 
 sumption, or suffers for the remainder of his life from 
 some other chronic complaint, it being no uncommon 
 thing to find persons attributing, and with good reason, 
 all the miseries of ill-health they have undergone, to 
 syphilis badly treated in bygone days. The proper 
 remedy must be selected with reference to the form, ex- 
 tent, and duration of the ulceration, the constitutional 
 and moral disposition being taken into consideration. 
 
 The greatest cleanliness is of course necessary ; a 
 small piece of wet lint may be introduced between the 
 glans and prepuce, when the ulcerations are not ex- 
 tremely painful : otherwise, water should be injected 
 under the folds of the prepuce, by means of a small 
 syringe. Absolute rest is to be enjoined, if possible, 
 (and always if the sore assumes a phagedenic type ;) 
 neglect of this rule prolonging the disease, in spite of 
 the best conducted treatment. 
 
 Diet. — Young plethoric persons should practise ab- 
 stemiousness in this complaint, but debilitated persons 
 should use a generous diet, provided inflammatory symp- 
 toms are not present, wine being allowed in cases of 
 great depression and prostration of strength. Rice or 
 barley-water, and cocoa, or weak black tea if accus- 
 tomed to it, are the best beverages. 
 
 Treatment. — "When Mercury has not been pre- 
 viously employed, we prescribe it for all sores which 
 present an indurated base and margin, whether they 
 secrete and are covered with a tenacious, or a thin, 
 offensive matter; and we should certainly most unwill- 
 ingly dispense with this valuable remedy in such cases, 
 
94 TKUE SYPHILIS. 
 
 notwithstanding the bad repute it has acquired, from 
 the frightful effects which have so frequently arisen from 
 its abuse in the hands of our allopathic brethren."* 
 
 The more particular indications are : spreading and 
 deeply penetrating ulcers on the glans and prepuce, or 
 pale-red vesicles breaking into small ulcers on these 
 parts ; the chancres bleed readily, are very painful, and 
 secrete a yellowish-white fetid pus; ulcers with inverted 
 red edges and a cheesy bottom, or circular ulcers with 
 inflamed base, accompanied, in females, with swelling of 
 the vagina. 
 
 Merc, corros. is very useful in chancres with the 
 ichor firmly adhering to the bottom of the ulcer, and 
 secretion of thin pus, leaving stains on the linen as from 
 melted tallow. 
 
 Cinnabaris. We have found this medicine remarkably 
 useful when no benefit has accrued from Mercurius, 
 although apparently well indicated ; it is in scrofulous 
 cases where it best displays its remedial powers. 
 
 Acid nitric. This remedy, which ranks equally with 
 Mercurius in this complaint, is to be employed against 
 the chancre with raised edges, with a tendency to bleed 
 easily and profusely, and where no signs of central 
 granulation are present, or, if they are, instead of a firm 
 and florid appearance, pale, flabby, and prominent, the dis- 
 charge being generally thin. This remedy is very useful 
 in those cases maltreated with mercurial preparations. 
 
 Aconite is necessary (as an intercurrent remedy) when 
 there is violent inflammation of the penis, following the 
 exhibition of Mercury. When this occurs with chancres 
 on the glans, it will be advisable not to retract the pre- 
 puce, but effect the cure of the ulcer without exposing it. 
 
 * Laurie's "Elements of the Practice of Physic," p. 482. 
 
TRUE SYPHILIS. 95 
 
 Arsenicum is very appropriate in cases which, under 
 the administration of Mercury, are filled up with florid 
 but too elevated granulations, the margins of the ulcer 
 remaining hard and bleeding at the slightest touch, the 
 discharge being very thin and offensive. It cannot be 
 dispensed with in the phagedenic variety where the 
 ulcer presents livid elevations, which are jagged, sharp, 
 and undermined, with intense burning pains, gangrene 
 being imminent ; and is the principal remedy when the 
 latter complication is established, characterized by ces- 
 sation of the pain, livid or mottled appearance of the 
 sore, and the formation of a black slough, which sooner 
 or later separates, leaving either a healthy sore, or one 
 which plainly indicates that the ulceration is still ex- 
 tending. 
 
 Silicea is required in many of these cases when the 
 discharge is excessive, foul smelling, discolored, and 
 bloody and thin, or the sore is inflamed and irritable, 
 with unhealthy granulation. 
 
 Argent, nit. is efficacious for little ulcers on the pre- 
 puce, the margins of which are at first covered with pus, 
 spreading gradually, and covered with a tallowy lar- 
 daceous substance. 
 
 Causticum is very good for chancres secreting an acrid 
 corrosive pus, or a watery, greenish fluid, with complica- 
 tion with cutaneous affections, gout, or scurvy. 
 
 Sulphur, as an intermediate remedy, is extremely use- 
 ful for chancres occurring in unhealthy individuals, 
 where the disease threatens to assume a bad type, and 
 particularly where the bottom of the ulcer is covered 
 with the characteristic lardaceous secretion, with dis- 
 charge of fetid ichor; but it is especially in the super- 
 
96 
 
 TKUE SYPHILIS. 
 
 ficial ulcer, with raised margins, that its greatest results 
 are manifest. 
 
 Thuja. This medicine is required in flat, itching 
 ulcers, with unclean bottoms, or whitish chancres, with 
 hard edges. In complications with gonorrhoea, Thuja 
 is extremely useful. 
 
 CHANCRE.— SYMPTOMATIC INDICATIONS. 
 
 Acrid corrosive pus 
 
 Bleeding readily, with ichorous secretion 
 
 Burning pains in the chancres . 
 Deep ulcers on the penis 
 Edges resembling raw flesh 
 Flat ulcer with red edges 
 Florid chancres, with raised edges 
 Gangrene of the penis . 
 Gangrenous ulcers with bloody edges . 
 Ichor adhering to the bottom of the ulcer 
 Ichorous pus from chancres 
 Inflamed circular ulcers 
 Lardaceous ulcers, with white places in 
 centre . 
 edges, with fetid secretion 
 Little ulcers, which spread gradually . 
 Painless ulcer, with hard edges 
 Red chancres on the prepuce . 
 Secretion of copious watery fetid ichor 
 Small chancres with clean bottoms 
 Superficial ulcers and excoriations 
 Torpid ulcers in cachectic individuals . 
 Vesicles, pale-red 
 
 smarting, on the labia 
 
 . Arsen., Caust. 
 . Ars., Carb. v., He- 
 par s., Merc. 
 . Ars., Calc. 
 . Mercurius. 
 . Mercurius. 
 . Thuja. 
 . Iodium. 
 
 . Arsen., Lachesis. 
 . Arsenicum. 
 _. Merc, corros. 
 . Aurum. 
 . Mercurius. 
 the 
 
 . Arsenicum. 
 
 . Hepar sulph. 
 
 . Argent, nit. 
 
 . Arsenicum. 
 
 . Merc, Thuja. 
 
 . Arsenicum. 
 
 . Mercurius. 
 
 . Sulphur. 
 
 . Sulphur. 
 
 . Mercurius, Thuja. 
 
 . Staphysagria. 
 
 BUBO. — Syphilitic buboes are classed as primary, 
 secondary, or constitutional. The first appear commonly 
 from the third to the sixth day of the infection, without 
 premonitory symptoms ; secondary buboes arise from 
 gonorrhoea, or as sequelae to syphilitic chancre; whilst 
 
TRUE SYPHILIS. 97 
 
 constitutional buboes have for their origin an old infec- 
 tion, overlooked during its development, and which has 
 now become a constitutional disease. They are red, 
 hard, and rather indolent tumors, situated in a conglo- 
 bate gland, are very diffuse, suppurating with difficulty, 
 the pus being discharged through an opening with a 
 callous edge. Syphilitic buboes affect principally the 
 glands of the groin, and of the arm-pit, (axilla,) and 
 are produced from the absorption by the lymphatics of 
 the contagious virus of the chancre. Sometimes several 
 weeks elapse after the chancre has healed, and recovery 
 has taken place, when the (secondary) bubo begins to 
 develop itself. When the chancre is situated at the 
 orifice of the urethra, or on- the frasnum, bubo in the 
 groin is generally certain to follow ; should these two 
 co-exist, constitutional syphilis is usually developed. It 
 also happens that primary ulcers about the head and 
 face are liable to give rise to these troublesome swell- 
 ings, within a short distance of the affected parts. 
 Primary bubo presents itself under three varieties, cor- 
 responding pretty well to those of the chancre, viz., 
 acute, indolent, and phagedenic. The first, which is 
 inflammatory, terminates in suppuration ; the second, 
 characterized by induration, does not readily gather, 
 but runs a tedious course ; the last becomes a phage- 
 denic, gangrenous ulcer, and is the most dangerous form 
 of the disease. 
 
 The symptoms of the acute bubo are the following: 
 Violent inflammation of the gland, which becomes im- 
 movable, attended with pain, and rapidly increasing 
 swelling of the parts ; the cellular tissue around it be- 
 comes infiltrated and indurated with the inflammatory 
 
98 TRUE SYPHILIS. 
 
 exudation, the skin on the tumor is hot, shining, very 
 sensitive, and a slight redness develops itself in the 
 middle. When the suppurative process sets in, the ac- 
 cumulated pus gives rise to a soft, oval swelling round 
 the gland, which remains hard, and is not invaded by 
 the suppuration till a late period. Febrile symptoms, 
 and sometimes oedema (puffy swelling) of the abdomen 
 and the internal surface of the thighs, accompany this 
 affection. Rigors are present during the process, and, 
 when completed, the fever abates, the pain grows less, 
 and the motion of the limbs becomes more easy. 
 
 The indolent bubo appears after primary, indurated, or 
 constitutional chancre, and only when these are healed. 
 It progresses very slowly, is scarcely painful, and the 
 skin, unaltered in color or temperature, can be moved 
 over the hard tumor. Much larger than the acute kind, 
 these buboes remain unaltered for months, when the 
 skin at length becomes hot, and suppuration commences 
 in a portion only of the tumor. The pus is thin and 
 flocculent, the skin changing from a bright-red to a 
 bluish-red color ; fistulse often make their appearance in 
 various directions, through which pus pours in consider- 
 able quantities. 
 
 The phagedenic bubo commences with violent erysipe- 
 latous inflammation of the skin, spreading rapidly, and 
 accompanied by violent pains in the tumor, with acute 
 fever, intense thirst, and sleeplessness. The skin over 
 the part rapidly assumes a livid or dirty brownish-yellow 
 hue, and gangrene quickly supervenes, attended with 
 great anxiety and prostration. 
 
 [The exercise of walking tends in a remarkable man- 
 
TRUE SYPHILIS. 99 
 
 ner to develop buboes in syphilitic patients; as it does 
 to aggravate the discharge, and disposition to orchitis 
 in those suffering with gonorrhoea. Such exercise, there- 
 fore, should be strictly forbidden in either case. 
 
 Jahr recommends Merc, rub., prsec. the red oxide of 
 Mercury, in these cases, unless the patient has already 
 taken a good deal of Mercury allopathically. Or, if the 
 Prsec, rub. does not answer, he gives Cinnabar. (If 
 the patient had been mercurialized already, he uses Au- 
 rumj Nitric acid, or Hepar s.) If the first-mentioned 
 remedies do not disperse the tumor, and the chancre 
 does not demand immediate special treatment, he uses 
 Carbo animalis for the bubo with the happiest result. 
 If the chancre is in a fungous condition, Nitric acid 
 will be preferable. If fluctuation has already set in, he 
 begins the treatment with Carbo animalis; to be fol- 
 lowed, if necessary, with Nitric acid. 
 
 For gangrened buboes, Arsenicum may be used ; for 
 old indurated buboes, which remain as a clean ulcer 
 (scrofulous) after the extinction of syphilitic symptoms, 
 Silicea, Sulphur, or Hepar s. 
 
 Dr. Hempel * recommends the Deut-iodide or Bin- 
 iodide of Mercury (the red iodide) very highly, in the 
 first or second decimal trituration, as " a very efficacious 
 remedy for chancre and bubo." But the practitioner 
 who has not been in the habit of using the red iodide 
 of mercury should remember that it is a very active 
 poison, which, if not so corrosive as the sublimate, may 
 be no less dangerous. A patient may easily be fatally 
 poisoned with half-grain doses of the first decimal tritu- 
 ration of the Deut-iodide of Merc. The first decimal 
 * Jahrs Venereal Diseases, p. 136. 
 
100 TRUE SYPHILIS. 
 
 (or second decimal) trituration will be found powerful 
 enough, and will produce far more satisfactory results, 
 in most cases, than the first decimal possibly can. 
 
 The Iodide of potassium will also be found useful 
 (in addition to the cases in which Berjeau recommends 
 it) in persons who have been salivated, or otherwise 
 severely mercurialized ; but it seems entirely unneces- 
 sary to give it in the enormous doses (thirty grains in 
 eight ounces of water, to which half an ounce of tinc- 
 ture of iodine is added, and a desert-spoonful three times 
 a day) advised by Dr. HempeJ. 
 
 In some cases, buboes constitute a vicarious manifes- 
 tation of the syphilitic disease in place of chancre. 
 They need therefore to be carefully treated with the 
 appropriate anti-syphilitic (or it may be the anti-mer- 
 curial) remedy ; and to be radically cured by internal 
 medication, in order that the patient may not presently 
 find his last state (of secondary syphilis) worse than 
 the first.] 
 
 Mercurius corrosivus, Cinnabaris, Mercurius iodidum. 
 
 These are the most prominent remedies for this compli- 
 cation ; the first being principally required for acute bubo, 
 the two latter being more efficacious in the indolent vari- 
 ety. The principal indications are, inflammatory swelling, 
 redness and painful sensitiveness of the inguinal glands, 
 with suppuration, or ulceration, quickly taking place. 
 
 Acid nitric, may be employed when Mercurius has 
 failed to check the disorder, and particularly when the 
 character of the chancre points to this remedy. 
 
 Kali iodidum. This is required for scrofulous pa- 
 tients, when neither of the former medicines seem to 
 
TRUE SYPHILIS. 101 
 
 relieve. It is indicated by the swelling being very hard, 
 indolent , and suppurating with difficulty, the discharge 
 being curdy, and often discolored and foul -smelling. It 
 is also very useful when there is thickening of the 
 spermatic cord, occurring in complicated cases. 
 
 Apis mell. is invaluable when the glands are violently 
 inflamed, with red, hot, and shining swelling, accom- 
 panied with great pain and sensibility; this medicine 
 very frequently is sufficient to check the bubo imme- 
 diately, although powerless against the syphilitic virus 
 itself; this, however, is not to be wondered at, as the 
 bubo arises from irritation, caused by the absorption of 
 the virus. 
 
 Graphite is requisite in debilitated individuals, par- 
 ticularly females, when the swelling is painful and very 
 sensitive. 
 
 Hepar sulph.; Silicea. In suppuration of the gland, 
 these two remedies will materially forward the process, 
 and prevent the unsightly scars usually left at the ter- 
 mination of the process. 
 
 Thuja. Should the complaint be complicated with 
 excrescences of the penis, or round the anus, the glands 
 being painful, with drawing pains extending to the knee, 
 this medicine will exercise a satisfactory influence. 
 
 Arsenicum is indispensable in the phagedenic and gan- 
 grenous form of the disease, attended with similar symp- 
 toms to those of gangrenous chancre. ( Vide page 95.) 
 
 Lachesis, Carbo veg., are frequently required, either 
 singly or in alternation with Arsenicum, particularly 
 when the prostration is excessive, the parts extremely 
 livid or mottled ; or, in the case of the latter medicine, 
 when comatose symptoms supervene. 
 9* 
 
CONSTITUTIONAL SYPHILIS. 
 
 ERYTHEMA. — This complaint, attended with ero- 
 sions of the mucous membrane, affects principally 
 the interior of the mouth and fauces, constituting iso- 
 lated, circumscribed, dark-red or copper-colored, slightly 
 elevated, inflamed spots, especially on the back of the 
 palate, tonsils, uvula, pharynx, and larynx. The mouth 
 and fauces become hot, and the patient feels a difficulty 
 of swallowing, with burning sensation in the fauces, 
 hoarseness, and pain when talking, the mouth and throat 
 feel very dry, and the whole interior of the mouth is of 
 a bluish-red. In the centre of the intensely red spots 
 are insulated erosions, forming smaller spots, of a gray- 
 ish-white color. The mucous membrane of the nasal 
 cavity and the sexual organs are simultaneously affected 
 in the same way ; and small tubercles arise upon a 
 bright copper-colored base. These tubercles become 
 eroded, and secrete a grayish, purulent, fetid fluid. In 
 both sexes these erosions give rise to the formation of 
 excrescences (condylomata.) 
 
 Treatment. — Aurum is very useful in ill-looking 
 ulcerations of the mouth and nose, secreting fetid pus, 
 or for scabs in the nose, provoking an inclination to pick 
 it, as well as for swelling of the labia (in women), which 
 are covered with large red pimples. This remedy is one 
 of the most valuable when the disease is complicated 
 with mercurial symptoms. 
 
 Arsenicum is requisite when the discharge is very 
 offensive and corrosive, the ulcers liable to gangrenous 
 degeneration. 
 
 102 
 
CONSTITUTIONAL SYPHILIS. 103 
 
 Kali iodidum. For scrofulous subjects, with tendency 
 to ulceration, and also with discharge of corrosive burn- 
 ing serum, and lancinating pains in the throat. This 
 medicine is often required to combat mercurial symp- 
 toms, arising from ill-judged and excessive doses of that 
 metal in this complaint. 
 
 JVIercurius. Small and itching spots, which ulcerate 
 and become encrusted, bleeding easily, and secreting 
 purulent and fetid matter. 
 
 Acid nitric. Small, round ulcerations, bleeding easily, 
 and attended with lancinations as if from splinters. 
 
 Sulphur. In unhealthy patients, this remedy is very 
 efficacious in completing the cure, after the employment 
 of one of the before-mentioned medicines. 
 
 TUBERCLES. — Syphilitic tubercles are divided into 
 three classes, viz., cutaneous, mucous, and deep-seated. 
 
 The cutaneous or flat kind are either single, or form- 
 ing circular lines, and sometimes in groups or clusters ; 
 they frequently accompany mucous tubercles, and are 
 found principally on the scrotum, penis, mons veneris, the 
 perinaeum, and round the anus, the inside of the thighs, 
 and in the groin, the nape of the neck, the arm-pits, the 
 hairy scalp, in the face, round the mouth, in the nostrils, 
 on the forehead, between the toes, and along the nails, 
 but seldom appear in more than two or three of these 
 places at once, and the discharge from them is supposed 
 to be contagious. They are of a bright-red copper-color, 
 and almost always painless, and either assume a scaly 
 form, or ulceration takes place, and they become covered 
 with a hard crust, which, when detached, leaves a deep 
 cicatrix. 
 
104 CONSTITUTIONAL SYPHILIS. 
 
 Mucous tubercles occur most frequently in women and 
 children, developing themselves on the mucous mem- 
 brane of the female sexual parts, and in the mouth and 
 fauces. They form flat, circumscribed elevations of the 
 mucous membrane, which is engorged and thickened, 
 secreting a tenacious, purulent fluid of a peculiar and 
 extremely offensive odor. Sometimes several of them 
 unite, forming irregularly shaped elevations ; the small 
 ones, of the size of a millet-seed, are generally very hu- 
 mid, regularly rounded, forming truncated cones, being 
 of a brighter red color in the centre than at the. circum- 
 ference, and frequently forming regularly shaped rings, 
 especially on the glans, the inner surface of the cheeks 
 and lips, and the tongue and roof of the mouth. The 
 large mucous tubercles are raised about a line above the 
 mucous membrane, forming oval, full^ tense, flattened 
 elevations of a bright-red color, covered with a thick 
 grajnsh-white layer of epithelium. When these tuber- 
 cles form on the lining membrane of the nose, their 
 effects are most destructive ; the intense irritation and 
 itching causing the patient to believe he has caught 
 cold, and consequently there is blowing of the nose, and 
 perhaps scratching of the parts, which causes ulceration, 
 liable, if not speedily stopped, to attack and destroy the 
 whole surrounding parts, and even to endanger life by 
 the implication of the bones, no portion of which can 
 be reproduced, if once destroyed, causing the most 
 frightful mutilations of the face. In these cases the 
 mischief is aggravated by the acrid, corrosive, greenish, 
 or bloody pus that is secreted from the diseased surface. 
 Deep-seated tubercles and ulcerations of the mucous 
 membrane are always preceded by a tuberculous thick- 
 
CONSTITUTIONAL SYPHILIS. 105 
 
 erring of the mucous membrane and adjacent cellular 
 tissue. The ulcers penetrate frequently to a consider- 
 able depth, and are either isolated or in groups, with 
 their bottoms covered with granulations, and, like the 
 margins, covered with a grayish-yellow, creamy exuda- 
 tion. Their usual seats are the neighborhood of the 
 glans and fraenurn, and the entrance to the vagina and 
 uterus. If neglected, they may perforate the whole 
 thickness of the vagina, and cause recto-vaginal or ure- 
 throvaginal fistulas ; when they occur on the gums, ton- 
 sils, palate, or back of the fauces, at the glottis, or in 
 the larynx, they may frequently terminate fatally. 
 
 Treatment. — These tubercles will generally yield to 
 either Acid nitric, or Mercurius, although a few doses 
 of Aconite will be frequently required if febrile symp- 
 toms exist. 
 
 For mucous tubercles, the remedies most frequently re- 
 quired will be, Argenti nit., Calc, Nitric acid, Puls., 
 Thuja. 
 
 When affecting principally the nose, Acid nit., Acid 
 phosph., Argenti nit., Aurum, Calc, Kali carb., 
 Kreasotum, Lycop., Merc corros., Puls., Rhus, 
 Sepia, Staphysagria, and Thuja. 
 
 For deep-seated tubercles, Arsen., Carbo veg., ISTatr. 
 mur., Zinc 
 
 These remedies should be collated with the Charac- 
 teristic Effects, at the end of this work, and the preced- 
 ing observations on Chancre, &c. 
 
 EPHELIDES, MACUUE, Spots. — Ephelides are ex- 
 tremely common, and appear very early, are generally 
 
106 CONSTITUTIONAL SYPHILIS. 
 
 of a bright-red color, but occasionally are pale, coming 
 out only in the cold, on the chest, neck, face, arms, inner 
 side of the thighs, and the neighborhood of the genital 
 organs ; they resemble measles and roseola, but are dis- 
 tinguished from these by their persistence, measles dis- 
 appearing after some days ; they develop themselves 
 slowly, and grow larger at certain periods, e. g., after 
 eating. If not cured before the ninth month from the 
 time of their appearance, they assume the tuberculous, 
 or scaly form. 
 
 Treatment. — The principal remedies are, Antimon. 
 crud., Antim. tart., Canth., Merc. ; or Aurum, Bell., 
 Calc, Clemat., Lycop., Mezer., Petrol., Phosph. 
 Vide the Characteristic Effects, at the end of this 
 work. 
 
 SQUAMvt, Scaly Eruptions. — These ^rise either from 
 tubercles or spots, which change into large, irregularly 
 shaped, confluent elevations, of a bright copper color, 
 covered with hard, readily tearing scales of a dull white 
 color ; this affection usually is found in the hollow of 
 the hand (psoriasis palmaris) and the soles of the feet 
 (psoriasis plantaris) ; ulcers are very liable to arise from 
 this form of syphilis. 
 
 Treatment. — The most appropriate remedies are, 
 Acid nitric, Arsenicum, Hepar sulph., Kali iod., 
 Mercurius. The indications for which will be found 
 in the Characteristic Effects. 
 
 RUPIA. — Is frequently a sequel to pemphigus, (an 
 affection similar to that produced by the action of a 
 
CONSTITUTIONAL SYPHILIS. 107 
 
 blister on the skin,) or to ecthyma, (a pustular erup- 
 tion ;) although liable to break out, without any pre- 
 monitory symptoms. In the former case it arises from 
 not very tense blisters of a regularly round shape, about 
 the size of a bean, and surrounded by a copper-colored 
 areola ; they stand upon a swollen indurated basis, and 
 contain a dark-yellow purulent fluid, which generally 
 changes to a brownish color ; the pus dries up in the 
 middle of the blister, and forms a small brown crust, 
 around which the skin again arises in blisters, filled with 
 a peculiar brownish-red, purulent fluid ; the crusts grad- 
 ually acquire a conical or pyramidal shape, sometimes 
 increasing to an extraordinary size. They are never 
 very numerous, and are limited from twelve to twenty, 
 scattered over the whole body. The course of this affec- 
 tion is very tedious, and unless checked, the secretion of 
 pus is very great, the digestive functions become im- 
 paired, the strength is gradually undermined, and col- 
 liquative diarrhoea announces the impending dissolution 
 of the sufferer. Serpiginous and perforating tuber- 
 cles are related to this form of syphilides ; the former 
 are large and hard, assuming a tolerable roundness ; the 
 latter exist only in small numbers, forming spheroidal 
 rings on the skin, and penetrating to the subcutaneous 
 cellular tissue, where they can be felt with the finger, 
 as hard tumors. When these ulcerate, destruction of 
 the skin is no unfrequent occurrence. They are gener- 
 ally found in scrofulous patients with a delicate white 
 skin, and appear on the face, the cheeks, round the nose 
 and lips, in front of the ear, and on the legs. Serpigi- 
 nous tubercles occur most frequently on the face, the 
 nape of the neck, the head, forehead, shoulders, and 
 
108 CONSTITUTIONAL SYPHILIS. 
 
 trunk. At first they have a bright, shining, copper- 
 colored appearance, although never scaly ; but after- 
 wards they become inflamed, ulcerating at their points, 
 and afterwards covered with a thick, hard, conical, 
 brownish or yellowish-gray, firmly adhering crust. 
 
 Mercurius. Violent itching, renewed by the heat of 
 the bed ; small and very itchy pimples, which ulcerate 
 and become encrusted ; desquamation of the skin ; tet- 
 tery, excoriated, and oozing spots which bleed easily 
 when scratched. 
 
 Acid, nitricum. Copper or violet-colored spots on 
 the body ; lancinations in the parts, with burning pain, 
 and bleeding readily ; sanious, sanguineous, or corrosive 
 suppuration. 
 
 Clematis. Fungous excrescences ; scabby tetters, which 
 discharge a sanious pus, yellow and corrosive ; burning 
 or tingling, and pulsations in the parfs ; insupportable 
 itching of the parts in the heat of the bed. 
 
 Sarsaparilla. When Mercury, in large doses, has been 
 fruitlessly employed, this remedy will remove purulent 
 vesicles, not numerous, but itching intolerably, the irri- 
 tation causing depression of spirits. 
 
 Sulphur. Scabious eruptions, with burning itching, 
 surrounded by a yellow or brownish areola ; secretion of 
 a sanious, fetid, or thick and yellow pus ; spots covered 
 with small vesicles, discharging serous lymph. 
 
 Thuja. Brown or red mottled spots, with itching 
 shootings in the evening ; purulent pimples, containing 
 fluid j ike varnish. 
 
 ALOPECIA. — General or partial falling off of the 
 hair, with furfuraceous desquamations, especially on the 
 
CONSTITUTIONAL SYPHILIS. 109 
 
 head, spreading and coalescing. It arises gradually, the 
 hair coming off when combed, or when pulled, exposing 
 spots of a white or reddish shining hue ; finally, the 
 whole cutaneous covering is involved, and every vestige 
 of hair disappears, the skin being covered with thin, 
 whitish or bright-yellow scales, which form anew if re- 
 moved. Alopecia is, nevertheless, more a symptom than 
 a disease in itself, and may arise during the course of 
 many other complaints ; consequently, the history of 
 the patient's case must be well considered, and meas- 
 ures adopted for the eradication of the syphilitic dis- 
 ease, before this affection can be possibly relieved, the 
 cure of the one being generally followed by the removal 
 of the other. 
 
 Treatment. — Mercurius, Hepar, and Carbo veg. 
 are the principal remedies to be trusted in the syphilitic 
 form of the complaint, but other remedies may be re- 
 quired, regard being had to the other S3 7 mptoms which 
 always accompany it. ( Vide Characteristic Effects 
 of the medicines.) 
 
 IRITIS SYPHILITICA, Inflammation of the Iris. — 
 
 This disease, which seldom affects but one eye, is distin- 
 guished from the ordinary inflammation of this part by 
 the presence of tubercles on the anterior surface of the 
 iris. Iritis may be generally know^n in its first stage 
 by the presence of a circular ring of injected blood-ves- 
 sels round the cornea, with distortion of the pupil (gen- 
 erally), which gradually contracts, and, if not speedily 
 arrested, terminates in total and incurable closure. The 
 iris becomes discolored, the cornea dim and hazy, noc- 
 turnal pains are felt in the head, and the intolerance of 
 10 
 
110 CONSTITUTIONAL SYPHILIS. 
 
 light is great ; as the complaint progresses, the sclerotic 
 (white part of the eye) becomes of a rosy color, the 
 vessels being greatly enlarged and injected ; there are 
 dull, pressive pains in the eye, with profuse secretion 
 of tears ; the sight is also obscured and misty, the iris 
 becomes more and more discolored, and is generally of 
 a dirty-red hue, and exudation takes place upon its sur- 
 face, in proportion to the severity of the complaint ; its 
 free margin is swollen and thickened, and in very severe 
 cases becomes attached to the anterior surface of the 
 crystalline lens, (synechia posterior,) which, instead 
 of presenting a black appearance, is of a grayish color ; 
 the pupil becomes sensitive to light, immovable, con- 
 tracted, and distorted, whilst pedunculated excrescences, 
 termed condylomata of the iris, grow from its inner 
 circumference. The pains in the head and eye, of a 
 constrictive boring nature, extending to the surrounding 
 parts, becoming worse towards evening, coupled with 
 the malaise produced by the general disease, deprive 
 the patient almost entirely of rest. Towards the termi- 
 nation of the complaint, pus, or pus mixed with blood, is 
 often found in the anterior chamber of the eye, and can 
 be observed when the cornea is not too dim. 
 
 Treatment. — This disease, if not properly treated, is 
 very apt to produce serious disorganization of the struc- 
 ture of the eye, with complete closure of the pupil, 
 almost irremediable, if it has existed only a short time ; 
 whilst adhesions to the cornea or capsule of the lens are 
 utterly incurable, if not speedily relieved, and cause 
 more or less disfigurement of the eye. It is very essen- 
 tial to determine whether the patient has been previously 
 under a course of mercurial preparations, as these, inju- 
 
CONSTITUTIONAL SYPHILIS. Ill 
 
 diciously given, have a tendency to excite the complaint 
 in persons subject to weak eyes. In these cases, the an- 
 tidotes to Mercury are to be used, as directed below. 
 Rest and confinement to a dark room, with total absti- 
 nence from any work that might strain the eye, are 
 absolutely necessary. 
 
 Treatment. — Mercurius corros. and Cinnabaris 
 are the two principal remedies, the Latter being used for 
 scrofulous subjects. They should be employed when the 
 sclerotic presents the characteristic rosy circle round the 
 cornea, the pain being burning and cutting, with profuse 
 lachrymation, the cornea becoming dim, and the iris 
 showing signs of discoloration and contraction ; and in 
 severer cases, when there is danger of exudation or the 
 formation of pus. 
 
 It will be necessary to watch carefully the effects of 
 the medicine in this disease, and to change it if necessary, 
 should the affection progress, as the further it advances 
 the more difficult is the recovery. 
 
 Belladonna. This remedy must be resorted to (as a 
 palliative) should the contraction of the pupil not yield 
 to the apparently well-chosen remedy, and is often impe- 
 ratively necessary in neglected cases, when the pupil 
 has almost closed. 
 
 Acid nitric is to be substituted for Mercurius 
 should the symptoms have arisen from abuse of that 
 medicine, or the general symptoms point to its employ- 
 ment. 
 
 Thuja is requisite, either singly or in conjunction with 
 Acid nit., when tubercles or small warts appear on the 
 iris. 
 
 Aurum is very useful in mercurial iritis, and is pre- 
 
112 TERTIARY SYPHILIS. 
 
 ferable to Acid nit. when the moral symptoms, such as 
 great dejectedness, tremulous fearfulness, or a desire to 
 commit suicide, preponderate. 
 
 Hepar sulph. is required when pus is formed (hypo- 
 pion), or when mercurial symptoms are present. 
 
 [The principal remedies in Iritis syphilitica, are Merc, 
 sub. corros., Nitric acid, and Thuja.~\ 
 
 TERTIARY SYPHILIS. 
 
 GUMMATA SYPHILITICA, Gummatose Tumors.— 
 
 The skin, subcutaneous or interstitial cellular tissue, and 
 the mucous membrane are the principal seats of this 
 affection, which is tedious in its progress and liable to 
 relapses ; it belongs to the remotest stage of constitu- 
 tional syphilis. Appearing as hard, round, or pea-shaped 
 swellings under the skin, and increasing slowly in size, 
 they take months to attain the size of a small nut, and 
 are usually disposed in rows of four or six together, like 
 beads, adhering by their upper surface to the skin, 
 although they can be moved over the subjacent parts. 
 After remaining hard a long time, they become soft, pus 
 forms in the centre of the tumor, which, adhering to the 
 surrounding parts, is enclosed as in a cyst ; the skin over 
 the swelling now assumes a bluish, copper color, becomes 
 thin, and finally gives way ; an ulcer is formed with sus- 
 picious-looking edges, secreting a fetid ichor. When 
 these occur on the tongue, they are liable to be mistaken 
 for scirrhus or cancer ; the part becomes hard and knotty, 
 
TERTIARY SYPHILIS. 113 
 
 and in talking or chewing its free motion is greatly 
 impeded, but the absence of shooting pains and a reddish 
 appearance of the iris, the invariable accompaniments of 
 cancer, will suffice to distinguish them from that terrible 
 complaint. 
 
 Treatment. — The following remedies will be found 
 the most appropriate: — Mezereum, Plumbum, Stra- 
 monium, Ruta, Acid phosph., Calc, Graphite. 
 (Vide Characteristic Effects, at the end of this 
 work.) 
 
 Belladonna will be found very useful when any inflam- 
 matory symptom is present. 
 
 Arsenicum, w T hen the swelling is livid, with acrid, 
 offensive discharge. 
 
 Carbo, in similar cases, with burning pains, cachectic 
 constitution, and profuse unhealthy discharge. 
 
 Cinchona, for debilitated subjects, with discharge of 
 pus and great torpor of the parts. 
 
 Mercurius is very needful in hard, indurated swell- 
 ings, with unhealthy skin, or when attended with rest- 
 lessness and pains in the bones. 
 
 Aurum, when there are symptoms of mercurial com- 
 plication, or in severe cases which Mercury has failed 
 to relieve. 
 
