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MEDICAL LIBRARY.
No..
S. A. JONES. M. D.
18
14615
1489m
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A MANUAL
OF

PHARMACODYNAMICS.
TO
WILLIAM BAYES, M.D.,
TO WHOSE ENERGY AND PUBLIC SPIRIT
THE
LONDON SCHOOL OF HOMEOPATHY
OWES ITS EXISTENCE,
This Volume,
A RECORD OF SOME OF THE WORK DONE THEREIN,
Is Dedicated
BY HIS FRIEND
THE AUTHOR.
PREFACE.
WHEN publishing (in 1875-6) the third edition of this Manual,
I introduced it in the following words :-
"This work originally appeared in 1867, as the first part of
a 'Manual of Homœopathic Practice for students and begin-
ners.' It was couched in the form of letters to an enquiring
friend. A second edition was published in 1870. The addi-
tions rendered necessary by the progress of knowledge were,
for the convenience of those who possessed the volume in
its original form, placed between brackets or affixed as notes.
"When, in 1874, I was called upon to prepare a third
edition, it seemed desirable that the work should assume a
homogeneous and as it were primary character; and that the
matter of the first two editions, together with such additions
as I might have to make, should be welded together in one
consecutive whole. But I found, on consideration, that more
than this would be necessary. I had by this time become
painfully conscious of the limited range of the information
with which I had previously worked, especially as regards
original provings and French and German literature. The
endeavours I now made to extend my knowledge showed me
that the work must be, to a great extent, not only re-cast but
re-written, if it was to satisfy my present sense of what was
required of it.
"While I was planning and initiating the undertaking, the
circumstances arose which led to my being requested by the
British Homœopathic Society to deliver a course of lectures
in London on Materia Medica and Therapeutics. The form
247569
vi
PREFACE.
of my work was thus determined for me; and an additiona]
motive supplied for making its substance as full and accurate
as possible. The lectures were delivered between February
and June, 1875, and again from October to January, 1875-6.
The present volume contains them. I have added the minor
medicines omitted in my course, and some re-arrangement
has been necessitated hereby. With this exception, the lectures
stand here substantially as they were given.
"In my introductory discourse I have stated fully the scope
and method of my procedure; and need not dwell upon them
in this preface. On one feature of the work only I would
make a remark. While I had hitherto been content to say—
the proving of such and such a drug is in the Materia Medica
Pura, or Chronic Diseases, or elsewhere, I have now thought
it advisable to give a brief analytic account of each patho-
genesis, stating the sources from which it is derived, and the
proportion in which they have contributed to it; and also,
where possible, the manner in which the symptoms were
obtained. I have reason to think that a very vague concep-
tion exists in most minds (I know it once did in my own) as
to the nature of the pathogenetic materials of Homœopathy.
This imperfect knowledge is apt to lead, on the one side to
superstitious veneration, on the other to sceptical neglect-
both being, I conceive, unwarranted towards the Materia
Medica as a whole, and either being generally misplaced in its
own reference. I have accordingly done my best (though I
have yet more to do in the same field) to ascertain and exhibit
the general character of such pathogenetic collections as we
possess, so that a reference to them may carry its own
meaning with it. And I have also examined each constituent
member of these, and each separate contribution of the kind,
on its own merits, and stated the results; so that the student
may
know in each case the nature of the material with which
he is working, and esteem and use it accordingly."
In 1877, the London School of Homœopathy was founded,
and I was appointed to fill the chair of Materia Medica and
Therapeutics therein. My Manual naturally became the text-
PREFACE.
vii
book of my course, and the groundwork of the lectures I
delivered. Such fresh matter as from time to time I have
brought before my class, and such improvements in presenta-
tion as have occurred to me while going on, I have incorporated
into the substance of the book which is now offered to the
profession in its fourth edition.
I have described this as "revised and augmented." It is
not, as was the third edition, "mainly re-written :" the frame-
work on which that was constructed will be found here
substantially unaltered. But it has been filled in with a
liberal hand, so as to make the volume more than one-fourth
larger than its predecessor, and—I hope—proportionately
more satisfying to the student. There is hardly an article
which has not received some fresh touch; and those on most
of the polychrests, and on Chamomilla, Gelsemium, Iris,
Plumbum and others have been much enlarged. Supplemen-
tary lectures on some minor and recently-introduced medicines
are appended; while several of those which occupied such
rank in the former edition find place in the main series, in
which also will be found new sections on the picric and
salicylic acids, on chlorine and its derivatives, and on Enanthe
crocata.
Following upon the introductory lecture will be found six
new ones. The two on the sources of the Homoeopathic
Materia Medica contain the substance of the little book I
have published under that title. Those on the general prin-
ciples of drug-action bear the same relation to the lectures I
delivered at the London Homœopathic Hospital in 1877, and
which appeared in the earlier numbers of the Monthly Homœo-
pathic Review of that year. That entitled "Homœopathy-
what it is" is a similar reproduction of the paper on "The Two
Homœopathies " which I had the honour of reading at the
British Homœopathic Congress held at Liverpool in 1877;
and that on "Homœopathic Posology" has already appeared
in the British Journal of Homœopathy for January, 1879. By
including these materials in my present volume, I have made.
it contain all work I have hitherto been able to do in the field
viii
PREFACE.
to which it belongs; and I hope that it may continue to be
useful to the class which I am no longer able to conduct in
person.
My third edition, at its appearance in two parts, in 1875
and 1876 respectively, received very full notice in the Monthly
Homeopathic Review. Of the general tone and bearing of my
reviewer's criticism I have nothing to express but sincere
acknowledgment; and I have shown my sense of the weight
of such exceptions as he has taken to my work by the large
consideration I have given them, both here and elsewhere,
His remarks on my treatment of certain medicines I have had
before me in my revision of the articles upon them for the
present edition. His challenge of my ignoring or rejecting
the doctrine of the opposite action of large and small doses I
have fully met in the pages of the Review itself, and (to some
extent) in the fifth lecture of my present series.
The only
points raised by him which yet remain for notice are my
large employment of the results of experimentation on animals,
and my copious reference to and quotation of the works of
Drs. Ringer and Phillips. As to the first, I would remark
that the main object of my work is to illuminate the symptom
atology of our medicines by aid of such side-lights as can be
thrown upon it; and of these none are more important than
the experiments of the physiological laboratory. They are
necessarily excluded from our ordinary pathogenetic collec-
tions: it is all the more important that they should find large
place in commentary and interpretation such as this. My
object in making so much employment of the treatises men-
tioned was that, lecturing, as I always have done, to auditors
trained in the schools of traditional medicine, it was a clear
gain to be able to support my arguments as to the homœo-
pathicity of certain practices by evidence accredited therein.
Drs. Ringer and Phillips were both Professors of Materia
Medica in recognised colleges. It was for them to account
for the unusual amount of homœopathic matter contained in
their pages: I, finding it there, turned it to the advantage of
my position.
PREFACE.
ix
I have only now, in presenting this fourth edition of my
book to the profession, to repeat my hope that the kind ap-
preciation it has hitherto received, both in its own language,
and in French, German and Spanish translation, will continue
to be extended to it.
36, SILLWOOD ROAD, BRIGHTON.
June, 1880.
LECTURE
CONTENTS.
I. Introductory
II. Sources of the Homœopathic Materia Medica
III. The same (continued) ..
IV. The General Principles of Drug-action
..
V. The same (continued) ..
VI. Homœopathy—what it is
VII. Homœopathic Posology
VIII. Acidum benzoicum, carbolicum, fluoricum, hydrocyani-
cum, muriaticum
IX. Acidum nitricum, oxalicum, phosphoricum, picricum,
salicylicum, sulphuricum
X. Aconite
XI. Actæa, Æsculus, Æthusa, Agaricus, Agnus castus, Ailan-
thus
XIII. Antimonium crudum and tartaricum, Apocynum
XIV. Apis, Argentum metallicum and nitricum ..
XII. Allium Cepa and sativum, Aloes, Alumen, Alumina,
Ambra, Ammonium carbonicum and muriaticum, Amyl
nitrite, Anacardium, Angustura
XXI. Bryonia
XXII. Cactus, Calcarea
..
fr
•
:
•
·
XV. Arnica, Arsenic..
XVI. Arsenic (continued)
XVII. Arum, Asafoetida, Asarum, Asclepias, Asterias, Aurum,
:
:
:
Baptisia
XVIII. Baryta, Belladonna
XIX. Belladonna (continued)
XX. Berberis, Bismuth, Borax, Bovista, Bromine and the
bromides
:
:
:
:
:
•
PAGE
I
17
40
54
68
79
93
107
124
147
167
183
198
212
228
247
264
281
295
308
323
336
xii
CONTENTS.
LECTURE
XXIII. Calendula, Camphor, Cannabis sativa and Indica,
Cantharis..
XXIV. Capsicum, Carbon sulphuratum, Carbo animalis and
vegetabilis, Caulophyllum, Causticum, Cedron
Chloral,
XXV. Chamomilla, Chelidonium, Chimaphila,
Chlorum, Cicuta, Cina and Santonine
•
··
XXVI. Cinchona
XXVII. Cinchona alkaloids, Cistus, Clematis, Coca, Cocculus,
Coccus cacti, Coffea
XXVIII. Colchicum, Collinsonia, Colocynth, Conium, Copaiba
XXIX. Corallium, Crocus, Croton, Cundurango, Cuprum,
Curare, Cyclamen, Dioscorea ..
XXX. Digitalis, Drosera.
XXXI. Dulcamara, Elaterium, Eupatorium perfoliatum and
pnrpureum, Euphorbium, Euphrasia, Ferrum
XXXII. Gamboge, Gelsemium, Glonoin, Graphites, Gratiola,
Guaiacum..
488
XXXIII. Hamamelis, Helleborus, Helonias, Hepar sulphuris.. 505
XXXIV. Hydrastis, Hydrocotyle, Hyoscyamus, Hypericum,
Indigo
··
XXXV. Ignatia, Iodine and the iodides
XXXVI. Iodine and the iodides (continued), Iris
XXXVII. Ipecacuanha, Jaborandi, Kali bichromicum
XXXVIII. Kali carbonicum, chloricum, nitricum, and perman-
ganicum; Kalmia, Kreosote, Lactuca
•
..
•
XXXIX. Lachesis and the serpent-poisons
XL. Ledum, Leptandra, Lilium, Lithium, Lobelia, Lycopo-
dium, Lycopus
XLI. Mercurius
XLII. Mercurius (continued)
XLIII. Mercurius (continued)
XLIV. Magnesia carbonica and muriatica, Manganum,
Millefolium, Moschus,
Menyanthes, Mezereum,
Murex, Natrum carbonicum, muriaticum, and sul-
phuricum, Nuphar
· •
•
XLV. Nux vomica ..
XLVI. Nux moschata, Enanthe, Oleander, Opium
XLVII. Opium alkaloids, Origanum, Osmium, Pæonia, Paris,
Petroleum, Petroselinum, Phellandrium, Physo-
stigma, Phytolacca
•
PAGE
·
349
365
378
391
409
425
442
457
47J
520
534
547
563
580
595
609
624
636
649
665
582
695
711
CONTENTS.
xiii
LECTURE
XLVIII. Phosphorus
XLIX. Phosphorus (continued), Plumbum
• •
L. Platina, Podophyllum, Pulsatilla
LI. Ranunculus, Ratanhia, Rheum, Rhododendron, Rhus,
Rumex, Ruta
LII. Sabadilla, Sabina, Sambucus, Sanguinaria, Sarracenia,
Sarsaparilla, Scilla, Secale, Selenium, Senega
LIII. Sepia-Silica
LIV. Spigelia, Spongia, Stannum, Staphisagria, Stramo-
nium
APPENDIX
•
LV. Sulphur
LVI. Tabacum, Taraxacum, Tellurium, Terebinthina, Teu-
crium, Thuja, Uranium..
LVII. Urtica, Uva ursi, Valerian, Veratrum album and
viride, Verbascum, Viola odorata and tricolor, Xan-
thoxylum, Zincum
LVIII. Supplementary
LIX. Ditto
INDEX OF MEDICINES
CLINICAL INDEX
:
:
:
:
:
:
:
:
:
:
:
•
:
:
:
PAGE
726
741
759
775
791
807
822
837
850
869
886
900
913
923
927
CORRIGENDA.
p. 2 and p. 45, for "curantur" read "curentur."
1 p. 14, for "kaloid" read "haloid."
LECTURE I
INTRODUCTORY.
GENTLEMEN,-
We are met to-day to inaugurate a course of instruction
upon Materia Medica and Therapeutics, i.e., upon the materials
used in the practice of medicine, with their properties, and of
the application of these to the art of healing. It will be well,
at the outset, to indicate and define our field of study.
I. There are agents employed and measures prescribed in
the treatment of disease which are roughly classed under the
term hygienic. These include the diet and regimen of the
patient, the choice of his climate, the regulation of his habits.
Again, there are ways in which the various forces and elements
of nature can be pressed into therapeutic service, as the use of
water in its various forms, the bringing to bear of heat and
cold in due proportions, and the application of electricity. In
systematic treatises on Materia Medica many of these agents
are discussed, and they cannot be denied a title to the name.
If I exclude them from our consideration here, it is not from
their being undervalued. It is simply because I have nothing
to say about them which is not better said elsewhere; and
because I wish to devote our entire attention to the action of
drugs.
2. Drugs-that is, substances which have the power of
affecting the animal body in health and disease-are the
Materia Medica of which I propose to speak. And of these,
again, solely as they affect the body. Taken from the animal,
vegetable, and mineral kingdoms, they have characters and
relations which belong to the sciences dealing with those
departments of nature. In the treatises of which I have
spoken, such features of drugs often occupy a large space;
and to them I must refer you for all detailed information of
the kind. I shall use it only so far as may be necessary to
identify the drug before us, and to ensure a concrete concep-
B
2
INTRODUCTORY.
tion of its origin and character in your minds; for which pur-
pose the specimens contained in our museum will come in aid.
This done, it will be discussed as a drug and nothing else.
3. Such discussion, as I have said, will embrace the action
of each substance upon the organism in health and disease,—
its action physiological (or pathogenetic), and its action thera-
peutical. Of the former little needs now to be said. There
is no question but that our knowledge on this head should be
as full and accurate as possible. The only limitation is on the
side of Toxicology. Our subject is pharmacodynamics; but
it is the duraμes of pápμaka as medicines, not as poisons. We
require to know their poisonous action for the purpose of using
them as curative agents: in as far as it comes within the range
of Forensic Medicine-in all that relates to diagnosis, tests,
antidotes, and such like-it is beyond the range of our present
inquiry.
4. A far more important qualification of our task arises from
the therapeutic side of the action of drugs. These lectures are
delivered as part of the course of instruction of the London
School of Homœopathy. How far do the principles indicated
by this name modify the teaching of Materia Medica?
It is not my province to expound to you in any detail the
nature of homoeopathy: this task belongs to my colleague
occupying the chair of the Practice of Medicine. The only
assumption regarding it needful for my present purpose is that
it is a therapeutic method, and a legitimate one. It is never-
theless entirely ignored in the common text-books on Materia
Medica, the few known applications of medicines which come
within its range finding place there as empirical uses only. It
accordingly becomes the duty of a teacher of this subject in a
School of Homœopathy to give, in the therapeutic part of his
task, the foremost rank to such uses of his medicines as result
from the rule similia similibus curantur-let likes be treated
by likes. He will not neglect to glance at and estimate other
modes of employing them, but he will give his main strength
to these these he will do, and not leave the others undone.
But the avowed recognition of homœopathy in this place
will have further effects.
First, it will influence the range of the Materia Medica we
shall have to consider. Homoeopathy presses into its service
a far greater number of natural products than traditional
medicine employs. It has revived many valuable agents from
the unmerited oblivion into which they had fallen, and is con-
tinually adding new remedies to its stock by means of the
organon it possesses in the law of similars; for it has but to
1
INTRODUCTORY.
3
ascertain the pathogenetic action of any substance, and its
medicinal use is indicated forthwith. The Materia Medica we
shall study will be that of Homœopathy, which embraces all
the ordinary medicines, and adds many another thereto.
Secondly, our homeopathic standpoint will greatly enrich
the materials on which we can draw for the knowledge of the
pathogenetic action of drugs. The practical carrying out of
our therapeutic rule has necessitated extensive and minute
"proving" upon the healthy body. The record of such
experimentation constitutes the distinctive Materia Medica
Homœopathica. Passed by in the ordinary lectures and
treatises, this record will take special prominence here. We
may use as freely as others can the observations of poisoning
and over-dosing, and the experiments on animals, which con-
stitute the bulk of the pathogenetic material generally avail-
able. But we shall add to these, and rank above them in
importance, the pure proving on the healthy which, though
not unknown previously, has been in an especial manner the
(confessedly meritorious) endeavour of the disciples of Hahne-
mann. Such experimentation on the human organism is now.
gladly welcomed in the old school of medicine, but only when
its conductors and subjects are of the orthodox creed. We,
having no such prejudices, shall be free to use all material of
the kind, estimating it simply on its own merits.
Once more, the homœopathic character of our therapeutics
will give a special direction to our study of pathogenetics.
There are three recognised kinds of action possessed by drugs,
which are commonly called mechanical, chemical, and dynamic
respectively. The first is that which they exert in virtue of
their bulk, weight, or character of surface, as when mercury
used to be given to force a passage through obstructed bowels,
or the mucuna pruriens to detach intestinal parasites. The
second is the action of acid substances on alkalies and alkalies
on acids, and such like, whereby the re-actions of the laboratory
are reproduced as far as may be possible in the interior of the
organism. The third or dynamic operation of drugs embraces
all effects of theirs which cannot be accounted for by physical
and chemical laws, and which-unlike those of the two former
classes are only produced in the living body. It is this
last class of the actions of drugs which will chiefly occupy us,
as it is by means of this alone that homœopathy works its rule.
If we avail ourselves of the mechanical or chemical properties
of the substances we employ, we do so on mechanical or chemi-
cal principles. Similia similibus belongs to the living organism
only, and to the re-actions of drugs which are peculiar thereto.
M
4
INTRODUCTORY.
The sum of what has now been said is this. It will be my
duty to discourse from this chair on the Homœopathic Materia
Medica,-embracing, that is, all the substances which homœo-
pathy uses as medicines; setting forth, in addition to other
information, the peculiar knowledge which homoeopathy
possesses as to their pathogenetic properties; and, while omit-
ting no known actions or uses which belong to them, dwelling
especially on those which homœopathy employs in its treat-
ment of disease. These lectures will not attempt to supersede,
but only to suppiement, the instruction on the subject elsewhere
given, and which you have already received or will be receiving.