 ORCHITIS SYPHILITICA, Sarcocele Syphilitica, 
 Syphilitic Swelling of the Testes. — This disease consti- 
 tutes one of the first and most frequent symptoms of 
 tertiary syphilis. It rarely affects but one testicle, and 
 it is only in a few cases that premonitory symptoms 
 occur; these consist of acute boring pain in the loins, 
 usually at night, or there is painful pressure in the re- 
 10* 
 
114 TERTIARY SYPHILIS. 
 
 gion of the kidneys, and sometimes a sensation as if a 
 knife were thrust through the flesh. Even when swell- 
 ing of the testicle takes place, the patient is seldom 
 aware of it. On examination we find one or more indu- 
 rated nodes, and on pressure a small spot that is harder 
 and less elastic than the other parts. The induration 
 often spreads round about like a circular belt (cirsocele), 
 or in other cases the hardness is only partial, but gradu- 
 ally spreads till the whole testicle becomes involved. 
 When there are no complications, and the disease runs a 
 regular course, the epididymis remains unaltered for a 
 considerable period, and can be clearly distinguished 
 from the testicle proper, which seldom or never swells at 
 all, and then only within certain limits. This disease is 
 very regular in its progression, the testicle preserves its 
 pear-shaped form, but feels harder tharr the other ; even 
 the inequalities we discover with the finger preserve a 
 certain regularity, constituting a progressive series of 
 circular indurations as *soon as the swelling has reached 
 three or four times the original size of the testicle. 
 Should it attain a large size, it will often lose the sensi- 
 bility it possesses in its normal shape. In these cases 
 the epididymis, though not morbidly altered, is no longer 
 perceptible. The swelling is now hard, firm, and in- 
 elastic, pressure with the finger conveying the sensation 
 of a massive fibro-cartilaginous, inelastic texture. Occa- 
 sionally it is associated with hydrocele of the tunica va- 
 ginalis, without any fever or general derangement of the 
 functions. 
 
 When the internal structure of the testicle is dis- 
 organized, the seminal secretion gradually ceases, as 
 well as the erections, which finally disappear altogether. 
 
TERTIARY SYPHILIS. 115 
 
 Although this complaint may last for months, or even 
 years, it never terminates in suppuration, nor does it 
 transgress certain limits. Resolution either takes place 
 spontaneously or in consequence of adequate treatment; 
 but sometimes it happens that a diminution takes place, 
 which progresses till the entire testicle disappears ; it will 
 also happen that the swelling will change to a fibrous, 
 cartilaginous, or even osseous, tumor. This disease is 
 developed not only from syphilitic infection, but also 
 from injuries, excessive sexual indulgence, exercises hav- 
 ing an irritating or exciting influence upon the testicles, 
 or from gonorrhoea contracted during the course of 
 secondary syphilis. If syphilis is complicated with a 
 cancerous or scrofulous diathesis, this complaint is very 
 easily developed. It is also found complicated with all 
 sorts of disorganizations, such as varicocele, hydrocele, 
 orchitis gonorrhoeica, cysts, and hydatids. 
 
 Treatment. — In this disease, as in many others hav- 
 ing a syphilitic origin, it will be highly necessary to 
 study the whole history of the case previous to selecting 
 any remedy, as it will be often very difficult to choose 
 the appropriate medicine. The following remedies are 
 very efficacious in the various phases of the disease. 
 
 Arsenicum, Cinchona, Acid phosph., Plumbum, are 
 particularly indicated if the general constitution seems 
 to be broken down, or the disease has been aggravated 
 by excess. 
 
 Belladonna, if symptoms of inflammatory congestion 
 develop themselves in the tumor. 
 
 Clematis, Copaiba, Mercurius, Pulsatilla, when gonor- 
 rhoea was the immediate cause of the disease, or at any 
 rate had complicated or aggravated it. 
 
116 TERTIARY SYPHILIS. 
 
 Graphite, Conium, Lycopodium, Belladonna, when the 
 disease is complicated with general scrofulous glandular 
 swellings, chronic eruptions, or from the suppression of 
 the latter by improper applications. 
 
 The other remedies which can be consulted with ad- 
 vantage are Aurum, Gale, Garbo veg., Kali carb., 
 Spongia; or, Acid nitricum,, Barytas carb., Mercurius, 
 Mezer., Rhododendron, Rhus tox. {Vide Character- 
 istic Effects. 
 
 OSTITIS; PERIOSTITIS. — The tertiary syphilitic 
 affections of the bones may be divided into four stages: 
 periostitis, or inflammation of the membrane covering 
 the bone; ostitis, or inflammation of the bone itself; 
 exostosis, a bony tumor 'protruding from the bone; and 
 caries, with necrosis, rottenness, and total death of 
 the affected part. Syphilitic bone-pains may affect any 
 portion of the osseous tissue, either superficial or deep- 
 seated, in the flat or long bones, and in the periosteum; 
 it is, however, in the superficial portions that they occur 
 most frequently. These pains may occur ten or twenty 
 years after the contraction of the disease, during changes 
 in the weather. They are always aggravated towards 
 night, and when the patient is warm in bed. Rjcord 
 says that among the rich who spend the summer in the 
 country and the winter in town, the pains are more felt 
 at night in the summer, and in the daytime in winter. 
 In most cases, if the patient goes to bed in the evening, 
 the pains commence about 11 o'clock, and continue until 
 2 or 3 o'clock the next morning. They commence with 
 a disagreeable sensitiveness, which gradually increases 
 to a pain, until it finally changes to a frightful torture. 
 
TERTIARY SYPHILIS. 117 
 
 This pain is always seated in one spot, and reappears 
 constantly in the same place. The least pressure causes 
 an aggravation, which is not the case with a simple 
 rheumatic pain. These pains are very often the pre- 
 cursory symptoms of material changes in the bones, 
 terminating in periostitis. After these pains have con- 
 tinued for some length of time, alterations in the tissue 
 of the periosteum begin to develop themselves. It be- 
 comes inflamed, and exudations become distinctly per- 
 ceptible when pressing on the part. The exuded matter 
 is yellowish at first, of a gelatinous consistence, and, 
 after a while, changes to a reddish or brownish fluid, 
 mixed with extravasated blood. 
 
 Periostitis generally appears in the region where the 
 pain has been felt. A rather circumscribed swelling 
 appears at this place, with its base firmly adherent to 
 the subjacent bone, the skin over this swelling being 
 movable and its color unaltered. Gradually the swelling 
 increases to the size of a pigeon's or hen's egg, being 
 rather firm at first, and does not fluctuate ; but when 
 pressed upon does not impart the sensation of a resisting 
 bone. If no suitable treatment is instituted, osseous 
 degeneration (vide Exostosis, p. 119) may take place. 
 Ostitis is characterized by pain more or less severe, 
 attended with swelling and redness of the surrounding 
 tissue. The presence of fever depends greatly on the 
 state of the patient's health, and is generally worse, in 
 conjunction with the pain, towards evening. If not 
 speedily checked, it will most likely terminate in caries 
 or suppuration of the spongy portion of the bone. 
 
118 TERTIARY SYPHILIS. 
 
 [It should be remembered that, with scarcely an ex- 
 ception, both Periostitis and Exostosis result from the 
 previous exhibition of large doses of Mercury. 
 
 In many of these cases, very high potencies of Mercu- 
 rius may be found useful; in others, the best indicated 
 antidote to Mercury should be selected, especial refer- 
 ence being made to the particular part of the system 
 affected: for the remedy which would remove a difficulty 
 of either kind (peri- or exostosis) on the long bones 
 might not avail on the skull.] 
 
 Treatment. — Mercurius is the principal remedy in 
 the first stage of the disease, provided that it has not 
 been previously used to excess. 
 
 Kali iodidum is to be preferred when Mercury has 
 been taken in large quantities, or the disease has arisen 
 from the abuse of that remedy. 
 
 Acid nitric, is recommended when Mercurius does 
 not succeed, although apparently well indicated. 
 
 Lachesis is very useful when mercurial preparations 
 have been abused, or that medicine proves ineffectual 
 with lividity of the skin, and great tenderness on pressure. 
 
 Mezereum, Staphysagria, may be employed when the 
 part where the pain is located feels sore, as if ulcerated. 
 
 Arsenicum, Calc. carb., Phosphorus, Sulphur, in cases 
 where there is great debility, or tendency to scrofula. 
 
 The following remedies are also worthy of attention: — 
 Acid fluoric, Acid phosph., Caust., Kali carb., 
 Lycopodium, Natr. mur., Platina, Plumbum, Pe- 
 trol., Pulsat., Rhodod. {Vide Characteristic 
 Indications. 
 
TERTIARY SYPHILIS. 119 
 
 EXOSTOSIS, — This term is applied to any unnatural 
 protuberance on a bone, constituting a tumor, inelastic, 
 immovable, hard, and bony to the touch ; seated on the 
 substance of a bone, it is sometimes composed of bony 
 spiculae, resembling crystallizations; at others it is ex- 
 quisitely hard and smooth, resembling ivory. Although 
 very rough at first, the older it becomes the smoother 
 and more polished form does it assume. They are found 
 in various shapes; round, knotty, fusiform, or even 
 pedunculated. 
 
 It occasionally happens that the exudation takes place 
 in the interior of the bones (exostosis), in which case 
 the part assumes a very hard consistence, like ivory, 
 and the cavity of the bone is often obliterated, whilst 
 its diameter is materially increased. In the syphilitic 
 varieties of this disease, periostitis is always the pre- 
 cursor. Directly the bone begins to swell, the pains 
 commence to subside ; but the patient is variously incom- 
 moded according to the seat of the disease; locomotion 
 being impeded when occurring on the legs or feet, or 
 paralysis may be induced if the morbid growth invades 
 the inner portion of the skull. 
 
 Treatment. — Mercurius is here again one of the 
 principal remedies, and is to be employed at the outset, 
 when the swelling commences to form, and the pains in 
 the bones are very violent towards night. 
 
 Acid nitricum should be substituted for Mercurius 
 when that remedy has been taken to excess, or does not 
 appear to influence the complaint. The pains indicating 
 this medicine are generally drawing and pressing, par- 
 ticularly in the bones of the head. 
 
 Silicea is very useful in swelling of the bones, espe- 
 
120 TERTIARY SYPHILIS. 
 
 cially of the lower jaw, or when the spine is swollen and 
 distorted. 
 
 Staphysagria, when the patient is debilitated, and suf- 
 fers from swelling of the bones of the face and feet. 
 
 Aurum, in cases of mercurial poisoning, or when the 
 head and face are the chief seats of the disorder. It is 
 very useful when the nose is implicated.* 
 
 Mezereum is to be given when the disease is preceded 
 by pains aggravated by touch, and principally seated in 
 the bones of the face, thighs and legs. 
 
 Ruta, often required in alternation with the latter 
 remedy, is invaluable in those cases where the premoni- 
 tory pains partake of a contusive character, and there are 
 burning, gnawing pains in the bones of the legs, feet, or 
 head. 
 
 Sabina is very efficacious when the disease affects the 
 hollow bones, and more remotely those of the hands and 
 feet. The pain is generally lancinating, or drawing, and 
 tearing. 
 
 Asafcetida, Phosphorus. In affections of the long, 
 hollow bones, attended with numbness, these two reme- 
 dies, either singly or in alternation, are frequently re- 
 quired, particularly for cachectic subjects. 
 
 Kali iodidum in scrofulous cases, and particularly when 
 complicated with mercurial disease. 
 
 [For bone-pains, ostitis and periostitis, Jahr advises 
 Mez., Phosph., Staph., Phos. ac., Nit. acid, Aurum, 
 Guiacum. 
 
 For swelling of bones, periostoses, exostoses — Aurum, 
 Fluoric acid, Phosph., Staph., Mez., {Gale, c.,) Silic, 
 Sulph., Phos. acid. 
 
 * Jahr gives Aurum in the third trituration, one half a grain 
 every four days. 
 
TERTIARY SYPHILIS. 121 
 
 The osteocopus nocturnus, or mer curio-syphilitic bone- 
 pains at night, are often relieved by large doses of Kali 
 iodidum, in solution, when nothing else will. Sometimes 
 these pains seem to be rheumatic in their nature ; always 
 they are worse in damp and wet weather. Ten or even 
 fifteen-grain doses afford very strongly marked relief to 
 sufferings, which, resulting from the combined influences 
 of syphilis and mercurial drugging in a scrofulous con- 
 stitution, no earthly medication can entirely remove. I 
 have used grain doses of the first trituration of this drug 
 in such cases with great benefit.] 
 
 CARIES AND NECROSIS. —Another of the remote 
 forms of the syphilitic process, unfrequently met with, 
 but extremely pernicious, is caries, which invades the 
 bones, after overlooked or badly treated syphilitic in- 
 flammation of the parts. It is principally the bones of 
 the head, the leg-bones (tibia), the breast-bone (sternum), 
 palate, and bones of the nose that are liable to be im- 
 plicated. When the bones of the skull are affected, the 
 greatest danger exists, as, should they be destroyed, their 
 reproduction is impossible. Caries manifests itself by 
 obtuse pains deep seated in the bones, the superincumbent 
 integuments being discolored, flabby, and tender to the 
 touch ; ulceration of the soft parts then commences, and 
 ichor, thin, acrid, and dark-colored, flows from sinuses in 
 communication with the caries. The diseased part pre- 
 sents varied appearances, according to the nature and 
 type of the complaint. Sometimes the bone is full of 
 small holes (worm-eaten caries), or is soft and moist; 
 or, at other times, it is dry, brittle, and of a grayish- 
 white color. When necrosis (death of the bone) takes 
 11 
 
122 TERTIARY SYPHILIS. 
 
 place, the pain is extremely violent and deep-seatod ; an 
 abscess soon forms over the affected part, which bursts, 
 and fistulae open which will not heal till the dead portion 
 of the bone is removed ; when the abscess bursts, co- 
 agulable lymph is effused round the bone, which, in con- 
 junction with the cedematous condition of the cellular 
 membrane, forms a swelling of a hard, unyielding char- 
 acter. 
 
 Treatment. — Silicea is one of the most prominent 
 remedies in these diseases, and is to be employed when 
 the abscess is formed, and the pus is thick, dark colored, 
 and offensive. It is invaluable when the dead portion 
 of the bone is still adherent to the living part (second 
 stage), or when it becomes loose (third stage), and the 
 discharge of pus and ichor is excessive. 
 
 Hepar sulph. is often required when there is putrid 
 ulceration or discharge, smelling like decayed cheese. 
 It is especially useful when the bones of the face are 
 implicated. 
 
 Lycopodium is useful, as an intermediate remedy, when 
 the discharge is of a bright lemon-yellow color. 
 
 Aurum, Acid nit. These two are specially indicated 
 when the bones of the nose are implicated. Aurum is 
 requisite when there is nasal speech, the bones of the nose, 
 os frontis, and upper jaw swollen and reddened, with dis- 
 charge of stinking ichor and small pieces of bone, ulcers 
 on the palate, and offensive discharge from the ears, and 
 rending pains in the bones of the extremities. 
 
 Acid nit. is more useful when the patient suffers from 
 previous mercurial treatment, or when there is inflam- 
 mation and painful sensitiveness of the bones, with sani- 
 ous and corrosive discharge. 
 
TERTIARY SYPHILIS. 123 
 
 Belladonna is required as a palliative when the skin 
 assumes an erysipelatous appearance, with thirst and 
 fever. 
 
 Phosphorus is needed, sometimes in conjunction with 
 Mercurius or Staphysagria, when the bones of the 
 face, and particularly the jaw, are affected. There is 
 always great pain and swelling of the parts, with exfolia- 
 tion of pieces of the bone. In patients of a scrofulous 
 habit, one or other of these remedies is almost always 
 requisite. 
 
 Mezereum, Asafcetida, are principally required when 
 the shin-bones are affected, and there is pain, swelling, 
 and softening of the bone&, with serous, fetid, and san- 
 guineous suppuration. 
 
 Acid fluoric. This remedy, which appears to exercise 
 a great influence on diseases of the bones in general, is 
 very useful when the pains are burning and intermittent, 
 with discharge of thin, acrid ichor, and great swelling 
 about the diseased part, caries of the temporal bone. 
 Caries from syphilis or mercury. [After abuse of 
 Silicea.'] 
 
 Arsenicum is of great use in very debilitated cases, 
 and when the antrum highmorianum (the cavity in the 
 upper jaw) is affected, with insupportable burning pain, 
 and great depression of the vital powers. 
 
 Calcarea, Sulphur. In scrofulous subjects these reme- 
 dies will be frequently required, particularly when the 
 medicine, although apparently well indicated, does not 
 seem to exercise any appreciable effect. 
 
 Should the disease increase in spite of the means 
 employed, and serious irritation of the system set in, an 
 operation for the removal of the part is indispensably 
 necessary. 
 
124 CACHEXIA SYPHILITICA. 
 
 CACHEXIA SYPHILITICA.— This is one of the re- 
 motest forms of constitutional syphilis, and is a diseased 
 state in which the whole habit of body is manifestly 
 altered. After having first attacked the skin and mucous 
 membrane, then the serous membranes and the bones 
 and muscles, the virus at last invades the fleshy organs, 
 the lungs, liver, spleen, kidneys, and even the heart and 
 brain. The general symptoms of this disorder (but re- 
 cently attributed to its real cause) are the following: 
 The skin becomes sallow, yellowish, or livid ; the muscles 
 waste; the strength fails; sight and hearing gradually 
 diminish ; and the patient experiences violent palpitation 
 of the heart, and chlorotic symptoms. Should the liver 
 be more particularly affected, jaundice sets in, which may 
 lead to suppuration of this organ, and finally to dangerous 
 inflammation of the peritoneum. When the blood and 
 blood-vessels are invaded, remittent fever, sanguineous 
 extravasations under the skin, scurvy, and effusions of 
 blood in the lungs and intestines, &c, supervene, followed 
 by general dropsy. Ricord adds his testimony to 
 Hahnemann's observations on latent syphilis, when he 
 advises an antisyphilitic treatment to be instituted for 
 inexplicable, deep-seated, mysterious, disguised derange- 
 ment of the functions, even when there is no reason to 
 suppose that the mischief arises from syphilitic taint. 
 
 The symptoms of this complaint are so numerous, and 
 vary so much with the patient's idiosyncrasy, that only 
 the principal remedies can be indicated. It is also neces- 
 sary to observe that those remedies which are mentioned 
 for particular isolated symptoms, and not being of that 
 
CACHEXIA SYPHILITICA. 125 
 
 class which are curative in syphilis proper, are only- 
 palliative, and are not to be depended on for the eradica- 
 tion of the complaint. 
 
 [It is important that the practitioner remember in all 
 these cases that his patients need not only the best 
 possible medication, but also (and if possible still more) 
 the best possible adaptation of external influences. A 
 dry climate is indispensable. Xo physician need expect 
 to see a patient suffering under general syphilitic cachexia, 
 combined, as this usually if not always and invariably 
 is, with mercurial demoralization of his constitution, im- 
 prove in any perceptible manner, unless he is favored by 
 residence in a dry and warm climate, and unless, also, he 
 is supplied with suitable diet,' and freedom from anxious 
 cares. In many such cases advice is of vastly more 
 consequence than medicine ; and at any rate the latter 
 without the former will do no good. Pure air, a dry, 
 warm climate, suitable food, and other accessories to a 
 careful and strictly homoeopathic medication (and if this 
 latter be confined to the administration at long intervals 
 of single doses of the highest potencies, so much the 
 better) will sometimes do wonders in such cases. But 
 both physician and patient must " learn to labor and to 
 wait;" they must be both patient and persevering.] 
 
 Treatment. — Merctjrius is one of the principal re- 
 medies, and can be employed when there is emaciation 
 and atrophy of the whole body, with slow or hectic 
 fever ; swelling and hardness of the liver, with complete 
 jaundice; or for circular ulcerations in the skin, mouth, 
 and throat, and disorganization of the tonsils; livid, 
 11* 
 
126 CACHEXIA SYPHILITICA. 
 
 sallow, or copper color of the skin ; pains in the bones, 
 and urine depositing a whitish or purulent sediment; 
 sensation of indescribable malaise; low spirits; peevish, 
 irritable temper. 
 
 Acid nitricum is indicated where there are signs of 
 general decomposition of the fluids, with scorbutic symp- 
 toms in the mouth and salivation, the gums being ulcer- 
 ated and bleeding; falling off of the hair, and ulcerated 
 soreness of the scalp ; difficulty of hearing and smelling, 
 the nose being ulcerated, with yellow, fetid discharge ; 
 the larynx being dry, producing hoarseness, frequently 
 accompanied with cough and expectoration of coagulated 
 blood ; general indisposition, and feeling tired of life ; fits 
 of anguish, accompanied with palpitation of the heart. 
 
 Arsenicum. In desperate cases, in which there is rapid 
 emaciation and debility, the disease showing a malignant 
 disposition, there being dropsical effusjon of the whole 
 body, trembling of the limbs, on which are malignant 
 ulcerations with acrid discharge, and often fetid or ex- 
 hausting bloody diarrhoea with continual urging, the skin 
 being livid or covered with scales. It is also very useful 
 in those cases where there is an indescribable feeling of 
 illness with no particular symptoms, but where there is 
 evidence of serious, though unseen, mischief. The moral 
 symptoms are generally either melancholic and sad, or 
 there is great restlessness and anguish, with fear of 
 death, and excessive sensitiveness. 
 
 Cinchona is very useful when there is a tendency to 
 jaundice, with yellow color of the skin, great depression 
 and debility, with tendency to dropsy, and attended with 
 heat and chills ; the head is confused, and there is indis- 
 position to work ; the spirits are low, with sadness and 
 
CACHEXIA SYPHILITICA. 127 
 
 hopelessness, and often attended with great nervous 
 irritation. 
 
 Carbo veg. is requisite when the digestive organs are 
 impaired, with acidity of the stomach and great flatu- 
 lence, the skin being yellowish, and there are shooting 
 pains in the liver and spleen, and often when there is 
 palpitation of the heart ; the patient complains of lassi- 
 tude and great weariness, his intellects are clouded, dull 
 and confused, and his temper irritable and impatient. 
 
 This remedy is very important in rousing the dormant 
 energies, and developing symptoms which before were 
 masked, and which are valuable and often indispensable 
 to the proper selection of the appropriate remedy. 
 
 Phosphorus, Acid Phosph. These remedies are very 
 useful when the skin, bones and lungs are invaded ; 
 when there is dry cough with or without sanguineous 
 expectoration, heat in the chest, and a tendency to con- 
 sumption ; or for affections of the ends of the long bones 
 of the jaw, with nocturnal burning pains, and threaten- 
 ing caries ; or in inveterate ulceration of the skin, with 
 secretion of bad pus, and burning, stinging pain in the 
 parts. There is also a feeling of weakness, as if proceed- 
 ing from the loss of animal fluids. 
 
 Sulphur. In obstinate affections of the skin, attended 
 with bleeding of the gums, salivation, rheumatic pains in 
 the limbs, small ulcerations on the leg, and disturbance 
 of the functions of the liver and stomach. 
 
 Plumbum is very useful for general emaciation, 
 attended with hectic fever, paleness and flabbiness of the 
 muscles, and great debilit}^ and also when there is pal- 
 pitation of the heart and difficulty of breathing. 
 
 Kali iodidum, Hepar sulphur. These remedies are 
 
128 SYPHILIS OF LITTLE CHILDREN. 
 
 required in scrofulous cases, where the system is in bad 
 condition, and there is reason to fear mercurial complica- 
 tion ; they are especially useful in ulcerations and effu- 
 sions of fluid into the cellular tissue, or when abscesses 
 threaten ; and in induration of the liver they will often 
 procure speedy resolution. 
 
 The other remedies that may be consulted with advan- 
 tage are Calc, Iod., Kali carb., Lycop., Sepia, and 
 Thuja. ( Vide Characteristic Effects.) 
 
 SYPHILIS OF LITTLE CHILDREN. Constitutional 
 syphilis can be transmitted by the father or mother to 
 the foetus, but infants are seldom infected during the pas- 
 sage through the vagina ; for the first three weeks a child 
 so infected seems robust and healthy, but afterwards the 
 first signs of the disease make their appearance. The 
 little patient is uneasy, and cries continually, emaciating 
 very rapidly, and looking old and withered. [In some 
 cases the infants look old and withered from birth ; they 
 never increase in weight, but grow lighter till they die, 
 in the course of three or four months, or less. Such 
 cases no medication can save ; nor indeed is it desirable 
 that such diseased persons should grow up. — Note by 
 Editor.] The eyes being deeply sunk; circumscribed 
 spots, of a bright copper color, rising speedily above the 
 skin, in the shape of blotches, and sometimes running 
 together, appear in the region of the sexual organs, in the 
 groins, on the thighs, buttocks, heels, soles of the feet, 
 round the anus, about the navel, and sometimes over the 
 whole skin. Soon after, the palms of the hands are like- 
 wise invaded, and simultaneously a papulous eruption, 
 which afterwards changes to small, dirty, yellowish pus- 
 
SYPHILIS OF LITTLE CHILDREN. 129 
 
 tules, surrounded by a broad areola, breaks out on the 
 chest, back, face, and the hairy scalp. Tuberculous ele- 
 vations start up on the inflamed portions of the feet, 
 hands and anus. Sometimes these eruptions disappear 
 without any medical treatment, but oftener superficial 
 ulcers show themselves in the corners of the mouth, and 
 in the nose, from which flows a discharge, which at first 
 looks like catarrh. This discharge gradually increases ; 
 the margins of the eyes and the meibomian glands be- 
 come inflamed and suppurate ; the voice sounds hoarse, 
 feeble, and moaning ; the breathing is accompanied with 
 slight rattling, and — the nose being stopped by crusts — 
 is performed through the mouth ; the ulcers deepen and 
 extend, their edges being raised, and suppuration takes 
 place. Ulceration likewise affects the fauces, rendering 
 deglutition painful and difficult ; should the disease still 
 progress, acute tuberculosis of the brain is apt to arise ; 
 but should it escape this evil, anaemia slowly supervenes, 
 and the child dies. 
 
 Treatment. — The first and most important rule for 
 treating children infected with this disease, is to remove 
 them from the mother or nurse who is suffering from the 
 same complaint. Should this be found impossible, the 
 sick mother or nurse must be treated simultaneously and 
 with the same remedies as the child. Cleanliness is in- 
 dispensable, as well as the use of tepid baths every day, 
 and the patients should be kept in a rather elevated tem- 
 perature. The child is to be treated according to the 
 symptoms manifested, in the manner prescribed in treat- 
 ing of syphilis. Should a mercurial preparation be re- 
 quired, the use of Cinnabaris (Mercurius bisulph.), 
 or Merc, pr^ecip. rub., is to be preferred to the other 
 forms of the medicine. 
 
SYCOSIS. 
 
 THIS is a disease distinct from syphilis in its mani- 
 festations, and partaking of a different character, al- 
 though arising from impure connection. Although liable 
 to be suppressed by the violent means used to remove its 
 external signs, it never produces such ravages upon the 
 constitution. It consists of excrescences resembling 
 warts, sometimes dry, but generally soft, spongy, and 
 similar to cauliflowers or cocks-combs. A fetid fluid is 
 secreted from them, and they are liable to bleed upon the 
 least irritation. At the same time there is usually a 
 painless, thick, and purulent discharge from the urethra, 
 and the penis is more or less indurated; attended with 
 swelling of the lymphatic glands on its dorsum. 
 
 When badly treated, either by Merotry or other re- 
 medies having no relation to the disease, analogous ex- 
 crescences arise on various parts of the body, sometimes 
 consisting of white, flat, spongy elevations, seated in the 
 mouth, lips, tongue, or fauces ; or of large, prominent, 
 brownish tubercles, situated in the armpit, or the neck 
 and scalp ; or again, retraction of the flexor tendons, par- 
 ticularly of the fingers, will often supervene. 
 
 [Condylomata or Fig-warts appear in connection 
 with gonorrhoea ; or with syphilis ; or by themselves. 
 To this independent affection the term Sycosis is ap- 
 plied by Hahnemann. He uses the term differently 
 from ordinary allopathic writers, who principally apply 
 it to a peculiar fig-shaped eruption on the chin. Sycosis 
 
 Menti. 
 
 130 
 
SYCOSIS. 131 
 
 Fig-warts grow about the genitals and anus, at the 
 junction of the external skin with the mucous membrane : 
 they may be flat ; conical ; growing on a pedicle, or small 
 stem ; or appear like a cocks-comb. They are dry, or ex- 
 ude a slimy, acrid, badly-smelling and contagious fluid. 
 
 In syphilitic condylomata, the principal remedies are, 
 Thuja, Nitric acid, and Cinnabar. 
 
 Moist, itching condylomata, Psorin.~\ 
 
 Treatment. — It is much to be recommended that no 
 external application should be applied to the warts, as, 
 in such instances, we are unable to judge of the effects of 
 the internal remedy, and whether the disease is really 
 yielding to the means applied, as it is easier to suppress 
 than to cure this affection. 
 
 Thuja. This remedy, in simple, uncomplicated cases, 
 will generally suffice to entirely remove the symptoms ; 
 should, however, the patient have been previously 
 drugged with Mercury, Acid nitric, will be required, 
 either singly or in alternation. In sycosic buboes these 
 two remedies are also of great service, although Staphy- 
 sagria, Sulphur, or Mercurius may be required. 
 
 [This is the principal remedy in condylomata ; and it 
 is suited to each of the three varieties, of simple or un- 
 complicated, gonorrheal, and syphilitic sycosis, or fun- 
 goid syphilis. The thirtieth, and still higher potencies 
 have proved remarkably efficacious. 
 
 According to Jahr, " the chief sphere of action of this 
 remedy, and the modifications of the chancre virus that 
 are described as idiopathic condylomata, mucous tuber- 
 cles, and sycosic excrescences" also in " mucous tubercles 
 on the labia, at the anus, in the corners of the mouth, on 
 
132 sycosis. 
 
 the alee nasi, eye-lids, and nipples ; especially in the case 
 of women and children." 
 
 A gonorrheal patient of my own, an hostler, had large 
 and abundant condylomata on the prepuce, of long stand- 
 ing and very troublesome. I gave him a small vial of 
 mother tincture of Thuja ; from this he made a single ap- 
 plication externally, and broke the vial in his pocket be- 
 fore he made another. But all the fig-warts had disap- 
 peared, in the course of a week or two, when he came to 
 report ; and they did not return. 
 
 Euphrasia. — Tincture, externally applied, with suc- 
 cess, by Miiller, of Leipzig, in broad condylomata in ano 
 — when Thuja, Nit acid, and Cinnabar, had proved in- 
 efficient. 
 
 Eiickert, Therapeutics, p. 401, mentions two cases of 
 fig-warts cured by its external and internal use. 
 
 In moist, suppurating fig-warts, Euphrasia is men- 
 tioned among other remedies, by Bane, p. 390.] 
 
 [Nitric Acid. Has cured " dry pedicular excres- 
 cences on the foreskin, and in the furrow behind the 
 glans, which were almost an inch in length. The whole 
 glans, the inner surface and the margin of the foreskin 
 were bordered with innumerable excrescences, looking 
 like raw flesh, from the size of a pin's head to that of a 
 hazle-nut, bleeding and secreting when touched ever so 
 lightly, and exuding a purulent matter of a disgusting, 
 sweet odor." Nitric acid is affirmed by Jahr to be the 
 chief remedy in syphilitic condylomata. The pus, which 
 is secreted in large quantity, is corrosive, smells like 
 brine, and causes a furious itching. It is indicated still 
 more strongly in mercurialized patients ; and where 
 
sycosis. 133 
 
 buboes are present. Also in flat fig-warts ; in those com- 
 plicated with gonorrhoea ; and in mucous tubercles, or 
 fungoid syphilis.] 
 
 Mercurius. This medicine is only to be employed 
 when the case is complicated with syphilis, and is very 
 frequently required to be alternated with Sulphur. The 
 indications for these remedies will be found fully set forth 
 in the article on " Syphilis." 
 
 In the secondary stage, when Thuja and Acid nitric 
 have failed in relieving the patient, in consequence of 
 complications with some dyscrasia, the following remedies 
 may be consulted with advantage : 
 
 Sulphur is very useful when the sore throat, enlarge- 
 ment and ulceration of the tonsils, hoarseness, stains on 
 the skin, or scaly spots have not yielded to the former 
 remedies ; it is especially indicated when shooting pains 
 are experienced in the joints, the flexor tendons of the 
 fingers retracted, the lips tumefied, and the tongue red, 
 rough, and fissured. 
 
 [Cocks-comb-shaped, soft, spongy, readily-bleeding 
 excrescences on the corona glandis ; moist warts and con- 
 dylomata on the hard swollen labium.] 
 
 Lycopodium can be employed for superficial whitish 
 ulcerations of the tonsils, the tongue being fissured and 
 covered, together with the interior of the mouth, with a 
 scaly eruption. Lycop. 200 , has cured condylomata on 
 the penis. 
 
 Staphysagria. This remedy is of great service for 
 moist and soft excrescences, the gums being soft, swollen, 
 and spongy ; and for dry, or cocks-comb-shaped fig-warts 
 and mucous tubercles. 
 12 
 
134 sycosis. 
 
 Sabina is very useful for large, moist and painful 
 warts, even when free from contact. 
 
 Acid Phosph. has been recommended for old warts 
 which have been only slightly benefited by previous 
 treatment ; and in mercurial syphilis with condylomata. 
 
 Cinnabaris. In old and complicated cases, with en- 
 largement of the tongue, and swelling and ulceration of 
 the tonsils, with other symptoms apparently indicating 
 the presence of syphilis, to which this complaint some- 
 times bears a resemblance, this remedy is often of efficient 
 service. 
 
 [From Raue's Pathology and Therapeutics, p. 390, we 
 take the following therapeutic hints : 
 
 Fig-warts complicated with gonorrhoea, require : Thuja, 
 Merc, corros., Cinnabar., Nit. acid, Sulphur, Lycopo- 
 dium. 
 
 When complicated with chancre ; Cinnab., Nit. acid, 
 Phosph. acid, Staph., Thuja. 
 
 When flat ; Magn., Nit. acid, QSabina.^) 
 
 When exuberant, like cauliflowers ; Thuja, Staph. 
 
 When fan-shaped ; Cinnabar. 
 
 When pediculated ; Lycop., Nit. acid. 
 
 When conical ; Merc. sol. 
 
 When dry ; Thuja, Staph., Merc, sol., Merc. sub. corr., 
 Nit. acid, Lycop. 
 
 When moist, suppurating; Nit. acid., Thuja, Sulphur, 
 Euphrasia. 
 
 When soft, spongy ; Sulphur. 
 
 When intolerably burning and itching ; Sabina.~\ 
 
NON-SYPHILITIC DISEASES. 
 
 SPERMATORRHOEA; Involuntary Seminal Emis- 
 sions. — This disease consists of an involuntary discharge 
 of semen, taking place either during stool, on emission 
 of urine, sudden movements, or on the least lascivious 
 excitement. 
 