They belong, not to a School of Medicine in general, but to a
School of Homoeopathy. Of course, if the time should ever
come when the lectures given here should be officially
recognised as substitutes for corresponding courses delivered
elsewhere, I should not assume any previous knowledge, but
should treat my subject ab initio. As it is, it will economize
time and strength on your part and mine to confine ourselves
within the limits just laid down.
I have now to introduce you to that which, in a more limitcd
and technical sense, homœopathy calls its "Materia Medica,"
viz.: the record of the pathogenetic effects of the medicincs
it uses.
The primary sources of our information on this
head, and the compilations of pathogenesy which are avail-
able for us, I shall bring before you in the next two lectures.
It will also be my duty to refer you, for each medicine,
to the original records of its provings, and to any special
work in the way of study or arrangement which has been
done upon it. The means of following up such references
are to a large and increasing extent provided by the library
of our School. I must now tell you what, in this so-
called Materia Medica" itself, you must expect to
find.
((
Let us take as an example the section on Arnica in the first
volume of Hahnemann's Materia Medica Pura. After a short
preface, speaking of some of its therapeutic uses, we have a list.
of symptoms, 638 in number, purporting to be observed patho-
genetic effects of the drug. Of these, 280 have no name
attached, and are to be understood as contributed by
Hahnemann himself. Of the remainder, 311 are marked
with the abbreviated names of the fellow-observers acknow-
ledged by him in his preface, seven in all; and 47 are credited
to certain authors, reference being given to the place where
the observation may be found. The symptoms are arranged
in an order mainly anatomical, proceeding from those of the
INTRODUCTORY.
5
head to those of the extremities, and ending with generalities
and psychical phenomena. No information is given as to the
subjects on whom they were observed, the doses by which
they were produced, or the connection and sequence in which
they occurred.
This description, with slight variations, will hold good for
all Hahnemann's medicines, and for a great many of those
furnished by his followers. The first impression made upon
the mind by the symptom-lists it characterises is one of utter
confusion and discouragement. As has been said (in allusion
to the order of the schema)—the reader begins with vertigo,
and ends with rage. But let us inquire why Hahnemann
originated, and others imitated, such a mode of presenting
the pathogenetic effects of drugs; and what use was intended
to be made of the symptoms furnished. Then, perhaps, we
shall understand the rationale of the form adopted.
Now it is obvious to any one who considers the subject, that
there are two conceivable modes of working the homoeopathic
method-of following the rule, "let likes be treated by likes.”
The one may be called the à priori mode, the other the
à posteriori. The former infers from the pathogenetic action of
any substance what will be the morbid conditions in which it
should prove curative. The latter begins with disease instead
of drugs it is the course we adopt when, having examined a
case, we turn to our pathogenetic records to see what medi-
cine has caused similar symptoms in the healthy.
That the latter was Hahnemann's ideal plan seems to me
incontestably proved by his Organon. There is no trace
there of wish on his part that the homoeopathic practitioner
should make any study of medicines in themselves prior to
their application to practice. Their pathogenetic effects
having been ascertained and recorded, we have but to refer to
such record, after we have examined our patient, to discover
the similimum to his case. Hence the arrangement of the
pathogeneses in the form of a schema of disconnected symp-
toms. If every case is to be treated by writing down its
phenomena in anatomical order, and finding what medicine
has produced all, or the greatest number, or the most charac-
teristic of them, then the form adopted answers every purpose.
That it is impossible to form any à priori notion of the
medicine, or to see in its effects any true pictures of disease, is,
upon this system, of no consequence.
That this is the explanation of the form of the Homœo-
pathic Materia Medica is, I think, unquestionable.
doubtful but that provision must be made for this
Nor is it
mode of
6
INTRODUCTORY.
-
homœopathising. So many morbid states are known to us
only as an assemblage of phenomena, that there is no other
way of treating them than by comparing them at the time
with our pathogenetic records, and fitting drug symptoms to
those of disease. Hence the pathogenesis of every medicine
must be arranged in schema form for our purposes, and the
only change to be desiderated is the improvement of the
arrangement. But were this the whole of homoeopathy, the
function of a lecturer on Materia Medica would have no
existence. The only knowledge required would be the where-
abouts of the pathogeneses; the only faculty to be exercised
upon them would be that of memory, and even this would be
superseded by the employment of the indices we call reper-
tories.
The fact of my delivering this course of lectures in the
London School of Homœopathy shows that in the judgment
of its conductors previous knowledge of medicines is necessary
and desirable. Even to use the Materia Medica aright upon
the à posteriori plan, it is very helpful to know the significance
of the several symptoms as fully as may be, and to be
acquainted with the general sphere and character of the
medicine. Mere mechanical symptom-covering is as likely to
miss as to hit the mark. Still more important is it that you
should be furnished for what I have described as the à priori
method of homoeopathising, that as far as possible you should
go forth ready equipped for your work without cumbersome
apparatus of books of reference. So to inform, and so to
furnish you, is the task I have undertaken.
Let me say a
few words upon the To σT which a lecturer has for this
purpose.
First, in nearly all the new provings which have appeared
since the death of Hahnemann, it has been recognised as
essential that the daily records of the experiments should be
furnished, and not merely a schema of the results. These
records are invaluable, both for illuminating the individual
symptoms, and for revealing the morbid states to which the
drug-effects are similar. For the provings of Hahnemann and
his immediate followers we have no such aids, so far as their
own symptoms are concerned. But those cited from authors,
which in some pathogeneses constitute an important element,
can in most cases be examined in their originals, and thus
their meaning and value be ascertained. This work has been
done for some of the medicines by Drs. Roth, Langheinz, and
others; and I have myself completed it for the whole
Hahnemannic series. Dr. Allen's Encyclopædia, and also the
INTRODUCTORY.
7
new translation of Hahnemann's Materia Medica Pura now
in progress, embody my results.
Secondly, we have the facts brought forward in the ordinary
treatises on Toxicology and Materia Medica. They want the
fulness and minuteness required for the application of the law
of similars; yet in their measure they are extremely helpful.
To know that a poison is narcotic, narcotico-irritant, or irritant
only is knowledge sufficiently vague; but it is a clue. It
indicates the relative importance of various symptoms, and the
class of diseases to which the drug corresponds. The revela-
tions of morbid anatomy carry us a step onward yet. They
show the organs and tissues upon which the poison exerts its
influence, and in a broad way the character of that influence.
The classifications of manuals of therapeutics-which study
drugs as cathartics, diuretics, expectorants, and so forth-help
us still further to localise the sphere of the influence of each;
and of late the physiological side of the action of medicines
has received much greater attention in these works, to our
corresponding profit.
It is perhaps supererogatory to point out the best books.
of this kind.~ Christison and the first edition of Taylor On
Poisons, with Orfila's Toxicologie, have made any later works.
on the subject needless at present. Of the older treatises on
Materia Medica, the English Pereira, the French Trousseau
and Pidoux, and the American Wood may be named as
excellent in their way. The modern books of Phillips,*
Ringer, and the younger Wood ‡ are of a different stamp.
The first is rather the record of what the writer learned during
the twenty years in which he avowedly practised homœopathy,
than the result of his observations since he only did so in
secret: it is of interest to us mainly as showing how much
he could retain and put forward under another name. Dr.
Ringer's book, when it first appeared, was an incorporation
with the traditional uses of medicines of such knowledge as he
could obtain of their employment in the school of Hahnemann.
The facts of this latter class it contained (stated always without
reference to their source) made it like a stream of fresh air to
practitioners of the old system; and it rapidly attained great
popularity. In subsequent editions, the author has spoken
* Materia Medica and Therapeutics. Vegetable Kingdom. By
Charles D. F. Phillips, M.D., F.R.C.S.E. 1874.
† A Handbook of Therapeutics. By Sydney Ringer, M.D. 7th
Edition. 1879.
A Treatise on Therapeutics. By H. C. Wood, junr., M.D. 3rd
Edition. 1879.
8
INTRODUCTORY.
more frankly as to the authorities for his novel statements;
and has himself both supplied many fresh provings on the
human subject, and enlarged the therapeutic sphere of several
medicines by using them according to the law of similars in
the large field of practice at his command. His seventh
edition—which I shall cite here--is thus a work of great
value. The Treatise on Therapeutics of Dr. Horatio Wood
has a usefulness of another kind. Himself a diligent worker
in the physiological laboratory, he has made it his business to
keep au courant with all that is done of this sort elsewhere.
He can thus present to us a summary of all experimentation
that has been carried on with any drug down to the date of
his publication, and has done so with very satisfying fulness.
His book is as necessary for our knowledge of the patho-
genetics of the old school, as they now are, as Dr. Ringer's
for its therapeutics, and throws many a side-light on our own
Materia Medica. Besides these works, I may name with much
commendation the elaborate, and indeed exhaustive treatise of
Dr. Stillé,* and the later American contribution on the
subject by Dr. Bartholow.†
Thirdly, we are materially aided in our studies of phar-
macology by clinical experience, by what we are accustomed
to call the usus in morbis. As soon as this has become suffi-
ciently extensive, it avails to stamp the character of the
various medicines, and to show in what part of the body and
in what kinds of derangement they have real energy. Light
is thus thrown back on the pathogeneses, and their character-
istic features and fundamental phenomena become manifest.
In these, each medicine seems to affect more or less every
organ or function of the body; but from the usus in morbis we
learn which are the primary seats of its influence, and which
the merely subordinate and sympathetic.
A great mass of clinical experience with medicines used
after the homoeopathic method has now accumulated in our
periodical literature. Collections of it have been made from
time to time, as those of Rückert in German and Beauvais (a
pseudonym for Roth) in French. But for your introduction
to the subject, and for our present purpose, I can commend to
you no more excellent books than the Applied Homœopathy
of the honoured founder of this School, Dr. Bayes, and the
Hints for the Practical Study of the Homœopathic Method of
* Therapeutics and Materia Medica. By Alfred Stillé, M.D. 4th
Edition. 1874.
† A Practical Treatise on Materia Medica and Therapeutics. By
Robert Bartholow, M.A., M.D. 1877.
INTRODUCTORY.
9
Dr. Chepmell; both of which are in our library. The former
by stating his own experience with our leading remedies, the
latter by a series of typical clinical records with observations,
stamps indelibly on the mind of the student the leading
features of the drugs he specifies. But it is not on avowed
homœopathic experience only that we can draw for this
object. All treatment by single medicines used for their
direct effects upon the disease is truly of this kind, though it
knows or acknowledges it not. Hence such collections as
those of Frank's Magazin* are of great value to us. This
exists only in German; but in M. Teste's Systématisation
pratique de la matière médicale homœopathique (1853), which
we have also in English, copious use is made of the experi-
ence of the older medical writers as illuminative of the special
properties of our remedies.
Taking his stand upon the ground thus described, the
lecturer on Materia Medica will survey for his hearers the
field of pathogenetic phenomena he has to characterise. My
main object will be to set forth the sphere of action of each
drug. Every medicine, even though it be one of those great
polychrests which seem to embrace nearly the whole organism
within the circle of their influence, has one or more centres of
action. What these centres are we learn, sometimes from the
pathogenetic, sometimes from the clinical side. When we
have learnt them, they become all-important stand-points for
the understanding and the remembrance of the medicine.
These centres I shall endeavour, wherever practicable, to
reach, and around them to group the several actions and uses
of the drugs. There will always be residuary phenomena in
such a process; but these I shall not fail to note when their
importance demands it.
Besides sphere, moreover, I shall endeavour to set forth the
kind of action of each drug. Its action upon a certain organ
or tissue, a certain physiological function, a certain pathological
process, may belong to it in common with several other
medicines; and yet there is nearly always something special
in the manner of its action which differentiates it from these,
and gives it an individual character. Such specialty may
sometimes be capable of rational description; but more com-
monly, perhaps, it will reside in certain symptomatic phe-
nomena which can only be given as they are observed,
without attempt at explanations of their meaning. To these
belong the facts about drug-action known as "characteristics"
*
Magazin für physiol. und klinisch. Arzneim. und Toxikol.
4 vols. Leipzig, 1845–54.
10
INTRODUCTORY.
and "key-notes," which have been largely used in homoeo-
pathising of late, especially in America. Their foremost
advocate is Dr. Guernsey, of Philadelphia; and I know no
better exposition of their true place and value than a paper
upon them from his pen contained in the third volume of the
Hahnemannian Monthly. They are shown there to be no
substitutes for the "totality of symptoms" required by Hahne-
mann in the comparison between drug-action and disease,
but ancillary only thereto, in suggesting the remedy which
shall be found to contain this totality, or in determining
the choice between several candidates for the post of the
similimum. For our present purpose, in giving an à priori
view of medicines, these characteristics have been aptly
compared to personal peculiarities which, as much as outline
and feature, conduce to the recognition of any one, and, in
the case of there being others like him, aid in his distinguish-
ment. I shall indeed lay much more stress upon outline and
feature, complexion and manner; but I shall not neglect any
"trick o' the voice," any habitual working of the lips or twitch
of the eyelids which may serve in cases of difficulty to identify
the individual. Nor may we despise such characteristics
because of their seeming triviality. It may appear a small
thing (the illustration is Dr. Guernsey's) to say that Cina
is indicated in metrorrhagia when the patient is given to
picking the nose; but when we remember the occasional
dependence of this symptom on the presence of worms in the
intestines, the reality of the indication becomes obvious.
Our method will be as follows:-After defining what it is
that we are administering under the common names of the
drugs-Aconite, Arsenic, and so forth-I shall refer you to
the authorities for our knowledge of each. Under this head
will be mentioned the original provings, and any special
sources of information which may exist. Then I shall pro-
ceed to describe the pathogenetic influence, and to indicate
the therapeutic uses of the drug. A list of allied medicines
will next be given, with which the drug under study may be
profitably compared. Lastly, I shall touch upon the question.
of dose, but only so far as to state whether the lower or higher
dilutions seem to have been most efficacious in the treatment
of disease. The question of the relative superiority of these
is a moot one among us; and I have no pretensions, nor is
this the occasion, to pronounce upon it. But it is a matter of
fact that certain remedies belong almost exclusively to the
partisans of infinitesimals, while others are in chief favour
among those who prefer appreciable fractions of the drug.
INTRODUCTORY.
II
Such facts I shall state for what they are worth. They,
together with the individual items of experience on record,
are the data from which all future generalisations must be
drawn ; and in the meantime they are hints for practical use.
Here, as elsewhere, you will desire to know whether homoeo-
pathic literature possesses any books which you may profitably
study in connection with the present course of instruction.
There are two well known among us, the Traité méthodique
et pratique de matière médicale et de thérapeutique of Dr. Espanet
of Paris (1861), and the New and Comprehensive System of
Materia Medica and Therapeutics of our indefatigable American
colleague, Dr. Hempel (2nd ed., 1865). The former is brilliant,
but its pathogenetic statements have rather too much assump-
tion about them. The latter contains much information; and,
with pruning of many redundancies, and supplying of more
deficiencies,* would be a valuable treatise. No commenda-
tion of mine, moreover, is needed in introducing to you the
posthumous Lectures on Materia Medica of the lamented
Carroll Dunham, now just given to the world. A smaller and
humbler work, yet one in which I cannot but feel an interest,
since it is my own, is the Manual of Pharmacodynamics. The
third edition of this book, containing the lectures given by
me at our Hospital in 1875-6, will be the text-book of our
present course, which will embrace all that is contained there,
with such additions, modifications, and re-arrangements as the
progress of knowledge requires.
And here, as there, I must state that what I shall say in no
way professes to be a substitute for the Materia Medica itself.
It is rather an introduction at first, and then a guide and
companion to it. The pathogeneses of the medicines, given in
detail therein, I shall present in the way of descriptive outline,
of analysis, or (wherever possible) of physiological expression.
But the Materia Medica itself is the mine where the treasure,
however rough its form, really lies. To indicate the vein where
each mineral may be worked, to estimate the value of its yield,
to exhibit such of its products as have been obtained and
smelted, and especially such as have been applied to use,—this
will be my task. If there are any who cannot or will not work
the mine for themselves, the knowledge of what I show them.
out of it will be better than total ignorance. In most of my
hearers I hope that the specimens I exhibit will excite a thirst
for research on their own part, rather than a less worthy
content with the result of the labour of others.
How best to study the Materia Medica-i.e., the catalogues
* See review in Brit. Journ. of Hom., xxiii.
12
INTRODUCTORY.
of pathogenetic symptoms-is a question of importance. I
would advise you to read three excellent papers on the sub-
ject. The first is by Dr. Constantine Hering, in the second
volume of the British Journal of Homœopathy; the second
by Dr. Dunham, in his tractate entitled Homeopathy the Science
of Therapeutics, first published in 1863, and now forming the
eponymous essay of the first volume of his collected works; the
third by Dr. Madden, read before our Congress of 1870, and
printed in the Monthly Homœopathic Review of that year.
The methods they respectively advocate may be described
as those of simple comparison, of physiological analysis, and of
pathological relation. Dr. Hering would have us learn to know
our medicines as a forester comes to know every tree within his
range. Dr. Dunham would impress each upon our minds by
penetrating to its inmost character. Dr. Madden would group
them around morbid conditions, and study their pathogenetic
effects in reference thereto, so that "the knowledge of the
entire action of any medicine should be left as the ultimate
result of a completed study of pathological phenomena." All
these methods have their value. The two former are best
suited to those who are yet students, the last to those who are
already in practice. Perhaps the comparative method of Dr.
Hering may go best with these lectures, as I shall be myself
occupying Dr. Dunham's ground in delivering them.
A few words in conclusion upon the nomenclature and
pharmaceutics I shall employ in these lectures, which will
necessarily be those of homœopathy.
1. If any of you have read much of homoeopathic literature,
you must have been surprised at our many singularities in
the matter of nomenclature. That the liquid now known as
hydrochloric acid we style muriatic might be passed over as
of little importance. But it seems strange that we should
talk of China and Chininum sulphuricum instead of Cinchona
and sulphate of quinine, and of Mercurius instead of Hydrar-
gyrum. Still more strange is our retention of the old names
kali and natrum, so long superseded in ordinary parlance by
potassa and soda. And the apparent uncouthness is crowned
by the phraseology used to designate the chemical salts, e.g.,
Ammonium carbonicum, Antimonium tartaricum, Argentum
nitricum, Calcarea phosphorica, Magnesia muriatica, and .
Natrum sulphuricum. Perhaps, at a first glance, all may not
recognise under these titles their old acquaintances carbonate
of ammonia, tartar emetic, nitrate of silver, phosphate of lime,
chloride of magnesium, and sulphate of soda.
INTRODUCTORY.
13
The explanation of this singularity is easy to find. At the
time when homœopathy first arose, our present nomenclature
prevailed throughout Europe. The medicines were proved,
and took their places in the Materia Medica, under their
ancient names.
In this form the converts to the new doctrine
received them: under these titles they spoke and thought of
them. It would have seemed little less than sacrilege to alter
the familiar names because modern chemistry had rechristened
its compounds. Perhaps if Germany, the mother-land of our
system, had revised the nomenclature of her drugs, other
countries might have followed in her wake. But the German
Pharmacopoeia of either school still retains the ancient names.
And so we also have them unaltered; and even name our
newly proved medicines-e.g., Kali bichromicum-according to
their analogy.
But the explanation does not in this case contain in itself
the justification of the usage. If you should feel disposed to
protest against the retention of such obsolete and often
cacophonous forms, I cannot but sympathise with you; for I
myself felt of much the same mind in the early days of my
homœopathy, and I retain my sentiment still. I have con-
tended myself, however, with things as they are for the
following reasons :—
Ist. Our nomenclature is of historical value; it tells of the
place of our origin, of the rock whence we were hewn and the
pit from which we were dug. The preservation of names
involving history is much thought of elsewhere; one must
attach some little importance to it here.
2nd. It affords a bond of union to homoeopathists in all
parts of the world. It is like the Latin language to the
learned in the middle ages. Each country is free to revise its
pharmacological nomenclature independently; and, to a great
extent, has done so. If a German or French book is translated
into English, many of the names of the drugs have to be
explained. It is not so in homoeopathic literature: we speak
a language universally intelligible.
3rd. It is like the Latin tongue, not to the learned only, but
to the Church. While the Roman Empire was one, the
public Offices were, as a matter of course, recited in Latin.
When it fell to pieces, and separate nations, each with its own
language, began to rise out of the ruins, some may have
desired that the Service-books should be rendered everywhere
into the vernacular. But such a step would have been most
unwise. The Church held on to her original and unalterable
tongue, and would not commit her prayers to the ever changing
14
INTRODUCTORY..
and endlessly varying dialects of the nations in her communion.
The wisdom of her course is obvious; and the retention of our
ancient nomenclature rests on the same grounds. Chemistry
is perpetually and necessarily changing her names, and the
adoption of her suggestions is not simultaneous in all countries.
So, while each national Pharmacopoeia speaks a drug-dialect of
its own, homoeopathy holds on to the changeless mother-
tongue, and her words are comprehensible by all alike.
You will have anticipated me in suggesting that this parallel
must ultimately tell the other way—that a time did come at
last when the demand for vernacular Offices of worship was no
longer unwise, but most just and righteous; and that so it
must be here. I grant it fully. When chemistry has finally
made up her mind as to the nature of the compounds she
studies, and when the nomenclature she suggests has met with
general acceptance, and has stood firm for many years, then it
will be our duty to translate our present language into one
understanded of the people. To do so earlier would just be to
quit our vantage-ground, and commit ourselves to the waves of
change and confusion.
That this time has now come has been maintained with much
ability by Dr. Hutchinson, in a paper on "Our Nomenclature"
in the twenty-fourth volume of the British Journal of Homœo-
pathy. I cannot, however, assent to his conclusions. When
the latest edition of the British Pharmacopoeia converts calomel
and corrosive sublimate into the subchloride and perchloride
of mercury, after they had so long been known as the chloride
and bichloride respectively, I see no permanence yet in
chemical nomenclature. For practical purposes, I think it
better to go on calling them Mercurius dulcis and Mercurius
corrosivus, as we have done from the beginning.
The principles of our nomenclature of the chemical salts are
very simple. Instead of making two substantives of the base
and the acid, putting the former into the genitive and the
latter into the nominative case, we throw the acid into the
adjectival form, with an ending in "ic" or "os." Thus, instead
of Magnesiæ carbonas, we have Magnesia carbonica ; instead
of Potassæ arsenis, Kali arsenicosum. For the kaloid com-
pounds we use the termination "at," as in Kali iodatum.
The last revision of her nomenclature made by chemistry (in
the larger use of the terminations "ous" and "ic" to express
different degrees of oxidation), is a return in this direction.
II. So much for our nomenclature; and now a few words
upon pharmaceutics. I have no intention of entering into
the minute details which belong rather to the chemist than to
INTRODUCTORY.
15
the physician. I just want you to know what it is you are
prescribing when you order this attenuation of a vegetable or
that of a mineral substance. We have now an excellent
Pharmacopoeia :* and to this I refer you for the full informa-
tion of which here I give you an outline.
The object of homoeopathic pharmacy is so to prepare each
substance that the whole of its active virtues shall be present
in a form suitable for administration. In the case of vegetable
substances this is always done, when practicable, by expressing
the juice of the whole plant, and mixing it with alcohol in
which the residue has been steeped for some hours. When
the plant can only be procured in the dry state, or when but
little juice is obtainable by pressure, a tincture is made from it
by percolation. The resulting tincture in each case is arranged
to contain the medicinal substance in the proportion of about
one part in ten. This is what is dispensed as the "mother-
tincture," and is ordinarily represented by the Greek or 0.
From it are prepared the " dilutions," "potencies," or (as best
called)" attenuations." The 1st is made by adding one part
of the mother-tincture to nine of alcohol; the 2nd by mixing
one part of the 1st with nine of alcohol; and so on up to the
6th. These dilutions are on what is called the " decimal
scale;" and the 2nd, 4th, and 6th decimal obviously correspond
with the 1st, 2nd, and 3rd of a centesimal scale, i.e., in which
the dilutions are prepared in the proportion of one to ninety-
nine. This latter being the method originally in use, its
nomenclature is preferred when practicable. So that through-
out these lectures, when an attenuation is mentioned, you will
understand that the centesimal scale is intended. When I
mean the decimal, I will say so. The usefulness of this latter
scale is that it gives us dilutions intermediate between 0 and 1,
and between 1 and 2, which are written 1 and 3* respectively.
After 3 such intermediate stages are unnecessary, and the
further dilution may always be proceeded with upon the
centesimal scale.
X
The mineral substances used in our practice are differently
prepared according as they are soluble or not. In the former
case the dilutions are made with water, which is also the
vehicle of the mineral acids. The metals themselves, and
their insoluble salts, are prepared by the Hahnemannic pro-
cess of trituration. This consists in rubbing up a grain of the
substance with nine grains of sugar of milk to form the first
trituration, a grain of this with nine grains more of sugar of
* British Homeopathic Pharmacopæia, published by the British
Homœopathic Society. 1870. 2nd edition, 1876.
16
INTRODUCTORY.
milk for the 2nd, and so on to the 6th. After the 6th decimal
the further dilution is carried on according to the centesimal
scale, and is commonly effected by solution. A grain of the
3rd trituration is dissolved in fifty drops of water, and to this
are added fifty drops of alcohol. A drop of this fourth dilu-
tion is mixed with ninety-nine drops of alcohol for the fifth
potency, and so on. Long ago, however, Dr. Madden advised*
that all the potencies of insoluble substances should be pre-
pared by trituration; and the recommendation is now very
generally carried into effect.
Struck by the remarkable development of medicinal power
obtained by this process of trituration-even such inert bodies
as the metals becoming actively pathogenetic and curative—
Hahnemann was led to employ it in the preparation of several
vegetable substances, as lycopodium and charcoal, with the
result of elevating them to a high rank as medicines. The
process of trituration is also resorted to in the case of such
products as coral and sponge, and (as an alternative to a
tincture prepared by percolation) of such dry plants or por-
tions of plants as Ipecacuanha and Nux vomica.
The globules or pilules used in homoeopathic practice are.
small spheres of sugar of milk, prepared by immersion for
some time in the tincture of the drug they are intended to
represent. The former were introduced by Hahnemann to
reduce still farther the quantity of the drug administered;
the latter perform no such office, and are employed simply
for convenience. Both labour under the objection of being
second-hand preparations; and we cannot desire to furnish an
additional element of uncertainty to a process already so
perilously delicate as that of attenuation. Tinctures and
triturations are the form in which our drugs are most gene-
rally used, and to my mind are greatly preferable to any
other. The globule, however, is still a useful form in which
to administer medicines to infants.
* British Journal of Homeopathy, v. 372-3.
LECTURE II.
SOURCES OF THE HOMEOPATHIC MATERIA MEDICA.
In my introductory lecture I spoke briefly of the distinctive
"Materia Medica "-technically so called-of Homœopathy. I
stated that when this phrase is used in our literature, it is not
to be understood of drugs themselves, but of that collection of
their pathogenetic effects-of the derangements they are capable
of causing in the healthy body, by means of which is worked
the principle, "let likes be treated by likes." Some of these
pathogenetic effects are observations of poisonings and over-
dosings, as recorded in general medical literature; but the
great bulk of them are the result of "provings" of the various
drugs on the healthy human body, or of their side effects (so to
speak) when administered as medicines to the sick. Such
collections of drug-symptoms are called "pathogeneses;" and
they have been appearing from time to time in the school of
Hahnemann ever since 1805. The history of the several
publications containing them, and an analysis of the material
presented in each, will constitute the account of the sources of
the Homœopathic Materia Medica which I now design to
bring before you.
1. The earliest volume of the series is that of Hahnemann's
entitled Fragmenta de viribus medicamentorum positivis, sive
in sano corpore humano observatis. It was written in Latin, as
its title implies, and published at Leipsic in 1805. A copy of
the original edition, and another of the more elegant form in
which Dr. Quin edited the work in 1834, lie on the table
before you.
The Fragmenta de viribus contains pathogeneses of twenty-
seven drugs, which you will see enumerated in the list I now
hand round, with the number of symptoms in each.
с
18
SOURCES OF THE
Belladonna
Camphora
Cantharides
Aconitum napellus .
Acris tinctura (Causticum)
Arnica montana
I.-Fragmenta de Viribus.
Hahnemann.
138
30
117
ΙΟΙ
Capsicum annuum
Chamomilla
•
Cinchona
Cocculus.
Copaifera balsamum
Cuprum vitriolatum
Digitalis
Drosera
Hyoscyamus
Ignatia
Ipecacuanha
Ledum
Melampodium (Helleborus)
Mezereum
Nux vomica
Papaver somniferum (Opium)
Pulsatilla
Rheum
Stramonium
Valeriana
Veratrum album
•
73
20
144
272
122
156
12
29
23
36
45
157
70
75
32
62
272
257
82
280
39
59
25
161
..
Obs. of others.
75
O
33
304
74
74
3
3
99
6
8
38
33
4
290
19
13
5
25
34
51
192
29
13
157
ΙΟ
106
You will notice that some of the symptoms of each drug are
"observations of others." This does not mean that Hahne-
mann had as yet any fellow-observers. The "others
are in
every case authors from whose writings he has cited. The
symptoms for which he himself vouches are such as had come
under his own observation as effects of poisoning or excessive
dosing, and (in far larger proportion) those which he had
obtained by provings on himself and others. "I have insti-
tuted experiments," he writes in the preface, "in chief part on
my own person, but also on some others whom I knew to be
perfectly healthy and free from all perceptible disease."
He gives no information as to his doses or mode of adminis-
tration. We can shrewdly infer these, however, from the
remarks on the proving of medicines made in his essay
entitled The Medicine of Experience, which was published in
the next year (1806). "In order," he writes, " to ascertain the
effects of medicinal agents, we must give only one pretty
strong dose to the temperate healthy person who is the sub-
ject of the experiment; and it is best to give it in solution.
If we wish to ascertain the remaining symptoms which were
>>
HOMOEOPATHIC MATERIA MEDICA.
19
not revealed by the first trial, we may give to another person,
or to the same individual, but to the latter only after the lapse
of several days, when the action of the first dose is fully over,
a similar or even a stronger portion, and note the symptoms
of irritation thence resulting in the same careful and sceptical
manner. For medicines that are weaker we require, in addi-
tion to a considerable dose, individuals that are healthy, it is
true, but of very irritable delicate constitutions." It would
thus appear that the symptoms of the Fragmenta obtained
from provings were the results of single full doses of the
several drugs.
Of the twenty-seven drugs which this volume shows to have
received Hahnemann's earliest attentions, twenty-two were
carried on into his Reine Arzneimittellehre. Two-Cuprum
and Mezereum-did not reappear till the second edition of his
Chronischen Krankheiten; and three-Cantharis, Copaiba, and
Valerian-were not again taken up by himself.*
*
2. Six years now elapsed before Hahnemann published any
more pathogeneses. But all this time he must have been
diligently working, both in provings and literary researches ;
for in 1811 appeared the first volume of his Reine Arzneimit-
tellehre, containing twelve medicines, six of which were new,
the pathogeneses also of those which had already appeared
being considerably increased. In 1816 a second volume was
published, containing the pathogenetic effects of eight medi-
cines, together with those ascribed to the magnet. This was
followed in 1817 by a third, with eight medicines; in 1818 by
a fourth, with twelve; in 1819 by a fifth, with eleven; and in
1821 by a sixth, with ten.
The first edition of the Materia Medica Pura (so we render
Latiné Hahnemann's name for his book), which I have now
described, is a very rare work. I am glad to be able to lay a
copy of it before you to-day; and the table which I now put
into your hands will show you its contents as I have done
those of the Fragmenta de viribus.
(C
* Dr. Waring, in his Bibliotheca Therapeutica recently published by
the New Sydenham Society, speaks of the Fragmenta as "the basis of
However much," he adds,
the homœopathic system.
one may be
inclined to differ from the inferences or conclusions drawn by the author
from his facts, all must admire the zeal and labour bestowed by Hahne-
mann in his investigations, as set forth in this work."
20
SOURCES OF THE
Belladonna
Dulcamara
Cina
Cannabis sativa
Cocculus
Nux vomica
Opium
Moschus
Oleander .
Mercurius
Aconite
Arnica
II.-Reine Arzneimittellehre. 1st ed.
Ferrum
Ignatia
Magnes
Causticum
Arsenicum
"
""
Pulsatilla
Rheum
Rhus
Bryonia
•
Guaiacum
Camphor
Ledum
Ruta
?
?
Chamomilla
Cinchona
Helleborus
Asarum
Ipecacuanha
Scilla
Stramonium
Veratrum album
Hyoscyamus
Digitalis
Aurum
North Pole
South Pole
•
Sarsaparilla
Conium
Chelidonium
Sulphur
Argentum
VOL. I. 1811.
VOL. II. 1816.
VOL. III. 1817.
VOL. IV. 1818.
Hahn.
176
31
23
15
224
908
114
O
10
232
206
175
99
294
228
570
243
236
237
971
79
409
408
448
391
90
14
144
85
83
307
103
63
IIO
26
104
182
23
34
87
23
I12
48
:
•
•
•
Others.
474
92
15
54
53
464
39
18
110
108
55
176
368
36
en
54
51
14
48
102
115
334
102
30088
33
691
254
87
201
463
404
436
355
203
116
240
130
201
III
286
128
49
152
HOMEOPATHIC MATERIA MEDICA.
21
Euphrasia
Menyanthes
Cyclamen
Sambucus
Calcarea acetica
Muriatic acid
Thuja
Taraxacum
Phosphoric acid
Spigelia.
Staphisagria
Angustura
Manganum
Capsicum
Verbascum
Colocynth
Spongia
Drosera
Bismuth
Cicuta
Stannum
•
•
•
•
VOL. V. 1819.
VOL. VI. 1821.
Hahn.
25
28
3
19
O
57
222
O
160
95
210
93
89
277
32
17
89
124
در
4
36
95
•
•
•
•
•
:||
Others.
90
269
197
97
255
217
287
209
411
543
398
209
242
69
143
210
227
155
97
205
457
There are, you will see, sixty-one medicines contained in
these volumes, besides the magnet. Twenty-two of them are,
as I have said, transferred from the Fragmenta, but always
with their pathogeneses enlarged: the remaining thirty-nine
are new. There is an important change now manifest, more-
over, in the "observations of others.' These had hitherto
consisted entirely of citations from authors; and the descrip-
tion still holds good of them as they appear in the first volume
of the Reine Arzneimittellehre. In the five years, however,
which elapsed before the second was published, Hahnemann-
now in Leipsic, and at the zenith of his fame—had gathered
round him a band of disciples, and enlisted them in the task
of proving.
Of the eight medicines which appear in the
second volume, seven have contributions from this source; and
henceforth their presence becomes the invariable rule, and
they form an increasing proportion of the bulk of the patho-
geneses.
It is right that the names of the men who thus combined
with Hahnemann to prove drugs on their own persons, and
so to lay, at the sacrifice of their own ease, the foundation
22
SOURCES OF THE
of the future Materia Medica, should be on record. They
are as follows, arranged alphabetically:-
Ahner.
Anton.
Baehr.
Becher.
Clauss.
Cubitz.
Franz.
Gross.
Günther.
Gutmann.
Hartmann.
Hartung.
Haynel.
Hempel.
Herrmann.
Hornburg.
Kummer.
Langhammer.
Lehmann (two).
Meyer.
Fr. Hahnemann. Michler.
Möckel.
Mossdorf.
Rosazewsky.
Rückert (two).
Stapf.
Teuthorn.
Urban.
Wagner.
Wahle.
Walther.
Wenzel.
Wislicenus.
Harnisch.
*
Of these thirty-seven names, some occur comparatively
rarely among the provers, but some with great frequency. Of
the latter I may specify Franz, Gross, Hahnemann's son
Friedrich, Hartmann, Herrmann, Hornburg, Langhammer,
Rückert the elder, Stapf, Teuthorn, and Wislicenus. From
the accounts we have of these men we seem generally
warranted in full dependence on the symptoms they have
furnished. Of the few exceptions to this rule, the mental and
moral symptoms of Langhammer are the chief. This prover,
deformed in body and unfortunate in his circumstances, is
represented by those who knew him as so depressed and alto-
gether morbid in disposition, that his psychical state could at
no time be fairly ascribed to the medicine he was taking.
His moral symptoms are, as Dr. Roth has shown,† of a very
similar character under every drug he proved; and they must,
I think, be held as doubtful unless confirmed from purer
It has also been noted that every drug proved by
Stapf and von Gersdorff excited in the former erotic manifes-
tations, in the latter flatuosities; so that such symptoms in
them are of dubious connection with the medicaments taken.‡
sources.