 It may occur at night when dreaming, or frequently 
 towards morning; when lying on the back, or sleeping 
 on the sofa. When the semen escapes with the urine 
 during micturition, without erection, and the patient is 
 unaware of the circumstance, the most disastrous con- 
 sequences are likely to ensue ; and it is by far the most 
 dangerous form of the complaint. It results generally 
 from sexual excesses, and particularly from long-con- 
 tinued masturbation; but it may likewise arise from 
 chronic gonorrhoea, the use of irritating injections, strict- 
 ure of the urethra, morbid conditions of the rectum in- 
 ducing straining at stool, excessive abstemiousness from 
 connection, diseases of the cerebellum and spinal marrow, 
 excessive length of the prepuce causing an inflammation 
 of the surface of the glans, the use of aphrodisiacs, intes- 
 tinal worms, &c. Nocturnal emissions are at first accom- 
 panied with lascivious dreams, erections, and pleasurable 
 sensations; but as the disease advances the sensations 
 disappear, and the loss is only revealed by the moisture 
 or stains on the linen. "[Infrequent at first, they occur 
 in time two or three times a week, and latterly every 
 night, and even several times in the night. Gradually 
 the semen loses its consistence, the spermatozoa diminish 
 in number, and it becomes reduced to a thin, pellucid 
 
 135 
 
136 NON-SYPHILITIC DISEASES. 
 
 mucus, occasionally mixed with blood. When the dis- 
 ease has reached this stage the most trivial cause induces 
 a loss of semen. 
 
 In the daytime it generally occurs during micturition or 
 at stool, without erection, and by the simple mechanical 
 pressure on the organ. During an emission of urine the 
 loss of semen takes place only when the last drop is about 
 to be discharged. These last drops are thicker, viscous, 
 ropy, adhere to the orifice of the urethra, and stain the 
 linen. If the urine is collected in a glass, it becomes tur- 
 bid, and at the bottom of the vessel are small, rounded, 
 transparent, granular bodies. When spermatorrhoea is 
 complicated with spinal irritation, the urine deposits in 
 the morning a copious light-brown sediment ; it reacts 
 like an acid, has a sickly odor, and throws up to its sur- 
 face a fine, opalescent, greasy pellicle, which, after re- 
 moval, is invariably reproduced. One of. the unavoidable 
 consequences of the disease is impotence ; the quality and 
 consistence of the semen becoming altered, and the sper- 
 matozoa either disappear, or become so weak that they 
 lose all fecundating power. 
 
 The continued loss of semen gradually diminishes, and 
 finally destroys, the power of digesting food, the patient 
 complains of weight in the stomach, distress, restlessness, 
 fetid eructations, colicky pains, irregular stools, and cos- 
 tiveness alternating with diarrhoea, till at last constipation 
 becomes permanent, and keeps up the loss of semen ; the 
 pulse also becomes irregular, and there is a tendency to 
 cerebral congestion. He loses flesh, is sensitive to the 
 cold, his complexion is sallow, with blue circles round the 
 eyes ; his voice grows thinner, the speech timid, there is 
 great taciturnity, and the whole activity is impaired. As 
 
NON-SYPHILITIC DISEASES. 137 
 
 the emaciation increases, the skin becomes pale-yellow, 
 the eves are deeply sunken, the muscular energies sink, 
 and the least exertion produces weariness. 
 
 The nervous system is also particularly affected ; the 
 visual power is weakened, the pupil dilates, short-sighted- 
 ness and double vision set in, black or shining spots hover 
 before the eyes, there is great intolerance of light, and 
 even blindness may supervene ; the hearing is also affected, 
 the taste impaired, and the tongue thickly coated. Pa- 
 tients suffering from spermatorrhoea become languid, 
 effeminate, pusillanimous, the power of volition is weak- 
 ened, and even destroyed ; they are diffident, sensitive, 
 capricious, irascible, low-spirited, melancholic, and averse 
 to any kind of work. 
 
 In order to ascertain the existence of spermatorrhoea, 
 and not mistake it for the symptoms of some other affec- 
 tion, many phenomena may lead to the recognition of 
 the disease. The stains on the linen are proofs of the 
 seminal losses ; but when, in consequence of the long con- 
 tinuance of the disease, the semen becomes thin and 
 watery, or is mixed with urine, it is more difficult to 
 arrive at a certainty as to the nature of the discharge. 
 In such cases the urine ought to be filtered, and then it 
 will be found that the globular flocks of the semen and 
 the spermatozoa remain behind on the filter ; but should 
 the alteration of the semen be considerably advanced, 
 the globular flocks disappear, and the spermatozoa fall 
 to the bottom of the vessel, where they may be easily 
 viewed with the microscope ; otherwise the formation of 
 crystals of oxalate of lime may be a sufficient diagnosis. 
 The microscope supplies valuable indications concerning 
 the quality and numerical increase or decrease of the 
 12* 
 
138 NON-SYPHILITIC DISEASES. 
 
 spermatozoa. If the disease is in an advanced stage, the 
 spermatozoa diminish in number, are imperfectly de- 
 veloped, move but very slowly, or are quite motionless. 
 Should marasmus (rapid emaciation) set in, they entirely 
 disappear, and in their places are seen shining, roundish 
 little bodies, devoid of all fecundating powers. As soon 
 as improvement in the condition of the patient takes 
 place, the spermatozoa reappear in the semen. 
 
 Treatment. — Besides strict diet and regimen, the 
 firmest resolution on the part of the patient to abandon 
 the practice which may have been the source of the 
 disease, and to follow implicitly the advice of his medical 
 friend, are imperative. If possible, both bladder and 
 rectum should be emptied before retiring to bed, which 
 should not be too soft, and the patient should rise early, 
 and lie on his side in preference to his back. In the day- 
 time, body and mind should be occupied in a useful 
 manner, and exercise in the open air is advantageous, 
 even in the severer forms of the disease. 
 
 [This disorder, like the tendency to masturbation (its 
 principal immediate cause), may be regarded as inti- 
 mately connected with a psoric constitution. Some per- 
 sons incline very much this way ; and others not. A 
 careful study of the family constitution of those who do 
 thus suffer, will show the truth of the above remark, 
 which Hahnemann himself first made, in the Organon. 
 The reason for re-stating it here is this : in the absence 
 of any specific remedy for spermatorrhoea, (see Jahr's 
 Repertory in loco,) the physician must study the 
 constitutional symptoms of his patient, and even of 
 his patient's family. From this point of view, it will 
 
NON-SYPHILITIC DISEASES. 139 
 
 be seen that the principal remedy for spermatorrhoea, as 
 also for disposition to masturbation, has been omitted by 
 Berjeau. This is sulphur. The higher preparations of 
 this powerful antipsoric — so suited to the most common 
 characteristics of such persons — will, if not actually effect 
 a complete cure, at least greatly facilitate, and render 
 possible such a cure by some other medicine. 
 
 In some constitutions a single cup of tea, either black 
 or green, at supper will surely cause an emission in the 
 course of the night. The use of cold water to the parts on 
 going to bed tends to strengthen them, and thus enable the 
 organs to hold their precious contents. Cold bathing in 
 the open air, when practicable, is a most important aid to 
 the treatment of such cases. Let the patient be encour- 
 aged and cheered by his physician in every possible way.] 
 
 [Allium cepa, which is homoeopathic to this complaint, 
 I have used with success.] 
 
 [Gelseminum is another still more important remedy. 
 See Raue, in loco.~\ 
 
 Capsicum. Repugnance to movement; great sensi- 
 bility to fresh air ; sleeplessness without apparent cause ; 
 impotence, atrophy, and coldness of the genitals ; violent 
 erections in the morning ; trembling of the whole body 
 during venereal excitement. 
 
 Carbo veg. is useful when the disease is accompanied 
 with constipation and heartburn, acidity of the stomach, 
 and flatulence, distress after eating, and distention of the 
 bowels. 
 
 Causticum is required when the urine contains stringy 
 mucus, with sensation of burning in passing water, or 
 when blood is also passed, the pollutions being very fre- 
 quent, with continual loss of prostatic fluid ; it is very 
 
140 NON-SYPHILITIC DISEASES. 
 
 efficacious when the memory is very deficient, or the head 
 appears confused. 
 
 Cinchona is very important when the disease has 
 weakened the patient considerably, the least exercise pro- 
 ducing great fatigue, and he is troubled with a ravenous 
 craving for food. 
 
 Graphite can be given when the emission is almost 
 involuntary, without erection, or when there is tension 
 and cramp-like pain in the genital organs. 
 
 Nux vomica is of importance where there is great 
 costiveness and bad taste in the mouth, with soreness of 
 the stomach, accompanied with pain after eating, and 
 fulness at the pit of the stomach, and also when there is 
 great irritability and feeling of lassitude and fatigue. 
 
 Mercurius should be given when the tongue is thinly 
 coated, the taste depraved, complexion sallow, with 
 chilliness and great sensitiveness to cold ; also when 
 there is costiveness, the motions consisting of hard balls 
 or lumps, having a dark color. 
 
 Phosphorus is of great value when the nervous system 
 seems shattered and the patient complains of oppression 
 and pains in the chest, with tendency to cough. 
 
 Acid Phosph. This remedy is of special value in 
 many cases, particularly when there is great feeling of 
 weakness of the genitals, the semen being lost on the 
 least provocation ; for the debility which ensues from the 
 long continuance of the complaint it is invaluable. 
 
 MASTURBATION, Onanism, or Self- Abuse. — This 
 
 vice, the pernicious effects of which on the system have 
 been so powerfully described by Tissot, that his book has 
 been said to "have brought many sufferers to despair, 
 instead of curing them," is the source of a great many 
 
NON-SYPHILITIC DISEASES. 141 
 
 diseases, destroying the body, and at the same time the 
 mental faculties of those addicted to it. Children, after 
 having indulged in this practice for a time, without 
 being otherwise sick, lose their bright complexion, which 
 becomes pale, with a greenish tint, especially around the 
 eyes, which are sunken, surrounded by blue margins ; 
 their minds are indolent, they sit with the head inclined 
 forward, staring as if absorbed in deep thought, are 
 averse to play, prefer to sit quiet and alone, become ob- 
 stinate, peevish, and irritable, and cannot bear the least 
 joke. Gradually every function, especially digestion, 
 suffers more or less, the tongue and teeth are coated, 
 the body becomes emaciated, and the mental faculties 
 weakened. Should some kind of sickness attack them, 
 it is generally severe, and the least fever is apt to assume 
 a typhoid form. If this vicious habit is continued beyond 
 the age of puberty, the mind is weakened, the memory 
 impaired, if not lost, the ideas become confused, and the 
 patients are frequently seized with mania : the body is 
 exhausted, its growth checked; violent pains, such as 
 headaches, pressure at the stomach, colic, nausea, and 
 vomiting, or pains in the chest, with indescribable lassi- 
 tude of the limbs, torment the unhappy sufferer; the 
 face is covered with itching pimples, or pustules, on the 
 nose, chest, and thighs; some lose all power of erection, 
 others lose their semen at the least excitement, or are 
 troubled with spermatorrhoea, whilst many either lose 
 their urine involuntarily, or, on the contrary, suffer from 
 retention of urine. 
 
 In women, however, the consequences of self-abuse are 
 not less troublesome than in men. Nervous prostration 
 is the first effect produced in young females, and is cha- 
 racterized by headache, depression of spirits, obstinacy, 
 
142 NON-SYPHILITIC DISEASES. 
 
 sadness, indifference to worldly pleasures, and, finally, 
 melancholy, or other forms of mental derangement. The 
 senses become duller, especially the eyes, which are red 
 and dim, with a staring look; all sorts of spasmodic 
 symptoms, such as hysteria, palpitation of the heart, 
 chorea, epilepsy, catalepsy, convulsions, are the conse- 
 quences of this nervous irritation. The face looks sallow 
 and thin, the skin is rough and dry, cracked, covered 
 with pimples ; the lips are pale, and the teeth decay ; a 
 copious mucous discharge takes place from the vagina, 
 excoriating the thighs, groins, and perinaeum ; the inter- 
 nal organs become diseased, and induration and cancer 
 of the womb may be the final results of this pernicious 
 practice. 
 
 Treatment. — The ill consequences of self-abuse may 
 be prevented or removed by the timely and appropriate 
 administration of remedies (homoeopathic) to the patho- 
 logical signs presented, and by acting morally on the 
 mind of the patient. 
 
 The most efficacious remedy in obliterating a tendency 
 to this vice is Sulphur, a dose of which may be given, 
 followed, in a week or so, by Calcarea. 
 
 Nux Vomica is of very great importance where the 
 digestive organs are impaired, attacks of uneasiness, 
 principally after dinner, with nausea and trembling of 
 the limbs, emaciation of the body, frequent erections and 
 pollutions, principally in the morning, with flaccidity of 
 the penis, followed by coldness and weakness in the 
 lower extremities, and increased sexual desire, occur. 
 [It should be taken on going to bed ; and is especially 
 indicated when high living, coffee, spirits, &c, have 
 promoted the difficulty.] 
 
 Staphysagria is perhaps the most efficacious remedy 
 
NON-SYPHILITIC DISEASES. 143 
 
 in this complaint, particularly in cases of long standing, 
 and may be employed when there is hypochondria with 
 great taciturnity, constant uneasiness as to the state of 
 one's health, anxious imagination, imaginary fears, queer 
 notions that expose the patient to the suspicion of being 
 thought crazy, great deficiency of animal heat, and ten- 
 dency to take cold ; or when the memory is weak and 
 confused, and there is giddiness and sleepiness ; the eyes 
 are deep-sunken, red, and lustreless, the hair falls off, 
 there is gnawing toothache and caries of the teeth, which 
 are very brittle, a dry cough, aggravated frequently 
 after eatiug, and indigestion attended with great flatu- 
 lence, the stools being dry and lumpy. The urine is of 
 a deep red or yellow color, with brick-dust sediment ; 
 there is continual loss of prostatic fluid, and the sexual 
 desire is impaired and the penis relaxed, with dull and 
 contusive pain in the testicles. Nux Yom., Calc. c, or 
 Cocculus are frequently required after this remedy. 
 
 [With Berjeau's opinion of the superior efficacy of 
 Staph., in this complaint, I heartily coincide. While 
 preparing these pages for the printer, a young man, to 
 whom I had given this remedy, reported himself cured. 
 He was also very much improved in physical appearance 
 and that of feeling. A weakness of his chest, and tight- 
 ness and sense of compression, with which he was apt to 
 be troubled, w^hen not suffering from emissions, were per- 
 manently removed by a single dose of sulphur 55 thou- 
 sand. The intimate connection of this complaint with 
 consumptive persons and families, and its almost inevi- 
 table tendency to extend to phthisis pulmonalis, but 
 confirms its psoric nature, as asserted in my remarks on 
 Spermatorrhoea.] 
 
144 NON-SYPHILITIC DISEASES. 
 
 Cinchona. When the patient has practised this vice 
 to excess, or for many days in succession, this remedy 
 will speedily relieve the weakness and lassitude which 
 have been produced. It is more especially indicated when 
 there is dulness and confusion of the head, with indiffer- 
 ence to everything, the spirits being low, and attended 
 with anxiety; the sleep very bad, the appetite poor, 
 sensation of fulness and oppression at the stomach, with 
 great flatulence ; the stools loose, of a white color, con- 
 sisting principally of undigested food, the skin being 
 cold, with a febrile, small, soft, frequent pulse. 
 
 Kreasote. In chronic cases, with tendency to scrofu- 
 lous degeneration, this medicine is very useful; it can 
 be given when there is bleeding of the nose, swollen and 
 bleeding gums, and toothache, foul breath, and loss of 
 appetite, with cutting, colicky pains, and diarrhoea of a 
 fetid kind; general lassitude, yawning T drowsiness, and 
 coldness of the skin, with eruption of pimples of a bright 
 red color, are also good indications for its employment. 
 
 Carbo veg. is very efficacious in subduing an excessive 
 excitement of the sexual organs, with lascivious fancies 
 and onanism; and particularly when there is present 
 greenish acrid leucorrhcea in females, often the cause or 
 effect of self-abuse ; it can be given when the patient is 
 irritable and ill-tempered, with constant restlessness and 
 great prostration; or for shuddering and great sensi- 
 bility to cold, with deranged stomach, excessive flatu- 
 lence, and frequent emissions of semen (spermatorrhoea). 
 
 Phosphorus. This remedy is of good service when 
 the patient is very debilitated, and is subject to affections 
 of the chest; it may be employed where the head is 
 affected, the memory being weak or almost gone, with 
 
NON-SYPHILITIC DISEASES. 14.5 
 
 pulsations in the brain and various parts of the body, the 
 eyes being red and sunken, the sight and hearing im- 
 paired, the appetite either bad or extremely ravenous, 
 with nausea and drowsiness after eating, diarrhoea of a 
 painless kind being often present ; or frequent pains in 
 the chest, attended sometimes with cough and palpitation 
 of the heart. It is also very useful in milky leucorrhcea 
 in females, attended with bearing-down pains. 
 
 Calc. carb. is required when there is great depression 
 of spirits, excessive sensitiveness, fatigue produced by 
 the least exertion, and a general sense of illness and de- 
 rangement of the various animal functions ; the head is 
 dizzy, and headache is produced by the least mental ex- 
 ercise, thinking being difficult ; the hair comes off, the 
 eyes are suffused, pus is discharged from the ears, and 
 there is difficulty of hearing, the nose bleeds, the face is 
 covered with itching pimples, a foul taste is in the mouth ; 
 there is loss of appetite, with constant thirst, constipa- 
 tion, and hard and scanty stools, sometimes as white as 
 clay, with great flatulence, frequent emission of milky 
 urine, deficiency of sexual desire, premature and profuse 
 menses, often attended with acrid leucorrhcea, swelling 
 of the feet, great sensitiveness to cold, and followed 
 sometimes by cough and profuse expectoration and 
 violent palpitation of the heart. 
 
 Cocculus. This remedy can be employed when the 
 head is more particularly affected, and there is sadness, 
 irascibility, anxiety, restlessness, particularly at night, 
 headache, affecting the forehead, and often a feeling of 
 intoxication, and very frequently imaginary fears. 
 
 Pulsatilla is very often required, especially for females, 
 
 when the practice has brought on leucorrhcea or hysterical 
 13 
 
146 NON-SYPHILITIC DISEASES. 
 
 affections. The leucorrhoea is generally milky and pain- 
 less, attended with pains in the back; the menses are 
 generally profuse, of a dark or blackish color, and there 
 are spasmodic pains in the lower abdomen, with great 
 sexual excitement, and pains resembling labor-pains. 
 
 Antimon. cruel, is useful when the digestive faculties 
 have become impaired, with eructations and vomiting of 
 food, attended with colic and flatulency, and diarrhoea 
 alternating with constipation ; a constant sensation being 
 present, as if the stomach were overloaded, the appetite 
 totally failing ; sadness, weeping, and impressibility often 
 accompany these symptoms. 
 
 SPINAL IRRITATION. — Pain or soreness of the 
 spine frequently accompanies diseases of the urinary and 
 sexual organs, and is generally felt in the lumbar and 
 sacral regions ; it may arise from hysteria, sexual ex- 
 cesses, masturbation, leucorrhoea, cancer of the uterus, 
 gonorrhoea, and various urinary diseases. The symptoms 
 are aggravated by disagreeable emotions, luxurious living, 
 stimulating drinks, menstrual derangements, late rising, 
 and sleeping on the ground. The strictest investigation 
 is necessary as to the probable cause of the complaint, 
 as the treatment is necessarily dependent upon a right 
 appreciation of certain circumstances. It is important 
 to enforce strict dietary rules, abstaining from meat, 
 coffee, tea, or spirituous liquors; perfect abstinence from 
 all sexual excitement; gentle exercise in the open air, 
 early rising, walking, and sea-bathing, are very useful 
 and restorative. 
 
 Arsenic is very useful in debilitated subjects, who 
 complain of acute drawing pains in the back, which ne- 
 cessitate lying down. 
 
NON-SYPHILITIC DISEASES. 147 
 
 Belladonna can be given for dull distressing pains, 
 drawing round the whole pelvis, or for intense cramp- 
 like pain in the small of the back and sacrum, relieved 
 by standing or walking, and when there are nocturnal 
 emissions without erection. 
 
 Calc. carb. is of great service when there is great 
 weakness of the back and nervousness, with excessive 
 sexual desire, in persons addicted to self-abuse. 
 
 Chamomilla is efficacious in cases of drawing or great 
 bearing down, with pressing pain in the small of the 
 back and down the thighs, and coupled with sexual ex- 
 citement and itching of the scrotum. 
 
 Causticum. Xervous weakness and pains in the 
 loins, rendering the least movement intolerable, and 
 painful stiffness of the parts. 
 
 Cocculus is good in tremors affecting the back, which 
 feels bruised, with increased sexual desire. 
 
 Conium can be employed when there are spasms or 
 stitches in the small of the back, with drawing in the 
 lumbar region when standing ; the sexual desire is lost, 
 and emission of semen takes place on the least excite- 
 ment. 
 
 Lycopodium is required for violent pain in the back, 
 with stiffness of the parts, chilliness, and shrinking and 
 coldness of the penis. 
 
 Nux Vomica is one of the most efficacious of the reme- 
 dies employed against this complaint arising from sexual 
 excesses. The pains are principally felt at night in the 
 small of the back, with sore and bruised feeling in the 
 lumbar region when pressed; attended with sudden 
 stitches in the back, on turning to one side, with dull 
 pain when sitting perfectly quiet ; it is also very useful 
 
148 NON-SYPHILITIC DISEASES. 
 
 in nocturnal emissions, with contused pain in the testi- 
 cles, and continued painful erections. 
 
 Pulsatilla can be used with success when there is weari- 
 ness and stiffness of the back, the right testicle being 
 drawn up and swollen ; continual erections day and night, 
 with excited sexual desire, and seminal emissions. 
 
 Rhus toxic, will be found useful for contusive pains 
 in the back, when lying still, or sensations as if the part 
 were pressed against a sharp edge ; also in tympanitic 
 swelling of the scrotum, with violent sexual desire, and 
 seminal pollutions. 
 
 Sepia. When there is a tendency to chronic conges- 
 tion of the vessels of the spine, occasioning great in- 
 crease of sexual desire, with painful and violent erections, 
 and great weakness in the small of the back. 
 
 [CEREBROSPINAL MENINGITIS.— Although this 
 formidable disease is not known to be anywhere prevalent 
 at this time, some account of its most common forms and 
 prominent symptoms may neither be unacceptable for 
 present study, nor without value for future use. And we 
 are the rather led to undertake the work from the fact, 
 that, while Epidemic "Spotted Fever" may at any time 
 make its appearance, and in any section of the country, 
 very little can be found recorded hitherto, in the periodi- 
 cal or other literature of our school, concerning its pa- 
 thology or its therapeutics.* 
 
 * Marcy and Hunt (" Theory and Practice " Vol. I. p. 527) give 
 a brief account of this disorder, with no other aid — besides men- 
 tioning a few remedies — as to " treatment" than : " this must be 
 conducted on the same general principles as we are governed by 
 in congestive intermittents." This advice is meagre enough in 
 
NON-SYPHILITIC DISEASES. 149 
 
 The base of the brain becomes the seat of two distinct 
 forms of meningeal disease ; these have been designated 
 as simple meningitis, and as tubercular meningitis. In 
 the former, the pia mater, and sometimes the arachnoid 
 of the convexity of the ventricles, are inflamed — often to 
 very considerable extent — and infiltrated with pseudo- 
 membranous and purulent liquid deposits. The latter, 
 — characterized by tuberculous granulations deposited in 
 the meshes of the pia mater, accompanied by ventricular 
 effusion, by cerebral tubercles, and often by tuberculous 
 deposits in some other organ — is usually called acute 
 hydrocephalus. 
 
 True, tubercular meningitis can only be developed, of 
 course, in persons under the influence of the tuberculous 
 diathesis ; that is, in tuberculous (scrofulous) subjects. 
 While simple meningitis, so far from being restricted to 
 those who are not of a scrofulous or psoric constitution, 
 is certainly more apt to be developed in those who are. 
 
 " These differences," says M. Rilliet, " which M. Bar- 
 
 itself, but the assertion which precedes, that "the pathological 
 features of the disease cannot be distinguished from those of con- 
 gestive intermittent," is still worse, because more misleading. 
 Here again we find repeated the great error of the allopathic 
 school, — the very one of all others which a work on homoeopathic 
 practice should have eschewed ; a conjectural therapeia, based 
 upon a supposititious pathological trestle-work. Not only do our 
 authors furnish no indications for the remedies, but their " treat- 
 ment" rests upon a pathology which is at once hypothetical and 
 unsound. 
 
 Raue (" Pathology and Therapeutics," p. 13) gives a concise 
 statement of the principal symptoms, and "therapeutic hints " for 
 a few remedies, of which we have made use in the latter portion 
 of this article, 
 13* 
 
150 NON-SYPHILITIC DISEASES. 
 
 thez and myself have already expressed in detail, are so 
 decided, that, if we are shown the brain of a child in 
 which the fissure of Sylvius is agglutinated, and pseudo- 
 membranous, or concrete purulent infiltration exists at 
 the base, whilst the arachnoid and the pia mater of the 
 convexity are uninflamed, we do not hesitate to affirm, 
 on this simple examination, and without further micro- 
 scopic investigation, that most probably there are granu- 
 lations in the meninges, that the ventricles are, or have 
 been distended by serous effusion, and that there cer- 
 tainly exist tubercular deposits either in the lungs or 
 bronchial glands, or elsewhere. We could affirm that 
 the acute symptoms have been preceded by prodromata, 
 that the outbreak was insidious, that the meningitis was 
 announced by vomiting, constipation, and moderate ceph- 
 alalgia, without acute fever ; that the intelligence was 
 intact, at any rate during the first week, and that the 
 disorder lasted from fourteen to twenty-one days. On 
 the other hand, on being shown the brain of a child, 
 where the convexities of the hemispheres are covered 
 with purulent deposits or false arachnoidian membranes 
 to considerable extent, we do not hesitate to affirm, with- 
 out fear of being contradicted by experience, that no 
 tuberculous deposit is to be found either in the meninges, 
 brain, or elsewhere ; that the outbreak was abrupt and 
 violent, introduced by convulsion, if the patient was 
 very young, by vomiting, constipation, and violent head- 
 ache, if the child was older. That the symptoms were 
 followed, after from one to three days, by formidable 
 phrenesis, and that the course of the whole malady was 
 very short, viz., three, four, or six days."* 
 
 * Traits Clinique et Pratique; par M. M. Rilliet et Barthez. 
 Paris, 1846. 
 
NON-SYPHILITIC DISEASES. 151 
 
 This description — written in France nearly twenty 
 years before the appearance of the epidemic cerebro- 
 spinal meningitis in this country — so closely resembles 
 our " spotted fever," that it seems to prove this strange 
 and malignant disorder to be but a development of 
 ''simple meningitis." But the distinction so much dwelt 
 upon by our authority, and which admits of demonstration 
 only upon the dead subject, would scarcely be deemed 
 of any practical importance, were it not possible to indi- 
 cate some peculiarity by means of which it may be rec- 
 ognized in the still living patient. This peculiarity we 
 think may be found in the pseudo-membranous nature 
 of the deposit already described as occurring at the con- 
 vexities of the hemispheres. or ventricles, and which no 
 doubt extends downwards along the course of the spinal 
 meninges. But this false membrane, which is obvious 
 enough upon examining fatal cases of " simple meningi- 
 tis," — and we believe no less so in those of the modern 
 epidemic " cerebro-spinal meningitis,"* — can itself be 
 
 * "Four cases are related of the disease with the post-mortem 
 appearances. In all the cases, deposits of lymph, of greater or 
 less extent, were found on the brain and spinal cord. In one 
 case, the anterior two-thirds of the cerebrum superiorly, was 
 covered with an adventitious deposit of lymph, of a greenish 
 yellow color, forming adhesions between the arachnoid and the pia 
 mater, and following the latter as it dips down into the convolutions 
 of the brain. In another case, there was a deposit of lymph be- 
 tween the pia mater and arachnoid, on the anterior surface of the 
 cerebrum superiorly, extensively upon and around the optic 
 commissure, over the entire cerebellum, crura cerebri, pons 
 Varolii, medulla oblongata, and spinal cord throughout its whole 
 extent to the cauda equina. The nerves arising from the cord on 
 both sides were enveloped with this deposit also. At several 
 
152 NON-SYPHILITIC DISEASES. 
 
 recognized during life only by some other and constantly 
 attendant symptom. This constant and pathognomonic 
 symptom may be found, we believe, in the " spots," 
 from which arises the popular name of the disorder. 
 For here, as in many other forms of disease, the conse- 
 quences, which are seen, take precedence, in naming the 
 disease, of its causes and essential nature, which may be 
 alike unknown. We speak of these " spots " as being 
 constant ; but in the milder cases they may not be dis- 
 cernible, and the severest cases may prove fatal before 
 they are developed, — as children sometimes succumb to 
 malignant scarlatina before the eruption is developed. 
 
 From the constancy of the appearance of "spots," pe- 
 techia, ecchymosis, &c, in the lowest form of typhoid 
 fever, in jail and ship fevers, in diphtheria, in croupous 
 diphtheria, and in epidemic cerebro-spinal meningitis, or 
 " spotted fever," we learn that these " spots " result from 
 a certain suppression of the capillary circulation and 
 dyscrasia of the blood itself, which indicate a profound 
 prostration of the vital forces. And we may with safety 
 conclude that this same blood disease and accompanying 
 nervous prostration, which cause these " dark purplish 
 spots," produce also those plastic exudations, which are 
 known as pseudo-membranous formations, or false mem- 
 branes. Hence the most remarkable pathological differ- 
 ence between the two forms of disease — diphtheria and 
 spotted fever- — which have all along been regarded as 
 mysteriously similar, will actually illustrate and confirm 
 
 points along the cord it had degenerated into pus." This 
 ' ' lymph " upon interior surfaces corresponds to the denser false 
 membranes organized from plastic exudations upon exterior, 
 mucous surfaces. 
 
NON-SYPHILITIC DISEASES. 153 
 
 this very similarity. For, in diphtheria, the blood-dys- 
 crasia gives rise to plastic exudations, or false membranes, 
 on free mucous surfaces ; while in epidemic cerebro-spinal 
 meningitis the pseudo-membranous deposit occurs on the 
 convexity of the ventricles, or hemispheres, — that is, on 
 enclosed and confined surfaces. And, in consequence, we 
 find, in the former disease, final paralysis from nervous 
 prostration, but no previous spasm from compression; 
 while, in the latter disorder, convulsions from nervous 
 compression precede paralysis from exhaustion. 
 
 Dr. Kempf, an intelligent physician of Southern In- 
 diana, gives an account of the epidemic as it occurred in 
 his section, in the month of December, 1862.* He 
 makes three divisions of the disease, according to its 
 intensity: cerebro-spinal asphyxia, — corresponding to 
 the worse forms of cholera, or yellow fever, in which 
 there is no reaction; cerebro-spinal inflammation, the 
 fully developed cerebro-spinal meningitis; and cerebro- 
 spinal irritation, in which the attack of the disease is 
 comparatively slight. We give his description of each 
 form ; his whole account, although it may not exactly 
 resemble the epidemic anywhere else, will enable the 
 physician to recognize the disorder the first time he 
 meets with it. 
 
 " Cerebro-spinal asphyxia is generally ushered in with 
 an alternation of chilliness and heat, violent pain in the 
 head and back, pain in the extremities, vomiting, and 
 diarrhoea of a bilious character. The patient presents an 
 appearance as though he was deeply intoxicated. When 
 roused, he will give a half intelligent look and an inco- 
 herent answer. His eyes are dull, injected, watery, and 
 
 * Am. Jour. Med. Sci., No. CIII. New Series, p. 55. 
 
154 NON-SYPHILITIC DISEASES. 
 
 the pupils dilated, or one contracted and the other dilated ; 
 the pupil may be round, elliptical, or irregular. Tongue 
 cool and swollen ; breath cool. Pulse irregular, feeble, 
 and frequent; though sometimes it is almost natural, 
 calm, regular, soft and full, whenever the patient is sink- 
 ing rapidly and the approach of death is imminent. The 
 surface of the patient is mottled with purplish spots. 
 Cramps of the extremities are common ; sometimes there 
 is jactitation of the whole body, but not of the violent 
 character observed in cerebro-spinal inflammation. 
 
 " Cerebrospinal meningitis, the sthenic type of the 
 disease, with evidence of inflammation of the meninges 
 of the brain and spinal cord, generally commences with 
 a peculiar nervous agitation, wandering pains of a rheu- 
 matic or neuralgic character, followed by a chill and by 
 inflammatory reaction ; pain in the head, darting from 
 temple to temple ; pain along the spine^ and in the ex- 
 tremities, much aggravated by movement or pressure ; 
 acute sensibility of the surface, the least pressure or the 
 slightest touch causing the patient to moan or scream ; 
 high vascular excitement. As the disease advances, the 
 patient becomes more or less delirious, his countenance 
 having a wild expression. He is often affected with 
 cramps of the extremities, tetanic spasm or hysteric con- 
 vulsions. The eyes are injected, and intolerant of light ; 
 the pupils are generally contracted, though sometimes 
 one is dilated and the other contracted, the edge of the 
 pupil being round, oval or notched ; the pupil itself is 
 either clear or opaque, with a milky or greenish effusion 
 — this is generally, however, a symptom of the latter 
 stage of the disease ; there is defective vision, muscse 
 volitantes, or complete amaurosis. The sense of hearing 
 
NON-SYPHILITIC DISEASES. 155 
 
 is sometimes very acute, again very obtuse, or totally 
 lost. The stomach is generally irritable, with more or 
 less vomiting of a bilious character. The bowels are 
 mostly costive. Urine high-colored and scanty. In 
 most of these cases, herpetic eruptions appear about the 
 mouth and nose. A prominent symptom, which has 
 been considered by some writers as pathognomonic, is 
 generally present, namely, spots or petechiae of a scarlet 
 color, generally minute in size and few in number, though 
 in some instances they cover the greater portion of the 
 surface of the body. In the malignant type, the skin 
 presented a maculated appearance, of a dull crimson, or 
 deep purple hue. 
 
 "The duration of cerebro-spinal meningitis is from 
 twenty-four hours to two or six days ; the majority die 
 between the latter periods, but now and then a case is 
 protracted for several weeks or months. The patient, 
 after becoming convalescent from an acute attack, and, to 
 all appearance, out of danger, may have a slight exacer- 
 bation towards evening, slight pain in the head, cloudi- 
 ness of intellect, and indistinct articulation. He may 
 complain of dimness of vision, anomalous sights, or one 
 eye may be perfect and the other nearly blind. He may 
 have buzzing in the ears, hear unusual sounds, or the 
 organ may be too sensitive or too obtuse. I have visited 
 patients in whom the analogy between intermittent fever 
 and the disease under consideration was so perfect that 
 the most circumspect would be deceived. 
 
 " Of cerebrospinal irritation, I will only remark that, 
 on the decline of the epidemic, a great number of indi- 
 viduals, especially adults, complained of headache, ma- 
 laise, neuralgic pains in various parts of the body, and 
 
156 NON-SYPHILITIC DISEASES. 
 
 pain in the nape of the neck, or other parts of the spine. 
 The ailment yielded readily to morphia and quinia. Ce- 
 rebrospinal irritation very likely was a precursor to the 
 graver forms ; but as not much alarm was felt before the 
 epidemic had made some ravages, the physician was not 
 consulted in this minor form of the epidemic." 
 