Of the pains taken by Hahnemann to ensure the genuineness
of his symptom-lists we have abundant evidence. He him-
self writes thus, in the preface to the latest edition of his
first volume:
"In those experiments which have been made by myself
and my disciples, every care has been taken to secure the
* See Allg. Hom. Zeit., xxxviii. and xxxix., and Brit. Journ. of
Hom., xxxii., 451.
† See Brit. Fourn. of Hom. xix, 625.
See also my remarks on F. Hahnemann's contributions to the
pathogenesis of Mercurius solubilis.
HOMOEOPATHIC MATERIA MEDICA.
23
true and full action of the medicines. Our provings have
been made upon persons in perfect health, and living in con-
tentment and comparative ease.
“When an extraordinary circumstance of any kind—fright,
chagrin, external injuries, the excessive enjoyment of any one
pleasure, or some event of great importance-supervened
during the proving, then no symptom has been recorded after
such an event, in order to prevent spurious symptoms being
noted as genuine.
"When such circumstances were of slight importance, and
could hardly be supposed to interfere with the action of the
medicine, the symptoms have been placed in brackets, for the
purpose of informing the reader that they could not be con-
sidered decisively genuine."
To this we may add the testimony of one of the later
accessions to the band of disciples-one who still lives, the
venerable Constantine Hering, of Philadelphia :—
"Hahnemann's way of conducting provings was the follow-
ing. After he had lectured to his fellow-workers on the rules
of proving, he handed them the bottles with the tincture, and
when they afterwards brought him their day-books, he
examined every prover carefully about every particular
symptom, continually calling attention to the necessary
accuracy in expressing the kind of feeling, the point or the
locality, the observation and mentioning of everything that
influenced their feelings, the time of day, &c. When handing
their papers to him, after they had been cross-examined, they
had to affirm that it was the truth and nothing but the truth
to the best of their knowledge, by offering their hands to him-
the customary pledge at the universities of Germany instead
of an oath. This was the way in which our master built up
his Materia Medica."
Of the doses used and the mode of administration em-
ployed in these later provings, we have no more information
than we had as to those of the Fragmenta. From the few
glimpses we get here and there it seems probable that insol-
uble substances were proved in the first trituration, and
vegetable drugs in the mother tincture-repeated small doses
being taken until some effect was produced.
3. In 1822 Hahnemann began to issue a "second, aug-
mented edition" of his Arzneimittellehre. It appeared volume
by volume, like the first, in the years 1822, 1824, 1825 (two),
1826, and 1827 respectively. Each contained the same list of
medicines as before, save that in the sixth Ambra and Carbo
animalis and vegetabilis were introduced for the first time.
24
SOURCES OF THE
Of the extent to which the augmentation has been carried
you will best form an estimate by looking at the table I now
pass round.
III.-Reine Arzneimittellehre.

Acidum muriaticum
Acidum phosphoricum
Aconite
Ambra
Angustura
Argentum
Arnica
Arsenicum
Asarum
Aurum
•
Cicuta
Cina.
Belladonna
Bismuth
Bryonia
Calcarea acetica
Camphor
Cannabis
Capsicum.
Carbo animalis
Carbo vegetabilis
Causticum.
Chamomilla
Chelidonium
•
Medicine.
Cinchona
Cocculus
Colocynthis
Conium
Cyclamen
Digitalis
Drosera
•
•
Dulcamara
Euphrasia.
Ferrum
Guaiacum
Helleborus
Hepar sulphuris
Hyoscyamus
Ignatia
Ipecacuanha
Ledum
Magnes-sud und nord
•
•
•
Ist Edition.
Hahn.
57
160
206
93
48
175
294
14
110
176
4
408
O
104
15
277
118008
448
23
36
སྶུསཚཿམ
31
25
228
26
90
182
103
570
144
182
716
Others.
217
411
108
209
152
55
50
368
254
203
474
97
102
255
240
-5811
54
69
176
33
128
205
15
691
6
210
286
197
355
155
92
90
36
116
108
24
436
54
87
130
113
2nd Edition.
Hahn.
61
268
246
141
96
64
278
431
16
173
380
II
537
34
105
42
275
159
276
106
461
28
36
40
427
330
26
89
5
73
132
52
37
249
29
92
282
104
620
146
186
861
Others.
218
4II
183
349
203
175
314
517
254
205
1042
97
244
236
240
266
69
32
447
201
33
128
205
247
716
224
224
286
197
355
155
297
90
4I
116
196
24
478
54
87
152
372
HOMOEOPATHIC MATERIA MEDICA.
25
Manganum
Menyanthes
Mercurius.
Moschus
Nux vomica
•
Oleander
Opium
Pulsatilla
Rheum
Rhus.
Ruta.
Sambucus .
Sarsaparilla
Scilla
Spigelia
Spongia
Stannum
•
•
Staphisagria
Stramonium
Sulphur
Taraxacum
Thuja
Veratrum
Verbascum
Medicine.
Ist Edition.
Hahn. Others.
89
28
232
0
908
10
114
971
79
409
23
19
3oo co
455
34
85
95
89
95
210
83
112
O
222
307
32
242
269
110
39
53
18
464
102
115
334
201
97
III
201
543
227
457
398
463
49
209
287
404
143
2nd Edition.

Hahn.
89
28
663
2
1198
16
119
1046
94
575
26
20
34
86
130
156
204
283
96
755
334
315
32
Others.
242
267
761
150
69
336
519
117
115
361
262
99
III
202
542
235
456
438
473
62
264
300
401
141
It will be noticed that the chief increase has taken place in
the medicines of the first volume, and here mainly in the
((
observations of others." This is easily accounted for. In
the first edition, as we have seen, this volume contains no con-
tributions from fellow-provers. But when its medicines re-
appear in the second edition, their pathogeneses have been
freely supplied from this source, and are largely augmented
accordingly.
Hahnemann's own additions, moreover, occur most largely
in the medicines of the earlier volumes of the series. Four
only of those contained in the fifth volume, and two only of
the sixth, have their pathogeneses notably increased in his
section of the symptoms. We may be glad that it is so, for
Hahnemann had now been driven from Leipsic, and since
1821 had been living in solitude and obscurity at Cœthen.
Entering upon the eighth decade of his life, he was too old for
further experimentation on his own person; and he had no
26
SOURCES OF THE
other material at hand. We shall see, when we come to the
pathogeneses of the Chronic Diseases, that his main source of
symptoms at this time was the supposed effect upon the sick
of the medicines he administered to cure their chronic mala-
dies. We shall see, moreover, that his avowed prepossessions
and actual mode of practice in this matter make all symptoms
so obtained by him of dubious value. We are glad, therefore,
that most of his additions to the second edition are referable
to the Leipsic instead of the Coethen period, and may be
counted as homogeneous with the unmistakeably genuine
matter of the first edition.
It is time now that I should speak of the citations from
authors, which occupy so large a space in many of the patho-
geneses, and are entirely absent from but very few. This
table will exhibit the number of symptoms due to such
sources in the various pathogeneses of the Reine Arznei-
mittellehre.
Acidum muriaticum
Aconite
Argentum nitricum
Arnica.
Arsenicum
Asarum
Aurum .
Belladonna
Camphor
Cannabis
Capsicum
Carbo animalis
Chamomilla.
Chelidonium
Cicuta
Cina
•
Cinchona
Cocculus
Colocynth
Conium
Cyclamen
Digitalis
Drosera
•
Dulcamara
Euphrasia
Ferrum
Guaiacum
•
IV.—Citations from Authors.
Helleborus
Hepar sulphuris
Hyoscyamus
Ignatia.
Ipecacuanha
Ledum.
Magnes
Manganum
Menyanthes.
Mercurius
Moschus
Nux vomica.
•
•
•
•
·
22
ΙΙΟ
8
47
382
6
475
93
47
4
3
36
37
I I
141
6
29
155
I
131
3
83
2
37
3
Oleander
Opium.
Pulsatilla
Rheum
Rhus
Ruta
•
•
•
•
Sambucus
Sarsaparilla.
•
Scilla
Spigelia
Stannum
Stramonium.
Sulphur
Veratrum
•
●
34
IO
355
15
41
4
195
I
3
139
39
48
IO
518
25
11
49
3
I
4
30
17
5
383
10
247
The medicines which are omitted from the list, as having no
citations from authors attached to them, are Acidum phos-
HOMOEOPATHIC MATERIA MEDICA.
27
phoricum, Ambra, Angustura, Bismuth, Bryonia, Calcarea
acetica, Carbo vegetabilis, Causticum, Spongia, Staphisagria,
Taraxacum, Thuja, and Verbascum-thirteen only. Of the
remainder, you will see that many are abundantly supplied
from this source, whose value it is therefore of importance to
ascertain.
I have said that these symptoms are taken from observa-
tions of poisoning or of over-dosing. But it makes a great
difference to which of the two classes they belong. If they are
from poisoning, their subject will ordinarily be a healthy one,
and all is well. If they are from over-dosing-real or sup-
posed-they must have occurred in sick persons who were
taking the drugs as medicines; and here an element of uncer-
tainty comes in. There can be no doubt, indeed, that, with
proper precautions, the pathogenetic effects of a drug may be
observed upon patients taking it for their ailments almost as
well as upon healthy subjects. Some of our best records of the
effects of Atropia-as those of Grandi and Michéa-have been
made from epileptics treated by it. The disease must be of a
definite and limited character, consistent with fair general
health; all symptoms conceivably resulting from it, or occupy-
ing the same seat, must be excluded, and likewise all pheno-
mena previously observed in or by the patient during his ill
health.
Nor did Hahnemann fail to recognise the necessity of such
precautions to obtain even a tolerable result, as is evident
from his preface to the first volume of the Reine Arzneimit-
tellehre. He there writes:-"Among the observations of others
which are mingled with the following symptoms some were
obtained from sick persons. However, inasmuch as they were
chronic patients, with symptoms well known, these last need
not be confounded with the effect produced by the medicines,
as Greding has shown and carefully exemplified. Symptoms
observed upon such patients, therefore, are not without value,
and may at any time serve for corroboration when analogous
or identical symptoms appear among the pure effects of the
drugs in healthy persons.' He also says, in his Medicine of
Experience (1806): "how, even in diseases, amid the symptoms
of the original disease, the medicinal symptoms may be dis-
covered, is a subject for the exercise of a higher order of
inductive minds, and must be left solely to masters in the art
of observation." This statement stands unchanged in the last
edition of the Organon (1833); and a note is added to the
words "medicinal symptoms," explaining them to be such as
"during the whole course of the disease might have been
>>
28
SOURCES OF THE
observed only a long time previously, or never before; conse-
quently new ones belonging to the medicines."
We, then, acknowledging Hahnemann a "master in the art
of observation," and seeing how sound were the canons he
professed, might have taken without question the symptoms he
has cited in his pathogeneses, even though they were obtained
from the sick. But, unfortunately for our trustfulness, he has
given us by his references the means of testing his practice in
the matter; and the result is by no means favourable.
Let us first take Greding, as one whom Hahnemann men-
tions by name as a typical instance of care in distinguishing
between medicinal and morbid symptoms. It is the way of
this writer to give a series of cases of the same disease treated
by a particular drug, recording all the phenomena noticed in
the patient during its administration. He sometimes, but not
always, in summarising the results, indicates which of the
symptoms recorded may or may not be fairly referred to the
drug. Now, when he does so, Hahnemann does not neces-
sarily follow him. When treating some epileptics with Cuprum,
one, immediately after swallowing the pill, lost sense and
thought for a short time; and another, who suffered from
piles, had hemorrhage from them for four days together.
These, Greding with good sense writes, "huic remedio nequá-
quam tribui posse videntur." But they appear (S. 15 and 208)
in Hahnemann's pathogenesis as effects of Cuprum. Again,
this author narrates the treatment of twenty-three epileptics
and epilepto-maniacs by Belladonna. One would expect that
any symptoms taken from such a source would steer very
clear of epileptiform and maniacal phenomena. Yet from one
of them we have S. 1322 (“with a sudden cry, he trembles in
the hands and feet "), which Dr. Russell, in his Clinical Lectures,
cites as contributing to the evidence for the homoeopathicity of
Belladonna to epilepsy;* and the forms of mental disturbance
standing as S. 1375, 1376, 1377, and 1387 are all taken from
maniacs or melancholics. Once more, Greding treats three
cases of jaundice with Belladonna. Two of them have green
stools during the transition from clayeyness to their natural
tint; but this phenomenon stands (S. 703, 704) among the
effects of the drug on the healthy. Lastly, I would refer you
to the account I have given in the seventeenth volume of the
Monthly Homeopathic Review of the cases treated by Greding
with Aconite, from which Hahnemann has taken symptoms.
One was a female maniac, and, not unnaturally, showed signs
of her disorder at the monthly period. Hahnemann tells us
* See also S. 1374.
HOMOEOPATHIC MATERIA MEDICA.
29
(S. 252) that Aconite causes "rage at the time of the appear-
ance of the menses." Another has, as part of a chronic
ailment, a troublesome cough. S. 353 belongs to him, and
speaks of "frequent cough" as if a part of the effect of the
drug.
I need go no farther to show that the use Hahnemann has
made of Greding's records has no countenance from that
observer himself, and is of a most questionable character.
Let us take another author of the same stamp, the famous
Baron Störck. His cases treated by Aconite are summarised
In one of these
in the paper to which I have already referred.
a "considerable tumour in the left iliac region " diminished
and finally disappeared under the action of the drug, with an
accompanying discharge from the vagina of a viscous yellowish
matter in abundance. Hahnemann (S. 251) sets down "profuse,
tenacious, yellowish leucorrhoea " as caused by Aconite! But
the most curious facts in relation to this author belong to his
celebrated reports of the use of Conium in cancer.
He re-
peatedly states that no bad effects were observed from the
doses he gave; and his recorded cases, as well as our subse-
quent knowledge of the drug, seem to bear out the assertion.
Hahnemann, however, cannot believe this; and so the patho-
genesis of Conium contains thirty-three symptoms, to which
the name of Störck is attached. The following are specimens
of them. A patient with mammary cancer coughs and brings
up pus before she dies. As might have been expected, her
lungs are found invaded by the disease; but “purulent expec-
toration" and "a pain shoots into the ulcers when coughing
are contributions from her to the pathogenesis of Conium.
Another sufferer with the same disease gets a chill in the
street while selling fruit on a cold, windy day, has colic and
purging, and finally dysentery, of which she dies. "Violent
belly-ache with chill" and "weakening diarrhoea are ex-
tracted from the narrative as effects of the Conium she was
taking. Another had a group of symptoms deemed traceable
to overloading of the stomach, and which all disappeared after
an emetic; but they swell the pathogenesis of Conium.
I could mention numerous facts of the same order. Most
of the cited symptoms of Arnica were observed upon injured
persons treated by it, or paralytics recovering under its use,
and they belong, as a rule, solely to the bruised or powerless
parts. To Antimonium crudum are credited a number of
phenomena which are obviously the mechanical effects of the
violent vomiting caused by it. All the bad results ascribed
to suppressing agues by bark, as dropsy, jaundice, phthisis
>>
""
30
SOURCES OF THE
and the like, are given us as pure effects of Cinchona, though
they never occurred in any but aguish subjects. The critical
evacuant phenomena with which Dulcamara, in the hands of
Carrére, accomplished the cure of gout, rheumatism, cutaneous
disease, and suppression of the latter or of the secretions—the
eruptions, diarrhoeas, sweatings, and urinary depositions which
accompanied the subsidence of the symptoms-are set down
by Hahnemann as pure pathogenetic effects of the drug. It
is needless to go farther. The principles on which he selects
the true medicinal symptoms from among those of the disease
are not such as we can approve at this day.
It has been suggested that Hahnemann must have employed
others in this part of his collection, and hence is not charge-
able with their errors. I wish it could be proved so to have
been; but there is an entire lack of evidence for the supposi-
tion. I believe that the real explanation lies in the exaggerated
notions he was led to entertain of the potency of drugs. In
the later Organon, he lays down the canon (§ cxxxviii) that
"all the sufferings, accidents, and changes of the health of the
experimenter during the action of a medicine (provided the
proper conditions are complied with) are solely derived from
this medicine, and must be regarded and registered as belong-
ing peculiarly to this medicine, as symptoms of the medicine,
even though the experimenter had observed, a considerable
time previously, the spontaneous occurrence of similar pheno-
mena in himself." He seems to have entertained the same
principle in his mind as regards the administration of drugs in
disease, and to have considered "all the sufferings, accidents,
and changes of health" of the patient as "solely derived from
the medicine" he was taking.
It is clear, then, that before you can use with any reliance
the symptoms cited by Hahnemann from authors, you must
know whether they are taken from narratives of poisoning of
the healthy, or whether they were observed upon the sick; and
if of the latter kind, under what circumstances they appeared.
In Dr. Allen's Encyclopædia, and in the new translation of the
Reine Arzneimittellehre issued by the Hahnemann Publishing
Society, are contained the results of an examination of the
originals of all Hahnemann's cited symptoms. Under the
head of the authority for each is given all available information
regarding the circumstances under which the observation was
made. The symptoms themselves, thus illuminated to their
utmost, are also corrected, or (in Dr. Allen's work) bracketed
as dubious, whenever required; so that you will know exactly
what you are about in making use of them.
HOMOEOPATHIC MATERIA MEDICA.
31
4. I have only a few words to say upon the two remaining
volumes of Reine Arzneimittellehre which stand upon the
table. They are the commencement of a third edition, and
bear the dates of 1830 and 1833 respectively. This new
edition was not wanted, and it stopped there.
The two volumes contain the same medicines as before, save
that Causticum is omitted from the second, having been trans-
ferred to the Chronic Diseases, the first edition of which was
now published. The pathogeneses are somewhat increased in
most instances. When the new symptoms are but thirty or
forty in number, they are usually Hahnemann's own, i.e.,
observed upon the sick. When they are more numerous, they
will be the result of some fresh provings, which are mentioned
in the preface. But the chief change which has taken place
has been the amalgamation of all the symptoms of Hahne-
mann's own observations with those of others into one con-
tinuous schema. This was done, Dr. Hering tells us, under
pressure from his disciples, and against his own judgment.
However, it continued to characterise all his pathogeneses
from this time forward.
5. Our attention is now claimed by another collection of
pathogeneses from the same author-those contained in the
work entitled Die chronischen Krankheiten, that is, Chronic
Diseases.
You will remember that in 1821 Hahnemann had been
compelled to leave Leipsic, and, in difficulty where to find a
place in which he could practise in freedom, had been offered
an asylum in the little country town of Cothen. Thither he
repaired, and there he remained till his removal to Paris in
1835. He now ceased to attend acute disease, save in the
family of his patron, the reigning Duke. But his fame brought
him for consultation chronic sufferers from all parts; and the
varied, shifting, and obstinate morbid states under which so
many men and women labour were pressed closely upon his
attention. It is not my place here to tell you of the facts and
reasonings which led him to his celebrated theory of chronic
disease, namely, that it was always the outcome of one of three
infections-the psoric, the syphilitic, and the sycosic. The
point of interest to us at present is, that to meet the multiform
disorders induced by the first of these miasms it seemed to
him that a new set of remedies were required. For, in the
years from 1828 to 1830, there appeared from his pen the four
volumes, now before you, of the first edition of the Chronischen
Krankheiten; the last three of which (the first being devoted.
to an exposition of his theory) contained pathogeneses of
32
SOURCES OF THE
medicines hitherto strange to his Reine Arzneimittellehre, and
(in some cases) to any Materia Medica whatever.
These new medicines are seventeen in number, and are as
follows:
Ammonium carbonicum.
Baryta carbonica.
Calcarea carbonica.
Graphites.
Iodium.
Kali carbonicum.
Lycopodium.
Magnesia carbonica.
Magnesia muriatica.
Natrum carbonicum.
Natrum muriaticum.
Nitri acidum.
Petroleum.
Phosphorus.
Sepia.
Silica.
Zincum.
All these, save Kali carbonicum and Natrum muriaticum,
are contained in the second and third volumes of the work,
and follow in the alphabetical order of their (Latin) names.
The fourth volume was evidently an after-thought. It con-
tains in this succession-Carbo animalis and vegetabilis,
Causticum, Conium, Kali carbonicum, Natrum muriaticum,
and Sulphur; five of which medicines will be recognised as
having already appeared in the Reine Arzneimittellehre.
Another difference, moreover, is manifested in the seven
medicines of the fourth volume. The pathogeneses of those
of the second and third are introduced without a word of
explanation, and no fellow-observers are acknowledged. But
of the two new medicines of the fourth volume-Kali carboni-
cum and Natrum muriaticum-we are told that two persons
co-operated in obtaining the pathogenesis of the one and three
in that of the other, and that the symptoms of the latter were
produced on healthy persons taking globules saturated with
the 30th dilution. Fresh associates also are acknowledged in
the case of Conium. The difference evidently is that the first
list of medicines was compiled, and their symptom-lists com-
pleted, as part of the original scheme of the work; but that
their publication brought fellow-workers to Hahnemann's aid,
and thus—and through the later recognition of other medi-
cines as "anti-psorics "-evoked the additional volume. This,
indeed, bears the date of 1830, while the other three were all
published in 1828.
In estimating, then, the character and value of the patho-
geneses of the first edition of the Chronischen Krankheiten, I
must speak of those of the second and third volumes separ-
ately from those of the fourth, as belonging to different
HOMEOPATHIC MATERIA MEDICA.
33
categories. The last, indeed, so entirely correspond with the
distinctive features of the second edition of the work, that I
shall say nothing of them till I come to that.
The pathogeneses of the fifteen drugs contained in the
second and third volumes appear (as I have said) without a
word of explanation as to how the symptoms were obtained,
and without acknowledgment (as there is in the Reine Arznei-
mittellehre) of fellow-observers. The absence of any co-opera-
tion on the part of others is further to be inferred from what
we are told of the first announcement of the work. After six
years of solitude at Cœthen, Hahnemann "summoned thither
his two oldest and most esteemed disciples, Drs. Stapf and
Gross, and communicated to them his theory of the origin of
chronic diseases, and his discovery of a completely new series of
medicaments for their cure." So writes Dr. Dudgeon. This
was in 1827. That he should now first reveal these new
remedies, and in the following year should publish copious
lists of their pathogenetic effects, confirms the inference to be
drawn from his position and from his silence as to fellow-
observers. He was himself between seventy and eighty years
oid, and it is hardly likely that he did anything in the way of
proving upon his own person. We are compelled to the con-
clusion that he drew these symptoms mainly—if not entirely—
from the sufferers from chronic disease who flocked to his
retreat to avail themselves of his treatment.
The prefatory notices to the several medicines still further
substantiate this view, and throw some light on the doses with
which the symptoms were obtained. He recommends all the
medicines to be given in the dilutions from the 18th to the
30th (save Magnesia muriatica and Natrum carbonicum, of
which he advises the 6th and 12th respectively); and re-
peatedly makes some such remark as this:-"For a long time
past I have given the 6th, 9th, and 12th potencies, but found
their effects too violent." Occasionally, too, he must have
used the second and third triturations; as he speaks of having
begun by giving a "small portion of a grain" of these, but,
as this was an indefinite quantity, having subsequently dis-
solved and attenuated them. He mentions cases, moreover,
in which he treated itch with Carbo vegetabilis and Sepia of
the latter strength.
We conclude, therefore, that it is these "violent effects" of
the attenuations from the second to the twelfth, experienced by
the sufferers from chronic disease who took them, which make
up the bulk-if not the whole-of the symptoms of the first
edition of the Chronischen Krankheiten.
D
34
SOURCES OF THE
6. The second edition of the work was published in succes-
sive parts-five in all-between 1835 and 1839.* Besides the
twenty-two medicines of the first edition it contains twenty-
five others, of which thirteen are new, and twelve had already
appeared in the Reine Arzneimittellehre. The new ones are—
Agaricus.
Alumina.
Ammonium muriaticum.
Anacardium.
Antimonium crudum.
Borax.
Clematis.
The old ones are
Arsenicum.
Aurum.
Colocynth.
Digitalis.
Dulcamara.
Guaiacum.
Cuprum.
Euphorbium.
Mezereum.
Nitrum.
Platina,
Sulphuris acidum.
Hepar sulphuris.
Manganum.
Muriatis acidum.
Phosphori acidum.
Sarsaparilla.
Stannum.
The pathogeneses appear in one continuous list, as in the
third edition of the Reine Arzneimittellehre. Those which had
already seen the light have (generally) large additions: for all
he acknowledges contributions from fellow-observers,† and for
many cites symptoms from the extant literature of his day.
The tables I now lay before you exhibit these facts, and
enable the history and growth of each medicine to be ascer-
tained at a glance.
* Parts 1 and 2 in 1835; parts 3, 4, and 5, in 1837, 1838, and 1839
respectively.'
†These associates are fewer than they were in the days of the Reine
Arzneimittellehre, and are taken from a fresh set of men. Their
names are Adam, Apelt, Bethmann, Brunner, Bute, Caspari, Foissac,
von Gersdorff, Goullon, Hartlaub, Haubold, Hering, Jahr, Lesquereur,
Kretschmar, Nenning, Piepors, Röhl, Rummel, Schönke, Schreter,
Schweikert, Seidel, Tietze, Trinks, Wahle, Woost. Many of these
names appear only once or twice. Wahle's is the only one found also in
the older work.
HOMOEOPATHIC MATERIA MEDICA.
35

Agaricus
Alumina
Ammonium carbonicum
Ammonium muriaticum
Anacardium
Antimonium crudum
Arsenicum
Causticum
Clematis
Colocynth
Conium
Name.
Aurum.
Baryta carbonica.
Borax.
Calcarea
Carbo vegetabilis.
Carbo animalis
Cuprum
Digitalis
Dulcamara
Euphorbium
Graphites
Guaiacum
•
Hepar sulphuris
Iodium.
Kali carbonicum.
Lycopodium
Magnesia carbonica
Magnesia muriatica
Manganum
Mezereum
Muriatic acid
Natrum carbonicum
Natrum muriaticum
Nitric acid.
Nitrum
•
•
Petroleum
Phosphorus
Phosphoric acid
Platina
Sarsaparilla
Sepia
Silica
Stannum
Sulphur
Sulphuric acid
Zincum
•
•
•
•
Materia Medica Chronic Diseases. [Chronic Diseases.
Pura.
Ed. I.
Ed. II.
1 1 1 1
1079
376
269
720
191
307
250
375
428
401
| 1
145
307
| | | |
331
279
111
679
145
I
660
815
11
11
159
111
286
1090
930
191
1014
|
700
111
590
133
938
891
128
69
111
306
897
803
623
1025
11
1242
567
1
1041
723
715
1161
789
397
622
47I
1231
461
794
460
1631
1189
728
1505
150
283
912
397
702
409
281
1144
160
661
624
1650
1608
890
749
469
610
574
1082
1349
1424
710
776
1915
818
527
561
1655
1193
648
1969
521
1375
36
SOURCES OF THE
Number of symptoms cited from Authors.
Name.
Total symptoms.
715
Agaricus
Anacardium
622
Antimonium crudum
Arsenicum.
Aurum
Baryta
Clematis
Colocynth
Conium
Cuprum
Digitalis
Dulcamara
Euphorbium
Guaiacum
Hepar sulphuris
Iodium
Mezereum
Muriatic acid
Nitric acid
Nitrum
Phosphorus
Sarsaparilla
Stannum
Sulphur
Sulphuric acid
471
1231
461
799
150
283
912
397
702
409
281
160
661
624
610
574
1424
710
1915
561
648
1969
521
•
Cited symptoms.
21
3
71
382
6
46
29
155
154
131
83
22
3
II
348
34
16
30
122
84
4
5000
ΙΟ
8
There are, it is evident, some fresh features in the patho-
geneses of the second edition of the Chronic Diseases; and
there are more than appear on the surface. Hahnemann was
able, at this time, to draw upon other sources than those I
have hitherto specified. Hartlaub and Trinks had published
an Arzneimittellehre of their own. Stapf had begun to issue
his journal called the Archiv; and many provings, made
more or less independently of Hahnemann, adorned its pages.
And, while these pathogenetic materials were accumulating
in the homœopathic school, outside of it Professor Joerg, of
Leipsic, was following in Hahnemann's track, and proving
medicines on himself and his students. Hahnemann availed
himself of all these materials, incorporating them with his
own observations and those of the fellow-observers he acknow-
ledges. In my future lectures I shall take pains to specify
the proportion in which these several elements exist in the
pathogenesis of each medicine, and of their sources them-
selves I shall speak at our next meeting. Hahnemann's own
additions to the second issue of his work must be of the
same character as his contributions to the first, ie., they must
be collateral effects of the drugs observed on the patients to
HOMOEOPATHIC MATERIA MEDICA.
37
whom he gave them. They must all, moreover, be supposed
to have resulted from the 30th dilution; for since 1829 Hahne-
mann had urged the administration of all medicines at this
potency. The same thing must be said of the contributions
of Hahnemann's friends to this edition. They may fairly be
conceived to have been provings on themselves or other
healthy persons, save where, as in Wahle's symptoms of
Mezereum and Hering's of Arsenic, the internal evidence is
strong in the contrary direction. But they must in all cases
have been evoked from the 30th dilution; for in the edition
of the Organon published in 1833 Hahnemann recommends
all provings to be made therewith, as yielding the best results.
In the preface to Natrum muriaticum in the fourth volume
of the first edition of the Chronic Diseases he states that the
symptoms of that medicine were so obtained; and we may
fairly extend the inference to all provings subsequently made.
It thus appears that a large proportion of the symptoms
contained in the final recension of the Chronic Diseases are
effects, real or supposed, of very infinitesimal doses of the
potencies from the sixth to the thirtieth of the centesimal
scale. This is an altogether new element of our pathogeneses,
one which has not encountered us as we have been studying
the Materia Medica Pura. It may fairly be demanded what
evidence we have in support of the assumption made in these
symptom-lists, viz., that infinitesimal portions of drugs, from
the billionth to the decillionth of a grain, have the power of
affecting the healthy organism.
Now into this question I propose to enter on a subsequent
occasion, when I shall discuss the infinitesimals of homoeo-
pathy. I shall then adduce evidence which will, I think,
satisfy your minds-as it does my own-that there is nothing
in the fact that the symptoms before us were chiefly obtained
with such doses which need discredit them as genuine effects
of the drugs administered; though it does give them a special
place and character. But there is another element in Hahne-
mann's own contributions, at least, to these pathogeneses,
which is novel. I have shown that his symptoms must be
presumed to have been observed upon patients taking the
medicines, and not upon healthy persons proving them. Here,
again, you will challenge me, and ask what guarantee we have
that such symptoms are not effects of the disease existing
rather than of the drug being taken.
And here I regret that I cannot meet your challenge. We
saw, when upon the Reine Arzneimittellehre, how very unsatis-
factory was Hahnemann's mode of proceeding in this matter.
38
SOURCES OF THE
We followed him, by means of the references he has given us,
to the authors whose observations he cites, many of which
were made upon the sick. Here we saw him, as it were, at
work among his patients; we noticed the symptoms he selected
as resulting from the drug administered, and not from the
disease present; we noted their conformity to his own canons
and to common sense. The result was to show that his eager
desire for symptoms, and his over-estimation of the activity
of drugs, had led him in numerous instances to put down
as pathogenetic effects phenomena which were obviously those
of the disease or of occasional causes. We can have no con-
fidence, but rather the reverse, that he has not followed the
same course in his observations upon his own patients. Hence
the thousand symptoms of Calcarea and Phosphorus and the
twelve hundred of Sepia-all derived from sick persons during
the six or seven years of the Cœthen period. The recent
re-proving of the latter medicine in America, in which thirty
healthy persons took part, has only yielded 517 symptoms as
its result.
There is one source especially on which Hahnemann seems
to have relied at this time for pathogenetic effects of drugs.
I mean aggravations, real or supposed, of the existing symp-
toms of patients. In 1813, he had written to Stapf:*"You
are right in supposing that the increase by a medicine of
symptoms that had been previously present most probably
indicates that the medicine given can of itself also excite
similar symptoms. Still, we must not include such symptoms
in the list of the pure, positive effects of the medicine, at least
not in writing." Egidi's Colocynth case shows how, in the
later time, this salutary caution was dropped. A patient
labouring long under neuralgia starting from a nephritic com-
plaint, and suffering several times a day from “agonizing pain
proceeding from the region of the left kidney down the corre-
sponding limb as far as the outer malleolus," took at 9 a.m.
a drop of Colocynth 6. In the evening the patient had,
periodically, "a dreadful cutting in the abdomen, proceeding
from the left renal region, spasmodically drawing the left thigh
up to the body, and forcing the patient to bend herself com-
pletely forward." This, at the utmost, was a medicinal aggra-
vation, but it appears as S. 114 of the pathogenesis of Colo-
cynth in the second edition of the Chronischen Krankheiten.
This suggests how many of the apparently wonderful effects of
drugs which experience has proved of little activity (as Natrum
carbonicum) were obtained.
* Dudgeon's Lectures, p. 181.
HOMOEOPATHIC MATERIA MEDICA.
39
I am compelled, therefore, to draw the conclusion that the
great bulk of the pathogeneses of the Chronischen Krankheiten
are not to be relied upon as genuine physiological effects of
the drugs. The fact of their being obtained with infinitesimal
doses would not at all disqualify them, however much they
would stand in need of clinical verification. But their appear-
ance in the sick, after the revelation we have had of Hahnemann's
mode of dealing with such symptoms, puts them (to my thinking)
utterly without the pale of genuine drug effects. They may
be such, but we have no means of knowing that they are; and
here pathogenetic verification-the reproduction of the same
symptoms on the healthy-is required ere we can use them
with any confidence in working the rule similia similibus.
It is otherwise with the Reine Arzneimittellehre. We have
in that work a genuine contribution, and the first made on any
large scale, to the ascertainment of the physiological effects of
drugs, of their action on the healthy human body. Urged as
a necessity by Haller, feebly attempted by Störck and Alex-
ander, no real step was taken towards this end till Hahnemann
published that Fragmenta de viribus, of which the Reine Arznei-
mittellehre is the flower and fruit. Whatever additions have
been made to our knowledge since, whatever improvements
have been introduced into our methods of obtaining it, this
first essay of the kind can never be superseded, and stands as
an imperishable record of the wisdom, devotion, and industry
of its author. If I have had to criticise here and there, it is
not that I less admire. I cordially subscribe to Dr. Dudgeon's
panegyric. "I may safely say
"I may safely say " (he writes)*
(he writes)* "that in the
mere labour of the Materia Medica, Hahnemann's own doings
are tenfold as great and important as all the labours of all his
predecessors and all his followers; that while we might manage
to get on though we were deprived of all the provings of every
other contributor to our Materia Medica, were we deprived
of Hahnemann's observations, and especially his earlier provings,
such as those of Belladonna, Aconite, Bryonia, Nux, Pulsatilla,
Rhus, Arnica, Mercurius, &c., we might shut up shop at once.
In the matter of the Materia Medica, we must all acknowledge
that among them that are born of women there hath not arisen
a greater than Samuel Hahnemann."
*Lectures, p. 241.
LECTURE III.
SOURCES OF THE HOMEOPATHIC MATERIA MEDICA.
(Continued.)
In the preceding lecture on the sources of the Homœo-
pathic Materia Medica I gave you an account of our chief
mines of knowledge on this subject-the Reine Arzneimittel-
lehre and Chronischen Krankheiten of Hahnemann. Before
proceeding to speak of the other and later contributions to it
which go to make up our wealth, I ought to tell how far
Hahnemann's pathogeneses have been rendered available to us
in our mother tongue.
It is obvious that such work must come either from Great
Britain or from America; and it is a physician practising in
the latter country who has given us the only English version
of the master's provings we have hitherto possessed. I refer
to Dr. Hempel, from whose pen appeared, in 1846, the four
volumes of the Materia Medica Pura and the five of the
Chronic Diseases which now stand before you. You have only
to open them to find that they fall very far short of reproduc-
ing their original. It is perhaps a small matter that the
medicines of the Materia Medica Pura are re-arranged accord-
ing to the alphabetical order of their Latin names.
But you
will perceive that all names of authorities are omitted, so that
for the medicines where the symptoms from all sources are
thrown together we have no clue whatever to their origin, and
in no case can we distinguish between the results of provings
and the observations cited from authors. The pathogeneses
in which Hahnemann has separated his own symptoms from
those contributed by others are rarely allowed to stand as he
left them; but sometimes (as with Bryonia) the latter are made
to follow the former in each division of the schema, enclosed
in square brackets for distinctness, sometimes (as with Argen-
tum and Camphor) they are thrown together in one series
without distinction. The symptoms are printed continuously,
instead of in separate paragraphs; and are divided into sec-
tions, with headings according to their subject.