 Dr. Kempf narrates five cases of the severest, or, as he 
 would term it, the asphyxia form of the disease ; all of 
 which proved fatal within six or seven hours at the 
 furthest. The second case we quote : " H. B., a fine 
 boy, of seven years of age, left home at 8 a. m., to at- 
 tend school, half a mile distant; he returned at ten 
 o'clock, complaining of violent pain in the head. As the 
 child had been subject to ague, the parents attributed his 
 symptoms to an attack of that disease ; but as he soon 
 became insensible, and his surface covered with purplish 
 spots, I was requested to see him at 2 ft m. I found the 
 child comatose ; insensible to shaking or pinching of the 
 extremities ; to all appearance blind and deaf ; eyes in- 
 jected and turned upwards, pupils dilated ; pulse per- 
 fectly natural. This condition was found to be in every 
 instance a very unfavorable symptom. Death occurred 
 the same evening." 
 
 The following description of the same disorder as it 
 appeared in Mobile, Ala., during the winters of 1863-4, 
 and 1864-5, will be found interesting and instructive.* 
 
 "In the midst of good health, after taking a hearty 
 meal, or after a full day's work, the patient, without any 
 premonitory symptoms, is suddenly attacked with coma, 
 or stupor, so profound that he is with difficulty aroused 
 even for a moment. 
 
 * Atlanta Med. and Surg. Jour., June, 1866. 
 
NON-SYPHILITIC DISEASES. 157 
 
 " In other cases, vertigo, pain in the head and cervical 
 region, extending along the spine, with lassitude and ap- 
 prehension of impending danger, are observed. Then 
 again, chilly sensations at intervals of two or three hours, 
 with cold extremities, followed by exacerbation of heat, 
 flushed face and increased pulse, mark the approach of 
 the disorder. Lastly, delirium, more or less w^ild, with a 
 disposition forcibly to leave the bed or room, is in the 
 outset a prominent symptom. The condition of the pulse 
 was variable ; usually ranging from ninety to one hun- 
 dred, hardly reaching one hundred and ten, unless just 
 before the termination in death ; on the other hand, it 
 occasionally sank to forty or fifty beats per minute. 
 Vomiting of bile and constipation are usually, in the be- 
 ginning, prominent symptoms ; the tongue is furred, and 
 as the disorder advances, the teeth become covered with 
 sordes. 
 
 " The urine is highly colored, scanty and often re- 
 tained ; at other times, especially towards the close, it is 
 passed involuntarily. Intolerance of light and sounds, 
 when present, appears at the early part of the attack ; 
 the least ray of light being sufficient to cause spasmodic 
 closure of the eyes and intense suffering ; walking across 
 the floor is excessively annoying to the sufferer ; deafness 
 and a general indifference to surrounding objects are 
 m generally noticed. 
 
 " The most prominent and almost universal symptoms 
 are pain in the head and neck, accompanied by a tetanic 
 rigidity of the cervical muscles, and of the large extensor 
 muscles of the back. This trouble, slight at first, in- 
 creases until the head is drawn back upon the shoulders, 
 and no ordinary degree of force used by the attendant 
 14 
 
158 NON-SYPHILITIC DISEASES. 
 
 can overcome it. The muscles of the back and lower 
 extremities are occasionally so much involved as to pro- 
 duce complete opisthotonos. In connection with this 
 condition, paralysis of the muscles of the face is some- 
 times present, as exhibited in depression of the lower 
 jaw and protrusion of the cheeks and lips in expiration. 
 Involuntary twitchings of the muscles and want of pre- 
 hension often exist also— the patient being unable to 
 drink without assistance. Strabismus in one or both 
 eyes was met with in several cases. The appearance of 
 the pupils is not always the same, in the majority of 
 cases being dilated ; sometimes one is contracted and the 
 other dilated, and I have occasionally seen both con- 
 tracted. Delirium may be present at any period of 
 cerebro-spinal meningitis, though most common in the 
 latter stages before coma sets in ; and is then of a low, 
 muttering character. 
 
 "When coma comes on, which is usually about the 
 fourth or fifth day, the pupils become widely dilated, the 
 pulse more full, but is never, so far as my observation 
 extends, of a bounding character, as in coma from apo- 
 plexy. Involuntary discharges from the bowels and 
 bladder are now of most frequent occurrence. Stertorous 
 breathing is rarely present, and until coma is profound, 
 the patient is continually tossing himself from side to 
 side in bed, and carrying his hands to his head asthough* 
 in great pain. 
 
 " Another very common symptom is hypersesthesia 
 of the whole nervous system ; pressure upon the ex- 
 tremities, slight mo.ving of feet or bending the toes, 
 causes the patient to cry out from pain. This exaltation 
 of sensibility does not often appear at first, but towards 
 
NON-SYPHILITIC DISEASES. 159 
 
 the latter part of the attack. While vertigo, pain in the 
 head, chilly sensations, intolerance of light and sound, 
 deafness, stupor, exalted sensibility of the nervous sys- 
 tem, delirium and coma were the usual symptoms by 
 which this epidemic was characterized ; yet there were 
 few cases of an intermittent type, accompanied by high 
 fever, with pain in the head. Under the use of quinia, 
 these symptoms would yield for a few days, and conva- 
 lescence seemed to be established. A recurrence of these 
 symptoms would take place two or three times, when 
 those more violent, as extreme pain in the head and neck, 
 rigidity of the muscles, &c, would supervene and de- 
 clare unmistakably the formidable nature of the disease. 
 
 " The duration of this affection is variable ; it may de- 
 stroy life in twenty-four or forty-eight hours, but from 
 five to eight days is the usual time. During the winter 
 of 1863-4, it proved fatal sooner than in the following 
 — a few of the last cases seen having lived from ten to 
 fifteen days." 
 
 Therapeutics. — Aconitum. Chilliness; high fever; 
 hot, dry skin ; great thirst ; restlessness. Dilatation 
 of the pupils ; avidity for light ; desire to look at bright 
 light. Hah. — Great photophobia. (S. Codex.) Contrac- 
 tion of the pupils (photophobia), according to Hale, indi- 
 cates Aconite in cerebral diseases : as dilatation of the 
 pupil (and thirst for light) does Gelserninum.* 
 
 It may be remarked that Aconite is thus indicated by 
 its characteristic symptoms in cases which may indeed 
 become developed as " Spotted Fever ; " but which — 
 
 * Drs. Hale and Searle, — New Remedies, pp. 405, 426, — 
 seem to deny that Aeon, primarily causes dilatation of the pupil ; 
 but this is contrary to Hahnemann's experience in proving thia 
 remedy. 
 
160 NON-SYPHILITIC DISEASES. 
 
 except from the recurrence of other cases with similar 
 symptoms terminating in this disease — could not be de- 
 termined in advance as instances of it. And when thus 
 administered, where alone its symptoms call for it, in the 
 early stage of this disorder, (as also in incipient Diph- 
 theria and Pneumonia,) this remedy may suffice to cure 
 the patient entirely, by arresting the morbid processes 
 before they have reached the stage of plastic effusion. 
 
 Apis. Yiolent pains in the head, — aggravated by 
 lying down ; relieved temporarily by pressing firmly 
 with the hands. Great inclination to sleep, but inability 
 to do so from extreme restlessness and nervousness. 
 Sleep disturbed by oppressed respiration and disagree- 
 able dreams. Rapid, painful, and spasmodic respiration, 
 aggravated by lying down, (opposite to Cantharis,) and 
 ameliorated by inhaling the fresh air in an upright posi- 
 tion. Sensation as though he should notbe able to breathe 
 again. Sudden prostration of the vital force. Burning, 
 stinging pains. 
 
 The direct pathogenesis of Apis presents neither the 
 convulsions nor the " spots " which characterize cerebro- 
 spinal meningitis ; but it has the violent headache, and 
 all the paralytic symptoms which result from the serous 
 or other exudation of the advanced stage of this disease. 
 "While its acknowledged value in acute hydrocephalus, 
 in arachnitis, and in the secondary or exudative stage of 
 what is termed " Meningitis Basilaris of Children,"* will 
 entitle it to a careful study in this connection. 
 
 * U. S. Med. and Surg. Journal, Vol. I. p. 237; and II. pp. 31, 
 129. Valuable indications for the remedies are given in this 
 article, — equally applicable to Cerebro-spinal Meningitis, and to 
 " Basilar Meningitis of Children." 
 
NON-SYPHILITIC DISEASES. 161 
 
 The Apis seems to produce serous rather than plastic 
 exudations; but when indicated by its dynamic subjec- 
 tive symptoms, it will always do good. And we can 
 see when the remedy is called for, during the life of our 
 patients, by means of these dynamic symptoms ; while 
 if we were to rely upon the demonstration of the exact 
 pathological condition, (the nature of the exudation as 
 serous or pseudo-membranous), we should be obliged to 
 postpone prescribing till after we had made a post-mortem 
 examination of the subject. 
 
 In a very bad case of Spotted Fever in a young man — 
 successfully treated by Dr. Williamson, some years ago — 
 Apis (and also Cantharis) was found of great service in 
 relieving the accompanying urinary difficulties. These 
 nephritic complications, which are so common to both 
 Spotted Fever and Diphtheria, furnish additional proof 
 of the similar nature of the two disorders. 
 
 In Spotted Fever, as in other affections of the nervous 
 centres, Apis is believed to be far more efficient in the 2° 
 than in any lower preparation.* 
 
 Arnica. Red, blue, and yellow spots, like ecchymoses. 
 Coma somnolentum, with delirium and carpologia. Jac- 
 titation of single muscles; twitching in all the limbs; 
 tremor of the limbs. Convulsions and tetanic spasms. 
 Painful and excessive sensitiveness of the whole body.f 
 
 These strongly-marked objective symptoms, and the 
 great efficacy of Arnica in certain forms of Typhoid and 
 
 * Compare Marcy and Hunt's Practice, Vol. I. p. 530 ; and 
 U. S. Med. and Surg, Jour., Vol. II. p. 180. 
 
 f "Pressure on the back of the neck elicits a cry of pain," on 
 the fourth day, in a case which terminated fatally on that day. — 
 Am. Jour. Med. Set., July, 1866, p. 126. 
 14* 
 
162 NON-SYPHILITIC DISEASES. 
 
 Typhus Fever — where the symptoms in many impor- 
 tant respects resemble those of cerebro-spinal meningitis 
 — should ensure the thorough study of this remedy in the 
 latter disorder 
 
 Arsenicum. This powerful drug acts primarily upon 
 the organic or vegetable nervous system, and only in a 
 secondary manner upon the cerebro-spinal system, al- 
 though recommended with others, in a general manner, 
 by Marcy and Hunt. Still, if dynamically indicated, — 
 that is, by the prevailing symptoms, especially the sub- 
 jective ones, — it should be carefully exhibited. And 
 the success which must attend its administration will 
 show the superiority of nature's great law of the Similars 
 over all the deductions which we may make from our 
 own petty pathological theories. 
 
 Belladonna. Headache in paroxysms, as if the brain 
 would burst, aggravated by moving the eyes, by shaking 
 the head, ivhen lying down, by light and by noise ; re- 
 lieved by compressing the head with the hands. Glow- 
 ing redness of the face ; dark red face ; bluish red face. 
 Contraction of the pupils ; dilatation of the pupils (im- 
 movable pupils) ; double vision. Convulsions, especially 
 of the arms. Screaming ; moaning, starts, which wake 
 him even when on the point of falling asleep. Rigidity, 
 with bending the body and head backwards, or to the 
 left side. Right side principally affected. The peculiar 
 character of the delirium and moral symptoms will de- 
 termine the choice between Bell, and Stram., Hyos., and 
 Yeratrum.* 
 
 * For a full and elaborate comparison of Bell, and Stram., — 
 one differing from and far superior to that of Gross, — see Wells on 
 Scarlatina, Am. Mom. Review, Vol. V., March, 1865. 
 
NON-SYPHILITIC DISEASES. 163 
 
 Bryonia. Sharp, lancinating pains in the head, worse 
 from motion, better when lying down. Bursting head- 
 ache, worse when rising up. Face red and bloated, like 
 Bellad. ; but neither dilatation nor contraction of the 
 pupils. Petechia?. Stiffness in the neck ; great pain in 
 the limbs and joints, not allowing of motion. Plastic 
 exudations, or pseudo-membranous formations;* these, 
 in accordance with our view of the nature of cerebro- 
 spinal meningitis, may be deposited about the base of 
 the brain. And as in Diphtheria and in Croup, so in this 
 disease, Bryonia, instead of being entirely overlooked, 
 should be most carefully studied. 
 
 Cantharis. Affections principally of the right side. 
 Violent pains in the head ; drawing, tearing in the head; 
 stitches in the head, in the occiput, as if in the bone, or 
 deep in the brain, — in the right temple, — in the fore- 
 head; lancinations in the head, waking him from sleep. 
 Protruded eyes ; eyes in spasmodic motion; fiery, spark- 
 ling, with steady, staring look; things look yellow. 
 Bloatedness in the face. Lock-jaw, with grinding of the 
 teeth, and discharge of foamy and even bloody saliva. 
 Oppression of breathing, relieved in a recumbent position ; 
 (opposite to Apis.) Retention of urine ; suppression of 
 urine ; strangury ; dysuria ; paralysis of the neck of the 
 bladder. 
 
 The remarkable efficacy of this medicine in Diphtheria; 
 in removing the false membranes from the fauces, and 
 also from the vaginal, uterine and urethral mucous sur- 
 faces ; and its value in the urinary complications of 
 Spotted Fever, in conjunction with Apis, — according to 
 the experience of Dr. Williamson, — strongly confirm our 
 * Yide Neidhard on Diphtheria, p. 118. 
 
164 NON-SYPHILITIC DISEASES. 
 
 supposition of tbe plastic nature of the exudation at the 
 base of the brain in the latter disease. The respective 
 subjective symptoms of Cantharis or of Apis, which may 
 predominate, will determine the choice of the one or the 
 other of these two remedies, when nephritic or urinary 
 complications arise in cerebro-spinal meningitis. And 
 the improvement brought about by either, when thus 
 indicated, if not equal to the entire cure of the patient, 
 will at least prepare the way and enable some other 
 remedy to complete the work. In healing, as in learning, 
 all that is gained is doubly valuable, — for its own sake, 
 and for the sake of the still further progress which it 
 facilitates and secures. 
 
 Cicuta vi. Insensibility. Stiffness of the jaws. He 
 bends his head backward. Stiff, sore neck. He feels 
 sore all over. 
 
 11 The petechia," remarks Dr. Lippef — to whom we are 
 indebted for the above, and other symptoms, — "are not to 
 be found in the pathogenesis of Cicuta ; but cures with 
 it have been reported." 
 
 Crotalus horrid. Pain in all the limbs ; horrid head- 
 ache ; red face ; delirium with open eyes ; ecchymosed 
 spots everywhere ; Raue. Most of the symptoms appear 
 on the right side. Compare Crotalus cascavella in 
 Mure's Materia Medica. 
 
 Elaps corallinus.* Bight side principally affected. 
 Pain in cerebellum, right side ; pain in the whole spinal 
 marrow. The arm and hand are swollen, bluish, covered 
 with red spots ; also, the right leg and foot, Cramps in 
 the calves. Cramps in the right side. Paralysis of the 
 right side ; the right side is numb, as if paralyzed. The 
 
 * Dr. B. Mure's Materia Medica, Wm. Radde, New York, 1854. 
 
NON-SYPHILITIC DISEASES. 165 
 
 extremities look blue, with reddish spots. Phlyctenae 
 here and there, especially on the extremities. 
 
 Lachesis. The leftside is principally affected. Affec- 
 tions of the throat, beginning at the left side, and ex- 
 tending to the right, require Lachesis rather than Lycop. ; 
 while those which beginning at the right side extend to 
 the left, require Lycop. rather than Lachesis.* Convul- 
 sions and other spasms, with violent shriek, particularly 
 about midnight, waking the patient. Aggravation of 
 the symptoms during rest ; amelioration during motion ; 
 exacerbation after every sleep, in the day or night. 
 
 Each one of these several varieties of the serpent- 
 poison seems capable of developing upon the skin colors 
 resembling those of the serpent from which it is derived. 
 " The skin (of the prover) looks like that of the snake." 
 Observe the contrast : Elaps and Crotalus hor. for the 
 right side ; Lachesis for the left. 
 
 Gelseminum. Headache; heaviness, giddiness, as if 
 intoxicated. Headache, which comes on suddenly, with 
 dimness of sight, or double vision, and dizziness. Dila- 
 tation of pupils (compare Aconite) ; complete loss of 
 muscular power, of vision and speech ; icy coldness of 
 the hands and feet ; nausea ; vomiting. Drowsiness ; 
 wants to lie still and rest. Fever without thirst ; (thirst 
 during the sweat.) Profuse emission of watery urine, 
 accompanied by transient chilliness, tremulousness, and 
 an evident alleviation of the sensations of heaviness of 
 the head, dulness of the mind, and dimness of sight. 
 
 " Gelseminum has direct relation to the incipient or 
 congestive stage of cerebro-spinal meningitis, and also in 
 some degree to the consequent inflammation. An attack 
 
 * Dr. Ad. Lippe, Am. Horn. Review, Vol. V. p. 438, April, 18G5. 
 
166 NON-SYPHILITIC DISEASES. 
 
 of this disorder is usually sudden, and is ushered in by a 
 severe chill, accompanied by evident congestion to the 
 spine and brain, with its ordinary symptoms, — among 
 which dilatation of the pupil is, I believe, always seen. 
 This state is followed — except in those cases which die 
 collapsed — by reactionary fever of corresponding vio- 
 lence. In such a condition of the system, no remedy is 
 so homoeopathic as Gelseminum." Searle. 
 
 Aconite — in some respects similar to Gelseminum * 
 — produces restlessness; while Gelseminum produces 
 (drowsiness) prostration and even paralysis of the 
 muscular system. In addition, we note that Aconite 
 has violent thirst, and bright redness of the face ; while 
 Gelseminum has moderate thirst, or little or none, and a 
 crimson hue of the cheeks. 
 
 Kreosotum. My attention is called to this remedy by 
 J. J. Detwiler, M. D., of E'aston, — by whom it has been 
 found useful under the following conditions : 
 
 Discharges from the bowels, with symptoms peculiar 
 to Kreosotum. Rigidity of the muscles. 
 
 Yesicles round the mouth, white-tipped, filled with 
 water. Yesicles on the tongue, like little blisters. 
 
 Eruption peculiar to K., — more like flea-bites. 
 
 Fetor, similar to the smell of Kreosote. 
 
 Chlorine. Has also been recommended in this disorder. 
 
 Oxalic acid. Eruption, or mottled appearance of the 
 skin in circular patches.f Paroxysms of tetanic convul- 
 
 * See a comparison of these two remedies in Gross's Comparative 
 Materia Medica. Curiously enough, this comparison, which Gross 
 never saw, — it having been prepared after his decease, by the 
 joint contribution of the American editor and his collaborators, — 
 is the only one which was republished by his reviewers as a spe- 
 cimen of his life-work ! Sic vos non vobis ! 
 
 f Dr. W. Williamson, to whom I am much indebted for valuable 
 
NON-SYPHILITIC DISEASES. 167 
 
 sions, which arrest the respiratory process entirely for 
 the time being. Acute pain in the back, gradually ex- 
 tending down the thighs, occasioning, ere long, great 
 torture. Great prostration. 
 
 This remedy deserves to be carefully studied in severe 
 cases of Spotted Fever ; and it may prove to be suited, 
 especially to its advanced stages, after exudation. Com- 
 pare Apis. 
 
 Baptisia. "Has many symptoms which resemble 
 very much those which are said to occur in the so-called 
 ■ Spotted Fever. 7 Dr. Rogers claims to have used it 
 with benefit in his own case, during an attack of ' Cerebro- 
 spinal fever,' which was epidemic in his locality. We 
 would suggest to our colleagues a careful comparison of 
 the symptoms of this dreaded malady with the proving 
 of Baptisia. It may be found a valuable remedy in the 
 treatment of that fatal epidemic." * 
 
 Cimicifuga. Successfully employed by Dr. Searle,f 
 from whose "Xotes on the Xew Remedies" the follow- 
 ing, partly pathogenetic and partly clinical, indications 
 are extracted: "Severe chills, nausea and vomiting, de- 
 lirium and acute pain in the head, shooting down the 
 spine, with rigidity of the muscles of the back," — symp- 
 toms of incipient cerebro-spinal meningitis, — in a feeble 
 woman of fifty years, — which w^ere removed in twenty- 
 hints derived from his own successful experience in treating this 
 disease, informs me that Dr. Hering, when engaged in proving 
 this drug upon himself, was for a long time marked by the 
 "spots." The first symptom, given above, is quoted in S. Codex, 
 from Christison. 
 
 * Hale, Materia Medica of New Remedies, p. 120. 
 
 f New Remedies, p. 209. 
 
168 NON-SYPHILITIC DISEASES. 
 
 four hours. Alternate tonic and clonic spasms. Pain in 
 every portion of the head, chiefly in the vertex and occi- 
 put, extending often to the shoulders and down the spine, 
 accompanied by a delirium which perfectly simulates 
 maniaa-potu. The pain is sometimes paroxysmal, and 
 is pressive, throbbing and aching in its nature, and at- 
 tended by tremor and illusions of vision. Intense, 
 throbbing pain, like a ball driven from the neck to the 
 vertex, with every throb of the heart. Intense and per- 
 sistent pain in the eye-balls, which are dull, aching and 
 sore. Dilatation of the pupils. Swollen tongue. Dys- 
 phagia. It has cured Chorea when attended with almost 
 complete loss of the power of swallowing. 
 
 Sulphuric acid. This remed}^ has the petechia, or 
 rather maculated spots, with soreness of the flesh, and 
 great and sudden sinking of strength. It has, also, jerks, 
 cramps, and other minor spasmodic ^symptoms, and sub- 
 sultus tendinum, and, therefore, may be indicated and 
 found useful even in the more advanced stages of the 
 disease. 
 
 Eupatorium perf. Has been found curative in this 
 disorder, by Rafinesque, (allopathic, in 1820,) and later 
 by Drs. Pratt, Belden, and others. It is indicated by 
 severe aching and soreness in the limbs; aching pain 
 and soreness, as if from having been beaten, in the calves 
 of the legs, small of the back, and in the arms above and 
 below the elbows ; aching in the bones of the extremities, 
 (as if the bones were broken,) with soreness in the flesh ; 
 copious perspiration, which gives no relief; cramps; 
 thirst before the chill ; — nausea and vomiting after the 
 chill.* 
 
 * Materia Medica of New Remedies, p. 352. 
 
NON-SYPHILITIC DISEASES. 169 
 
 Veratrum viride. This most important and powerful 
 remedy has proved curative in a desperate case of trau- 
 matic eerebro-spinal meningitis — arachnitis — which was 
 strongly marked by dilated pupils ; the muscles of the 
 back of the neck contract, drawing the head back on the 
 shoulders ; delirium ; clonic spasms ; complete opistho- 
 tonos ; during the spasm, the heels almost touched the 
 head, forming a hoop of the body. Another case, equally 
 hopeless, occurring after scarlatina, was cured by the 
 Verat. v., in which was observed "a strip, about six 
 inches wide, extending from the crown of the head to the 
 bottom of the spine, very pungently hot and dry, reddish 
 in appearance, with several large and small petechia, 
 like mosquito bites, scattered over the inflamed strip." * 
 
 Our limits will not allow of any attempt to present 
 the special indications for this remedy, in this connec- 
 tion ; but enough has been given to show that no one 
 can expect to do justice to such cases, who does not care- 
 fully study its entire literature — both the pathogenetic 
 and the clinical. 
 
 Alumin. met. Dr. Ruhfusf narrates a case of com- 
 plicated disease of the brain and nervous system— -chronic 
 eerebro-spinal disease — successfully treated by him, with 
 Alumin. met. 30 , after some advantage had been derived 
 from Bell., Phosph., and Xux vom. 
 
 Nux vom., Rhus tox., and Cuprum acet. Dr. H. Ben- 
 nett, of Rochester, N. Y., reportsj a case of spotted fever, 
 
 * Materia Medica of New Remedies, p. 1039. 
 
 f Allgemeine Horn. Zeitung, Vol. LXYIII. p. 75, quoted in Am. 
 Horn. Review, Vol. IV. p. 511. 
 
 \ North American Journal of Homoeopathy , Vol. XVI. p. 9. Au- 
 gust, 1867. 
 15 
 
170 NON-SYPHILITIC DISEASES. 
 
 in a lad of thirteen years, recently from England. He 
 was taken with severe pain in the head, on Thursday ; 
 the same evening became delirious, and had spasms fre- 
 quently during the night. On Friday, a. m., his head 
 was drawn back ; pupils dilated ; livid spots upon face, 
 breast, arms, and lower extremities ; pulse 115 to 120 per 
 minute. Yery feeble ; jaws firmly set part of the time ; 
 had occasionally vomited a green, bilious matter the pre- 
 vious night. He got jSux v., Rhus t, and Cup. acet., 
 alternately, at intervals of fifteen minutes ; gradually im- 
 proved, and finally recovered, in a few days, under the 
 same medicines continued at longer intervals. 
 
 Hyoscyamus. Double Vision; convulsions; delirium. 
 
 Lycopodium. Sopor; sinking of the lower jaw; fan- 
 like motion of the nostrils ; jerkings of the body and 
 limbs. Baue* 
 
 Opium. Stupor; spasms; drawing the body back- 
 wards and rolling it first to one side, then to the other ; 
 deep, slow breathing ; very quick, or else very slow 
 pulse ; often violent mental emotions, fear, grief, fright, 
 which act like a blow, stunning the whole nervous sys- 
 tem. Raue.^ 
 
 Conium, Nux v., and Phosph. All have some symp- 
 toms often occurring in this short-lived disease, and 
 should be carefully studied. In this, as in many other 
 dangerous forms of disorder, the true homoeopathic, and 
 therefore the only life-saving remedy, in a particular case, 
 may not prominently suggest itself from among those 
 which are apparently indicated, so that, unless it is dili- 
 gently sought for, the patient may be lost who might have 
 been saved. 
 
 * Special Pathology, by C. G. Raue, M, P,, p. 14. f Loc. cit. 
 
NON-SYPHILITIC DISEASES. 171 
 
 We are aware that there are other remedies which 
 have been used in this form of disorder, or which may 
 be indicated in cases yet to occur ; and trust that in re- 
 spect to them, as well as to those here mentioned, other 
 physicians will contribute the results of their observa- 
 tion and experience. And we close with a single re- 
 mark : the remedy which is indicated by the leading, 
 d} r namic, characteristic symptoms, — or by the general 
 totality of the symptoms, — will prove beneficial even in 
 desperate cases ; although its pathogenesis does not re- 
 cord the livid " spots," which often form the most re- 
 markable objective features of cerebro-spinal meningitis. 
 These " spots " represent the ultimate consequences of 
 the disorder, in partial failure of capillary circulation ; 
 just as corresponding insensible spots * indicate a similar 
 partial failure of innervation, — and it is well known that 
 very few of our remedies have been proved to the ex- 
 tent of developing all their ultimate, objective, pathologi- 
 cal symptoms.] 
 
 TABES DORSALIS. — This affection of the spinal 
 marrow, which affects more particularly young men, is 
 either the direct or indirect consequence of sexual ex- 
 cesses, bodily fatigue, or cold. It commences with an 
 unusual disposition to weariness in the lower limbs and 
 back, and inability to bear fatigue, or to stand or stoop 
 for any length of time ; after a while the muscular sensa- 
 tions become altered, the patient fancies, when walking, 
 that he is stepping on wool, or that the floor is shaking 
 
 * "Along the course of the femoral nerves there were several 
 spots, in which the skin was devoid of sensibility. " Am. Rom. 
 Review, May, 1864, Vol. IV. p. 511. 
 
172 NON-SYPHILITIC DISEASES. 
 
 or soft, and gradually he loses, without special attention, 
 the faculty of using his muscles. In the dark, or when 
 his eyes are closed, he loses his sense of equilibrium, and 
 staggers; he becomes incapable of buttoning his coat, 
 and all his motions are awkwardly and hurriedly per* 
 formed ; even when walking he cannot arrest his pro- 
 gress without holding on to something, and the most 
 trifling obstacle disturbs him. 
 
 Accompanying symptoms are, a feeling as if ants were 
 running up and down the spine, drawing and shooting 
 pains, sensitiveness to currents of air, pains in the abdo- 
 men and chest, shortness of breath, and palpitation of 
 the heart. 
 
 Treatment. — The precautions noticed under the 
 heads of self-abuse, &c, must be rigidly observed in this 
 complaint, and the diet must be light and nourishing. 
 The most appropriate remedies are : -= 
 
 Arsenicum, which can be given when the patient has 
 been exhausted by excesses, his flesh being pale, soft, 
 and bloated ; attended with great palpitation of the 
 heart, pulling and tearing pains in the back and legs, 
 and formication along the spine. 
 
 Graphite is very useful, particularly when the com- 
 plaint occurs in females, and is attended with great 
 weakness in the legs and back, with palpitation, dulness 
 of the senses, numbness or torpor of the genital organs, 
 and pains in the chest. 
 
 Acid phosphoricum can be given when there is exces- 
 sive formication, and heaviness which increases to pain 
 in the lower limbs ; with painful spasms in the chest and 
 diaphragm, and palpitation of the heart. In cases of 
 great emaciation, with languor of the body, mental op- 
 
NON-SYPHILITIC DISEASES. 173 
 
 pression, and feeling as if the hands and feet were gone 
 to sleep, this remedy is veiy efficacious. 
 
 Lycopodium can be employed when there is total 
 relaxation of the nervous system, with great emaciation, 
 extreme weariness and weakness, coldness and deficiency 
 of animal heat, the lower extremities being particularly 
 cold and heavy. 
 
 Nux vomica is very frequently of great service in this 
 complaint, particularly when, from spermatorrhoea or 
 sexual excesses, the patient is brought to a state border- 
 ing on imbecility, the whole body being insensible, as if 
 asleep, the lower limbs constantly trembling, and at- 
 tended with fluttering of the heart; there is great lia- 
 bility to cold, even the slightest current of air producing 
 a disagreeable sensation on the skin ; in fact, the whole 
 of the organs of sense are in a state of great nervous 
 irritation, and attended with great weariness ; even the 
 gait is unsteady, and the patient reels as if intoxicated. 
 
 Calc. carb. is excellent when the feet go to sleep, and 
 pains as from bruises, with lameness, occur in the small 
 of the back, during motion and even when sitting or 
 standing ; or when the hands and feet are cold, with 
 paleness of the face, and frequent palpitation of the heart. 
 
 HYDROCELE, Dropsy of the Scrotum. — This is 
 
 caused by an infiltration of serous fluid either into the 
 cellular tissue of the scrotum, the tunica vaginalis of the 
 testes, or of the spermatic cord. It is when the tunica 
 vaginalis is implicated, that the term hydrocele is applied 
 more especially. It is common to all ages, and may 
 arise from constant riding on horseback, bruises, contu- 
 sions, trusses badly applied, or inflammation of the 
 16* 
 
174 NON-SYPHILITIC DISEASES. 
 
 urethra and testicles. The tumor is soft, semi-trans- 
 parent, pyriform, progressively enlarging without pain ; 
 if percussed simultaneously on both sides, fluctuation is 
 manifest; the safest diagnostic, however, is the trans- 
 parency of the swelling, a light being held in front of 
 which, is to be examined from behind. The contained 
 fluid is generally clear, yellowish, and smells of semen, 
 but occasionally it is turbid, green, brownish, or deep 
 brown. When found mixed with blood, it is termed 
 
 HEMATOCELE. 
 
 Treatment. — -Cases of recent origin in young people 
 may generally be cured by the following remedies : 
 
 Calc. carb., Spongia, are more particularly adapted 
 for scrofulous patients. 
 
 Conium, when the affection can be traced to mechani- 
 cal injuries. 
 
 Dulcamara, should it arise from cold. 
 
 Digitalis, if there is constant disposition to urinate. 
 
 Graphite is appropriate for persons subject to eruptions 
 on the skin, habitual constipation, and dropsical swelling 
 of the prepuce and scrotum. 
 
 Mercurius is useful should the patient have been 
 troubled when young with soreness and swelling of the 
 genital organs, especially of the prepuce, and is very 
 chilly and liable to take cold during damp weather, and 
 also when his flesh is soft and flabby, with tendency to 
 perspiration at night. 
 
 Pulsatilla, if the swelling is of a bluish color, in per- 
 sons subject to varicose veins, and of a lymphatic consti- 
 tution, with blue eyes and light hair. 
 
 Rhus toxicodendron is very useful when the left side 
 of the scrotum only is affected. 
 
NON-SYPHILITIC DISEASES. 175 
 
 Helleborus niger is of great importance in dropsy of 
 the scrotum, when the desire to urinate is great, although 
 but a small quantity is discharged ; the body being gen- 
 erally cool, with occasional tendency to puffiness of the 
 lower limbs. 
 
 Digitals can be given when the swelling does not per- 
 mit the rays of light to pass, or only very feebly, arising 
 from the fluid being dark-colored ; and particularly when 
 the patient complains of being bilious, and is otherwise 
 very poorly from indigestion. 
 
 Arsenicum, Cinchona, cannot be dispensed with when 
 the patient is in a weak and debilitated state, with great 
 weakness of the vessels, and tendency to general dropsy. 
 
 Silicea is greatly recommended for this disease, espe- 
 cially in strumous habits, and can be given in such cases 
 in doses the same as prescribed for Mercurius. 
 
 When an operation is imperative from the great accu- 
 mulation of fluid, a single dose of Arnica will be suffi- 
 cient to ward off any traces of inflammation. 
 
 It may here be necessary to state that the dangerous 
 plan of injection after au operation, for the purpose of 
 obliterating the cyst containing the fluid, cannot be too 
 strongly reprobated, as the disease will generally yield 
 to appropriate remedies. 
 
 VARICOCELE; CIRSOCELE. — These two terms are 
 almost synonymous, and are used to describe the swelling 
 of the veins of the testes, which may often be mistaken 
 for hernia (rupture). Its slow disappearance, however, 
 in a horizontal position, and its equally slow return in 
 an upright one, constitute a characteristic difference be- 
 tween the two affections. It is liable to affect persons 
 
176 NON-SYPHILITIC DISEASES. 
 
 subject to piles or varicose veins, but may also be pro« 
 duced from sexual excesses, excessive costiveness, the 
 pressure arising from a large hernia, constant riding on 
 horseback, or continual standing during work, badly ap- 
 plied trusses, and venous congestion of the abdomen or 
 of the portal system. It presents the following symp- 
 toms. A soft, knotty, elastic swelling extends from the 
 scrotum to the inguinal ring ; the nodosities disappear 
 under pressure, but reappear again rapidly when that is 
 removed; the scrotum hangs down relaxed, and the 
 swelling when pressed imparts to the hand the sensation 
 of a bundle of worms. Dull pains in the loins and kid- 
 neys are also experienced, with a feeling of heaviness and 
 drawing in the spermatic cord and testicles, but a sensa- 
 tion of relief is afforded by supporting the scrotum with 
 the hand ; there is also a good deal of perspiration on 
 the inner side of the thigh, which is in contact with the 
 diseased testicle. Although this affection never endan- 
 gers life, at times the pains become very severe, and 
 strike to the renal region and thighs, so as to impede 
 walking ; depression of spirits, fretfulness, and hypochon- 
 driasis are sometimes the consequences of it. 
 