P
HOMOEOPATHIC MATERIA MEDICA.
4I
A closer examination will discover still further and more
serious faults. The medicines of the second volume of the
Reine Arzneimittellehre have been translated from the edition.
of 1824, not—as they should have been-from the later one of
1833. Ferrum and Verbascum have been omitted from this
work, doubtless by accident. But we miss from it a number
of other medicines, and find by the translator's preface that
these include all those which subsequently appeared in the
Chronischen Krankheiten. The reasons Dr. Hempel assigns
for such omissions are incorrect, and, in my judgment,
wholly insufficient; and English readers have lost materially
from not having had the articles on these drugs, with their
prefaces and annotations, presented to them in their original
forms.
A yet graver objection remains behind; and that is, that the
translation is not a faithful one. Dr. Wilson has abundantly
proved this in respect of wholesale omission and careless.
rendering of symptoms, and I must affirm the same as to the
presentation of the introductions and notes. Il va sans dire
that we
can never depend upon the version of the cited
symptoms, which often suffer materially in their passage from
English, French, or Latin into Hahnemann's German, and
thence (in ignorance of the originals) into Dr. Hempel's
English. I must regretfully say that I have long ceased to
have any reliance on this translation, and never venture now
to quote Hahnemann as given by Hempel lest I should mis-
represent him.
You will find these facts stated in more detail in an article
"On the Translations of Hahnemann's Pathogeneses; with a
plea for a new English version," which I published in the
British Journal of Homœopathy in 1877. My plea has since
been entertained by the Hahnemann Publishing Society of
this country, so far as the Reine Arzneimittellehre is concerned;
and Dr. Dudgeon, so favourably known by his rendering of the
Organon and the lesser writings of the master, has undertaken
this work also. I have gladly co-operated with him in revising
from the originals the quotations made from authors, and
supplying to these from the same sources such illumination as
they need. The first volume of the work is now before you,
and I am sure that you will find it as true a reproduction in
detail as you will see it to be in general outline. I hope that,
either here or in America, the Chronischen Krankheiten will
soon be presented in a similar manner; so that English
readers may feel with confidence that they possess Hahne-
mann's pathogeneses in their own tongue.
42
SOURCES OF THE
I now proceed to tell you of the later contributions which
have been made to the Materia Medica of Homœopathy.
1. The first to appear in the field of drug-proving after
Hahnemann had led the way was no follower of his, but a
professor of the University of Leipsic, Dr. Johann Christian
Gottfried Jörg. His academical position gave him pupils to
assist him; and twenty-one of these, with himself, his two
young sons, and three females (aged forty-five, eighteen, and
twelve respectively), formed his company of provers.
He
published at Leipsic in 1825 a first volume of the results
obtained, under the title of Materialien zu einer künftigen
Heilmittellehre durch Versuche des Arzneyen an gesunden
Menschen. It contained experiments with the following drugs:
Acidum hydrocyanicum (with aqua
laurocerasi and aqua amygdalarum
amararum).
Arnica (flowers and root).
Asafoetida.
Camphor.
Castoreum.
Digitalis.
Ignatia.
Iodium.
Moschus.
Nitrum.
Opium.
Serpentaria.
Valerian.
All these substances were taken in moderate doses, repeated
(and if necessary increased) until a decided impression was
made. The experiments of each prover are related in full,
just as they were made and as the symptoms occurred.
the preface a description is given of the age, temperament,
and constitution of those engaged in the task, and the assur-
ance afforded that all were in good health.
You will see at once that in the mode of giving these
provings to the world, Professor Jörg has greatly improved
upon Hahnemann. While the latter leaves us in darkness as
to the subjects of the provings, the doses taken, and the order
and connection in which the symptoms appeared, here all is
clear daylight. Of the intrinsic value of the provings the best
evidence is that Hahnemann was glad to incorporate them in
his own pathogeneses. He seems to have been ignorant
of them up to 1833; for in the volume of the Reine Arznei-
mittellehre then published, he credits Jörg's symptoms of
Ignatia to Hartlaub and Trinks, who had simply copied
them into the collection of theirs of which I shall speak next.
But in the second edition of the Chronischen Krankheiten
(1835-9) he uses Jörg's pathogeneses of Digitalis, Iodium, and
Nitrum, referring them to him by name and work.
HOMOEOPATHIC MATERIA MEDICA.
43
You have only, I think, to examine these provings to come
to the same opinion of their value. You may see the original
work in the library of the College of Surgeons; or may read
its experiments in the fourth volume of Frank's Magazin,
from which, moreover, many of them have been translated by
Dr. Hempel in his Materia Medica. It is a pity that a volume
so rich in instruction and usefulness has not long ago been
rendered into English as it stands; and I commend the work
to any competent person who desires to do service to his
fellow-homœopathists of the English speech.
2. The next to take up the work of instituting and publish-
ing drug-provings were two distinguished members of the
homœopathic school-Drs. Hartlaub and Trinks. They also
named their collection Reine Arzneimittellehre, evidently
intending it to be a sequel to Hahnemann's work. It was
published at Leipsic in three volumes, dated 1828, 1829, and
1831 respectively. Each contains an elaborate pathogenesis
of certain new medicines, and shorter contributions to the
knowledge of others already familiar to homœopathists. The
former, like Hahnemann's, are made up of original provings
instituted by them and of citations from authors; the latter
are chiefly single provings or cases of poisoning. All are
arranged in the usual schematic order; and there is a great,
though not entire, lack of information as to the circumstances
of the experiments.
The first volume contains full pathogeneses of Plumbum,
Cantharis, Laurocerasus, Phosphorus, and Antimonium cru-
dum, and shorter additions to the symptomatology of eighteen
other drugs.
The second volume gives us, in the first category, Gratiola,
Oleum animale, Alumina, and Phellandrium, and fourteen
medicines in the second.
The third volume introduces to us Bovista, Kali hydriodi-
cum, Ratanhia, Strontian, and Tabacum, and adds to our
knowledge of no less than thirty other substances.
As these volumes came into existence between 1828 and
1831, it was obviously open to Hahnemann to avail himself
of them for the third edition of his Reine Arzneimittellehre
(1830-3), and the second of his Chronischen Krankheiten
(1835-9). This he has done to the fullest possible extent.
He has not only used their new provings, but has transferred
to his pages the symptoms they have extracted from authors,
and in doing so has frequently omitted the references to the
work and page, leaving those curious in the matter to refer to
Hartlaub and Trinks. I was much hindered in my work of
44
SOURCES OF THE
examining the originals of some of his citations until I dis-
covered this practice of his.
I come now to an important and much-questioned feature
of Hartlaub and Trinks' pathogeneses—I mean the provings
furnished by the person designated as "Ng." On the first
occasion of Hahnemann's using their work in his Chronischen
Krankheiten, viz., in the section on Alumina, he makes in his
preface the following remarks:-"With merely these two
letters (anonymousness indeed!) Drs. Hartlaub and Trinks.
designate a man who has furnished the greatest number of
symptoms for their Annalen, but these often expressed in a
careless, diffuse, and indefinite manner." He goes on to say
that he has extracted that which was useful from his contribu-
tions, believing that he was a truthful and careful person; but
that it was not to be expected that in so delicate and difficult
a matter as drug-proving, the homoeopathic public would
place confidence in an unknown person designated simply as
Ng." This note of Hahnemann's has led to a good deal of
mistrust of the symptoms of the anonymous observer in ques-
tion, which has been increased by their excessive number,-
Dr. Roth having counted more than eleven thousand in the
several contributions to the Materia Medica furnished by him
between 1828 and 1836. So far has confidence been lacking,
that the compilers of the earlier parts of the Cypher Repertory
have felt themselves warranted in omitting " Ng.'s" symptoms
from the materials they have indexed. But there are im-
portant considerations on the other side. Dr. Hering has
satisfactorily explained the anonymousness. "Ng.,” he writes,
-
:
was a surgeon near Budweis, in Bohemia, a candid, upright,
well-meaning man, not very learned his name was Nenning,
and everybody knew it. According to the laws of his country
he had no right to practise except as a surgeon. A lameness
of the right arm disabled him from following his calling. His
wife commenced a school and instructed girls in millinery;
she supported the family by this. Nenning became acquain-
ted with homœopathy, and soon was an ardent admirer. He
had the grand idea to aid the cause by making provings on
the girls in his wife's millinery shop. He succeeded in per-
suading them. Unluckily enough he came in connection with
Hartlaub in Leipzig, instead of with Hahnemann himself. All
Austrians were forbidden by a strict law to send anything
outside of Austria to be printed; hence not only Nenning, but
all other Austrians, appeared in our literature with only
initials." Nenning himself has given, in the Allgemeine Hom.
* See Allen's Encyclopædia, III.. 640.
<<
(6
J
*
HOMOEOPATHIC MATERIA MEDICA.
45
Zeitung for 1839, a similar account, to explain the number of
his symptoms. "If I have perchance," so he writes, " made
too many provings, for it is remarked that I have furnished
too many symptoms, that should, in my opinion, deserve sym-
pathy rather than ridicule. The exhortation of Hahnemann
not only to enjoy but to put our hand to the work animated
my zeal, and the active support of Hartlaub rendered it pos-
sible for me to do that which perhaps strikes Hahnemann as
surprising. A number of persons, partly related to me, and
partly friendly, were gathered together by me, and, in consid-
eration of board and payment, made experiments. Along
with them were also my two daughters, and, with complete
reliance on the honesty of them all, I gave one medicine to
one and another to another, writing down all that they re-
ported. It was a matter of conscience on my part also not to
omit the smallest particular; and that thereby frequent repe-
titions have arisen I grant readily, but I thought that just in
that way the sphere of action of the medicine could be best
recognised."
It seems, then, that Nenning's symptoms were obtained in
the true way, viz., by provings on the healthy body; but that
the payment of the provers and the want of discrimination
exercised in receiving their reports throw some shade of doubt
upon the results. I cannot think, however, that they warrant
their entire rejection. The only thing which such symptoms
need is "clinical verification," testing, that is, by being used
as materials wherewith to work the rule similia similibus
curantur. If, when submitted to this test, they (as a rule)
prove trustworthy, we may safely assume them to be genuine,
and admissible into the Materia Medica. Now, we have the
testimony of three of the most industrious symptomatologists
of our school-Bönninghausen, Hering, and Wilson-that
they have found no reason to distrust Nenning's symptoms,
and have used them as satisfactorily as those of other ob-
servers. No statement to the reverse of this has come from
the other side; so that we may accept Nenning's contributions.
as at least provisionally established to be good and sound
additions to our pathogenetic material.
3. The next name on our list is that of Dr. Ernst Stapf.
This physician, one of Hahnemann's oldest and most valued
disciples, began in 1822 to publish a journal devoted to the
interests of the new method. He called it Archiv für die
homöopathische Heilkunst; but it is generally known simply
as the Archiv, or-very often-Stapf's Archiv. To this
journal the contributions most urgently called for and most
46
SOURCES OF THE
largely furnished were provings of medicines. By the time
that fifteen volumes had been published a considerable number
of these had accumulated; and it became desirable to give
them a separate form for practical use. Some of them-
notably those of Anacardium, Cuprum, Mezereum, and
Platina-Hahnemann (who had himself taken part in many
of the experiments) designed to use for the second edition of
his Chronic Diseases; and these Stapf left alone. But the
rest-in all containing twelve medicines--he published in
1836 in a volume entitled Beiträge zur reinen Arzneimittellehre,
i. e., Additions to the Materia Medica Pura. The medicines
are-
Agnus castus.
Clematis,
Coffea.
Crocus.
Ranunculus
(bulbosus and sceleratus).
Rhododendron.
Sabadilla.
Sabina.
Senega.
Teucrium.
Valerian.
All those as to which any information is given on the point
were proved in Hahnemann's earlier manner, i. e., in moderate
but substantial doses, generally taken singly. The results are
presented in the usual schema form, but with copious reference
to the separate experiments of the provers, when these are
specified. The introductions to the several medicines are full
and interesting, and contain much information about their
former uses and about such homoeopathic experience as had
been gained with them. The whole makes a very valuable
volume; and, as it has been rendered into English by Dr.
Hempel, it is available for all students.
4. I have next to speak of the Austrian provings. By the
year 1842 homoeopathy had come to number many able and
active representatives in Vienna; and it seemed to them (in
the words of one of their number) "a shame to be stretching
their indolent limbs and lolling lazily upon the couch prepared
for them by the laborious toil of the master: " they deter-
mined to have "courage to tread bravely in his footsteps, and
to pursue, with untiring patience, the path he had opened up
to them." They considered the most serious obstacle to the
practice and advance of the homoeopathic method to be the
form in which Hahnemann had given his provings to the
world, i. e., as a schema of detached symptoms, without infor-
mation as to how, or in what order and sequence, they were
obtained. They set therefore before themselves, as their main
task, the re-proving of medicines, without excluding occasional
original experiments.
HOMOEOPATHIC MATERIA MEDICA.
47
In pursuance of this object they gave us re-provings of
Aconite, Bryonia, Colocynth, Natrum muriaticum, Sulphur,
and Thuja; and primary provings of Argentum nitricum,
Coccus cacti, and Kali bichromicum. Each drug was en-
trusted to one member of the society into which they formed
themselves, who undertook and superintended the experi-
ments, and published them in full detail, with an elaborate
account of all that was known of the medicine up to the time
of writing. From twenty to thirty persons took part in every
proving; and, though trials of the attenuations were not
neglected, the great aim of the experimenters seems to have
been the development of the full physiological action of drugs
from repeated and increasing doses of the mother-tincture,
which, in the case of Thuja, even reached as much as 1000
drops at a time.
The monographs containing these most valuable provings
were chiefly published in the Esterreichische Zeitschrift für
Homöopathie, a journal conducted by the Austrian Society,
which runs through four years. Wurmb's re-proving of
Sulphur is contained in a later periodical, the Zeitschrift des
Vereins der homöopathischen Aerzte Esterreichs (vols. i and
ii). Most of them have been translated into English* with
more or less completeness. They will always be ranked
among the chief materials we possess for the construction of
the Materia Medica of the future; and the labourers at them,
of whom we may mention as pre-eminent Watzke, Huber,
Mayerhofer, Wachtel, Wurmb, Arneth, Gerstel, and von Zlat-
arovich, have written their names indelibly on the roll of the
heroes of the homoeopathic history.
While thus giving prerogative rank to the Austrian prov-
ings, it must be added that they are but one instance of the
activity of German homoeopathy in this field down almost to
the present day. Not only Stapf's Archiv, but the other
journals published in that country, as Hartlaub and Trinks'
Annalen, Griesselich's Hygea, and, later, the Allgemeine homöo-
pathische Zeitung and Vierteljahrschrift, teem with provings
and re-provings. Among the former may be mentioned those
of Berberis, Coca, Colchicum, Hypericum, Kreosote, and
Nux moschata; among the latter those of Agaricus, Chamo-
milla, Cyclamen, Chelidonium, and Euphrasia. The men
whose names stand out most prominently as conductors of
* Colocynth, Coccus cacti, and Thuja, in Metcalf's Homeopathic
Provings, Sulphur in the British Journal of Homeopathy (vols. xv.
and xvi.), and Argentum nitricum as an appendix to Hempel's trans-
lation of Stapf's Beiträge.
48
SOURCES OF THE
these experiments are Buchmann, Buchner, Helbig, Hencke,
Hoppe, Koch, Lembke, and Reil. The last great contribu-
tion to the Materia Medica we have received from this source
has been Buchmann's Chelidonium; but an endeavour to have
a thorough re-proving of Cuprum has recently been set on
foot by the Central Verein, and we hope it may bear good
fruit.
Nor has the old school of medicine in Germany been alto-
gether insensible to the exhortations and example of Jörg.
Professor Martin, of the University of Jena, has occasionally
proved medicines on his students, and published the results
obtained to this source we owe the pathogenesy of Kali
chloricum. In 1848 the Vienna Society of Physicians set
itself-in emulation of its homoeopathic "double "-to make
provings. The medicines selected were Arnica, Belladonna,
Chamomilla, and Chelidonium; and each was tested by from
five to twelve persons, taking the drugs after the manner of
Jörg. Unfortunately, "the committee
(I quote from Dr.
Dudgeon's account) "who had the drawing-up of the report of
the results of the trials cut down the symptoms of each prover
in a most arbitrary manner, and only recorded such symptoms
as were common to all or most of the experimenters." One
of these, however-Schneller by name-has given a detailed
account of his provings of the above-named drugs, and also of
some additional experiments instituted on himself with
Aconite, Conium, Hyoscyamus, Rheum, and Stramonium.
You will find his communication translated in the sixth
volume of the British Journal of Homœopathy. Besides these,
the followers of Rademacher have made a few provings; their
experiments with Ferrum have been translated in the ninth
volume of the same journal. More recently Professor Schroff,
though giving his attention mainly to experiments with drugs
on animals, has not been unmindful of the value of occasionally
instituting them on the human subject, and has given us
(especially from Aconite) some valuable provings.
Before passing to the other chief scene of homœopathic
provings the United States of America-let me say a few
words as to what has been done of the kind in the rest of the
countries into which the method of Hahnemann has pene-
trated.
The only original pathogenesis of note which France has
given us is that of Quinine by Dr. Alphonse Noack; and the
two great compilers of Materia Medica in that country have
been Drs. Roth and Jahr. All these three names point plainly
HOMEOPATHIC MATERIA MEDICA.
49
肇
​to the German extraction of their bearers. Some indigenous
proving, however, has been done by Pétroz, Ozanam, Teste,
Molin, and Imbert-Gourbeyre; and published in the French
homoeopathic journals.
England has contributed little more to our pathogenetic
treasury. The Kali bichromicum of Drysdale, the Naja of
Russell, the Cedron of Casanova, the Cotyledon umbilicus of
Craig, and the Uranium nitricum of Edward Blake—these are
all the provings of any note of which we can boast during the
forty and more years in which homœopathy has been prac-
tised in this country.
Still less can be said of Spain and Italy, which have only
given us (so far as I know) one medicine each-the Tarantula
of Nuñez from the former and the Cactus of Rubini from the
latter. From Brazil we have received a collection of provings.
of the plants and animal venoms indigenous to that country
instituted by Dr. Mure, of Rio. They are of obscure origin
and doubtful value; and hardly one of the substances tested
has come into general use. Still more dubious are the
Nouvelles Données of Dr. Houat, of the French island of
Réunion. If you will read the review of his first volume in
the_twenty-seventh volume of the British Journal of Homœo-
pathy, and will then verify the suspicions expressed by looking
through a few of his pathogeneses as given by Dr. Allen in
his Encyclopædia, you will not wonder that the latter generally
(I could have wished it had been always) places them in an
appendix by themselves, as unworthy to rank with the bond
fide experiments derived from other quarters.
5. I come now to the American sources of the Homœo-
pathic Materia Medica; and the first and most illustrious
name on the record is that of Dr. Constantine Hering. I
should suppose that the number of medicines in whose proving
this physician has taken a more or less principal part is only
less than that which we owe to Hahnemann; and though the
latter, being first in the field, has given us most of our greatest
remedies, yet we cannot forget our debt to Hering for Lachesis,
for Apis, and for Glonoin.
I believe that a good many of Dr. Hering's provings remain
in manuscript to this day; and I hope that, in spite of his
already venerable age, he may live to publish them. Those
which have already seen the light are contained in the Transac-
tions of the American Institute or the American Homeopathic
Review, or they appear in one or other of his two separate
publications-the Amerikanische Arzneiprüfungen and the first
1
E
50
SOURCES OF THE
(and as yet only) volume of his Materia Medica. The former
is written, as its name imports, in the German tongue, Dr.
Hering having originally come from that country. He began
to issue it, in parts, in 1852; and, when discontinued, it had
come to contain monographs on twelve medicines-most of
them new to homoeopathy-embracing clinical observations as
well as pathogenetic effects. Among the drugs included I
may mention Benzoic acid, Aloes, Apis, Allium Cepa, Glonoin,
and Millefolium. The greater number of these have been
translated in one or other of our journals. In 1869 Dr. Hering
set on foot the American Journal of Homœopathic Materia
Medica, with the design of appending thereto another series of
monographs on medicines. He ceased to do so when sixteen
of these had been completed, and then published them separ-
ately as the volume of Materia Medica which I have men-
tioned. Besides elaborate arrangements of several of our old
remedies-as Cuprum, Spongia, and Stramonium-it gives us
the Biniodide of Mercury, Natrum sulphuricum, and Osmium.
I have omitted to mention Dr. Hering's first publication,
which dates as far back as 1837. It is his Wirkungen des
Schlangengiftes—a full collection of the observed phenomena
of snake-bites, together with provings on the healthy subject
mainly instituted with Lachesis, which great remedy he thus
introduced to medicine.
But, while all would give the precedence to this honoured
name among the American contributors to our Materia Medica,
it is far from standing alone. In the earlier period those of
Neidhard, Jeanes, Williamson and Joslin may be named in
association with it: in later times those of Dunham, Allen
and Conrad Wesselhoeft-not to mention Dr. E. M. Hale, of
whose work I must speak separately. The chief instigation
and collection of the provings of the United States has pro-
ceeded from the American Institute of Homœopathy. This
association, at its first meeting (under Dr. Hering's presidency)
in 1846, appointed a “bureau
bureau" (or committee as we should
call it) for the augmentation and improvement of the Materia
Medica. The first fruit of its labours was the volume entitled
Materia Medica of American Provings, whose third edition I
now lay before you. It contains the original provings of the
Benzoic, Fluoric, and Oxalic acids, of Kalmia, Podophyllum,
Eupatorium, Sanguinaria, and several other important drugs.
From that time to this, the Transactions of the Annual
Assembly of the Institute have rarely failed to contain fresh
provings furnished by its Bureau of Materia Medica, down to
those of Physostigma and Sepia which constitute its chief
HOMOEOPATHIC MATERIA MEDICA.
51
labours for 1874 and 1875 respectively. Provings have also
formed a prominent feature in many of the American journals.
Excellent material for them is now afforded by the students of
both sexes who flock to the homœopathic colleges of the
States; and the teachers of Materia Medica therein have not
been slack in availing themselves of their opportunities.
""
6. A new fountain of Materia Medica was opened in 1865
by Dr. E. M. Hale, of Chicago. For some years previously
his attention had been drawn to the mine of remedial wealth
which existed in the indigenous plants of his country. A few
only had been proved and employed in the homoeopathic
school; but all around him he found them in constant use by
the common people, and by the "botanic" and "eclectic
practitioners-cures often resulting from them where both
allopathy and homoeopathy had failed. He determined to
collect into one volume all pertinent information regarding the
principal medicines thus obtained, to reproduce old and
institute new provings, and to present all trustworthy recom-
mendations and experiences as to their use. The result was
the volume entitled New Remedies in Homoeopathic Practice.
It obtained great success, so that in two years a second
edition was demanded. This appeared in 1867, following the
same order as the first, but incorporating all fresh facts that
had come to light, and adding thirty-five more medicines to
the forty-five previously published. In 1873 a third edition
was issued, in which (very unwisely, as I think) the materials
previously collected were boiled down to a list of (so-called)
"characteristic" symptoms. But in the fourth and latest form
which the work has assumed this error has been retrieved.
The first volume, indeed-entitled Special Symptomatology—
is of the same character as the third edition. But in the
second volume, or Special Therapeutics, history, account of
provings, testimonies of authors, and narratives of cases have
been restored. We only want the detailed provings of the
second edition to make the work complete.
I do not hesitate to say that by these publications Dr. Hale
has rendered an inestimable service to homœopathy, and
thereby to the art of medicine. There has been plenty of
severe criticism on his indiscriminate collection of material,
his too fond estimates of his new treasures, and the assump-
tions in which he has sometimes indulged. But these are
small matters compared with the actual enrichment of our
remedial treasury which has been effected by his means. We
really owe to him Actæa, Esculus, Apocynum, Baptisia,
Caulophyllum, Collinsonia, Dioscorea, Eupatorium purpureum,
52
SOURCES OF THE
Gelsemium (as Dr. Allen will have us call it), Hamamelis,
Helonias, Hydrastis, Iris, Phytolacca, Sanguinaria, and Vera-
trum viride. It is no abatement of this obligation to say that
some of these had been known previously, and that none have
been actually proved by Dr. Hale himself. It was his book
that made them current coin, wherever they had been minted
before; and it was he who incited the new provings, though
he acted only as their promulgator and expositor. The school
of Hahnemann in every country owes him hearty thanks for
all this; and allopathy is beginning to share our gain.
I would advise students, until they can obtain the fifth
edition (which I have reason to believe will meet every
requirement), to endeavour to procure a copy of the second,
supplementing it, if possible, by a perusal of the second volume
of the fourth.
7. I have now mentioned all the primary sources of the
special Materia Medica of Homœopathy. In doing so I have
had to bring before you more than a score of separate
volumes, besides referring to whole series of Journals and
Transactions. You will naturally ask whether no attempt has
been made to bring these multitudinous and scattered provings
into one collection, so that they may be accessible to the
student and available for use by the practitioner. This brings
me to the last name in my list to-day, that of Dr. Allen of
New York.
Our only codices of symptomatology hitherto had been
those of Jahr and of Noack and Trinks. Both date from thirty
years ago; and were at the best abridgements. They were of
great use in their time, but have long been superannuated.
In 1874, however, a work was commenced which it will take
many decades to make obsolete, and which gives us our whole
pathogenetic treasury in full. I speak of the Encyclopædia of
Pure Materia Medica, whose ten volumes are now before you.
Here, under the head of each drug, are collected all the symp-
toms obtained from it by every prover who has tested it, from
Hahnemann down to the latest student of the American
colleges. All are copied, translated, and arranged afresh; and
every available information is given regarding the circum-
stances under which they occurred. Nor is this all. Dr.
Allen has made a new collection of symptoms observed from
poisoning and overdosing, as recorded in medical literature since
Hahnemann's day; and has thereby greatly enriched many of
our old pathogeneses, and originated no small number of
fresh ones. The work has been improving as it has gone on ;
and now that it is completed, it forms a treasury upon which
HOMEOPATHIC MATERIA MEDICA.
53
the homoeopathic practitioner will thankfully draw for many
years to come.
We may partly estimate the value of Dr. Allen's volumes by
comparing them with the only work of the kind we have
hitherto possessed in English, Jahr's Manual. I speak not so
much of the greater completeness of the present Encyclopædia,
as of its manner of presenting its material. Jahr gave us a
mind-burdening, a heart-breaking list of bare symptoms,
without hint of the manner in which they were obtained or the
subjects in whom they appeared. They were themselves but
a selection from the original pathogeneses, our sole warrant
for the choice made being the judgment of the compiler.
Interspersed with them were numerous so-called "clinical
symptoms,” obtained by breaking up the features of cases
reported as cured by the drugs into their component elements,
and sowing these in their appropriate plot in the schema.
This hideous composition, which has been fitly styled "non-
sense made difficult," was, I say, for many years the only
general Materia Medica available for homoeopathists of the
English speech. Contrast it with what we have now. To
every symptom Dr. Allen gives us (none but physiological
ones being admitted, and none of these omitted) a number is
attached, which refers to the observer who warrants it.
Appended to his name is a statement, whenever such informa-
tion is to be had, of the form and dose of the drug used, and
the subjects to whom it was administered; while the thousands.
of symptoms cited by Hahnemann from authors have received
all possible illumination and revision from their originals.
I earnestly recommend all students of homoeopathy to
possess themselves of Dr. Allen's Encyclopædia; but I do not
advise them to content themselves therewith. No collections
of symptoms, however thoughtfully made, can convey the
same instruction to the mind as the original records of
provings. Procure then (I would say), or seek access to as
many as possible of the primary sources of our knowledge
which I have characterised, and to which Dr. Allen's book will
refer you in the case of each drug. Read the day-books of
the provers (where we have them), and such narratives of
poisoning as are collected in Frank's Magazin, in Dr.
Hempel's Materia Medica, and in the "Pathogenetic Record"
which the industry of Dr. Berridge is now giving us as an
appendix to the British Journal of Homeopathy. You will
thus obtain that enlightened general knowledge of the action
of medicines which, and which alone, will enable you to use
the Symptomen-Codex aright.
LECTURE IV.
THE GENERAL PRINCIPLES OF DRUG-ACTION.
I think it well to occupy you, even yet, with considerations
of a general and preliminary character. It has occurred to
me more than once, when speaking in time past of the action
of special drugs, that we ought to have some mutual under-
standing on the principles of drug-action in general. I pro-
pose, therefore, in this and the following lecture, to ask your
attention to a brief exposition of my way of looking at this
subject, that you may know with what thoughts-whether
correct or not-I am wont to analyse the phenomena pre-
sented to us by the working of medicines in the organism.
I would begin by reminding you that the basis of all our
knowledge on this point must be the science of physiology.
Physiology tells us of the healthy substance and functions on
which drugs act: we cannot begin to think of the manner in
which they disorder unless we understand the order they
derange. This, thanks to the unwearied labours of several
generations of students, is very largely known. Some portions.
of it, indeed, are still obscure: some are yet of doubtful signi-
ficance. But a large tract is fully open to our gaze, and there
is substantial agreement as to its general features. It would
be quite beyond my province to sketch here, however briefly,
the special physiology of the body. But there are certain
general principles regarding it which I must recall to your
minds; if for no other purpose, at least to define the basis on
which my reasonings about drug-action will rest.
First of all, then, I conceive it must be postulated that this
organism of ours is not alive throughout and in every part. I
do not know what is the teaching now given in the schools as
to the nature of life. For myself, I hold what is called the
"protoplasmic theory"; and, whatever modifications may be
required in the time to come as to its details, I think there can
be no doubt of its substantial truth. Consider the difference
between hair and nails at the one extreme, and the amœboid
white corpuscle of the blood at the other. It is obvious; and
GENERAL PRINCIPLES OF DRUG ACTION.
55
we may follow either inwards or outwards as the case may be
for some distance, ere we come to a region of doubtful import,
where there may be gradual transition or a sudden transfor-
mation. All on one side is life: on the other, it is non-life.
Now this white corpuscle, which I have taken as the type of
living matter, is a structureless, transparent, colourless, semi-
fluid substance, consisting of minute spherical particles, of very
complex chemical constitution, and in continued spontaneous
movement. Such is living matter everywhere, whether it be
naked, as here, or, as in other parts (the cell for instance),
associated with material of another kind. The cell-wall may
be taken as a type of this other substance. In it there is the
beginning of structure, of rigidity, and perhaps of colour. It
is "formed material," and so far has passed from life to death,
and has become the subject of chemical and mechanical laws,
of which in its living state it was independent. Such formed.
material constitutes the great bulk of the organism, both of
animals and of plants, and determines the manner and fashion
of their lives. But that which, in all and everywhere, lives the
life is the protoplasm itself, the same whether animal or
vegetal, the germinal matter which, like a soul, forms its own
body, inhabits, and animates it.
To this protoplasm life belongs, as elasticity belongs to
india-rubber. Life is not a force, playing about it only at
times, and capable of interchange with other forms of energy :
it is its fixed, inherent property, never to leave it as long as it
maintains its own integrity. This is the doctrine long ago
taught by Fletcher of Edinburgh. It has been-so far as the
restriction of vitality to protoplasm goes-re-originated in the
present day by Dr. Lionel Beale, and established by him on
the basis of physical demonstration. He, however, regards
the life here manifested to be an independent entity, a quasi-
soul. Dr. Drysdale, from our own school, has taken up the
subject; and, while showing the essential harmony of Fletcher
and Beale, and the truth of the doctrine on which they agree,
has (to my mind) irrefutably argued the preferableness of the
position of the former as to the nature of life itself. I would
refer you to his works "On Life and the Equivalence of
Force" and "The Protoplasmic Theory of Life" for a full
exposition of the subject.*
*
Now this protoplasm, as it is the only vital substance, so
does all the vital work of the organism. There is, of course,
* See also what Dr. Drysdale justly calls a "brilliant essay
“brilliant essay" on this
matter, by Dr. Madden, in the fifteenth volume of the Monthly Homœo-
pathic Review.
56
GENERAL PRINCIPLES OF DRUG ACTION.
plenty of mechanical and chemical work done there; but with
this we are not at present concerned. It is protoplasm which
effects all those operations which belong peculiarly to living
bodies. It is the formative agent for all their tissues: accord-
ing to its situation it dies into (to use Dr. Beale's graphic
expression) nerve, muscle, epithelium, areolar tissue, bone.
And, lest by such continuous drain on its material it should
dwindle away, it has the power of taking up fresh pabulum
from the blood, and converting it into its own substance. It
has been itself in other situations the appropriator of the food
from the digestive canal and its elaborator up to the point at
which it reaches the tissues; and now, by a final act of assimi-
lation, it lays hold of it in its altered form, and absorbs it into
itself, to reappear as the tissue it has to make. Thus the
whole process of nutrition, from the time that the mechanical
and chemical acts of digestion are over--the chain of opera-
tions consisting of chylification and sanguification, of the
taking up of the blood-plasma by the tissues, and the forma-
tion from it of new material-all this is the work of proto-
plasm. No less is secretion performed by it. Secretion is but
nutrition under altered conditions. It is merely that the
matter appropriated by the glandular cells is formed by them
into bile, saliva, and so forth, instead of into bone and muscle
and skin. The process is the same, and the proceeder is the
same—the everywhere-present, everywhere-active protoplasm.
And as protoplasm is the agent in nutrition and secretion, so
is it the seat of vital function. It is this which, in the gray
substance of the nervous centres, enables us to think and feel,
which receives impressions and conveys volitions. It is this,
in all probability, which contracts in the muscles. Wherever
we have living action-action impossible to the same body
when dead, and unknown in the extra-vital world-there we
have protoplasm at work.
I have said that protoplasm exists alike in the vegetable
and the animal-in either the basis of organic life. But there
is this difference, that in the former it stands as it were on a
common level, while in the latter a portion of it is differentiated
into a system previously unknown,-the nervous. This new
organism (for so we may call it), while it lives its own life and
carries on its own operations of nutrition and function, exerts
a regulating influence over the vegetative processes which were
before it and are beneath it. Though they be for their own
affairs independent of it, yet they all acknowledge its sway.
By its control (through the muscular coats of the arteries) of
the circulation it determines the all-important blood-supply of
GENERAL PRINCIPLES OF DRUG ACTION.
57
the tissues; and if (as is most probable) there are secretory
and trophic nerves, ending in the cells themselves, it must
influence them still more directly.
This will suffice for our physiological basis. But, before we
go on to build upon it any theory of drug-action, we must
dwell awhile in the region of pathology. Pathology is physi-
ology altered by the causes of disease in general, as patho-
genesy-pharmacology we may call it for analogy's sake—is
physiology altered by drugs. Hence the one cannot but
throw much light upon the other. Since, moreover, pathology
tells of that very disorder which by means of our remedies we
seek to restore to physiological order, it is evident that we
must have clear conceptions and substantial agreement about
its principles ere we advance to the therapeutical side of phar-
macodynamics.
Now as we have seen physiology largely concerned with the
doings of protoplasm, so also pathology must be. If there
are any diseases primarily mechanical or chemical, in these of
course it would not come into account. But as most, if not
all, of the maladies to which flesh is heir are disorders of vital
processes-alterations in nutrition, secretion, or function, pro-
toplasm must be the seat of these also. Let us see how it is
in the two most frequent forms of disease, inflammation and
fever.
1. The most obvious fact about inflammation is the change
in the circulation of the affected part; the dilatation of its
blood vessels, the throbbing of its afferent arteries, its own
redder colour and heightened temperature. It was natural to
suppose that this vascular disturbance was the prime factor of
the process; that inflammation consisted in increased deter-
mination of blood to a part, and consequent functional change.
But experiment has shown that such elements do not of them-
selves constitute inflammation. The circulation of a part may
be greatly exaggerated by dividing its vaso-motor nerves, and
its colour, temperature, and nutritive and secretory operations
enhanced in proportion; but no inflammation need occur.
The blood flows through it more rapidly, instead of having its
current retarded; and there is an entire absence of exudation,
and of swelling or pain. On the other hand, let an irritant be
applied to a given spot, or conveyed thither by the circulation.