 Treatment. — This affection often proves very intrac- 
 table, and it is only possible in some instances to give 
 temporary relief. In all cases a suspensory bandage 
 should be worn. 
 
 Pulsatilla, Nux vomica, Sulphur. These three reme- 
 dies, which are generally the most efficacious in the treat- 
 ment of varicose diseases, can be employed with advan- 
 tage in this complaint. 
 
 Pulsatilla is likely to prove most useful when the pa- 
 tient is of a mild disposition, and subject to venous con- 
 
NON-SYPHILITIC DISEASES. 177 
 
 gestions, with a bluish appearance of the veins of the 
 part. 
 
 Nux vom., Sulphur, are to be preferred when there is 
 constipation and derangement of the stomach, with irri- 
 table disposition. 
 
 Aconitum is to be administered when there is great 
 engorgement of the vessels, and the tone of the vessels is 
 very much impaired. 
 
 Belladonna is useful when the patient suffers from con- 
 gestion in other parts of the body (e. g. in the head), and 
 when the swelling feels hot and hard, with stitching and 
 throbbing pains. 
 
 Arnica. When contusion has given rise to the com- 
 plaint, the external use of this remedy is very necessary. 
 
 Directions for Use. — -A teaspoonful of the strong Tincture to be 
 mixed in half a pint of water, and applied by means of a rag, 
 three times a day. 
 
 Lachesis is indispensable should the veins assume a 
 livid appearance, and there is great depression of spirits. 
 
 Calc. carb. may be given in alternation with, or after 
 Belladonna, especially if the sexual desire is very much 
 excited, the skin and hair dry, and there is costiveness. 
 
 Lycopodium can be employed in the same way as the 
 last remedy, when the sexual power is very weak, and 
 desire depressed. 
 
 Sepia is frequently of service when there is chronic 
 congestion of the parts, which feel very heavy and tense. 
 
 Hamamelis Virginica. This very important medicine 
 in varicose diseases will frequently prove of material 
 value, when no other medicine appears capable of effecting 
 any improvement. 
 
 In very severe cases, a lotion, made in the proportion 
 
178 NON-SYPHILITIC DISEASES. 
 
 of 1 to 10, from the concentrated tincture, and applied 
 three or four times a day, will prove very efficient. 
 
 Should these remedies produce no amelioration, it will 
 be necessary in severe cases to remove the varicose 
 vessels by means of an operation ; any inflammatory 
 symptoms that may arise being combated with Aconite 
 and Calendula. 
 
 RETENTION OF URINE is either complete or partial, 
 hence the three different stages of this complaint, viz., 
 dysuria (bv$j difficult, and ovpov, urine) ; stranguria 
 (crrpayl, drops, and ovpov, urine) ; and ischuria («*£«, to 
 stop, and ovpov, urine) ; it is a symptom of many dis- 
 eases, is frequently painful, and in many cases even 
 endangers life. Retention of urine is caused either by 
 paralysis of the nerves or muscles of the bladder, or from 
 mechanical obstacles, which impede -the flow of urine, 
 even though the bladder may possess its full contractile 
 power ; for instance, the urine may be retained from the 
 pressure of a large hernia, swelling of the testes and 
 scrotum, or accumulation of faeces in the rectum. In 
 women it may be caused by polypi in the uterus, fibrous 
 tumors, or scirrhus, retroversion, ante-version, or pro- 
 lapsus of that organ. The mechanical obstacles may be 
 either stone, gravel, coagula, hydatids, masses of mucus, 
 or foreign bodies closing the canal as w^ith a plug ; or 
 alterations in the tissues of the urethra, stricture, swell- 
 ing of the prostate gland, closing or constriction of the 
 prepuce, and engorgement of the veins at the neck of the 
 bladder. When the retention is complete (ischuria), 
 the patient experiences a sense of heaviness in the peri- 
 neal region, urging to stool without being able to gratify 
 
NON-SYPHILITIC DISEASES. 179 
 
 the desire, acute pains above the symphysis pubis, ex- 
 tending to the kidneys and glans penis, and greatly in- 
 creased on walking, coughing, or rising from a chair, 
 constant desire to pass water, with anxiousness and 
 restlessness, all endeavors to relieve nature being fruit- 
 less ; nausea and oppression of the chest set in, and face 
 and eyes become red, palpitation of the heart, sweat, 
 and vomiting next take place. As the bladder fills, it 
 rises to the pit of the stomach, forming a visible tumor, 
 which presses on the viscera. When the distention has 
 reached this stage, the urine is gradually absorbed into 
 the general circulation, while violent fever, delirium, and 
 coma supervene. Death ensues, either from inflamma- 
 tion or bursting of the bladder, which then discharges 
 its contents into the abdominal cavity. 
 
 Treatment. — Should the retention arise from an 
 accidental delay in voiding urine, a single introduction 
 of the catheter will remove the whole of the symptoms ; 
 the application of a bandage dipped in cold water, caus- 
 ing an immediate contraction of the bladder, will often 
 prove equally effectual. When paralysis of the bladder 
 occurs, the catheter should be used, and even left for 
 twenty-four hours in the bladder. The mechanical ob- 
 stacles in the other cases must also be met with appro- 
 priate mechanical remedies. 
 
 The following remedies relate only to those cases in 
 which the retention is caused by complete or partial 
 paralysis, or spasm of the bladder or its sphincter : 
 
 Aconitum is very useful in retention of urine, with 
 pressure in the bladder and pains in the loins, or when 
 the urine deposits a bloody sediment, and there is heat 
 at the neck of the bladder and continual urging to 
 
180 NON-SYPHILITIC DISEASES. 
 
 urinate, and particular^ when febrile symptoms are 
 present. 
 
 Arsenicum. Retention as if from paralysis of the 
 bladder, with difficult and painful micturition, of a scanty 
 nature, and burning in the urethra at the time. 
 
 Cannabis. Obstinate retention of urine, and nocturnal 
 strangury ; or emissions scanty and sanguineous, passed 
 drop by drop. 
 
 Cantharis. Spasmodic retention of urine, with cramp- 
 like pains in the bladder, with urgent and ineffectual 
 efforts to pass water ; or painful emissions taking place 
 drop by drop. 
 
 Nux vomica. This remedy is of great service, par- 
 ticularly when the lower part of the spinal column is 
 affected, causing abortive urging to urinate, attended 
 with pains in the bladder (dull pressure or burning), and 
 spasmodic contraction of the urethra^ the urine passing 
 drop by drop. 
 
 Pulsatilla is very good, when, with the retention, there 
 is heat in the region of the bladder, and uneasy pain 
 in the abdomen, accompanied with urinary tenesmus. 
 
 Sulphur can be given in cases when the urine is re- 
 tained, and, when any can be passed, is attended with 
 great pain and effort, and sometimes mixed with blood. 
 
 The other remedies which may be consulted with ad- 
 vantage in spasmodic cases are, Hyoscyamus, Bellad., 
 Calc, Carbo veg., Conium, Graphite, Helleb. nig., 
 Ignat., Lycop., Platina, Acid phosph., Staphys., 
 Zincum. 
 
 When mechanical causes are the origin of the reten- 
 tion, surgical assistance is necessary, but material aid is 
 afforded afterward by such remedies as Acon., Arn., 
 Bellad., Cocculus, Ipecac, ISTux vom., Stjlph., Verat. 
 
NON-SYPHILITIC DISEASES. 181 
 
 For the indications for which, vide Characteristic 
 Effects. 
 
 ENURESIS, Incontinence of Urine. — This disease, 
 which is not dangerous, but exceedingly disagreeable, 
 when not a symptom of incipient tabes dorsalis, most 
 frequently affects old people. It generally arises either 
 from weakness, or paralysis of the sphincter muscle of 
 the bladder, in which cases the urine passes off in drops 
 without intermission. Another variety is that of noctur- 
 nal enuresis, occurring generally among children, al- 
 though adults are sometimes subject to it. 
 
 Treatment. — When this is the case, the patients 
 should be roused two or three times in the night, in order 
 to accustom them to regular emissions of urine ; children 
 subject to it should eat and drink little before going to 
 bed, and void urine previously ; they should also sleep on 
 their sides, lying on the back being very injurious ; full- 
 grown persons would do well to provide themselves with 
 a caoutchouc convenience, to prevent the bed-clothes 
 from being soaked. Cold sponging of the abdomen daily 
 will be found very efficacious. 
 
 Aconitum is very useful when the disease occurs in 
 hysterical females, or is produced by fright or a cold, the 
 urine being pale and watery. 
 
 Carbo veg. is good when attended with acidity of the 
 stomach, and alternating or existing simultaneously with 
 palpitation of the heart. 
 
 Causticum is efficacious in enuresis where the inclina- 
 tion is frequent, with scanty emission and thirst. 
 
 Conium can be given when the tenesmus is great, and 
 the urine clear and pale. 
 16 
 
182 NON-SYPHILITIC DISEASES. 
 
 Digitalis is required for incontinence, accompanied 
 with irregularity of the heart's action, dizziness, and slow 
 pulse. 
 
 Natri mur. is recommended for frequent and urgent 
 tenesmus day and night, and often attended with copious 
 involuntary emission of urine. 
 
 Petroleum. In involuntary discharges of a reddish- 
 brown and fetid urine, this remedy is very efficacious. 
 
 Rhus tox. Incontinence of urine during rest, with 
 urinary tenesmus and profuse discharge of urine. 
 
 Sepia is generally useful when wetting the bed occurs 
 during the first sleep, and when there is frequent and 
 ineffectual desire to urinate. 
 
 Sulphur is to be selected when the patient is scrofulous 
 and subject to eruptions, is given to wetting the bed 
 every night, and tormented with constant desire to uri- 
 nate during the day. 
 
 [Physalis Alkenkengi, in the 12th, is said to have 
 cured a case of three years standing.] 
 
 H/EMATURIA, Bloody Urine. — This is an haemor- 
 rhage from the mucous membrane of the urinary organs, 
 and may be divided into two species, viz., active, and pas- 
 sive ; it may arise from the kidneys, bladder, or urethra. 
 In the former case, the pain is very acute in the back, 
 and is accompanied with chills, anxiety, urging to uri- 
 nate, and great numbness of the thighs. If the blood comes 
 from the bladder, the patient feels a pain in the hypo- 
 gastric region, heat, and itching in the urinary organs 
 and at the anus ; the pain extends to the perinseum and 
 the glans penis, the urinary tenesmus is great and fol- 
 lowed by the emission of a sanguineous fluid. When the 
 
NON-SYPHILITIC DISEASES. 183 
 
 urethra is the seat of the disease, the blood is pure, not 
 mixed with urine, and its flowing out is not preceded by 
 urging to urinate. When the urine is mixed with pus, 
 the matter becomes very serious, and great skill is re- 
 quired to conduct the case to a favorable issue. 
 
 This affection is seldom idiopathic, and usually befalls 
 persons of an advanced age, and men more frequently 
 than women. In some cases but very little blood is 
 passed, whilst in others the haemorrhage is so consider- 
 able as to endanger life. 
 
 Treatment. — In order to remove any cause of con- 
 gestion in the diseased organs, all spirituous beverages, 
 animal food, and substances that tend to excite the sexual 
 appetite, must be avoided. When the complaint has 
 arisen from sedentary habits, the suppression of piles, 
 or of the menses, the patient should take frequent exer- 
 cise in the open air. 
 
 Aconitum, when the patient is of a plethoric habit, or 
 the disease has arisen from external violence. 
 
 Cantharis can be employed when micturition is painful 
 and difficult, with violent cutting and spasmodic pains 
 in the hypogastric region, the urine is mixed with blood, 
 or blood and pus, or blood alone is continually dropping 
 from the urethra. 
 
 Camphor is to be employed when the complaint has 
 arisen from the internal use of Cantharis, or from the 
 application of a blister. 
 
 Carbo veg., Arsenicum, are frequently required after 
 the latter medicine, where there still remains burning in 
 the urethra, &c. 
 
 Mezereum, Millefolium, are of great importance in this 
 complaint ; the former can be used when the pains are 
 
184 NON-SYPHILITIC DISEASES. 
 
 trifling and the blood rarely or ever coagulated [a 
 crampy pain in the bladder, and after that bloody urine 
 is voided] ; the latter, when the haemorrhage is consider- 
 able, the blood having a tendency to rush to the parts 
 affected, and the urging to urinate excessive. 
 
 Nux vomica, Sulphur, Calc. carb. These remedies 
 are most useful when suppression of piles, or a free in- 
 dulgence in spirituous liquors has brought on the com- 
 plaint, and there is painful aching in the back, attended 
 with smarting in the urethra. They should be given in 
 the order here marked, Calcarea being preferred should 
 the blood be discharged in clots. 
 
 Pulsatilla is more useful for females with discharge of 
 dark-colored clots ; although it may be prescribed for 
 males, when there is constrictive and cutting pain around 
 the navel extending to the back, with burning in the 
 urethra. 
 
 Mercurius is of great service when the blood is dis- 
 charged during sleep, and often attended with seminal 
 emissions. 
 
 Cinchona, Nux vom., Phosphorus, Sulphur, Calc. 
 carb., are required when venereal excesses have brought 
 on the complaint, which arises from sheer debility of 
 the body generally, and the blood is more or less in a 
 morbid state, with deficiency of fibrin. 
 
 Clematis, Hepar sulph., Uva ursi. When hematuria 
 is accompanied with purulent deposit, these remedies 
 will be found in many cases to exert a favorable influence. 
 
 Clematis is useful when puriform discharge, attended 
 with burning sensation at the commencement of urina- 
 tion, is present. 
 
 Hepar sulph. is more indicated when there has been 
 
NON-SYPHILITIC DISEASES. 185 
 
 considerable inflammation of the mucous membrane, 
 either of the urethra or bladder, followed by greenish or 
 yellow discharge of pus, or urine of a blood red, or 
 brownish red, flocculent, and covered with a greasy 
 pellicle. 
 
 Uva ursi may be given for slimy purulent urine, at- 
 tended or not with hematuria. 
 
 [Constant urging to make water and straining, with 
 discharge of blood and slime; or constant straining 
 without any discharge at all, or only a few drops of 
 urine, after this cutting and burning in the urethra, 
 which is preceded by a discharge of blood ; hard stools. 
 — Raue.] 
 
 [Terebinthina, indicated, according to Raue, when 
 "the blood is thoroughly mixed with the urine, forming 
 a dirty, reddish brown, or blackish fluid, or a coffee- 
 ground-like sediment ; burning, drawing pains in the 
 kidneys ; pressure in the bladder, extending up into the 
 kidneys when sitting, disappearing when walking about ; 
 before urination, pressing and straining in the bladder 
 when sitting, going off when walking ; burning in the 
 bladder, worse during micturition; in complication with 
 scorbutic affections, and if caused by living in damp, 
 moist dwellings." 
 
 Terebinth succeeds well after Occimum canum; a 
 female, whose painful haematuria was temporarily re- 
 lieved by Occimum c, 2. c. (the 6th had no effect), was 
 permanently benefited by Terebinth. 3 ] 
 
 [Copaiba. Very similar in its action, and in its indi- 
 cations to Terebinth, is the famous Balsam Copaiba. 
 16* 
 
186 NON-SYPHILITIC DISEASES. 
 
 In several cases of Hematuria, in females, cases of un- 
 doubted disease of the kidneys themselves, the Copaiba 
 proved promptly curative. In one case of some months 7 
 standing, which several physicians of the old school 
 vainly tried to relieve, and in which I had, with much 
 study, determined the Horn, remedy to be Terebinth, its 
 use was followed by marked improvement. This was a 
 nursing woman, who had also diarrhoea. Her diarrhoea 
 and other stomach symptoms had been removed by Puis., 
 but she complained of pain all the time in the urethra ; 
 burning pain ; frequent micturition ; and pain in back 
 and kidneys ; much blood mixed with the urine. While 
 taking the Terebinth, which seemed to be curing her, 
 she was persuaded, by an old woman, to take the Balsam 
 Copaiba. She took about two ounces in the course of 
 two or three days, and was immediately and permanently 
 cured. I can, myself, vouch for the -iong standing and 
 severity of the case; and for the fact of the woman's 
 complete restoration to health and strength under the 
 influence of the Copaiba. There was no reason to suspect 
 the presence of any gonorrhceal complication or infection 
 in this case. Several similar cases have been reported 
 to me, as made with this same remedy in the hands of 
 the laity.] 
 
 [Lycopodium is often indicated when there is either 
 gravel (red sand in the urine) or chronic catarrh. See 
 also Sarsaparilla, in the next section.] 
 
 [Nitric Acid is said to be specific in active hemorrhage ; 
 it is, of course, all the more indicated in mercurialized 
 persons ; by tenesmus after urinating, and in gonorrhceal 
 cases.] 
 
NON-SYPHILITIC DISEASES. 187 
 
 [Secale c. In passive hemorrhage, as if from dissolu- 
 tion of the blood ; with coldness of the body (disposition 
 to throw off the clothes); great prostration.] 
 
 [Sulphur. After suppressed cutaneous eruptions, and 
 hemorrhoidal discharges; stinging and burning in the 
 urethra.] 
 
 [Occimum Canum. Indispensable in haematuria, with 
 venal colic, or cramps. See " Indications of the Medi- 
 cines/' in this work, for symptoms.] 
 
 [Erigeron and Hamamelis have been empirically re- 
 commended in hematuria. To this may be added 
 Urtica urens.] 
 
 [For further indications of most of these remedies, and 
 others not here named, consult Raue's Pathology, and 
 the pathogenesis of the remedies themselves.] 
 
 CALCULUS AND GRAVEL. — Under certain condi- 
 tions, arising generally from the presence of a gouty or 
 rheumatic diathesis, the urine, as it cools, deposits small 
 crystals, which assume various forms, their surfaces 
 being smooth, facet-shaped, or rough, according to cir- 
 cumstances, discernible to the naked eye ; varying in 
 consistence and size, from a fine pulverulent deposit like 
 sand, to that of bodies as large as a pea. They also 
 differ considerably in color ; when they consist of urate 
 of ammonia, with or without free urea, their color is 
 red, and the urine accompanying them gives an acid re- 
 action. 
 
 When the gravel is formed in the kidneys, although 
 generally red, it may be reddish-brown, brown, yellow, 
 grayish-white, or ash-colored. There are, perhaps, but 
 few complaints which are so modified by external circum- 
 
188 NON-SYPHILITIC DISEASES. 
 
 stances as gravel ; a patient, leading a sedentary life, 
 suffering from deposits of urea, uric acid, or urate op 
 ammonia, the urine giving an acid reaction, when re- 
 moved into the country, and taking plenty of exercise, 
 will find in a day or so that the deposit has totally 
 changed its character, and that oxalate of ammonia, 
 or of lime, is now present, with an alkaline reaction of 
 the urine. Again, a person having calculus in the 
 bladder, formed from the acid deposit, if placed under a 
 course of alkalies, so far from their removing the com- 
 plaint, they will often aggravate the original mischief, 
 by causing an alkaline deposit upon the acid calculus. 
 It hence follows that it is not so much the excessive 
 presence of azote in the blood, as a certain morbid dispo- 
 sition of the renal vessels, which causes the abnormal 
 secretion. Nor is strict attention to diet always effica- 
 cious, as the less azote the food contains, the greater the 
 deposition of acid or alkaline formations. It may be as 
 well to add, that an acid deposit is convertible into an 
 alkaline one, and vice versa; for this reason, that the 
 ultimate elements of both are the same, and only differ 
 in their proportions, or the tendency, at the time, of the 
 renal vessels to secrete lime or phosphates. Urea, uric 
 acid, ammonia, all contain azote and hydrogen, the two 
 former carbon and oxygen as well, whilst oxalic acid, 
 which forms the oxalates, consists of carbon and oxygen 
 alone.* Hence the exceeding difficulty and the great 
 
 * Urinary Deposits. — Urea. — C 2 H*N 2 2 or C 2 NO+NH 3 +HO. 
 This constituent principle of urine appears under the form of 
 silky crystals or prisms, with four transparent faces, having a 
 fresh savor, analogous to that of nitrate of potash ; it is inodor- 
 ous, and gives no acid or alkaline reaction. 
 
NON-SYPHILITIC DISEASES. 189 
 
 care required in treating this complaint, which, if mis- 
 managed, leaves to the unfortunate sufferer no resource 
 
 Uric Acid. — C 10 N 4 HK) 6 . This acid is deposited from urine as a 
 yellowish powder, which adheres strongly to the vessel. When 
 purified, it presents itself as white crystalline scales, soft to the 
 touch, is inodorous and without taste, is soluble in 1150 times its 
 weight of boiling water, and then changes litmus-paper to a bright 
 red. 
 
 Urate of Ammonia. — NH 3 +C 10 N 4 H 4 O 6 . Deposited as a gray 
 sediment when the urine begins to cool, but, in intermittent fevers 
 and acute rheumatism, the deposit is reddish ; it is often found 
 in calculi. When treated with caustic potash, the ammonia is 
 liberated. 
 
 Oxalate of Ammonia, — N 2 H 6 C 2 3 +HO. This salt forms crystals, 
 which are elongated, colorless, and transparent prisms, rather 
 less soluble in water than oxalic acid, and completely insoluble 
 in alcohol. 
 
 Phosphate of Lime. — 8CaO-f-3Ph0 5 . This is a whitish or gray 
 deposit, soluble without effervescence in diluted acids. 
 
 Oxalate of Lime. — CaO+C 2 3 . Mural stones. Calculi formed 
 entirely of this deposit are very rare ; when pulverized and 
 treated with sulphuric acid, they disengage a gas (carbonic oxide) 
 which burns with a bluish flame ; they are also soluble without 
 effervescence in nitric acid. 
 
 Cystine. — These calculi are very seldom to be met with ; they 
 are to be recognized by their ready and complete solution in 
 caustic potash, and if the solution be boiled, after an addition of 
 acetate of lead, it becomes black by the formation of sulphuret of 
 lead. 
 
 Ammoniaco - magnesian Phosphate. — Ph 2 M0 5 N 2 H 6 H 2 0. These 
 calculi are grayish-white, and readily soluble in acetic acid ; 
 when treated with the perchloride of iron and ammonia, the 
 solution yields a sediment of phosphate of iron, the magnesia re- 
 maining in solution. 
 
 Benzoic Acid. — C u H 10 O 3 . Is sometimes found in the composi- 
 tion of urinary deposits, the urine being then generally very fra- 
 
190 NON-SYPHILITIC DISEASES. 
 
 but that of an operation for the removal of the calculus. 
 Should the deposit take place in the bladder itself, or any 
 foreign body (such as a broken catheter) get lodged in 
 that organ, the urine is sure to form a coating upon it, 
 which gradually increases in size, till a veritable stone 
 is formed which can only be removed by an operation. 
 When this occurs, the symptoms of the disease are 
 greatly intensified. The pains become excessive, and 
 extend through the whole of the hypogastrium, and con- 
 vulsions and irritative fever are frequently the result. 
 Retention of urine and urging to urinate accompany 
 these symptoms, and are followed in a day or two by 
 the emission of red, or black urine, mixed with blood ; 
 haematuria and inflammation of the kidneys often accom- 
 pany lithiasis (stone in the bladder). 
 
 Treatment. — When this complaint is first suspected, 
 the first thing to do is to daily test the urine with pieces 
 of litmus and turmeric papers. Should the urine be 
 acid, the litmus-paper will change from blue to red; or if 
 alkaline, the turmeric paper loses its yellow color, and 
 assumes a brown tint. When the urine is acid, a vege- 
 table diet exclusively will be generally the best, or an 
 animal one when the deposit is white and alkaline ; much, 
 however, must depend upon circumstances, and the pa- 
 tient will often be called upon to display his judgment 
 and discretion in this matter. Cheese, and other indi- 
 gestible forms of azotized food, are very favorable to the 
 formation of uric acid, and must therefore be avoided, 
 
 grant. When purified, it crystallizes in hexagonal needles, or in 
 white, shining, flexible, and silky lamellae, of a smarting, acrid 
 savor, unalterable in the air, slightly soluble in water, but 
 readily so in boiling water and alcohol. 
 
NON-SYPHILITIC DISEASES. 191 
 
 as well as sour drinks or acid fruits, &c. All diseases 
 having a tendency to produce retention of urine are very 
 liable to favor the development of this complaint, and the 
 urine in these cases should be very carefully watched. 
 When there is no hereditary predisposition, or no organic 
 disease of the kidneys, gravel is generally easily cured, 
 particularly so if uric acid is the constituent ; but the 
 presence of the phosphates denotes organic disease of 
 the mucous membrane of the kidneys or bladder, and is 
 exceedingly intractable. 
 
 In gouty or rheumatic patients, this complaint is 
 usually only a symptom of the disease itself, and can only 
 be subdued with the eradication of the original taint. 
 
 Diet. — A strict diet is the best prophylactic against 
 gravel, and is sufficient sometimes to arrest the formation 
 of the urates in the kidneys. When the urine is deep red, 
 or bloody, animal food is absolutely poisonous, and light 
 vegetable diet is to be enforced. When it is induced by 
 the exclusive use of heavy food, cheese, farinaceous com- 
 pounds, or food containing much saccharine matter, and 
 the constitution is debilitated, animal food should be used 
 in moderation ; wine, beer, and spirits, are to be carefully 
 avoided, and fresh pure water, rice, barley, or toast and 
 water substituted. The influence of water on this com- 
 plaint must not be overlooked ; when possible, a residence 
 among the mountains, or wherever the water is nearly 
 chemically pure, is recommended. The solvent power of 
 pure water is so great, that secretions from the kidneys, 
 insoluble in ordinary water, are removed from the body in 
 a state of perfect solution, when the better water is drank ; 
 the absence, too, of earthy salts in the water relieves the 
 
192 NON-SYPHILITIC DISEASES. 
 
 secreting vessels of much unnecessary work. Where pure 
 soft water is not to be had, filtered rain-water is the best 
 substitute. 
 
 Belladonna is very good in cases where the urine is 
 of a gold or citron color, depositing a red sediment, with 
 nocturnal pressure in the bladder, and shooting, burning 
 pains in the region of the kidneys. 
 
 Cannabis is useful when the urine is turbid, as if mixed 
 with blood or pus (or when small calculi are discharged), 
 and attended with strangury and pain in making water. 
 
 Colchicum can be given when the urine is scanty, and 
 of a bright red color, or brownish and blackish, as if con- 
 taining blood ; it is also very useful in whitish deposit, 
 with great burning in the urethra. 
 
 Uva ursi. When the kidneys are affected, and the 
 urine is albuminous, or mixed with pus, and deposits a 
 white sediment, this remedy will be found useful. 
 
 Sarsaparilla can be given for sanguineous urine, or 
 urine charged with acrid and turbid matter, and deposit- 
 ing gravel. 
 
 The following remedies may be also studied with ad- 
 vantage : 
 
 For opalescent urine — Calc, Cinchona, Hep., Iod., 
 Petrol., Phosph., Puls., Sulph. 
 
 With gelatinous sediment — Coloc., Puls. 
 
 With gravel, sand, or stone sediments — (1) Lye, 
 Sarsap. (2) Calc, Cann., Nux v., Petr., Phos., Sep., 
 Sil. (3) Ant., Calc, Canth., Cinchona, Lach., Natr. 
 m., Nitr. acid, Puls., Thuja, Zinc 
 
 Loamy sediment — Sars., Sep., Sulph., Zinc 
 
 Sediment, resembling flour, chalk, or lime — Ant. t., 
 Calc, Cinchona, Graph., Merc, Natr. mur., Phosph. 
 acid, Sulphur. 
 
NON-SYPHILITIC DISEASES. 193 
 
 Reddish brick-colored sediment — (1) Canth., Cin- 
 chona, Lyc, Xatr. mu&, Xux v., Phos., Puls., Sep., 
 Scilla. (2) Acon., Ant., Arn., Dulc, Lach., Xitric 
 
 ACID, SlLIC. 
 
 Whitish sediment — Colch., Dulc, Hep., Xitric acid, 
 Petr., Phosph., Phosph. acid, Rhus, Sulph. 
 
 Smelling strongly of ammonia — Carbo veg., Iod., 
 
 MOSCH., XlTRIC ACID, PETR., PHOSPH. 
 
 BLENORRHCEA VESIC/E, Catarrh of the Bladder: 
 
 This is a mucous or puriform discharge from the lining 
 membrane of the bladder, without any inflammatory 
 symptoms being present ; there are two varieties, the 
 chronic and the ulcerous blenorrhoea, and both are se- 
 quelae of acute diseases, although they may be sometimes 
 idiopathic. It is characterized by a considerable secre- 
 tion of mucus, which is discharged from the bladder with 
 the urine, which at first appears simply turbid, and the 
 mucus suspended in it falls gradually to the bottom of 
 the vessel, as a w r hitish-gray transparent layer, above 
 which the urine remains clear, when precipitation has 
 entirely ceased. As the disease develops itself, the mucus 
 is secreted in larger quantities, and floats in the urine in 
 the shape of flocks and filaments, of a white, yellow r , or 
 greenish color, the urine becomes thick, and instead of 
 preserving as before its acid reaction, it becomes alkaline^ 
 emits an offensive odor, and is rapidly decomposed. The 
 discharge of urine now becomes painful, slow, and inter- 
 mittent ; the stream is sometimes suddenly interrupted, 
 and after many vain exertions, a plug of mucus is expelled, 
 and then the urine passes more freely. Incontinence of 
 urine, especially at night, obliges the patient to urinate 
 17 
 
194 NON-SYPHILITIC DISEASES. 
 
 every half hour, or oftener, which is attended with pain 
 in the bladder, urethra, and perinaeum. Spasm of the 
 bladder frequently precedes the emission of urine, and 
 disappears at the termination. 
 
 When this complaint has been overlooked at its com- 
 mencement, the general health suffers, digestion is im- 
 paired ; constipation and pains in the loins, and sometimes 
 paralysis of the bladder, are the consequences of this dis- 
 order, which may easily become fatal, should the urine 
 begin to be absorbed into the general circulation. Old 
 men rather than women, individuals of sedentary habits, 
 literary men, tailors, shoemakers, &c, are particularly 
 liable to catarrh of the bladder, and it is met with more 
 frequently in low and damp regions, and along the sea- 
 coasts, than anywhere. Organic diseases of the bladder, 
 mechanical or chronic irritation caused by frequent in- 
 troduction of the catheter, the use of-ardent spirits, new 
 beer or wine, piles or gout, the internal use of Can- 
 tharis, suppressed gonorrhoea, badly treated cystitis, 
 &c, are the most frequent causes of catarrh of the bladder. 
 
 Treatment. — It will be advisable for the patient be- 
 fore voiding urine, to move briskly about for a short 
 time to prevent the mucus settling at the bottom of the 
 bladder, which should be completely emptied before re- 
 tiring at night by means of a catheter. 
 
 In the first stage of the disease, the most useful medi- 
 cines are Bell., Hyos., Merc, and Puls. 
 
 The second stage requires Caps., Carbo veg., Hel- 
 leb. nig. 
 
 Scrofulous patients may require Con., Dulc, or Staph. 
 
 For the spasms wilich sometimes arise — Bell., Cann., 
 Canth., Digit. 
 
NON-SYPHILITIC DISEASES. 195 
 
 Gouty patients require Coloc., Sabix. 
 
 In chronic cases — Arg., Calc, Graph., Lyc. 
 
 Purulent urine requires Caxx., Caxth., Clem., Lyc, 
 Xux vom., Puls., Sep. 
 
 Fibrinous Jiocculent urine — Axt. tart., Caxx., 
 Caxth., Merc, Mez., Nitric acid. 
 
 Slimy urine or sediment — (1) Ars., Dulc, Merc, 
 Xatr. mur., Puls. (2) Ant., Caxth., Carbo yeg., 
 Coloc, Cox., Hep., Xitr. acid, Xux vom., Sarsap., 
 Sulph. 
 
 JIucous threads in the urine — Antim. tart., Caxx., 
 Caxth., Merc, Mez., Xitric acid. 
 
 Viscid urine — Argext., Caxth., Coloc, Kreas., 
 Phosph. acid. 
 
 The following are the indications for the principal 
 medicines : 
 
 Belladonna. Spasm or paralysis of the neck of the 
 bladder, and involuntary emission of urine, even during 
 sleep ; the urine deposits a red or whitish thick sediment ; 
 shooting pains in the region of the kidneys, and noctur- 
 nal pressure, and sensation of motion in the bladder. 
 
 Cannabis. Nocturnal strangury, as from paralysis of 
 the neck of the bladder; stoppage of the urethra by mu- 
 cus or pus ; urine bloody, and mixed with pus ; emission 
 of urine drop by drop, with burning pains in the urethra 
 and bladder. 
 
 Cantharis. Retention of urine, with cramp-like pains 
 in the bladder; flow of sanguineous mucus; pulsation in 
 all the urinary organs ; painful sensibility of the region 
 of the bladder when touched. 
 
 Colocynth. Tenesmus of the bladder; fetid urine, 
 
196 NON-SYPHILITIC DISEASES. 
 
 which soon becomes thick, gelatinous, and glutinous. 
 [Aggravation before and after urinating.] 
 
 Conium. Thick, white, and turbid urine, and mixed 
 with viscid mucus, with pressure on the bladder, as if 
 the urine were about to be ejected with violence. 
 
 Dulcamara. Viscid urine, mixed with mucus ; thick- 
 ening of the bladder ; involuntary emission of urine, as 
 from paralysis of the bladder. 
 
 Mercurius. The stream of urine is excessively small, 
 or is even passed drop by drop ; the urine appears as if 
 mixed with flour or chalk, depositing a thick sediment ; 
 white, flock-like clouds in the urine ; discharge of tough 
 mucus and filaments with the urine : cutting and contrac- 
 tive pains in the renal region. 
 
 Pulsatilla. Tenesmus of the bladder, with painful 
 pressure ; urine gelatinous, mucous, or mixed with blood 
 and pus ; or swelling at the neck of_the bladder, with 
 pain when pressed, and accompanied with pain in the 
 loins. 
 
 HYPERTROPHY OF THE BLADDER.— Thickening 
 
 of the bladder develops itself gradually, and is, perhaps, 
 not detected till the urinary discharge is much interfered 
 with. The tenesmus becomes troublesome, the emissions 
 of urine disagreeable, and the stream is weaker, while 
 the bladder is never perfectly emptied, and forms a pain- 
 less globular swelling above the pubes ; there is a sense 
 of heaviness in the pelvis, or pressure at the perinseuin or 
 the rectum, with difficulty of passing the faeces, and 
 pressure on the sacral nerves, and a feeling of numbness, 
 and even paralysis of the lower limbs. When the affec- 
 tion is accompanied with contraction, the bladder holds 
 
NON-SYPHILITIC DISEASES. 197 
 
 only a few ounces of urine, and the patient is compelled 
 to void urine every few minutes, the bladder feeling as 
 if it were full. 
 
 Treatment. — Generally speaking, this can only be 
 palliative. Depending as it does on the cause of the 
 complaint (for instance, catarrh of the bladder, calculi, 
 affections of the prostate gland, strictures of the urethra, 
 &c, &c.,) the means adopted must bear direct relation to 
 that cause. 
 
 Calc. carb. is useful when the mucous or glandular 
 systems are deranged, and the urine deposits a brick-dust 
 or whitish sediment. 
 
 Dulcamara is to be preferred when the complaint has 
 arisen from catarrh of the bladder, with profuse secretion 
 of mucus, or when it has arisen from cold or damp. This 
 remedy can often be followed by Sulphur with the best 
 effects. 
 
 Mercurius. When the complaint has been preceded 
 by inflammation of the mucous membrane of the bladder 
 or urethra, or as a sequel to gonorrhoea, with whitish 
 sediment in the urine. 
 
 Pulsatilla is of great service when catarrh of the blad- 
 der has produced engorgement and consequent exudation 
 into the tissues of the bladder, attended with slimy, mu- 
 cous, or purulent discharge. 
 
 SPASM OF THE BLADDER.— This may be a mere 
 symptom of some urinary disease, or an idiopathic affec- 
 tion of a purely nervous character, without any organic 
 alterations. In the latter case, the patients, toward the 
 end of an urinary emission, experience suddenly a violent 
 constrictive pain in the region of the bladder, especially 
 17* 
 
198 NON-SYPHILITIC DISEASES. 
 
 in the perinasum, which extends to the urethra, and in the 
 male spreads towards the glans ; sometimes it is accom- 
 panied with painful erections, and affecting the groins, 
 thighs, and testicles. It is also frequently accompanied 
 by painful tenesmus at the sphincter ani, involuntary 
 stool, and prolapsus of the rectum ; the pain, which sets 
 in in paroxysms, lasts a few minutes, never more than 
 fifteen to thirty minutes. There is painful tenesmus of 
 the bladder, which cannot be relieved till the spasm 
 abates, when a full stream of urine is emitted, which is 
 clearer and paler than usual. Violent spasm is accompa- 
 nied with anguish, restlessness, trembling, general ner- 
 vous paroxysms, cold sweat, small and contracted pulse, 
 and vomiting. 
 
 Treatment. — The most appropriate remedies are : 
 
 Aconitum, when the spasm is caused by a cold, ex- 
 posure to damp, suppression of perspiration, or when it 
 is a symptom of hysteria. 
 
 Cantharis is good for excessive urging to urinate, with 
 cutting and tearing pain in the region of the bladder. 
 
 Nux vomica can be given when the spasm is accompa- 
 nied with debility and tendency to general convulsions, 
 attended with a painful desire to urinate. 
 
 Pulsatilla is very useful for hysterical females, and 
 when the spasm is characterized by constrictive pain in 
 the region of the bladder, with urinary tenesmus, and in- 
 voluntary emission of a little urine. 
 
 The other remedies which sometimes are useful are 
 Arsen., Bell., Calc, Carbo, Conium, Graph., Helleb., 
 Ignat., Lycop., Phosph. acid, Plat., Staphys., Sulph., 
 Zinc, for indications for which the reader is referred to 
 the Characteristic Effects. 
 
CHARACTERISTIC EFFECTS 
 
 AND 
 
 INDICATIONS OF THE MEDICINES, 
 
 REFERRED TO IN THIS WORK. 
 
 PRELIMINARY REMARKS. 
 
 The Reader should be careful to observe the assemblage of the symp- 
 toms in consulting each article. A single symptom is rarely char- 
 acteristic. It is the presence of one symptom (or more) simultane- 
 ously with other manifestations which characterizes disease, and 
 indicates the treatment. It is, therefore, essential to the right use 
 of these articles, that the conditions and accompaniments should be 
 closely marked, and that the symptoms should be studied in groups .* 
 
 Acidum fluoricum. Continual dull pains, deeply situ- 
 ated in the groin and region of the bladder ; pressure on 
 the bladder, with sensation of warmth in the abdomen ; 
 before and after urination, pain in the lower part of the 
 bladder ; urine pungent and strong ; sexual desire much 
 increased ; pains in the bones, burning and intermittent ; 
 
 * "Laurie's Homoeopathic Domestic Medicine," 8vo, p. 729. 
 
 199 
 
200 CHARACTERISTIC EFFECTS AND 
 
 aching pains in the bones of the arms and legs ; bruised 
 and aching pains in the os sacrum ; temper ill-humored, 
 fault-finding, anxiously disposed, and given to imaginary 
 fears. 
 
 Acid nitricum. Disposition: sadness and despon- 
 dency; excessive nervousness, with timidity and ten- 
 dency to start; taciturnity, ill-humor, and aversion to 
 work ; at times changeable mood ; weakness of memory, 
 thoughtlessness, cloudiness, and dizziness of the head, 
 and inability to perform any mental work. Dryness and 
 itching of the skin ; ulceration of the skin, with stinging 
 pains, bleeding when dressed, the ichor discharged cor- 
 roding the skin. Painless ulcers, with gray inverted 
 edges, bleeding readily and with secretion of ichorous 
 pus. Itching, smarting, and stinging eruptions, like 
 psoriasis. Ulceration of the uvula, pharynx, fauces, and 
 cheeks, sometimes accompanied with_ salivation ; great 
 dryness of the mouth, with thirst; soreness of the 
 tongue ; vesicles on the tongue and at its edges. Thin 
 stream of urine, as from contraction of the urethra ; the 
 urine is pale and copious, or scanty, turbid, and offensive. 
 Often, after standing, it becomes milky white, or deposits 
 a quantity of red-brown gravel, or sediment, and occa- 
 sionally filaments and flocks ; when the sediment is white, 
 the odor is ammoniacal. Smarting and burning after 
 micturition, ulceration of the urethra, with yellowish dis- 
 charge ; discharge of bloody mucus from the urethra. 
 Great falling off of the hair of the genital organs. Itching 
 of the penis, especially the glans, under the prepuce ; red 
 spots on the penis, becoming covered with scabs ; ulcera- 
 tion of the glans, with elevated, lead-colored, sensitive 
 edges, or superficial flat ulceration of the corona glandis, 
 
INDICATIONS OF THE MEDICINES. 201 
 
 looking clean, but emitting a fetid pus ; considerable 
 swelling and phimosis of the prepuce without much 
 redness ; on its internal surface and border, and in the 
 orifice of the urethra, chancre-like, suppurating ulcers, 
 with flat edges, accompanied with violent lancinations, 
 increasing towards evening, becoming worse at night, 
 and hindering sleep, and much aggravated towards 
 morning by violent erections. Small flesh-colored ex- 
 crescences on the corona glandis, emitting fetid pus and 
 bleeding when touched ; small itching pimples, bursting 
 in a few days, and changing to a dry scurf; pimples, 
 bursting, and changing to flat ulcers when rubbed, on a 
 level with the skin, yellow, and covered with thick pus; 
 these are only slightly red, and painless ; swelling of 
 the (right) testicle and tearing in the spermatic cords, 
 and painful feeling of the testicles when touched ; dimin- 
 ished and even deficient sexual desire and copious emis- 
 sion of prostatic fluid. Drawing pain in the periosteum ; 
 caries of the bones of the head and face. 
 
 Acidum phosphoricum. Lowness and sadness of 
 spirits, with great anxiety about the health ; thoughtless- 
 ness and forgetfulness, want of ideas, and weakness of 
 mind, with difficulty of comprehension ; objects appear 
 unstable, and, when walking or standing, there is great 
 difficulty in keeping on his feet. Formication of the 
 whole body, and soreness of the skin, with violent burn- 
 ing, pricking, and red rash appearing in various parts. 
 Oppression of the stomach, with drowsiness ; sour eruc- 
 tations, with constant nausea, and occasional vomiting; 
 coldness in the stomach. Retention of urine, terminating 
 in frequent micturition, the urine being watery, — or 
 dark, with clouds ; pale urine, forming thick, whitish 
 
202 CHAKACTERISTIC EFFECTS AND 
 
 flocculi, — or milky urine, as if stirred with flour, and 
 containing bloody jelly-like lumps, and often very fetid ; 
 cutting, drawing, or burning pains in the urethra, with 
 swelling of the orifice ; painful spasmodic constriction of 
 the bladder ; tingling, itching, and heaviness of the glans, 
 pressure and pains, or gnawing in both testicles, increased 
 by contact, and swelling of the spermatic cord ; small 
 red pimples on the penis, with feeling of heat ; discharge 
 of prostatic fluid, when straining at stool ; falling off of 
 the hair of the sexual parts ; heat and burning in sycotic 
 excrescences, and soreness of the same when sitting or 
 walking. 
 
 Aconitum napellus. Heat, burning, and pressure in 
 the eyes, with great intolerance of light, the vessels of 
 the conjunctiva and sclerotica being very much inflamed 
 and injected ; painfully tensive, red, and hard swelling 
 of the lids. Enuresis, accompanied with profuse perspi- 
 ration, difficult and scanty emission of urine, which is 
 brown, burning, and depositing a brick-dust sediment ; 
 burning in the urethra during urination ; stinging and 
 pinching of the glans ; tingling in the genital organs. 
 
 Agaricus muscarius. Difficult emission of urine, the 
 stream being slow, feeble, and intermittent, or even 
 passing in drops ; pressure in the region of the kidneys 
 and loins ; frequent urging to urinate, with entire relaxa- 
 tion of the penis. Cramp-like drawing in the groin 
 during urination ; discharge of viscid tenacious mucus 
 from the urethra. Frequent erections, with involuntary 
 emissions; every embrace being followed by great de- 
 bility and languor, profuse perspiration, and sometimes 
 by burning itching of the skin. 
 
 Agnus castus. Great deficiency of sexual instinct, 
 
INDICATIONS OF THE MEDICINES. 203 
 
 the penis being so relaxed, that nothing excites it ; dis- 
 charge of yellow matter from the urethra ; emission of 
 mucus from the urethra, during sexual excitement. 
 
 Antimonium crudum. Brown spots and dots, like 
 small hepatic spots, here and there, especially on the 
 arms ; blotches in many parts of the body, coming out, 
 with itching, and disappearing in a few hours; golden- 
 yellow, or brownish-red urine, depositing small red cor- 
 puscles after standing some hours ; frequent micturition, 
 with considerable discharge of mucus and burning in the 
 urethra, with pain in the small of the back ; fine itching 
 of the penis ; violent itching of the extremity of the 
 glans. Dejection of spirits, with attacks of anxiety and 
 uneasiness ; weakness of the head, and threatened de- 
 mentia, with complete apathy ; falling off of the hair ; 
 lassitude, tremulous fatigue, and heaviness in all the 
 limbs after eating ; bitter eructations, like bile, with 
 pressure at the stomach, like a dull cutting ; feeling as 
 if the stomach were distended with food ; sensation in 
 the intestines, as after a violent diarrhoea. 
 
 Antimonii tartras. Dark yellow spots of a consider- 
 able size, particularly on the fingers. The coats of the 
 eye becoming redder and more sensitive, swell up, the 
 ciliary vessels becoming turgid with blood ; tearing and 
 burning pains in the eyes. Acute sticking pain in the 
 lower portion of the bladder, violent pressure on the 
 bladder, with scanty emission, and tension in the peri- 
 na3um ; the urine passes in drops, the latter portion 
 being bloody and accompanied with violent pains ; in- 
 flammatory, red urine, depositing bloody, red filaments 
 when standing, and having an acrid smell ; pustules on 
 the glans ; constant sticking pain in the posterior part 
 of the urethra ; tearing in the testicles. 
 
204 CHARACTERISTIC EFFECTS AND 
 
 Apis mellifica. Violent inflammation of the skin, ac- 
 companied with smarting and burning pains; bright 
 scarlet or crimson color of the skin, accompanied with 
 swelling; violent burning, itching, and swelling of the 
 urethra. 
 
 Argenti nitras. Burning and dryness of the eyes, 
 with pressure, heat, and pain when moving them ; 
 scarlet redness of the eyes, accompanied with intolerance 
 of light and dimness of sight ; secretion of mucus, and 
 agglutination of the lids ; the eyes, when opened, dis- 
 close the cornea swollen and intensely injected with 
 blood ; profuse purulent secretion from the inflamed 
 parts ; intense pains in the eyes, the cornea gradually 
 becoming infiltrated, producing haziness, and afterwards 
 more or less opacity of the part. Burning, dragging, or 
 ulcerative pains in the urethra, which feels swollen, hard, 
 or knotty ; oozing first of mucus, then -of pus of a bright 
 yellow color, accompanied with excessive pain in urinat- 
 ing. The urine is often dark-colored or bloody, is longer 
 in making its appearance than usual, the latter portion 
 passing off with difficulty ; painful tension of the penis, 
 producing chordee ; shootings, from behind, forward. 
 Chancre-like ulcers on the prepuce, at first covered with 
 pus, but afterwards exhibiting a pretty spacious depres- 
 sion, with tallow-like coating. 
 
 Arnica montana. Urine of a brownish color, deposit- 
 ing a brick-dust sediment ; brown clear urine, which im- 
 mediately becomes whitish and turbid; frequent, but 
 ineffectual desire to urinate, or slow and difficult emission 
 of urine ; reddish-blue swelling of the penis and scrotum, 
 with inflammatory swelling of the testicles ; painful 
 swelling of the spermatic cord, with lancinations from 
 the testes to the abdomen. 
 
INDICATIONS OF THE MEDICINES. 205 
 
 Arsenicum album. The indications for this remedy 
 are generally characterized by threatening paralysis of 
 the ganglionic system and of the capillary nerves, with 
 consequent disposition to decomposition and mortification 
 of the tissues, sudden sinking of the vital energies, pros- 
 tration of strength, general collapse, solution of continuity 
 (ulceration) of the organic tissues; it is, therefore, suited 
 to individuals with impoverished, exhausted, and nervous 
 constitutions, to leucophlegmatic temperaments with dis- 
 position to catarrh, blenorrhoea, and dropsical swellings; 
 to lymphatic constitutions liable to chronic eruptions, 
 herpes, ulcerations, and suppurations ; and for choleric, 
 lively temperaments, with disposition to melancholy. 
 
 Excessive sensitiveness, irresolution, and disinclination 
 for anything ; indifference to life, with disposition to 
 commit suicide, great restlessness, with trembling, and 
 weeping ; weakness of the mind and inability to think ; 
 frequent yawning, with sleepiness ; grinding of the teeth 
 at night, and restless sleep ; general rapid sinking of 
 strength, and excessive debility, particularly of the lower 
 extremities ; trembling of the w^hole body ; coldness and 
 chilliness of the body, the skin being dry, scaly, and 
 shrivelled ; blue spots on the skin ; little blotches, which 
 heal with difficulty; ulcerations and eruptions of the 
 skin, presenting a dark red, or livid, bluish-green, or black 
 appearance, with the characteristic burning pain, and 
 secretion of thin, acrid, burning, corrosive ichor. Re- 
 tention of urine, as if the bladder were paralyzed, with 
 great urging to urinate ; scanty dark yellow, or greenish 
 dark-brown urine, excessively turbid, and depositing a 
 slimy sediment ; involuntary micturition during sleep ; 
 inflammation and swelling of the genital organs ; corro- 
 18 
 
206 CHARACTERISTIC EFFECTS AND 
 
 sive itching of the penis ; stinging itching of the prepuce, 
 with burning in it during an erection ; acrid, thick, 
 yellow discharge from the vagina, corroding the parts. 
 
 Asafcetida. Dark red, hot swellings, with violent 
 pain in the bone when touched, and discharge of fetid, 
 thin, ichorous pus ; ulcers, having elevated bluish edges ; 
 numb pressure, as of a body pressing upon the bones ; 
 crampy jerking and drawing in the bones ; stinging in 
 the bones of the leg; pains in the bones during the night. 
 
 Aurum metallicum. Pains in the bones of the head, 
 as if broken ; small bony swelling on the upper left side 
 of the forehead; feeling of soreness in the nose, with 
 ulceration in the nostrils, swelling of the nose, and loss 
 of smell ; putrid smell and discharge from the nose ; 
 bony tumors on the head, arms, and legs ; swellings, 
 resembling those produced by mercury ; formication all 
 over the body. Turbid urine, like -buttermilk, with a 
 thick sediment of mucus ; painful retention of urine, 
 with pressure on the bladder ; pressure, tensive pain, 
 and swelling of the right testicle, which sometimes be- 
 comes indurated. 
 
 Barytae carbonas. Swelling of the epididymis ; numb- 
 ness of the sexual organs ; considerable sweat of the 
 scrotum. Tremor of the feet when standing, compelling 
 one to hold on to something to prevent a fall. Loss of 
 memory, vertigo, excessive irresolution and loss of self- 
 confidence, great sensibility to cold; palpitation of the 
 heart, especially in debilitated individuals. 
 
 Belladonna. Feeling of burning dryness in the eyes, 
 which feel as if they were full of sand ; the eyes are 
 glistening, red, and violently inflamed, with profuse se- 
 cretion of tears, and accompanied with burning pains. 
 
INDICATIONS OF THE MEDICINES. 207 
 
 Retention of urine, which only passes off drop by drop, 
 and deposits a white sediment, or turbid, like yeast, with 
 reddish deposit. Wetting the bed at night, with profuse 
 sw T eat. Itching titillation of the glans, resembling a 
 flea-bite ; repeated tearing in the left spermatic cord, 
 from below upwards, in the evening when in bed ; lanci- 
 nations along the urethra. Great general debility, with 
 weariness and unsteady gait, the knees tottering and 
 giving way ; swelling and induration of the glandular 
 system. 
 
 Bryonia alba. Stinging, burning, itching of the pre- 
 puce ; stitches in the testicles when sitting ; red itching 
 rash of the glans ; swelling of the labia ; itching, burning, 
 and stinging in the anterior, portion of the urethra, be- 
 tween the acts of micturition. Hard swelling of the 
 hypochondria; tension, burning, and stinging in the 
 region of the liver, particularly on contact ; bitter eructa- 
 tions and vomiting of food and bile, or yellowish-green 
 mucus ; loss of appetite and strength ; heaviness and 
 weakness in all the limbs. 
 
 Camphora. Thin stream of urine, as if the urethra 
 were contracted ; urine red and thick, or yellowish green 
 and turbid, having a musty smell. Total absence of 
 erections. 
 
 Calcis carbonas. Urine containing a great deal of 
 mucus, and depositing a white substance like flour ; urine 
 having a fetid ammoniacal smell, and very clear and 
 pale ; burning and soreness in the urethra during mictu- 
 rition ; violent stitches in the glans ; itching of the tip 
 of the glans and prepuce, which is red and inflamed ; 
 aching in the right testicle; pain, as from contusion, in 
 the testicle ; painful pressure and pain in the left groin, 
 
208 CHARACTERISTIC EFFECTS AND 
 
 while the left testicle is spasmodically drawn up to the 
 abdomen, and is also painful to the touch. Anxiety, low- 
 spiritedness, and melancholy, with great uneasiness 
 about the state of the health ; irritability, faintness, and 
 depression, with ill-humor ; weakness of memory ; con- 
 fusion and tremor in the head, with continual feeling of 
 fulness in the forehead; coldness, paleness, and flabby 
 feeling of the skin, with great sensitiveness to cold ; face 
 pale and thin, with dark circles round the eyes ; appetite 
 generally good, or even voracious, with bitter, fetid, or 
 saltish taste in the mouth ; oppression of the chest and 
 palpitation of the heart ; great general debility and faint- 
 ness. 
 
 Cannabis sativa. Retention of urine, or strangury, 
 the urine mixed with filaments or blood ; burning, sting- 
 ing, and smarting pain in the urethra during urination, 
 urine mixed with mucus and pus, requiring the use of a 
 catheter; spreading fan-shaped stream; frequent erec- 
 tions, followed by stitches in the urethra; painless 
 swelling of the whole penis ; swelling of the right and 
 lower side of the prepuce ; the prepuce is dark red, hot, 
 and inflamed ; continual burning of the whole prepuce 
 and glans ; corrosive burning and stinging of the outer 
 parts of the prepuce and the corona glandis ; soreness of 
 the margin of the prepuce, and its skin is covered with 
 bright red spots of the size of a pea ; the glans is dark 
 red, the same as the prepuce ; secretion of humor behind 
 the corona glandis ; tensive pain in the spermatic cord 
 when standing, and contraction of the scrotum, with sense 
 of pressure in the testicles, a sort of dragging swelling 
 of the prostate gland ; painless discharge of mucus from 
 the urethra. 
 
INDICATIONS OF THE MEDICINES. 209 
 
 Cantharis. Pains in the region of the kidneys, ex- 
 tending into the abdomen, with extreme pain during uri- 
 nation ; cutting, tearing, and contractive pains along the 
 ureters ; pressure, stinging, and tearing pain in the neck 
 of the bladder; heat and burning in the bladder; violent 
 cutting in the urethra, causing one to bend double ; con- 
 stant violent desire to urinate, with difficult or scanty 
 emission, which is often tinged with blood, or mixed 
 with tenacious mucus, attended with cutting ; violent 
 strangury, with pain in the back, and scanty, or some- 
 times profuse discharge ; the urine is either white, red, 
 or reddish, turbid like loam water, with white sediment, 
 full of mucus, or jelly-like, or mixed with sand or clots 
 of blood. During micturition, dysuria, burning, biting, 
 cutting, or burning, jerking pain ; after micturition, 
 burning and tingling in the urethra. Discharge of dirty, 
 purulent, or yellow fluid from the urethra, often mixed 
 with blood, and sometimes accompanied by chordee and 
 painful erections ; violent priapism, or frightful satyriasis, 
 with excessive pains, continuing nearly the whole night. 
 Inflammation of the penis ; itching, burning, and heat 
 of the sexual organs ; burning in the region of the excre- 
 tory ducts of the seminal vessels. Drawing pains in the 
 spermatic cord when urinating ; swelling of the scrotum, 
 penis, and fra^num. 
 
 Capsicum. Spasmodic contraction of the neck of the 
 bladder, with cutting pain; the urine is discharged in 
 drops, with burning in the orifice of the urethra, and 
 depositing a white or filamentous sediment ; continual 
 pressing and prickling in the glans ; drawing pain in the 
 spermatic cord, and crampy pain in the testicle during 
 emission of urine and some time after ; purulent discharge 
 18* 
 
210 CHARACTEKISTIC EFFECTS AND 
 
 from the urethra ; atrophy of the testicles, extinction of 
 the sexual instinct, falling off of the beard, and weakness 
 of sight. 
 
 Carbo vegetabiliso Weakness, such as is caused by 
 the loss of animal fluids, with anguish, irritability, ten- 
 dency to start, and peevishness ; bluish color of skin, 
 with coldness and chilliness, and attended with anguish 
 or palpitation of the heart ; burning and discharge of 
 ichor from ulcerations; |feat flatulence and distention 
 of the stomach ; urine dark red, as if mixed with blood, 
 and depositing gravel or a red sediment ; sometimes, 
 however, it is thick and milky ; tearing and drawing 
 pains in the urethra, and painful jerking and burning in 
 the urethra when urinating ; frequent nocturnal pollu- 
 tions, which violently depress the nervous energy. 
 
 Causticum. Itching of the glans and inner surface of 
 the prepuce, which is covered with vesicles, changing to 
 suppurating ulcers ; nocturnal emissions, producing great 
 dizziness the next day ; urine depositing a yeasty sedi- 
 ment, or containing mucus. Frequent and increased 
 micturition, with retarded emission of the last drops; 
 the urine passes so easily as not to excite attention, and 
 is lost when coughing, sneezing, or blowing the nose ; 
 involuntary discharge of urine when asleep; — great 
 weakness and loss of memory, or absence of mind ; 
 anxious solicitude about everything that happens ; ex- 
 cessive physical depression and failing of strength. 
 
 Chamomilla. Soreness of the border of the prepuce, 
 and itching, stinging pain of its margin ; burning in the 
 vagina, with yellow or watery acrid discharge; tearing, 
 drawing pains in the back, with contractive sensation in 
 the spine, and painful stiffness in the loins ; the sexual 
 
INDICATIONS OF THE MEDICINES. 211 
 
 desire is very excited, and accompanied with nocturnal 
 emissions. 
 
 Cinchona. Great debility, and tendency to passive 
 haemorrhages and decomposition of the organic tissues, 
 and consequent degeneration into a bad type of various 
 diseases. In such cases the following symptoms are 
 generally present : excessive sensitiveness of the whole 
 nervous system, debility, exhaustion, and intolerance of 
 noise ; extreme anxiety and apprehensiveness ; hypochon- 
 dria ; singing and roaring in the ears ; paleness of the 
 countenance ; swoons ; perspiration induced after the 
 slightest exercise ; restless sleep, disturbed by frightful 
 fancies and dreams ; loss of appetite, with bitter taste in 
 the mouth ; hardness and distention of the abdomen, 
 indigestion, jaundice, and diarrhoea ; scanty urine, of a 
 greenish-yellow, with brick-dust sediment, or pale urine, 
 depositing a loose, dingy-yellow sediment. Itching of 
 the glans and stinging of the frsenum, with darting pain 
 between the glans and prepuce ; drawing pains in the 
 testicles ; swelling of the testicles and spermatic cord ; 
 hydrocele, accompanied with tearing and drawing pains ; 
 nocturnal emissions, producing great debility. 
 
 Cinnabaris. Soreness in the urethra during micturi- 
 tion ; burning, stinging, itching, with small red spots on 
 the glans ; painful itching behind the corona glandis, 
 with exudation of fetid pus ; redness, soreness, and 
 swelling of the prepuce, with itching pain ; warts on the 
 prepuce, which bleed when touched. 
 
 Clematis erecta. Inveterate eruptions on the skin ; 
 scaly eruptions, with yellowish corrosive ichor; — long- 
 lasting contraction and Constriction of the urethra, the 
 urine can only be passed in drops, and the stream is 
 
212 CHARACTERISTIC EFFECTS AND 
 
 frequently interrupted ; frequent micturition, but little at 
 a time ; emission of puriform matter, with burning at the 
 commencement of urination, with painful drawing in the 
 spermatic cord, extending into the abdomen ; the testes 
 feel painful, as if bruised, when touched, accompanied 
 with drawing and stretching, and are often swollen and 
 indurated ; violent erections, with drawing pains in the 
 spermatic cord, and stitches in the urethra, lasting sev- 
 eral hours. 
 
 Cocculus. Sadness, anxiety, and tendency to start ; 
 restlessness at night; pressive headache, especially in 
 the forehead ; aversion to food, and bitter eructations, 
 with nausea and sinking at the stomach. Frequent de- 
 sire to urinate, and emission of urine at short intervals, 
 the pressure upon the bladder being constantly renewed ; 
 stinging pain in the margin of the prepuce ; violent pains 
 in the testicles, as if bruised ; nightly nocturnal pollu- 
 tions ; paralytic pain in the small of the back, with spas- 
 modic drawing across the hips, and hindering walking ; 
 drawing, tearing, or boring pains in the back. 
 
 Colchicum. Increased secretion of urine, with urging ; 
 it is either brown, blackish, or of a light yellow color, 
 and turbid ; when heated, it deposits a quantity of albu- 
 men ; occasionally it burns like fire, and passes off con- 
 tinually. 
 
 Colocynthis. Urine of an insupportable odor, which 
 becomes viscid, like white of egg 7 on standing, or urine 
 of a pale flesh color, with a light brown, flocculent, 
 transparent sediment, encrusting the utensil with small, 
 red, hard crystals, which are detached with difficulty; 
 retraction of the prepuce behind the glans during sleep ; 
 frequent erections. 
 
INDICATIONS OF THE MEDICINES. 213 
 
 Conium maculatum. Urgent desire to urinate, and 
 wetting the bed at night, with burning during the act. 
 Discharge of pus from the urethra ; itching of the penis, 
 glans, and prepuce, which latter is also inflamed. 
 Pinching, tearing, and drawing in the testicles ; swelling 
 of the testicles. 
 
 Copaibae balsamum. Excessive irritation of the blad- 
 der ; inflammation, swelling, and dilatation of the orifice 
 of the urethra, with pulsative pain through the penis. 
 Itching, burning, biting, and pain, as from soreness in 
 the urethra, before and after micturition. Foaming 
 urine, of a greenish turbid color, and smelling of violets. 
 Burning and sensation of dryness in the region of the 
 prostate gland and bladder. Induration of the prostate 
 gland, with great pain on urinating ; swelling and indu- 
 ration of the testicles ; yellow, purulent discharge from 
 the urethra. 
 
 Cubebae. Increased secretion of urine, which is dark 
 and foaming, and having a peculiar smell ; dark reddish 
 discharge from the urethra. Orchitis, and sensation of 
 pressure and heaviness in the pelvis. 
 
 Digitalis purpurea. Continual desire to urinate, with 
 excessive discharge of urine day and night, producing 
 great exhaustion. Involuntary emission of urine ; con- 
 tractive pain in the bladder during urination, which is 
 very difficult ; the urine is either light yellow, or dark, 
 becoming still more red and turbid after standing ; con- 
 tusive pains in the right testicle ; the scrotum appears 
 as if filled with water. Irritation of the sexual organs, 
 with painful erections. 
 
 Dulcamara. Urine turbid, white and fetid, or deposit- 
 ing at times a red sediment ; or urine containing whitish 
 
214 CHARACTERISTIC EFFECTS AND 
 
 mucus, attended with difficulty of passing water ; thick- 
 ening of the bladder from previous inflammation. 
 
 Ferri sulphas. Mucous discharge from the urethra, 
 dependent on atony of the vessels ; nocturnal emissions. 
 Constant erections; bright red urine, depositing crystals 
 of the same color. 
 
 Graphite. Swelling of the eyelids, and redness of the 
 conjunctiva, with intolerance of light, and fiery zigzag 
 appearances around and outside the line of vision, in the 
 evenings. Thin stream of urine, as if the urethra were 
 too narrow ; the urine is turbid, of a dark color, and de- 
 posits a reddish or sometimes a white sediment ; swelling 
 and induration of the right testicle, with sticking pain ; 
 darting in the left spermatic cord ; obstinate ulcerations ; 
 deficient circulation, chilliness, weariness, lassitude, lazi- 
 ness, great dejection of spirits. 
 
 [Guaco, Mikania Guaco. Turchetti states, that Guaco 
 locally applied, destroys the specific property of pus from 
 a chancre ; and prevents the production of a second 
 chancre by inoculation. He also claims for it positive 
 curative powers in Syphilis. 
 
 Schmidt's Jahrbuch, Bd. 101, p. 168, quoted by C. Dun- 
 ham, M. D., Am. Horn. Rev. Vol. Ill, p. 425.] 
 
 Helleborus niger. Paralysis of the bladder ; painful 
 emission of small quantities of urine, which is dark ; 
 itching and fine stitches in the top of the glans ; dropsy 
 of the scrotum ; general swelling of the lower limbs, par- 
 ticularly after suppressed eruptions. 
 
 Hepar Sulphuris. Salivation, ulceration of the mouth, 
 great nervousness, swelling or inflammation of the bones, 
 
INDICATIONS OF THE MEDICINES. 215 
 
 suspicious eruptions, and other symptoms traceable to the 
 action of mercury. Enlargement and suppuration of in- 
 durated glands, with discharge of pus , scurfy forma- 
 tions, without pain, on the skin ; falling off of the hair ; 
 urine flocculent and turbid, depositing a white sediment ; 
 greasy pellicle on the urine, glistening with various colors ; 
 blood-red urine ; the last drops are mixed with blood ; 
 sharp burning urine, corroding the internal surface of the 
 prepuce, and causing ulceration ; itching of the glans and 
 prepuce ; ulcers on the prepuce, resembling chancre ; 
 discharge of mucus from the urethra. 
 
 Hyoscyamus niger. Retention of urine, with pressure 
 in the bladder ; difficult micturition, the urine being 
 yellow, and even turbid, depositing a grayish-white sedi- 
 ment ; paralysis of the bladder; involuntary emission of 
 urine. 
 
 Ignatia amara. Lemon-colored urine, with w r hite sedi- 
 ment ; turbid urine ; painful pressure, w T ith a sensation 
 of scraping in the region of the neck of the bladder; 
 smarting itching of the glans, and the inner surface of 
 the prepuce ; soreness and ulcerative pain, with itching 
 in the margin of the prepuce ; severe strangulating sen- 
 sation, or pressure in the testicles ; swelling of the scro- 
 tum in the evening ; violent crampy pressing in the re- 
 gion of the uterus, with purulent discharge. 
 
 lodium. Chancre-like sores, a portion of which be- 
 comes elevated, whilst the remainder deepens ; swelling 
 and indurations of the glands ; wasting of the glands ; 
 dark, turbid, yellow, green, or milky urine, having an 
 ammoniacal smell, and corroding the urethra, with itch- 
 ing, smarting, and intensely painful cutting in the 
 urethra; great irritation of the nervous system, with 
 
216 CHARACTERISTIC EFFECTS AND 
 
 uneasiness in all the limbs, and increased sensibility of 
 the whole body ; trembling of the limbs, with vacillating 
 gait, and great weakness. 
 
 [Jacaranda Caroba. The orifice of the urethra looks 
 like two small inflamed lips, itching when touched. Heat 
 and pain of the penis. Discharge of a yellowish-white 
 liquid from the prepuce. Pain in the prepuce, as if a small 
 bundle of fibres were seized. The prepuce cannot be 
 drawn back, (phimosis.) Suppuration between the glans 
 and prepuce. Acute pain in left testicle when walking. 
 Heat and swelling of the scrotum. Slight pinching in 
 the prepuce. Itching pimple at the glans, suppurating 
 like a chancre, and leaving a red spot when dry Sup- 
 pression of the sexual desire. Painful erections during 
 a swelling of the prepuce. The contact of the urine 
 causes tearing pains, which affect the whole organism. 
 Itching and pricking at the margin of the prepuce. 
 Rheumatic pains. Sleeplessness. Frightful dreams. 
 Malaise. Nausea. Debility. 
 
 See Mure's Materia Medica ; and Lippe's Text-book 
 of Materia Medica.~\ 
 
 Kali carbonas. Inflammation of the eyes, with burning 
 and biting sensation, and swelling of the eyelids ; tear- 
 ing, with pressure in the interior of the eye; sharp tearing 
 in the orbit ; blue and green spots before the eyes. 
 Pinching in the left testicle, with dragging pain and 
 swelling ; the scrotum feels as if bruised. Pale greenish 
 urine, or dark yellow urine, or resembling loam-water, 
 with copious sediment, and emitted with difficulty. Vio- 
 lent tearing, as if in the marrow of the bones ; frequent 
 
INDICATIONS OF THE MEDICINES. 217 
 
 weariness and depression of strength, and feeling of 
 emptiness in the whole body ; the whole body feels 
 heavy and broken down ; pulsation of all the arteries of 
 the body ; sudden trernulousness. 
 
 Kali iodidum. Ulceration of the bones, with adventi- 
 tious growths of the soft parts, and fistulous openings ; 
 inflammation of the periosteum, or interstitial distention 
 of the bone ; enlargement of the glands, with incipient 
 purulent infiltration of the parts ; puffy swelling of the 
 mucous membrane ; interstitial deposit in the prostate 
 gland, occasioning a complete retention of urine ; painful 
 urging to urinate, the urine being as red as blood ; dis- 
 charge of mucus from the urethra ; profuse salivation, 
 with great swelling of the tongue and excessive ulcera- 
 tion of the mucous membrane of the mouth ; papulous 
 and herpetic eruptions on the skin. 
 
 Kreasotum. Smarting swelling of the vagina, with 
 soreness when passing urine ; corrosive itching between 
 the labia and vagina, succeeded by burning and swelling 
 of the labia and discharge of mucus and blood ; urine hot 
 and smoking, of a dark red or chestnut color, with sedi- 
 ment of a brown or sometimes white color ; great de- 
 pression of spirits, weariness of the limbs, and uneasi- 
 ness of the whole body ; great diminution of the vital 
 energy, with lax and impoverished constitution ; dis- 
 charge from the mucous surfaces ; passive haemorrhages 
 (venous), with tendency to putrefaction ; fetid diarrhoea, 
 and putrid character of many of the symptoms. 
 
 Lachesis. Urine of a copper color, depositing a floccu- 
 
 lent sediment ; discharge of mucus with the urine, which 
 
 looks like white of egg, when it has stood some time ; — 
 
 hard cartilaginous degeneration of the prepuce, or at- 
 
 19 
 
218 CHARACTERISTIC EFFECTS AND 
 
 tended with phimosis ; red spots on the glans and pre- 
 puce ; pressing in the testicles when sitting ; — violent 
 pains in the bones, preventing sleep ; ulcerations of a bad 
 character, being hard, cartilaginous, of a livid or greenish- 
 yellow color, and bleeding readily when touched, 
 
 Lycopodium. Red, inflamed eyes, with profuse lach- 
 rymation and burning and smarting pains ; tensive and 
 bruised feeling in the eyes ; — during urination the. flow 
 is suddenly interrupted, only a few drops of turbid and 
 slimy urine being passed ; urine foamy, reddish-brown, 
 and depositing a reddish-yellow sediment ; smarting sen- 
 sation in the female urethra during urination ; jerking 
 drawing in the posterior part of the urethra ; dropsical 
 swelling of the genital organs ; darting sensation in the 
 left testicle ; heaviness and pain in the testicles ; draw- 
 ing and cutting in the glans ; excessive nocturnal emis- 
 sions ; — pains in the periosteum ancLbones, with nightly 
 aggravation of a drawing character ; sensation as if the 
 bones contained no marrow ; — ulcers with hard, shining 
 elevated edges, and copious, watery, ichorous, very fetid 
 pus, and surrounded with blue, red, hard, painful areola, 
 with tearing lancinating pains, which are worse at night ; 
 relaxation of the body, with nervous irritation and 
 tremor, the weakness often increasing after rest ; cold- 
 ness and chilliness of the body ; great tendency to take 
 cold; oppression of the chest and palpitation of the 
 heart ; hiccough, sour eructations, frequent nausea, 
 weight at the stomach, dull and stitching pain in the 
 liver after eating ; hepatic spots on the chest. 
 
 Mercurius. As this remedy is so constantly used in 
 syphilitic diseases, and so much suffering has resulted 
 from its indiscriminate employment, the following anti- 
 
INDICATIONS OF THE MEDICINES. 219 
 
 dotes are here given, covering nearly the whole of the 
 groups of symptoms that arise from its abuse : 
 
 Acid nitric. Against violent pains in the bones; ul- 
 ceration of the mucous membrane ; mercurial symptoms, 
 combined with congestions and inveterate syphilis ; 
 stomacace mercurialis ; scorbutic haemorrhages ; ulcera- 
 tion of the mucous membrane of the mouth ; affections of 
 the periosteum and bones. 
 
 Acid phosjih. Against periostitis. 
 
 Arnica. Against pulmonary haemorrhage. 
 
 Artemisia. Against hydrargyrosis (mercurialization) 
 combined with rheumatism and gout. 
 
 Asafoetida. Against caries and ozaena. 
 
 Aurum. Against cachexia and scrofula ; hypochon- 
 dria ; ozaena ; induration and swelling of the testicles. 
 
 Belladonna. Against congestion to the head ; peri- 
 ostitis and ostitis ; phlegmonous (painful, tense, red, cir- 
 cumscribed) inflammation of the glands. 
 
 Carbo veg. In acute poisoning with Merc, corros., 
 with threatening gangrene ; ulceration of the mucous 
 membrane of the intestines, stomacace ; gangrene result- 
 ing from salivation ; ulcers having a scorbutic and gan- 
 grenous character, with nightly burning pains. 
 
 Cinchona. Against excessive weakness, consequent 
 on the loss of strength and humors ; excessive irritation 
 of the nervous system, excessive sweats, great sensitive- 
 ness of the skin to changes of temperature, and liability 
 to take cold ; affections of the periosteum and bones ; 
 caries. 
 
 Conium. Against cold, indurated, glandular swellings. 
 
 Dulcamara. Against rheumatism, great liability to 
 cold; herpes and impetigo (running tetter). 
 
220 CHARACTERISTIC EFFECTS AND 
 
 Ferrum. Against cachexia, ulcers, periostitis (Ferr. 
 phosph.) ; hydrargyrosis, combined with torpid scrofula 
 (Ferri iodidum) ; trembling of the limbs and neuralgia. 
 
 Guaiacum. Against rheumatism and gout, or the two 
 combined with hydrargyrosis. 
 
 Iodium, Kali iodidum. These are the chief antidotes 
 of mercury, especially when the lower tissues are the 
 seat of the affection, assuming the forms of secondary 
 or tertiary syphilis, and consisting of affections of the 
 inner mucous membrane, the outer skin, the periosteum 
 and bones, thickening and abnormal growths of the afore- 
 said tissues ; they should, therefore, be chiefly employed 
 in induration and thickening of glandular organs, of the 
 testicles, liver, mesenteric, parotid, cervical, axillary, and 
 inguinal glands ; salivation and gangrene arising there- 
 from ; cutaneous diseases, as tubercles, ulcers, and gum- 
 mata ; inflammation of the periosteum and bones, caries, 
 and tophi (soft swellings on the bone). When the sys- 
 tem has been saturated with mercury in the treatment 
 of secondary or tertiary syphilis, Iodium will neutralize 
 its effects and restore the susceptibility of the organism 
 to the action of that drug. 
 
 Kreasotum. Against scorbutic symptoms, ulceration 
 of the mucous membrane of the mouth and fauces ; cuta- 
 neous ulcers ; salivation. 
 
 Lachesis. Against ulcers of the fauces ; gangrene 
 from salivation. 
 
 Lycopodium. Against ulcers of the throat and fauces ; 
 affections of the bones. 
 
 Mezereum,. Against ostitis and periostitis; chronic 
 inflammation and induration of the testicles and tonsils ; 
 impetigo and herpes. 
 
INDICATIONS OF THE MEDICINES. 221 
 
 Natr. mur. Against scorbutic diathesis. 
 
 Nux vomica. Against trembling of the limbs; paraly- 
 sis of the optic nerve and lower limbs. 
 
 Opium. Against excessive nervous irritability ; neu- 
 ralgia ; painful salivation ; hydrargyrosis, combined with 
 rheumatism; adynamic fever, with congestion of the 
 brain; ulcers, attended with great pain; morbid sensi- 
 bility and hydrargyrosis, with decomposition of the 
 blood ; softening and puffiness of the solids and solid 
 tissues, and colliquative phenomena. 
 
 Phosphorus. Against mercurial phenomena ; neural- 
 gia ; ostitis and periostitis ; paralysis. 
 
 Sarsaparilla. Against cutaneous eruptions. 
 
 Silicea. Ulcerations and -caries. 
 
 Staphysagria. Hypochondria; ostitis and periostitis. 
 
 Sulphur, Hep. sulph. In the lower forms of h}^drar- 
 gyrosis, but not applicable in a perfectly developed scor- 
 butic mercurial cachexia ; for iritis, cutaneous eruptions, 
 and ulcers ; affections of the bones and mercurial asthma. 
 
 Zinc sulph. Against neuralgia in plethoric individ- 
 uals suffering from congestions, and sensitive individuals 
 disposed to spasms. 
 
 General Symptoms. — Greater or less affection of 
 the mucous membrane, the respiratory organs, the intes- 
 tinal canal, and the urinary and genital organs ; shortly 
 afterwards, the skin and glandular tissues are similarly 
 affected. The secretions, particularly those of the intes- 
 tinal canal, mucous membrane, liver, and skin, are in- 
 creased ; the excretions are more abundantly, and mor- 
 bidly altered ; the mucus is cruder ; the urine turbid ; 
 the alvine evacuations are darker and thinner, and 
 greenish ; the exhalations from the skin are clammy, 
 19* 
 
222 CHARACTERISTIC EFFECTS AND 
 
 smell disagreeably, and the epidermis becomes flaccid. 
 Gastric symptoms are in the meanwhile making their 
 appearance ; the taste becomes impaired, the breath 
 offensive, the tongue more or less coated, the appetite 
 diminishes ; the patient complains of general discomfort ; 
 the pulse is irritable ; the blood is of a serous, fluid con- 
 sistence ; all the secretions become more liquid, and 
 even the solids interstitially distended. The callus of 
 bony fractures is dissolved ; the fibrous tissues, particu- 
 larly the muscles, lose their tonicity; the patient feels 
 weary and languid. The whole body, and more particu- 
 larly the face, is bloated, and has a dingy, sallow ap- 
 pearance ; the milk in the breast becomes poisonous, 
 and often causes convulsions in the child. In severer 
 cases the following symptoms are present : languor and 
 exhaustion ; derangement of the digestive organs ; great 
 flatulence; constipation, alternating with diarrhoea; sour 
 eructations ; emaciation ; apathy. The hair loses its 
 lustre, becomes dry, and falls off; the eyes retreat into 
 their orbits, look dim and watery ; the conjunctiva is 
 dingy, has a reddish tinge, with clusters of varicose 
 vessels, which become closely interwoven around its 
 border. The iris loses its natural color ; whether blue, 
 brown, or blackish, it now looks gray and dingy; the 
 face looks pale, dingy, and sallow ; the cheeks are sunken 
 and flabby ; the nose becomes pointed ; the wings of the 
 nose assume a greenish or bluish tinge ; the lips are 
 withered and bluish (these symptoms constitute the so- 
 called quicksilver physiognomy') ; the gums recede from 
 the teeth, become bluish-red ; the teeth lose their enamel, 
 are covered with a fibrinous coating, tarn black, become 
 loose, and fall out. The mucous membrane of the fauces 
 
INDICATIONS OF THE MEDICINES. 223 
 
 and mouth, which is interstitially distended, looks pale, 
 bluish, and dingy ; the breath is offensive ; the lips red- 
 blue ; the chin pointed and prominent ; the skin of the 
 body feels flaccid, withered, and cold to the hand; the 
 veins, which are swollen, shine through it. The saliva 
 is tenacious ; the sweat clammy ; the urine pale and 
 turbid ; the stools are watery ; the exhalations have a 
 fetid smell ; mobility is diminished ; the activity of the 
 mind depressed ; the patient is indifferent, apathetic, and 
 frequently falls into a state of imbecility, preceded by 
 weakness of memory, sight, hearing, and other senses. 
 
 Mind and Disposition. — Paroxysms of oppressive 
 anxiety, general confusion of ideas, loss of memory, 
 great tendency to start, with trembling of the whole 
 body ; peevishness, taciturnity, suspiciousness, with great 
 irritability and quarrelsomeness. 
 
 Head. — Violent vertigo, heaviness, and dulness ; 
 weakness of intellect ; craziness ; absence of mind, and 
 strange ideas crowding on the mind when employed ; 
 violent headache, pressing from within outwards ; tear- 
 ing headache, especially in the forehead ; painful lancina- 
 tions in the left side of the forehead ; jerking, drawing, 
 and pinching pains in the right temple, extending to the 
 back part of the head ; burning itching of the forehead ; 
 boring in the occiput ; burning in the region of the left 
 temple. 
 
 Eyes. — Inflammation of the conjunctiva, the eyelids 
 swollen and red ; the canthi are excoriated, and attended 
 with smarting pain ; the margins of the lids are burning 
 and itching, are agglutinated in the morning after sleep, 
 and secrete a quantity of gum ; pinky redness of the 
 eyes (sclerotitis), with itching, smarting, and burning 
 
224 CHARACTERISTIC EFFECTS AND 
 
 pain ; secretion of mucus, and afterwards pus, from the 
 inflamed and swollen conjunctiva ; injection of the vessels 
 of the sclerotic, forming a circular ring round the cornea, 
 with discoloration of the iris, with tendency to contrac- 
 tion of the pupil ; burning aching in* the bottom of the 
 eye, with great intolerance of light; constant lachryma- 
 tion ; a variety of colors, sparks, and fiery rings before 
 the eyes ; ulceration of the cornea, afterwards terminating 
 in specks (nebulae), or denser white masses (albugo and 
 leucoma). Mistiness before the eyes, sometimes van- 
 ishing of the sight for a few moments. 
 
 Nose. — Swelling of the whole nose, especially of the 
 left side, with interstitial distention at its root ; frequent 
 sneezing and profuse fluent coryza, which is very acrid, 
 and afterwards changing to pus ; putrid smell in the nose. 
 
 Mouth. — Bluish redness and interstitial distention of 
 the mucous membrane of the mouth, which forms along 
 the line of contact with the teeth an arch of yellow color, 
 receding from the teeth together with the gums, and 
 bleeding readily on that account, causing the teeth to 
 become loose, and sometimes to fall out ; swelling of the 
 lymphatic glands, the cheeks, and tongue, w T hich last 
 frequently attains such a size as to fill, the whole cavity 
 of the mouth, causing the patient to open his mouth, in 
 order to give the tongue more space ; swelling of the 
 fauces and tonsils, involving the Eustachian tube, and 
 diminishing the hearing ; violent burning pains attend 
 these symptoms, and deglutition is very difficult. Cada- 
 verous smell from the mouth on expiration; frequent 
 accumulation of saliva in the mouth, inducing frequent 
 spitting; these symptoms increase, till the saliva runs 
 uninterruptedly from the mouth, which is constantly 
 
INDICATIONS OF THE MEDICINES. 225 
 
 open, the patients being prevented from spitting by the 
 swelling of the parts. The mucous membrane of the 
 mouth and cheeks breaks down where it touches the 
 teeth, the parts bleed, and flat, painful ulcers make their 
 appearance; the teeth are covered with thick putrid- 
 smelling sordes, corroding the enamel, after which the 
 teeth frequently turn black ; the saliva feels hot, is very 
 tenacious, so that it can be drawn into threads, and 
 looks glairy or milky, and sometimes yellowish, and 
 very rarely greenish or reddish ; to the patient it tastes 
 either sour, salt, sweetish, flat, bitter and putrid, metallic, 
 generally acrid, on which account it corrodes the mucous 
 membrane, occasioning cough, vomiting, &c. The quan- 
 tity of saliva varies from two or three pints to sixteen 
 pints in the twenty-four hours. 
 
 Pharynx and (Esophagus. — Dryness in the posterior 
 part of the fauces, unrelieved by drinking; at the same 
 time the voice becomes somewhat husky, peculiarly 
 rough, with feeling as if the entrance of the windpipe 
 were closed with swelling. There is now drawing pres- 
 sure in the posterior part of the pharynx, with stoppage 
 of the nose, consequent upon the supervening dryness of 
 the Schneiderian membrane, which the patients attempt 
 to relieve by expelling the air through the nostrils with 
 closed mouths ; the air thus expelled feels rough ; when 
 talking there is pain, which is partly stinging, partly 
 pressive, and increases to a burning if the talking is con- 
 tinued ; this irritation of the mucous membrane gradually 
 involves the fauces, the upper part of the larynx, and the 
 Eustachian tube as far as the internal ear ; in many 
 cases the membrane looks dry and corroded, the patients 
 being compelled to hawk frequently ; the tonsils, velum 
 
226 CHARACTERISTIC EFFECTS AND 
 
 palati, uvula, and particularly the back part of the fauces, 
 exhibit a redness, which varies from dark-red to bluish 
 red, with somewhat darker spots here and there, with 
 yellowish elevations, the size of half a pea, in those spots; 
 these are slightly swollen mucous glands. The vessels 
 of the mucous membrane now become injected, the uvula 
 in particular becoming surrounded with a perfect network 
 of vessels. Over other parts of the mouth single vessels 
 are seen spreading in various directions, like coarse 
 threads, generally from a$&ve downwards, of a violet- 
 bluish color, and surrounded by clusters of other varicose 
 vessels ; on the mucous membrane of the cheeks, or on 
 the inner side of the lips, a vesicle is seen, from the size 
 of a lentil to that of a pea ; it is formed by the delicate 
 epithelium of the mucous membrane, and is of a beautiful 
 pale-yellow color ; when opened, it discharges a clear, 
 tasteless lymph, and the wound rapidly heals. 
 
 Gastric Symptoms. — Bitter putrid eructations, with 
 heartburn, frequent hiccough, nausea, and inclination to 
 vomit ; excessive appetite and hunger, but there is total 
 want of relish for anything ; metallic or coppery taste in 
 the mouth, with very bitter taste, especially after drink- 
 ing coffee ; constrictive tearing pain in the stomach, with 
 burning pain, and intensely painful aching oppression at 
 the stomach from eating even the lightest kind of food. 
 Painful sensitiveness of the region of the liver to contact, 
 with burning tension and feeling of fulness ; pushing and 
 pressing from within outwards in the liver; in severe 
 cases, complete jaundice, or induration of the liver. 
 
 Stool. — Violent diarrhoea, with discharge of green, 
 slimy, acrid stools, or dark green, bilious, frothy stools, 
 with violent urging ; or dysenteric stools, consisting of 
 
INDICATIONS OF THE MEDICINES 227 
 
 blood, and mucus, or slime ; yellow or clayish stools, 
 indicating the total absence of bile ; violent burning, 
 biting, cutting, or pinching pains in the anus ; great 
 anxiety and trembling before stool, succeeded by bitter, 
 rancid eructations, and some heartburn. 
 
 Urinary Organs. — Frequent desire to urinate, with 
 scanty discharge of urine, the stream being extremely 
 feeble ; urine dark reddish brown, and very turbid, even 
 on leaving the urethra ; or it deposits whitish flocks, or 
 looks as if stirred with flour ; sometimes it is mixed with 
 mucus and pus, depositing a thick sediment, or smells 
 soar ; burning and smarting, or cutting pains accompany 
 the act of micturition. 
 
 Sexual Organs. — Itching, stinging, and pricking in 
 the glans, with swelling of the orifice of the urethra, with 
 suppuration between the glans and prepuce, which feels 
 red and hot, and is very painful when touched, or when 
 walking ; there is voluptuous itching on the internal sur- 
 face of the prepuce, with cracks and fissures, and a fine 
 eruption ; vesicles on the fore part and sides of the glans, 
 penetrating into the part and spreading, discharging a 
 fluid, and then disappearing ; small red vesicles, chang- 
 ing to ulcers, which burst and discharge a yellowish- 
 white, staining, strong-smelling matter ; they are round, 
 the edges, which look like raw flesh, overlap the ulcers, 
 the base of which is covered with a cheesy lining. Draw- 
 ing in the spermatic cord, and pressure in the testicles, 
 which are swollen and indurated. Biting sensation in 
 the female urethra during urination, with itching of the 
 labia. Inflammatory swelling of the vagina, with dis- 
 charge of flocks, mucus, and pus, of the size of hazel- 
 nuts ; discharge of greenish, purulent, acrid fluid from 
 the vagina. 
 
228 CHARACTERISTIC EFFECTS AND 
 
 Fever. — Restlessness, languor, and worn-out feeling ; 
 dryness of the mouth, tensive and aching pain in the 
 head, particularly at the back ; loss of appetite, rumbling 
 in the intestines, disgusting eructations, inclination to 
 vomit, and hot, dry skin ; little increase of thirst ; con- 
 stipation, with pressure in the precordial region ; sleep 
 now becomes restless, with heavy, fanciful dreams ; urine 
 fiery red, and pulse irritable, full, and quick ; the dry- 
 ness in the mouth is changed to burning, the gums are 
 dark red, and recede somewhat from the teeth, the tongue 
 commences to swell, and the tensive aching pain in the 
 occiput extends to the nape of the neck, and even the re- 
 gion of the scapulae, inducing stiffness of the neck. The 
 patient smells unpleasantly, and has a coppery, metallic 
 taste in the mouth ; he moans continually, and suffers 
 from great oppression and anguish ; the chills also 
 alternate w T ith flushes of heat; the- eyes become red, 
 glassy, and watery ; an aching pain commences to rage 
 in the forehead ; towards the root of the nose, which is 
 dry and obstructed, the cheeks are hot, deglutition is 
 impeded by a tensive burning and stinging pain, the 
 submaxillary and parotid glands are swollen, a drawing 
 and tearing is experienced in the ears, the teeth become 
 very sensitive, the root of the tongue is coated with a 
 whitish mucus, breathing becomes more and more anxious, 
 the oppression increases, the pulse quick and undulating. 
 These phenomena characterize the acme of the fever, and 
 disappear by violent critical discharges, such as saliva- 
 tion, profuse emission of urine, excessive perspiration, or 
 the breaking out of an eruption. Sometimes an opposite 
 state occurs ; the countenance looks livid, with blue 
 margins around the dim and glassy eyes ; the head feels 
 
INDICATIONS OF THE MEDICINES. 229 
 
 giddy ; the nose, face, and extremities are cold, but to- 
 wards evening, slight chills, with flushes of heat, are 
 present ; there is now oppression, moaning, anguish, and 
 pressure in the precordia ; the sleep is heavy and rest- 
 less, the pulse quick and small, the urine clear and yel- 
 lowish, and there is slight constipation ; this lasts a few 
 days, and then increases in violence ; there is complete 
 apathy, the face pale as death, the body feels cool, the 
 pulse somewhat fuller, and the patient lies in bed listless 
 and weak ; at this stage there is a sudden change ; in- 
 clination to vomit, or vomiting of a greenish tenacious 
 substance, oppression at the chest, the breathing difficult, 
 the eyes wander, and the pulse frequently intermittent ; 
 there is slight delirium, even in the day, the skin and 
 tongue are dry, the latter being clean ; death now gen- 
 erally ensues from effusion on the brain. When perspi- 
 ration supervenes upon any of the preceding symptoms, 
 it is always extremely profuse, and has a clammy, pecu- 
 liarly fetid smell, never to be forgotten ; it is very exhaust- 
 ing and debilitating, and leaves a great disposition to 
 sweat, even after taking warm drinks ; immediately it 
 has appeared, the abnormal symptoms vanish, and vio- 
 lent raging thirst, caused by the perspiration, sets in. 
 
 Skin. — Mercurial miliaria is always preceded by 
 symptoms of marked irritation of the nervous system, 
 and a slow, torpid, febrile paroxysm : the eruption on 
 making its appearance is accompanied by cessation of the 
 restlessness and anxiety of the patient ; the rash breaks 
 out in patches, every day, attended by the same precur- 
 sory symptoms, till the eruption is complete over the 
 whole body. The vesicles are white and close together ; 
 the fever returns every evening, the pulse is small, soft, 
 20 
 
230 CHARACTERISTIC EFFECTS AND 
 
 easily compressible, not very quick ; the urine is pale, 
 the skin drenched in perspiration, which has a flat, but 
 not sourish smell ; nervous symptoms, such as sleepless- 
 ness, slight delirium, and even convulsions, supervene ; 
 single portions of the eruption disappear, the others re- 
 maining ; whilst these symptoms decrease and increase 
 continually, the typhoid phenomena augment, the pulse 
 intermits, the rash recedes from the skin, which becomes 
 diy, and the patient dies comatose. This eruption is only 
 met with in extremely severe cases. — Mercurial eczema. 
 Troublesome itching, with gradually supervening rose 
 color of the skin, which is traversed by a few red streaks, 
 which on inspection prove to be sound skin. The red- 
 ness arises from an assemblage of larger or smaller spots, 
 and these impart a sensation of burning heat to the 
 finger ; this redness disappears on pressure, but returns 
 directly the pressure is removed ; after twelve hours or 
 so, slight elevations are discovered with the finger, which, 
 viewed through the microscope, prove to be vesicles, 
 crowded together ; on the second day they become more 
 elevated, and are perceptible to the naked eye, when 
 viewed obliquely, and are filled with yellow lymph ; 
 after this the itching abates. On the third day, they 
 become depressed; on the fourth day, 'they desiccate ; 
 on the fifth day, the skin scales off ; in severe cases the 
 itching increases to a burning sensation, the skin assumes 
 a dark-red tinge, the vesicles increase to the size of pus- 
 tules, and the patient is attacked with feverish chills, 
 even before the vesicles make their appearance ; the 
 eyes are slightly reddened and watery, the nose stopped, 
 the mouth and pharynx are dry, there is constipation, 
 scanty red urine, and the pulse rather hard, quick, and 
 
INDICATIONS OF THE MEDICINES. 231 
 
 small ; there is also great restlessness and uneasiness ; a 
 few bilious evacuations now occur in the course of the 
 day, the skin, which was burning hot, now begins to 
 perspire, and the skin peels off in patches where the 
 eruption was situated. — Mercurial herpes of the prepuce. 
 Internal redness at one spot on the inner surface of the 
 prepuce, attended with considerable itching ; the redness 
 is not circumscribed, but is diffused gradually into the 
 surrounding skin ; on the second day several vesicles are 
 seen rising slowly, of a pale red, bordering on white, of 
 the size of a millet-seed, and transparent ; they spread 
 rapidly, till they coalesce, when they become darker and 
 purulent; they burst on the third day, and then exhibit 
 a roundish excoriation, with a slightly elevated border ; 
 the base is yellowish white, secreting a good deal of pus ; 
 the continued redness of the mucous membrane, and the 
 recently formed ulcers, occasion an itching, burning sen- 
 sation, increased by the application of cold water; the 
 discharge continues four or five days, after which the 
 ulcers assume a whitish appearance, disappearing in a 
 day or two. A beautiful bright-red cuticle makes its 
 appearance in the place of the former ulcers, on a level 
 with the sound mucous membrane. — Mercurial impetigo. 
 Dark red spots, of various sizes, appearing in the region 
 of the sexual organs, and then on the chest ; they are 
 unequal, and run into one another, which gives them the 
 appearance of a map ; they do not seem to be raised 
 above the skin, but itch considerably ; some months 
 after their first appearance they become somewhat 
 browner, and rash-like vesicles make their appearance on 
 the spots ; they become depressed in their centre on the 
 fifth, and scale off on the ninth day, the itching continu- 
 
232 CHARACTERISTIC EFFECTS AND 
 
 ing. At first the vesicles are only seen on the sternum, 
 after which they spread over the whole chest, arms, 
 calves, and inner surface of the thighs; the vesicles 
 break out repeatedly ; sometimes some of them burst, 
 leaving small indented ulcers, which run into one another, 
 and secrete a brownish-yellow, tenacious, and viscid pus, 
 which dries up into a crust, under which the process of 
 suppuration continues ; the upper parts of this scurf 
 gradually assume a whitish-gray appearance, and scale 
 off; this scaling off and forming anew of the scurf is 
 going on constantly, as soon as the ulcers are once 
 formed. After the eruption has lasted two or three 
 months, the other parts of the skin, which had, so far, 
 remained free, become affected ; the skin becomes rough, 
 dry, parched, and covered with small bran-like scales; 
 these scales accumulate principally on those parts of the 
 skin that are covered with hair, which frequently falls 
 off in patches, along with the scales ; these symptoms 
 are accompanied with other mercurial symptoms in- 
 volving the gastric and urinary organs, and the mucous 
 tissues. — Mercurial ulcers. Interstitial distention of the 
 mucous membrane, which becomes bluish-red in one or 
 more places ; these spots soon become whitish, and the 
 dissolution of the part becomes evident ; in a few hours 
 the whitish-gray substance changes to a fetid ichor, flows 
 off, and exhibits an indented flat circular ulcer, with 
 almost spongy base, and indented edge ; the ichor is 
 profusely discharged, the ulcer spreads rapidly in extent, 
 but not in depth, and is very painful ; in severe cases it 
 assumes a dirty, putrid appearance, and becomes rapidly 
 phagedenic. Blood is now discharged from the ulcers, 
 not vigorously, but oozing as from a sponge, which 
 
INDICATION'S OF THE MEDICINES. 233 
 
 evinces a state of great debility. — Mercurial, combined 
 with syphilitic ulceration. The parts around the chancre 
 are somewhat reddened, which changes in a few hours 
 to a light bluish, violet color; the border of the chancre 
 swells somewhat, becomes raised, and looks like the sur- 
 rounding parts ; very small and fine vessels are now seen 
 running from the edge to the ulcerated surface, the base 
 of which was lardaceous previously, and discharged a 
 thickish pus, but now of a dirty, shaggy appearance, 
 secreting a thin acrid fluid. If red, healthy granulations 
 had existed, they change to a dirty yellowish brown; 
 blood is discharged from the ulcer, which spreads rapidly 
 in breadth and depth, destroying the surrounding soft 
 parts ; the sore becomes extremely painful as soon as the 
 neighboring parts turn red. 
 
 Nerves. — Along the track of a motor nerve, drawing 
 tearing pains are experienced, not generally fixed, but 
 wandering along its course. If the affection lasts any 
 length of time, it passes to other branches, particularly 
 when the weather is variable ; the pain has distinct but 
 irregular intermissions, and recurs after exertion, or 
 heating, or from a current of cool air; wet weather is 
 very distressing in such cases ; the nights are generally 
 quiet ; violent tearing pains in the tibia and face, pro- 
 ceeding, in the latter case, from the teeth, and extending 
 to the temple and side of the head, and depriving the 
 patient of rest. Trembling of the limbs, so violent that 
 the patient is unable to talk, walk, or eat; he has to be 
 dressed by others; violent trembling, first of the hands, 
 then of the whole body ; he is constantly convulsed, and 
 cannot raise his hands to his mouth without striking 
 himself; he even swallow T s convulsively, with danger of 
 20* 
 
234 CHARACTERISTIC EFFECTS AND 
 
 suffocation ; sometimes there is slight drawing in the 
 arm along the track of the nerves ; it may be likewise 
 felt in the lower limbs, occasioning a tensive feeling of 
 the muscles, when walking ; afterwards, involuntary 
 motion of single muscles supervenes; the drawing now 
 changes to trembling of the affected limbs, which, at 
 first, is slight, but afterwards increases to an intolerable 
 degree ; at a later period, single vibrations of the pectoral 
 muscles, and particularly of the neck, are perceived, 
 causing the head to totter, and inducing either a stutter- 
 ing speech, or an occasional interruption of it, by a con- 
 vulsive contraction of the parts ; sometimes these spas- 
 modic movements extend to the diaphragm, inducing 
 constant hiccough, and to the tongue, producing tremu- 
 lous and indistinct speech. On attempting to raise the 
 foot, the tremor recommences, and the foot descends 
 again to the ground. Sometimes the patient is, indeed, 
 free from trembling and spasm ; but any part of the body 
 that he attempts to move is at once affected by them ; 
 the muscles of the left side also suffer more than the 
 right ; consciousness is never disturbed. 
 
 Bones. — Slight tension and drawing in the bones, 
 which are only covered by cellular tissue and integument, 
 after sunset, and which recurs for some days, about the 
 same time ; on the fourth or fifth day the pain becomes 
 gnawing, and at one spot only ; this symptom increases, 
 depriving the patient of sleep and rest, till towards 
 morning ; there is no abnormal appearance to be observed, 
 but on touching the part there is pain evinced, of a partly 
 sticking, partly aching character ; the periosteum now 
 becomes interstitially distended, and exudes an albumi- 
 nous substance, where the gnawing pain is experienced ; 
 
INDICATIONS OF THE MEDICINES. 235 
 
 this exudation gradually increases, producing an adhesion 
 between the periosteum and the cellular tissue, and con- 
 verts both of them into a grayish-white, homogeneous, 
 somewhat doughy, but rather hard-feeling substance ; 
 the swelling thus formed varies in size from that of a 
 hazel-nut to that of a hen's egg, but in some cases ex- 
 tends the whole length of the periosteum; these swellings 
 are generally termed gummata ; the color of the skin on 
 the outside remains unchanged. As soon as the swelling 
 commences to form, the pains increase in intensity, the 
 intermissions become shorter, and finally disappear; the 
 nervous system suffers from the pain, and sleepless 
 nights, failing of the appetite, and hectic fever, often 
 supervene. Sometimes the patient complains of a wan- 
 dering, drawing pain in the interior of the bones ; this 
 shortly becomes fixed to one spot, increases in violence, 
 becomes gnawing and boring, and occasions indescribable 
 sufferings, depriving him of sleep; after some weeks, the 
 bone begins to swell, feels hard and bony, showing that 
 it arises from interstitial distention. The pains, wiiich 
 are now frightful, are characterized by intermissions, 
 aggravated by the warmth of the bed, decrease in a 
 cooler temperature, and are most violent during a change 
 of weather. Caries of the bone may result, the bone 
 becoming so friable that it may be crushed with the 
 fingers. 
 
 Mezereum. Dark urine, becoming turbid, and de- 
 positing loose flocculi, and a reddish sediment, and occa- 
 sionally blood ; burning in the fore part of the glans 
 during urination, and stinging, pricking in the urethra; 
 crampy sensation in the bladder, and discharge of mucus 
 from the urethra. Tearing in the penis, with jerks and 
 
236 CHARACTERISTIC EFFECTS AND 
 
 darting in the glans ; fine pricking stitches in various 
 parts of the glans; dark-red inflammation of the internal 
 surface of the prepuce, without swelling, with violent 
 itching and soreness in the evening; painless swelling 
 of the scrotum ; discharge of mucus from the vagina. 
 Tearing, boring, smarting, and burning in various bones ; 
 violent corrosive sensation and throbbing in contused 
 wounds ; itching redness, drawing, and stitches in ul- 
 cerated wounds. 
 
 [ Jft skin-diseases : Itching, occurring in the evening, 
 when in bed ; aggravated and changing to burning by 
 touch, or by scratching. Sensitiveness to touch.] 
 
 Millefolium. Congestion of blood to the urinary 
 organs, with sanguineous discharges, particularly haeina- 
 turia. 
 
 Moschus. Scanty and thick urine, like yeast; violent 
 sexual excitement, even in old people. 
 
 Natri murias. Frequent or involuntary emission of 
 urine, which deposits a loamy or brick-dust sediment ; 
 burning and biting in the urethra when urinating; dis- 
 charge of thin mucus, leaving stiff translucent spots on 
 the linen. Discharge of yellow pus from the urethra, 
 but without pain during micturition ; strong and offen- 
 sive smell of the genital organs, with intolerable smarting 
 itching ; itching and redness of the tip of the glans, with 
 great humidity of the part. Pinching and drawing 
 aching in the testicles ; dryness of the vagina. 
 
 Nux vomica. Pale urine, containing thick, white, 
 purulent matter, or tenacious mucus, with violently 
 burning pains. Urine depositing a red brick-dust sedi- 
 ment ; pain in the neck of the bladder, of a burning or 
 
INDICATIONS OF THE MEDICINES. 237 
 
 tearing nature ; burning in the urethra, and soreness at 
 its orifice ; spasmodic contraction of the urethra, with 
 retention or difficult emission of urine ; paralysis of the 
 bladder ; the urine coming away as soon as formed, 
 drop by drop ; urine mixed with blood. Sore pain at 
 the tip of the glans, which itches and smarts, and burns 
 and itches at its posterior part ; smarting itching of the 
 inner surface of the prepuce, and soreness of its margin, 
 particularly towards evening. Heat, stitches, and con- 
 strictive pain in the testicles, which are swollen, indu- 
 rated, and drawn up, with sticking and spasmodic feeling 
 in the spermatic cord ; nocturnal emissions, followed by 
 coldness of the feet, and great languor ; great nervous 
 prostration and debility, with noises in the head, rest- 
 lessness, and disturbed sleep ; sleepiness after eating ; 
 disinclination to work, which quickly wearies ; trembling 
 of the limbs, attended with palpitation of the heart, acute 
 nervous sensibility to light, noise, or even the least 
 trifle; ill humor and peevishness; general derangement 
 of digestion, with foul taste, costiveness, nausea, and 
 retching; feeling of constriction round the waist; mo- 
 tions large, hard, and lumpy, or consisting of slime and 
 froth ; shooting pains through the body ; weariness and 
 dragging pains in the back ; complexion sallow and livid, 
 with blue circles round the eyes ; coldness and chilliness, 
 and tendency to take cold. 
 
 [Occimum canum. Turbid urine, depositing a white 
 and albuminous sediment. Burning during micturition. 
 Urine of a saffron color. Diarrhoea, several attacks a 
 day. Crampy pain in the kidneys. Renal colic, with violent 
 vomiting every fifteen minutes ; one wrings one J s hands, 
 
238 CHARACTERISTIC EFFECTS AND 
 
 and moans and cries all the time. Red urine (or bloody,) 
 with brick-dust sediment after the attack ; (or discharge 
 
 OF LARGE QUANTITIES OF BLOOD WITH THE URINE ; CUra- 
 
 tive, reported by Dr. Lippe.) Thick, purulent urine, with 
 intolerable smell of musk. (Right kidney affected, like 
 Kali carb. L.) Swelling of inguinal glands. Heat, 
 swelling, and excessive sensibility of the left testicle. See 
 Mure's Materia Medica, p. 215, and Lippe's Text-Book 
 of Materia Medica. - ] 
 
 Opium. Suppression of urine, or, on the contrary, 
 excitation of the renal vessels, with increased flow of 
 urine ; feeling of closure of the urethra, and difficulty, or 
 spontaneous interruption in urinating. Lemon-colored, 
 or dark red urine, depositing a thick sediment. 
 
 Petroleum. Involuntary micturition ; frequent desire 
 to void urine, which passes off in a ^double stream, at- 
 tended with burning pain, and tearing in the glans, and 
 burning in the neck of the bladder ; the urine is either 
 dark yellow, with a red sediment, or turbid, and red as 
 blood, dark brown flocks subsiding after a time ; the 
 urine is generally fetid, or exhales an ammoniacal smell ; 
 throbbings in the urethra, with mucous discharge ; fre- 
 quent nocturnal pollutions. Reddish eruptions on the 
 glans, with itching and tearing ; cramp-like pains in the 
 left spermatic cord, the scrotum being drawn up ; herpes 
 on the genital organs. Brown spots on the wrist. Un- 
 healthy skin ; even small wounds ulcerate and spread ; 
 stitching in ulcerations. 
 
 Petroselinum. Secretion of milky moisture in the ure- 
 thra, and afterwards agglutination of the orifice by yel- 
 low albuminous discharge, with slight burning when 
 
INDICATIONS OF THE MEDICINES. 239 
 
 urinating, and tingling rather than burning from the 
 perinseuni through the whole urethra, followed by pres- 
 sure in the region of Cowper's glands. Profuse emis- 
 sion of semen towards morning. 
 
 Phosphorus. Profuse urination, smelling like garlic 
 or sulphur, or having a strong ammoniacal odor, depos- 
 iting a yellowish-white sediment; or acrid red or brown 
 urine, with sediment of red sand or yellow mucus. 
 Greasy pellicle on the urine ; cutting and smarting pain 
 on urinating, with discharge of a few drops of mucus or 
 blood ; difficult emission of urine, the passage feeling 
 choked or impeded. Violent drawing in the testicles, 
 and drawing stretching pains in the spermatic cord ; 
 frequent erections and loss of semen for several clays 
 together. Twitching, tearing, darting, and tension in 
 the cheek-bones and jaw, with threatening caries. Sense 
 of languor, indolence, and nervous debility, like that 
 produced by excessive loss of animal fluids ; great aeute- 
 ness of the senses, and tendency to start easily ; giddi- 
 ness and confusion of ideas, particularly in the morning ; 
 unrefreshing sleep, disturbed by anxious dreams. Dart- 
 ing pains in the left side of the chest; aching in the pit 
 of the stomach, with flatulency ; discharge of blood from 
 slight wounds or ulcers ; lymphatic swellings, perforated 
 in many places by fistulous openings ; scurfy eruptions 
 and pimples on the skin, with falling off of the hair ; 
 brown or bluish-red blotches on the skin ; sickly, wan, 
 and pallid countenance. 
 
 Platina. Red urine, with white clouds, becoming tur- 
 bid, and depositing a red sediment on the sides of the 
 vessel ; congestion of blood to the uterus ; painful sensi- 
 tiveness, and continual pressure in the region of the 
 
240 CHARACTERISTIC EFFECTS AND 
 
 female sexual organs, with internal, almost constant 
 chills ; frequent urging to urinate, as if the bladder were 
 contracted spasmodically. 
 
 Plumbum. Tenesmus of the neck of the bladder, be- 
 fore, during, and after urination, the urine looking satu- 
 rated, brown, and mixed with blood ; copious red or yel- 
 low urine, without containing albumen. Pulling, tearing, 
 and contractive pain in the testicles, spermatic cord, and 
 penis, attended with violent pain in the hypogastrium ; 
 it is generally that both testicles are attacked, though 
 sometimes one is more painful than the other ; when the 
 pains are violent, the testicles are drawn up ; and the 
 scrotum becomes wrinkled during the paroxysm, relaxing 
 again during the remission. Serous infiltration and 
 puffy appearance of the skin, which is dry, scaly, rough, 
 yellowish, or clay-colored, with dark spots; violent tear- 
 ing, crushing, sudden, violent jerkings in the bones, oc- 
 curing at night, and depriving the patient of rest. 
 
 Pulsatilla. Retention of urine, with redness and heat 
 of the external region, and painful when pressed ; con- 
 tinual pressure on the neck of the bladder, with cutting 
 pain, as if occasioned by flatulence. The urine is gener- 
 ally dark brown, depositing sandy or brick-dust sediment, 
 or occasionally of a violet color ; creeping, pressure, and 
 drawing in the urethra, w T hich is often contracted, the 
 stream becoming very thin ; discharge of whitish fluid, 
 or dark blood from the urethra. Stinging itching in the 
 prepuce when sitting and lying, but not when walking ; 
 biting itching under the prepuce, near the glans ; swell- 
 ing of the right side of the scrotum, which hangs down 
 low ; the right testicle is drawn up and swollen, in con- 
 junction with the spermatic cord, with tensive pains, the 
 
INDICATION'S OF THE MEDICINES. 241 
 
 left testicle being greatly relaxed. Inflammatory action 
 in the prostate gland, with pain and swelling in the 
 region of the neck of the bladder, with intermittent 
 stream and spasmodic contractive pain after urination, 
 extending to the thighs ; swelling of the veins of the 
 testicles ; burning, stinging in the vagina and labia ; 
 violent tearing, boring, and cutting pains in the eye, 
 with pressure as from heat, and feeling as if sand were 
 in the eyes ; inflammation of the eyes, with profuse 
 lachrymation, secretion of mucus and dimness of sight ; 
 redness and swelling of the lids ; contraction of the 
 pupil, followed by dilatation ; burning itching of the 
 skin, with bluish-red swellings ; ulceration of the skin, 
 similar to that present in caries, with stinging, biting 
 pain, or burning as from hot coals, with itching all 
 round ; swelling of the veins round the ulcer, with hard 
 and shining swelling of the part. Weakness, weariness, 
 and heaviness, with coldness and blueness of the skin, 
 and great chilliness, increased when the pains in the 
 limbs are present ; bruised pain in the muscles of the 
 thighs, with unsteadiness and weakness of the knees, 
 which give way when walking. Xumb pain in the soles 
 of the feet, or tingling and stinging when standing, as if 
 they were pithy and gone to sleep ; gastric symptoms, 
 consisting of nausea, hiccough, frequent eructations, with 
 putrid risings, pain, and pressure, with fulness of the 
 stomach ; whi-ning and melancholy temper. 
 
 Rhododendron chrysanthum. Itching and increase of 
 sweat about the scrotum, which shrinks easily; the tes- 
 ticles are drawn up, swollen, and painful to the touch ; 
 the pains are contusive and drawing, affecting first one 
 and then the other ; violent stitching in the testicle, as 
 21 
 
242 CHARACTERISTIC EFFECTS AND 
 
 if contused, felt only when sitting ; sometimes the pain 
 is pricking, commencing in the right testicle, and spread- 
 ing in a zigzag along the perinaeum to the anus, lasting 
 some minutes, and arresting the breathing while it 
 lasted ; darting, tearing pains in the bones. 
 
 Rhus toxicodendron. Incontinence of urine, particu- 
 larly during rest ; the emission is often profuse, fre- 
 quently every few minutes ; double stream of urine, with 
 snow-white sediment, and burning in the urethra, which 
 is nearly closed by swelling. Swelling of the prepuce, 
 close to where it unites with the glans ; thickening and 
 hardness of the scrotum, or puffy, itching swelling, at- 
 tended with a humid eruption ; vesicles on the glans, 
 which is swollen, and accompanied with biting in the 
 urethra ; warts on various parts of the body ; vesicles 
 and tubercles on the joints; pressure, with drawing in 
 the periosteum, as if the bone were' scraped ; numbness 
 of various parts, or paralysis of the lower limbs, with 
 dragging, slow, difficult walk, and tingling in the parts ; 
 staggering, and inability to stand erect. 
 
 Ruta graveolens. Pressure in the region of the neck 
 of the bladder, as if the neck were painfully contracted, 
 after micturition ; the quantity of urine discharged is 
 inconsiderable, but the sensation immediately occurs as 
 if the bladder were again full ; excessive urging, although 
 but few drops pass, and there is painful burning at the 
 same time ; burning, gnawing pain in the periosteum ; 
 bruised feeling in the thighs ; on rising the patient is 
 unable to stand, so that he falls back on the chair ; the 
 bone feels broken, the thighs giving way from weakness 
 and pain ; cramp-like tearing, with pressure in the 
 limbs ; affections of the periosteum, such as resuft from 
 ivjuries. 
 
INDICATIONS OF THE MEDICINES. 243 
 
 Sabina. Intermittent, almost constant desire to uri- 
 nate, with fleeting, burning pains in the region of the 
 bladder. Smarting during urination, the urine being 
 turbid at the time ; inflammatory action in the urethra, 
 with purulent discharge ; discharge of slime from the 
 vagina, and sanguineous urine, with strangury ; severe 
 stitches in the vagina from before backwards ; swelling 
 of the periosteum, with aching, burning pain. 
 
 Sarsaparilla. Burning and scraping in the urethra 
 during micturition, with emission of oblong flocks ; 
 severe tenesmus, as in gravel, with emission of white, 
 acrid, turbid matter, and mucus ; symptoms similar to 
 hydrargyrosis ; discharge of yellow pus from the urethra, 
 with redness and inflammation of the glans ; herpes on 
 the prepuce. Intolerable stench about the sexual organs. 
 
 Scilla maritima. Great desire to urinate, with emis- 
 sion of clear urine ; incontinence sometimes at first re- 
 sults. Afterwards scanty emission of dark urine, of a 
 brownish yellow, foaming, and forming flocks ; red sedi- 
 ment in the urine ; compressive pain in the testicles ; 
 stitches in the glans of a dull nature. 
 
 Sepia. Urine dark and turbid, as if mixed with 
 mucus ; urine throwing down a brick-dust or red sedi- 
 ment, or occasionally mixed with blood ; pressure on the 
 bladder, with burning after micturition ; frequent incon- 
 tinence of urine, more urine being passed than drink has 
 been taken. Smarting and tearing in the urethra ; 
 copious perspiration of the sexual organs, the glans hot 
 and itching, the prepuce being sore ; continual suppura- 
 tion and itching of the prepuce ; heat, cutting, pinching, 
 and tearing in the testicles ; gonorrhoea, preceded by 
 complete inertia of the genital organs for some days ; 
 
244 CHARACTERISTIC EFFECTS AND 
 
 coldness of the parts ; general nervous excitement, which 
 is almost always accompanied by sleeplessness, and occa- 
 sionally loss of appetite ; formication, voluptuous titilla- 
 tion, and occasionally acute stitches in the urethra or 
 vagina ; frequent urging to urinate ; discharge of mucus, 
 which gradually becomes milky, and at last slightly 
 greenish ; it increases from the first to about the tenth 
 clay, and decreases about the fifteenth, although liable to 
 last for months. Tremulous motion of the whole body, 
 with uneasiness, and pulsations in various parts; weak- 
 ness and faintness, sensibility to cold ; profuse perspira- 
 tion when taking exercise ; great weariness on rising ; 
 pulse small, feeble, and irritable ; tendency to congestion. 
 
 Silicea. Ulcerations discharging fetid, sanguineous, 
 whitish, or yellowish pus, generally thick and tenacious ; 
 ulcerations with shaggy, callous edges, penetrating to 
 the bone ; the soft parts round about-are swollen, hard, 
 and blue ; the orifices of fistulous canals are callous ; 
 hectic fever produced by caries, with exfoliation of the dis- 
 eased portion of the bone, attended with profuse secretion 
 of partly malignant or partly healthy pus, and extreme 
 nocturnal perspiration ; yellow, light-colored, hot urine, 
 depositing a yellow gravel, attended with smarting itch- 
 ing, with red spots on the glans ; swelling of the prepuce ; 
 with itching, humid pimples on the outside ; effusion of 
 fluid into the tunica vaginalis of the scrotum, which 
 itches, and is covered with moisture ; pain in the left 
 testicle, as if swollen or indurated. 
 
 Spongia tosta. Frothy, clear, saffron-colored urine, 
 depositing a yellow sediment ; or urine with thick gray- 
 ish-white deposit ; voluptuous itching of the tip of the 
 glans, with itching burning of the scrotum; squeezing, 
 
INDICATIONS OF THE MEDICINES. 245 
 
 strangulating pain in the testicles ; dull stitches extend- 
 ing to the spermatic cord, which is painful and swollen j 
 increasing swelling of the testicle, which is firm, smooth, 
 and round, the size of the fist, without alteration of the 
 external skin; generally painless, except dull, stitching 
 pains occasionally ; the testicles are sensitive to pressure, 
 . withdrawing in the spermatic cord and loins ; hard swell- 
 ing and suppuration of various glands. 
 
 Staphysagria. Sticking pain in the right side of the 
 glans when standing or walking ] passing of the urine at 
 night is attended with erection of the penis, with burning 
 in the region of the neck of the bladder ; the urine itself 
 being emitted in drops. Violent drawing burning stitches 
 from the right abdominal, ring, apparently in the sper- 
 matic cord, as far as the right testicle, which is painless to 
 the touch ; drawing and tearing in the right testicle, 
 with pressure, as if it were compressed ; white humid 
 excrescences in the hollow behind the corona glandis, 
 with similar excrescences on the corona itself, both itch- 
 ing when rubbed ; pressive pain in the periosteum of the 
 bones, not altered either by motion or rest, nor increased 
 by pressure ; blackness, brittleness, and caries of the 
 teeth ; despondency and uneasiness as to the state of the 
 health ; extreme irritability of temper, and susceptibility 
 to vexatious impressions ; sudden impulses ; embarrass- 
 ment and confusion of the intellectual faculties ; incapa- 
 bility of sleeping, owing to nervous excitement ; dulness 
 of hearing, and mistiness before the eyes ; tremulousness, 
 with palpitation of the heart at the least excitement, or 
 even exercise. 
 
 Stramonium, Sensation of impossibility of retaining 
 the urine, and as if the urethra were too narrow and 
 21* 
 
246 CHARACTERISTIC EFFECTS AND 
 
 wanted dilating ; frequent emission of urine, passing in 
 drops, but retained at first for a minute, before making 
 its appearance; during urination no stream is formed, in 
 spite of powerful straining; the urine is warmer than 
 usual, but passes only in drops ; copper-colored spots on 
 the skin ; discoloration of old cicatrices. 
 
 Sulphur. Retention or very scanty emission of urine, 
 with discharge of drops of bloody urine, after great ef- 
 forts ; frequent and sudden desire to urinate, preceded 
 by cutting in the hypogastrium, with thin or intermittent 
 stream of urine ; the urine deposits red or whitish sedi- 
 ment or slime, and blood is mixed with it, and is often 
 very acrid and fetid, or covered with a greasy pellicle ; 
 smarting, burning, itching, or cutting in the urethra 
 (which is frequently swollen at its orifice), during, before, 
 or after urination ; bluish coldness of the whole penis ; 
 violent itching of the glans ; redness and swelling of the 
 prepuce, with secretion of fetid pus from its inner sur- 
 face ; it becomes stiff and hard as leather ; it shines on its 
 inner surface, and secretes a disgustingly smelling ichor. 
 Thickening and swelling of the epididymis, with pressure 
 and tension in the scrotum and spermatic cord ; burning 
 and sore feeling in the vagina, with inflammation of one 
 of the labia. Swelling of the glans, with purulent infiltra- 
 tion or ulceration of the same, discharging thick yellow 
 pus; these ulcerations have a bluish circumference, not 
 very sensitive, the base being covered with pale red, 
 spongy, insensible proud flesh, with a smooth and shining 
 surface ; inflammatory swelling of the conjunctiva, which 
 is interstitially distended ; redness and ulceration of the 
 cornea ; puffy swelling of the eyelids ; purulent discharge 
 from the eyes ; contraction and immobility of the pupil ; 
 
INDICATIONS OF THE MEDICINES. 247 
 
 discharge of acrid tears, intolerance of light, with vio- 
 lent tearing pains round the eves and in the temples, 
 considerably aggravated at night ; fungous excrescences 
 on the skin ; biting, itching, and stinging in the diseased 
 parts. Sad, melancholy disposition, with irritability 
 and inclination to tears ; confusion and distraction of 
 the head, with dizziness, fulness, and pressure ; attacks 
 of giddiness, ending in fainting ; great restlessness, ex- 
 treme exhaustion being induced by the slightest exertion ; 
 pulse small, quick, and irritable ; tremulous palpitation 
 of the heart ; tendency of the limbs to become numb 
 and torpid. 
 
 Terebinthina. Inflammatory symptoms about the 
 bladder; violent dragging and cutting pains, or fre- 
 quently recurring spasmodic pains, with burning in the 
 bladder and urethra, difficult micturition, or complete 
 suppression of urine ; the urine is generally red and 
 scanty, or even bloody, smelling of violets, depositing 
 muddy white-yellow or slimy sediment ; dysuria, at- 
 tended with real urethritis, with painful erections ; 
 violent crampy pains in the left testicle, and along the 
 left spermatic cord. 
 
 Teucrium marum. Sore feeling, with pressure in the 
 fore part of the urethra, attended with smarting pain 
 when not urinating ; drawing pain at the root of the 
 penis on the left side, extending to the integuments of 
 the left testicle, so that they are painful for some time 
 after, when touched. 
 
 Thuja occidentals. Frequent and copious urination, 
 accompanied by straining, the stream being interrupted 
 several times before the urine is entirely voided, and 
 accompanied with burning pains ; after micturition some 
 
248 CHARACTERISTIC EFFECTS AND 
 
 urine remains in the urethra, which drops out afterwards ; 
 the urine is pale at first, but becomes cloudy on standing ; 
 red urine, depositing brick-dust sediment; burning and 
 cutting in the urethra during urination ; lancinations in 
 the fore part of the urethra, with burning, piercing 
 stitches ; painful stitches in the fore part and in the ex- 
 ternal surface of the prepuce, stinging and itching in the 
 fore part of the glans ; itching and pricking in the scro- 
 tum ; drawing sensation in the testes, with swelling of 
 the inguinal glands ; profuse perspiration of the sexual 
 organs, considerable swelling of the prepuce, which has 
 red excrescences on its inner surface ; reddish pimples 
 on the prepuce, changing to an ulcer, which is covered 
 with scurf, itches, and is sometimes painful and burning ; 
 fig-warts on the sexual organs, and around the anus, 
 which itch, sting, and burn, and occasionally bleed ; 
 smarting of the female sexual organs when urinating ; 
 tubercles in the mucous membrane of the vagina ; chronic 
 ulcers, with flat but widely indurated edges, grayish 
 bottom, and discharging ichorous and fetid pus ; falling 
 off of the hair ; sensitiveness to cold, and deficiency of 
 animal heat ; great coldness along the spinal column ; 
 sleeplessness, depression of spirits, vertigo, difficulty of 
 thinking ; benumbing, gnawing, twitching, crampy pains 
 at the nape of the neck, back, loins, and shoulders, &c. ; 
 palpitation of the heart. 
 
 Uva ursi. Painful micturition, with burning; slimy, 
 purulent urine ; mixed with blood. 
 
 Veratrum album. Burning, acrid, dark, red, greenish, 
 or yellow, turbid urine ; pain in the urethra, as if con- 
 stricted behind the glans, accompanied with ineffectual 
 desire to urinate, the bladder being empty ; burning in 
 
INDICATIONS OF THE MEDICINES. 249 
 
 the urethra when urinating ; soreness of the prepuce, 
 and drawing pains in the testes ; violent erections. 
 Violent ophthalmia, with cutting pains in the eyes, and 
 profuse lachryniation ; dilatation or contraction of the 
 pupils, with momentary vanishing of sight. 
 
 Zincum. Involuntary discharge of urine ; turbid and 
 loam-colored urine ; yellow urine, depositing flocks ; press- 
 ure on the bladder ; intensely painful drawing in the urethra 
 and fore part of the penis ; sharp cutting, tearing, itching, 
 and burning in the urethra ; great falling off of the hair ; 
 herpes of the tonsils, of the palate, or root of the tongue ; 
 swelling of the tonsils, with slight redness, followed by 
 irregular whitish-blue flat spots, having the appearance 
 of lard, the epidermis being raised ; the whitish, smooth, 
 jelly-like surface feels hard, and cannot be abraded; 
 stinging, smarting, and sore feeling, which is aggravated 
 by hawking or swallowing. 
 
INDEX. 
 
 Acidum fluoricum, 199; 
 
 nitricum, 126, 200 ; 
 
 oxalic, 166; 
 
 phosphoricum, 127, 201; 
 
 sulphuric, 168. 
 Aconitum napellus, 202. 
 Agaricus muscarius, 202. 
 Agnus castus, 202. 
 Allium cepa, 139. 
 Alopecia, 108; 
 
 treatment of, ib. 
 Alumin. met., 169. 
 Antimonium crudum, 203. 
 Antimonii tartras, 203. 
 Apis mellifica, 160, 204. 
 Argenti nitras, 204. 
 Arnica montana, 161, 204. 
 Arsenicum album, 162, 205. 
 Asafoetida, 206. 
 Aurum metallicum, 206. 
 
 Baptisia, 167. 
 Balanorrhoea, 52; 
 
 treatment of, 53 ; 
 
 preventive treatment of, 
 53; 
 
 table of indications for, 55. 
 Barytae carbonas, 206. 
 
 Belladonna, 161, 206. 
 Bladder, inflammation of, 69 ; 
 treatment of, ib. 
 chronic inflammation 
 stone in, 187 ; [of, 70 ; 
 
 treatment of, 190. 
 catarrh of, 1 93 ; 
 
 treatment of, 194. 
 hypertrophy of, 196 ; 
 treatment of, 197. 
 spasm of, 197 ; 
 
 treatment of, 198. 
 Blenorrhcea vesicae, 193; 
 
 treatment of, 194 
 Bone, caries of, 121 ; 
 
 treatment of, 122. 
 death of, 122; 
 
 treatment of, ib. 
 inflammation of, 116; 
 treatment of, 117. 
 Bony tumor, 119 ; 
 
 treatment of, 120. 
 Bryonia alba, 163, 207. 
 Bubo, 96 ; 
 
 primary, ib. ; 
 secondary, ib. ; 
 constitutional, ib. ; 
 acute, ib. ; 
 
 251 
 
252 
 
 INDEX. 
 
 Bubo, indolent, 98; 
 phagedenic, ib. ; 
 treatment of, 99. 
 Cachexia, syphilitic, 124 ; 
 
 treatment of, 125. 
 Calcis carbonas, 207. 
 Calculus, 187 ; 
 
 treatment of, 190. 
 Camphora, 207. 
 Cannabis sativa, 208. 
 Cantharis, 163, 209. 
 Capsicum, 209. 
 Carbo vegetabilis, 210. 
 Caries, 121 ; 
 
 treatment of, 122. 
 Causticum, 210. 
 
 Cerebro-spinal meningitis, 148- 
 159; 
 treatment of, 159-171. 
 Chamomilla, 210. 
 Chancre, 87, 89; 
 elevated, 89; 
 Hunterian, 89 ; 
 gangrenous, 89 ; 
 indurated, 89; 
 phagedenic, 89, 91 ; 
 sloughing, 88; 
 superficial, 87; 
 treatment of, 92, 93 ; 
 diet for, 93 ; 
 
 table of indications for, 96. 
 Characteristic effects of medi- 
 cines, 199-249. 
 Chordee, 60 ; 
 
 treatment of, 61 ; 
 neglected, consequences 
 of, 60. 
 
 Cimicifuga, 167. 
 Cinchona, 211. 
 Cinnabaris, 211. 
 Cirsocele, 175; 
 
 treatment of, 176 ; 
 surgical treatment of, 
 178. 
 Clematis erecta, 211. 
 Cocculus, 212. 
 Colchicum autumnale, 212. 
 Colocynthis, 212. 
 Conium maculatum, 170, 213. 
 Constitutional syphilis, 102. 
 Copaibae balsamum, 185, 213. 
 Cowper's glands, inflammation 
 of, 62 ; 
 treatment of, ib. 
 Crotalus hor., 167. 
 Cubebae piper, 213. 
 Cup. acet.^.169. 
 Cystitis, acute, 69; 
 
 treatment of, ib. 
 chronic, 70; 
 
 treatment of, ib. 
 
 Digitalis purpurea, 213 ; 
 Doses, 17; 
 
 repetition of, 20 ; 
 
 alternation of, 21. 
 Dulcamara, 213. 
 Dysuria, 178; 
 
 treatment of, 179. 
 
 Elaps cor. 164. 
 Enuresis, 181 ; 
 
 treatment of, ib. 
 Ephelides, 105. 
 
INDEX. 
 
 253 
 
 Ephelides, treatment of, 105. 
 Epididymis, inflammation of, 
 70; 
 treatment of, 71 ; 
 table of indications for, 
 73. 
 Erections, 59; 
 
 preventive treatment 
 
 of, 59; 
 treatment of, ib. 
 Erigeron, 187. 
 Erythema, 102; 
 
 treatment of, ib. 
 Eupat. perf., 168. 
 Exostosis, 119 ; 
 
 treatment of, 20. 
 on the inner part of 
 the cranium, conse- 
 quences of, ib. 
 
 Ferri sulphas, 214. 
 Fig-warts, 133 ; 
 
 treatment of, 134. 
 
 Gelseminum, 139, 165. 
 Glans, itching of, 66; 
 
 treatment of, 66. 
 Gleet, 47, 49; 
 
 treatment of, 48; 
 diet for, ib. 
 Gonorrhoea, 23 ; 
 
 treatment of, 24, 26; 
 preventive treatment 
 
 of, 25; 
 table of indications for, 
 
 35; 
 diet for, 25. 
 22 
 
 Gonorrhoea of the female, 38, 
 44; 
 treatment of, 40 ; 
 table of indications 
 for, 46. 
 Gonorrhoeal accessory affec- 
 tions, 59. 
 ophthalmia, 80 : 
 
 consequences of, 81; 
 treatment of, 81, 82. 
 Graphite, 214. 
 Gravel, 187 ; 
 
 treatment of, 190. 
 Guaco, 214. 
 Gummata, 112; 
 
 treatment of, ib. 
 
 Hematuria, 182; 
 
 treatment of, 183. 
 Hair, falling off of, 108 ; 
 
 treatment of, ib. 
 Hamamelis, 187. 
 Helleborus niger, 214. 
 Hepar, sulphuris, 214. 
 Herpes of the prepuce, 67 ; 
 
 treatment of, ib. 
 Hydrocele, 173 ; 
 
 treatment of, 174. 
 Hyoscyamus niger, 170, 215. 
 
 Ignatia amara, 215. 
 
 Induration of testicle, 75. 
 
 Introduction. Syphilis: prima- 
 ry ; constitutional ; second- 
 ary; tertiary. Hygiene. Se- 
 lection of medicines; doses, 
 13-22. 
 
254 
 
 INDEX. 
 
 Iodium, 215. 
 
 Iris, syphilitic inflammation of, 
 109; 
 treatment of, 109. 
 Iritis, syphilitic, 109; 
 
 treatment of, 111 ; 
 neglected, consequences 
 of, ib 
 Ischuria, 178 ; 
 
 treatment of, 179. 
 
 Jacaranda caroba, 216. 
 
 Kali carbonas, 216. 
 Kali iodidum, 217. 
 Kreasotum, 166. 
 
 Lachesis, 165. 
 Lycopodium, 170. 
 
 Maculae, 105; 
 
 treatment of, 106. 
 Masturbation, 140; 
 
 consequences of, ib. ; 
 treatment of, 142. 
 Medicines, rules for selection 
 of, 16. 
 selection of, 16. 
 characteristic effects 
 of, 199-249. 
 Mercurius, 218, 235. 
 Mezereum, 235. 
 Millefolium, 236. 
 Moschus, 236. 
 
 Mucous membrane, syphilitic 
 diseases of, 104. 
 
 Natri murias, 236. 
 Necrosis, 121 ; 
 
 treatment of, 122. 
 Non-syphilitic diseases, 135. 
 Nux vomica, 169, 236. 
 
 Occimum canum, 187, 237. 
 Onanism, 140; 
 
 consequences of, ib. ; 
 treatment of, 142. 
 Ophthalmia gonorrhoeica, 80 ; 
 
 treatment of, 82. 
 Opium turcum, 170, 238. 
 Orchitis, syphilitic, 113 ; 
 
 treatment of, 115. 
 gonorrhoeal, 74. 
 Osteo-copus nocturnus, 121. 
 Ostitis, 116; 
 
 treatment of, 118. 
 
 Paraphimosis, 68. 
 
 Pathological observations, in- 
 troductory, 13. 
 
 Periosteum, inflammation of, 
 116. 
 
 Periostitis, ib. ; 
 
 treatment of, ib. 
 
 Petroleum, 238. 
 
 Petroselinum, 238. 
 
 Phimosis, 67 ; 
 
 treatment of, 68. 
 
 Phosphorus, 170, 239. 
 
 Physalis alk., 182. 
 
 Platinum, 239. 
 
 Plumbum metallicum, 240. 
 
 Prepuce, herpes of, 67 ; 
 
 treatment of, ib. 
 
INDEX. 
 
 255 
 
 Priapism, 60 ; 
 
 treatment of, ib. 
 Prostatitis, 63; 
 
 treatment of, ib. 
 chronic, 64; 
 
 treatment of, 65, 66. 
 Pruritus glandis, 66. 
 Pulsatilla nigricans, 240. 
 Pupil, closure of, 109 ; 
 
 use of palliatives for, ib. 
 
 Rhododendron, 241. 
 
 Rhus toxicodendron, 169, 242. 
 
 Rupia, syphilitic, 106 ; 
 
 treatment of, 107. 
 Ruta graveolens, 242. 
 
 Sabina, 243. 
 Sarsaparilla, 243. 
 Satyriasis, 60 ; 
 
 treatment of, ib. 
 Sarcocele, syphilitic, 113 ; 
 
 treatment of, 115. 
 Scaly eruptions, 105 ; 
 
 treatment of, 107. 
 Scilla maritima, 243. 
 Scrotum, dropsy of, 173 ; 
 
 treatment of, ib. 
 Self-abuse, 140; 
 
 consequences of, ib. ; 
 treatment of, 142. 
 Sepiae succus, 243. 
 Silicea, 244. 
 Spermatorrhoea, 135 ; 
 
 neglected, consequen- 
 ces of, 136 ; 
 treatment of, 138. 
 
 Spinal irritation, 146 ; 
 
 treatment of, ib. 
 Spongia marina, 244. 
 Spots, syphilitic, 105 ; 
 
 treatment of, 106. 
 Squamae, 106; 
 
 treatment of, 107. 
 Staphysagria, 245. 
 Stramonium, 245. 
 Stranguria, 178; 
 
 treatment of, 179. 
 Stricture of the urethra, 75 ; 
 treatment of, 77 ; 
 mechanical treat- 
 ment of, 78. 
 Sulphur, 246. 
 Sycosis, 133 ; 
 
 Sycosis, treatment of, 134. 
 Syphilis. 87, 102. 
 
 infantile, 135; 
 treatment of, 
 
 Tabes dorsalis, 171 ; 
 
 treatment of, 172. 
 Terebinthina, 185, 247. 
 Tertiary syphilis, 112. 
 Testicle, swelled, 74, 113. 
 Teucrium marum, 247. 
 Thuja, 247. 
 Treatment, general directions 
 
 for, 13-22. 
 True syphilis, 87. 
 Tubercles, cutaneous, 103; 
 
 deep-seated, 104; 
 
 mucous, ib. ; 
 
 syphilitic, ib. ; 
 
 treatment of, 105. 
 
256 
 
 INDEX. 
 
 Uret hra, inflammation of, 38. 
 
 haemorrhage from, 61. 
 haemorrhage, treatment 
 
 of, 75, 77. 
 stricture of, ib. ; 
 mechanical treatment 
 of, 78. 
 Urinary deposits, composition 
 
 of, 188. 
 Urine, incontinence of, 181 ; 
 treatment of, ib. 
 bloody, 182 ; 
 
 treatment of, 183. 
 retention of, 178 ; 
 
 Urine, retention of, treatment of, 
 Urtica urens, 187. [179. 
 
 Uterus, inflammation of, 40. 
 Uva ursi, 248. 
 
 Vaginitis, 39. 
 Varicocele, 175 ; 
 
 treatment of, 176. 
 Venereal rheumatism, 83 ; 
 
 treatment of, 84-86. 
 Veratrum album, 248. 
 Viride, 169. 
 
 Zincum metallicum, 249. 
 
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