There is the same dilatation of vessels and increased afflux of
blood; but at the seat of irritation stasis soon supervenes, and
liquor sanguinis and corpuscles begin to be extravasated. If
any secretion is carried on there, it is (at least as far as the
production of fluid is concerned) diminished even to arrest,
58
GENERAL PRINCIPLES OF DRUG ACTION.
and nutrition, though still exaggerated, is perverted. There
is, in Hughes Bennett's words, increased attraction but dimin-
ished selection; and formation is hurried, but imperfect. What
can we conclude but that the protoplasm of the part is the
seat of the irritation; that the circulatory changes are subsi-
diary only, and the real seat of inflammation is (as Lister and
Virchow teach) the extra-vascular tissues? Nor is this less
true when division of the vaso-motor nerves of a part does
cause inflammation; which obtains when the subject of ex-
periment is already in a weak state, as from partial inanition.
The new factor which allows the process to be set up is still
the protoplasm of the tissues, which in its feeble state seems
unable to bear the stress of the active hyperæmia and its
consequences. Here, however, the inflammation is primarily
neurotic in origin, while in the case of the application of
irritants it begins in the organic cells of the part affected.
2. We have a corresponding series of facts in regard to
fever, which is-as Fletcher long ago pointed out-inflamma-
tion in the system at large. Here, too, the circulatory dis-
turbance is that which arrests the attention, and by which the
older observers sought to explain the phenomena. In dilata-
tion of the blood-vessels throughout the frame, preceded or not
by their contraction, with quickened action of the heart, they
thought they had all the necessary elements of the case. But
experiment now proves that we may have these conditions
without any fever necessarily being associated with them.
They may be induced, for instance, by paralysis of the arteries,
brought about by removal of the vaso-motor centres. The
result of this proceeding is to make the subject of experiment
very sensitive to its environment. If the animal be placed in
a hot room, it does become feverish, and probably the same
thing would occur if it were in feeble health; but if the sur-
rounding temperature be lowered, its own bodily heat falls in
proportion, and it may readily die from very moderate cold.
Clinical observation, moreover, ascertains that increased heat
of the blood itself is the real essence of fever; that the febrile
chill, when it occurs, is the first sign that such increase has
begun; and that the subsequent hot period, as also its several
common phenomena, depend upon the heightened temperature
of the blood stream, and vary with its intensity. Then, going
a little farther back to ascertain the cause of the augmented
heat of the blood, we find preceding it as well as accompany-
ing it throughout evidence of increased metamorphosis of
tissue. That this precedes the rise of temperature shows that
it is not caused by it: on the other hand, physiology tells us
GENERAL PRINCIPLES OF DRUG ACTION.
59
that it may well be its cause. We can follow Dr. Burdon
Sanderson, therefore,* when, after examining all the elements
of fever, he comes to the conclusion that at present we must
be content to refer it to increased heat-production, and to
connect this with the tissue-changes occurring in the proto-
plasm. Here, however, as with inflammation, the whole pro-
cess may begin in the nervous system, and reach the tissues
only secondarily; or, on the other hand, the tissues themselves
may initiate the morbid action. The former is probably the
history of the catarrhal fevers, the latter of those of toxæmic
origin.
I need hardly tell you that fever and inflammation, in their
various forms, lie at the bottom-constitute the proximate
cause of a very large proportion of the diseases we have to
treat. The remainder are mostly "functional" disorders-
increase, diminution, or irregularity of the action of the various
organs of the body. As protoplasm has been seen to be the
seat of function also, we are not beyond its sphere when deal-
ing with these disorders. The only difference is that we have
now to do with its vis rather than its substantia, with the
energy it puts forth rather than with its own internal opera-
tions of appropriation, assimilation, and transformation of
pabulum. Inflammation and fever belong to it as the agent
of nutrition; neuroses, spasms, and such like derangements
may be connected with its functional duties. And here a word
about secretion. This process, though merely nutrition under
altered conditions, by this very alteration comes somewhat
within the domain of function. It may be altered by inflam-
mation or fever, but it is easy to conceive of it as having a
plus and minus of its own, independent of these processes,
independent even of the state of its blood-supply. We must
bear this in mind when discussing the influence of drugs on
glandular organs.
It follows, from what has been said, that every organ of the
body is a complex whole, admitting of being reached in various
ways. Its own inherent living matter may be affected; and
this either by its nutrition being disordered in the special
manner we term inflammation, or by its functional activity
being altered in the direction of plus or minus. Again, all these
changes may be effected by the agency of the nervous system.
We do not need nervous intervention, indeed, for the sufferings
any more than for the actings of protoplasm; and an exclusive
neuro-pathology would be as false as a neuro-physiology.
But by the influence of the nervous system of which I have
* See Practitioner, vol. xviii.
Go
GENERAL PRINCIPLES OF DRUG ACTION.
spoken, certainly upon the blood-supply, and probably also
upon the actual substance of the tissues, both nutritive and
functional disturbance may be brought about. Yet again, the
nervous protoplasm may itself be the seat of trophic change;
and its functions, as also those of other parts, may be affected
secondarily through altered nutrition, as by the supervention
of inflammation or fever.
These, gentlemen, seem to me to be the physiological and
pathological data required for the construction of a theory
of drug-action; and to that task I shall now address myself.
All writers on the subject begin by distinguishing between
the mechanical, the chemical, and the dynamic effects of drugs.
The distinction is as true as it is obvious, and the ground of it
is not far to seek. Drugs can act mechanically and chemically
upon the body because a large portion of it, being no longer
alive, has come under the dominion of mechanical and
chemical laws. And that they have another action over and
above these exactly corresponds with that which physiology
has shown us, viz.: that there is in every organism, animal or
vegetal, a certain proportion of living matter, exempt from the
operation of merely physical laws, and subject to actions and
re-actions all its own. The dynamic influence of drugs is
exerted upon the living matter of the body-upon its proto-
plasm. And upon this as such. It does not (as is some-
times supposed) affect the nervous system only, for it manifests
itself to a large extent in plants, which have no nerves.
Nervous protoplasm may be the primary seat of the influence
of any drug, and other changes may be secondary to its
disorder; but no less may the same living matter anywhere
else be attacked in the first instance, and without such medium.
It is with these dynamic effects of medicines that homœo-
pathy, as a distinctive method, has to do. Homœopathists
-so-called because they acknowledge the rule similià simili-
bus and its practical corollaries to be by far the most important
thing in therapeutics-may have at times to avail themselves
of the mechanical and chemical influences which drugs can
exert; and they, as well as others, must understand these, and
know how to apply them when they are needed. But the
method they predominantly follow is concerned with the
dynamic actions of medicines only; and to these, accordingly,
my further remarks must be understood exclusively to refer.
Drugs act upon protoplasm; but in so doing they make
manifest that which is otherwise ascertained to be true, that
all protoplasm is not the same protoplasm. They do not
affect all parts of the body indiscriminately and alike, but
GENERAL PRINCIPLES OF DRUG ACTION.
6I
select one or more organs or tissues or regions, and there
expend their power. This elective action of drugs is no
novelty; it has been made the foundation of a system of
practice by Rademacher, who himself traces the thought to
Paracelsus.* But it receives very little recognition in the
orthodox school of medicine, and even in homoeopathic
philosophy has hardly taken the place it deserves. We are,
in this country, much indebted to Dr. Sharp for his insistance
on the truth of the local action of drugs. I hope you are all
acquainted with this author's "Tracts," which are about the
best exposition and defence of homoeopathy we possess. He
has in later years devoted himself to an enquiry into the
basis of the system; and you will do well to read the volume
of Essays in Medicine (1874) in which most of his work at the
subject is contained. But previous to the appearance of his
essays insisting on this point, Dr. Imbert-Gourbeyre had, in
his Lectures Publiques sur l' Homœopathie (1865), called atten-
tion to the same fact, and formulated it as the "law of
electivity." Dr. Drysdale also has laid much stress on what
he calls "specificity of seat," connecting it with the special
irritability displayed by the various parts for their natural
stimuli and for causes of disease, and extending it to the
minutest localities or nerve-branches which have anything
independent and special about them.† In quoting this phys-
ician now, I am referring to a series of papers of his extending
through the twenty-fifth and two following volumes of the
British Journal of Homœopathy. They are weighty with solid
and original thought; and I commend them to your earnest
attention.
In relation to these Wahlverwandschaften-these elective
affinities existing between drugs and organs, we must observe
the caution that we do not infer them from manifestations of
topical action only, however strong they may be. A substance
when swallowed may inflame the stomach and intestines;
when inhaled, it may set up coryza, cough, even bronchitis ;
when applied to the skin, erythema or eczema may result,—
but we cannot therefore infer its specific influence upon these
cutaneous or mucous tracts, and give it homœopathically for
their corresponding morbid states. We might do so, indeed,
if we applied it locally as a remedy also; but not if we
administered it by any indirect channel. We can only demon-
strate the elective action of a drug on a given part by intro-
* See Brit. Journ. of Hom., viii., 253; Monthly Hom. Review,
Nov., 1879.
† See Brit. Journ. of Hom., xxvii., 86.
62
GENERAL PRINCIPLES OF DRUG ACTION.
ducing it into the circulation at some other point, as when
gastritis results from Arsenic applied to an ulcer, duodenitis
from Podophyllin inserted into the peritoneal cavity (the
serous membrane itself being unharmed), bronchitis from
Kali bichromicum swallowed, eczema even on covered parts
from the emanations of Rhus. We know then that, how-
ever taken, it will go to its proper mark, that it is a
bullet which has its billet, and will assuredly find it. We
shall have abundant illustration of this distinction between
specific and merely topical actions as we proceed.
Special seat of action is the first fact about the behaviour of
drugs, and special kind of action is the second. Dr. Drysdale
has dwelt upon and illustrated what he calls the qualitative
action of drugs at considerable length. He shows that as there
are specific as well as common inflammations, so there must
be medicines related to the special quality present as well as
to the generic lesion-medicines appropriate to gouty, rheu-
matic, and syphilitic inflammation in virtue of some peculiar
similarity to the element which makes them what they are.
He goes on to make some very interesting remarks on the
fact of certain remedies being specially indicated by the
rature of the exciting cause of the morbid condition to be
treated—as Arnica when this is mechanical injury, Dulcamara
when it is damp cold, and so forth. He argues that there
must be a qualitative difference in the affections produced by
these various causes, and a corresponding one in the drugs
which thus become their best remedies. He also points out,
as others have done, that at the same seat there may be set
up very different pathological processes; that the intestines,
for instance, may be affected by cholera, common diarrhea,
the typhoid process, tubercular ulceration, and dysentery, and
require different remedies accordingly to modify their dis-
order.
K
So far I am entirely at one with Dr. Drysdale. But I go on
to make another distinction as to the kind of action of drugs
which he refuses to recognise. He maintains Fletcher's
doctrine that all drugs are stimuli, analogous to the natural
agencies so-called-heat, light, &c.-which, acting on the
excitability of organic matter, evoke the phenomena of life.
Any symptoms of depression which appear in the course of
their action he explains as signifying exhaustion following
upon over-stimulation. Now I cannot think that this view of
drug-action is borne out by facts. Take such a substance as
the nitrite of amyl, whose effects when inhaled are immediate.
We all know the general flushing of the surface which ensues,
GENERAL PRINCIPLES OF DRUG ACTION.
63
and agree to ascribe it to dilatation of the arteries from relaxa-
tion of their muscular coats. What is this but primary
depression, whether the drug's influence fall (as I think it
does) on the vessels directly, or through their nervous supply?
It may be suggested that the amyl really acts as a stimulant
to those vaso-dilator nerves which recent research has dis-
covered in connexion with certain vascular areas, and which
may exist throughout the circulatory system. But the proof
that it is otherwise lies in the fact that, simultaneously with
the flushing it excites, the inhalation of the amyl nitrite
causes relaxation of any spasm that may exist, as that of
angina pectoris or of dysmenorrhoea. As no dilator nerves
can be conceived to exist here, the hypothesis of a primary
sedative influence seems the only one applicable to the whole
group of phenomena. The same thing may be said of the
action of Curare, Conium, Physostigma, and Gelsemium upon
the musculo-motor nerves and centres. There is ordinarily no
trace of excitation here from first to last. Claude Bernard,
indeed, laid it down that "every substance which in large
doses abolishes the property of an organic element stimulates
it if given in small ones;" and so some evidence of augmented
energy may occasionally appear in experiments made with
these motor depressants. It is too slight, however, for the
subsequent paresis to be ascribed to exhaustion following
over-excitement; and I shall ere long have occasion to argue
that it is a reaction of the organism against doses too feeble
to induce the direct effect of the drug.
I must maintain, therefore, that while many drugs are
primarily stimulant to the tracts they influence, others are
primarily depressant. And I must draw a further distinction
between stimulants and irritants. Stimulants excite function,
irritants inflame tissue. Strychnia is an excellent example of
the former class. It powerfully excites nervous tissue, motor
or sensory, wherever it finds it: mobility and impressionability
are both morbidly heightened, but there is no inflammation.
On the other hand, substances like Arsenic, Iodine, and
Cantharides have no definite action upon function; but they
inflame tissue wherever they are locally applied or electively
attracted. They act (we may suppose) in the latter case like
other internal causes of the process. Conveyed in the circula-
tion to the part for which they have affinity, they there act
upon the protoplasm, and fret it into that morbid and blind
activity in which I apprehend inflammation to consist.
There are three things, then, which drugs can do with proto-
plasm. They can affect its functional operations simply, and
64
GENERAL PRINCIPLES OF DRUG ACTION.
this either by exciting or depressing them; or they can induce
that morbid change in its work of nutrition and tissue-making,
which (in its full development) locally we call inflammation,
and generally fever. The function-modifiers are those drugs
which, from their giving rise to nervous phenomena chiefly or
solely, we call neurotics; and I should add to them the
myotics, which seem to influence directly the unstriped mus-
cular fibre, as Secale does, and perhaps some direct excitants
of certain secretions, like Jaborandi. The modifiers of nutri-
tion form a still larger collection. To this belong all those
substances which Toxicology classes as irritants, so far as their
irritation is not a mere chemical effect, as with the strong
mineral acids. That they act topically only, and not when
introduced into the circulation, would not disqualify them for
this place; but they must be used topically as remedies also.
There are many true irritants, however, of which Toxicology
knows nothing; for they produce no dangerous effects. Nor
would they be discovered by the method which has recently
come into so much favour-of experiments on the lower
animals with large single doses. In this sphere they can only
be recognised by persistent administration over a length of
time, as carried out by Wegner with Phosphorus, and by our
colleague, Dr. Eugéne Curie, with Bryonia and Drosera. But
the main source of knowledge regarding thern is proving on
the healthy human subject. It is thus that we get a number
of drug effects which are not explicable on the supposition of
a plus or minus state of any function, but which, if not inflam-
matory or febrile in the full sense of the words, at least show
signs enough of these morbid conditions to evidence a power
on the part of the drugs of causing them, if pushed far enough,
and to lead us, on the principle of similarity, to give such
remedies for their cure. There is many a feverish condition in
childhood which yields to Calcarea, and many a smouldering
inflammation put out by Sulphur.
I would divide drugs, then, in their influence upon proto-
plasm-in other words, their dynamic operation-into two
classes, those which affect its performance of function, and
those which disorder its nutritive processes. There are, of
course, many drugs which belong to both classes, as Toxicology
recognises in naming some poisons acro-narcotics. Each sub-
stance must be separately studied, and examined on its own
merits. But the classification I have proposed, whether affect-
ing the whole or only a part of the actions, is no less valid.
It fits in, moreover, with an important distinction in the
dynamic effects of drugs which has been much insisted upon
A
GENERAL PRINCIPLES OF DRUG ACTION.
65
both by Dr. Drysdale and Dr. Madden. The latter, regarding
chiefly the fact that some properties are common to a number
of drugs-as emesis, purgation, and the like-and others.
peculiar to individuals, has named them genico-dynamic and
idio-dynamic respectively.* The former, pointing out that the
common dynamic effects of medicines are producible at will,
while the peculiar ones depend for their production on the
presence of a special susceptibility in the subject, would call
the one absolute and the other contingent. Now I think that
if these generic actions of drugs, producible at will, be ex-
amined, they will all be found to belong to functional excita-
tion or depression; while the peculiar effects, which require
special susceptibility, are nearly, if not quite, always disorders.
of nutrition. The subcutaneous injection of atropia, for
instance, will always dilate the pupil, always depress the in-
hibitory influence exerted upon the heart by the pneumogastric.
But it is only in this individual or in that that it produces a
scarlatinal rash or an inflamed throat, that it induces neuralgic
pain or excites fever. Dr. Drysdale has forcibly pointed out
that it is the contingent effects of medicines which we chiefly
use in applying the law of similars, their absolute actions being
often entirely incongruous therewith. "For example," he
writes, "if we are watching a group of chest symptoms pro-
duced by Tartar emetic, or the characteristic pustular erup-
tion on the skin, and suddenly a large emetic dose is given,
though the whole action is certainly that of Tartar emetic, yet
if we admit the vomiting as a part of either morbid picture,
we should be unable to comprehend it." Trousseau and
Pidoux, viewing the matter from Dr. Madden's stand-point,
make a similar remark upon the relation of the two orders of
symptoms to those of disease. "In special medicines, in
medicines properly so called, above all in poisons, we find two
elements. They enjoy properties which belong to the whole
genus; these are their common properties, which scarcely
excite in the organism more than common and general action,
as to stimulate, irritate, weaken, calm, etc.
But they possess,
beyond this, special properties peculiar to each, and which
excite in the organism morbid actions more or less resembling
the symptoms of disease." Dr. Imbert-Gourbeyre, without dis-
tinguishing between the absolute and contingent effects of
drugs, lays much stress on the latter, and adds contingenter to
the similiter and elective in which he formulates homœopathic
action.
He also adds omni dosi. Dr. Drysdale agrees with him, and
* See Brit. Fourn. of Hom,, viii., 13.
F
66
GENERAL PRINCIPLES OF DRUG ACTION.
shows that herein lies another distinction between absolute and
contingent symptoms, the former requiring the drug to be
given in a certain quantity for their production, the latter
being singularly independent thereof. You may, in proving a
medicine, reduce the dose until its recognised physiological
effects cease to appear; but, unless the subject of experiment
be insusceptible to its action, he will manifest one or more of
the peculiar phenomena which belong to it. Trousseau and
Pidoux, also, say of the "special effects" of drugs which they
recognise, that "if we wish to obtain them, small doses must
generally be administered, for then the common effects are
very little perceived." Dr. Drysdale believes that the same
independence of quantity holds good in disease; and that,
where a condition resembling the contingent effects of a drug
is present, you can hardly (within certain limits) give so small a
dose as to fail to benefit, or (and this is a new point) so large
a dose as to aggravate. Everything depends on the special
susceptibility of the part; and, this once exhausted, the
medicine has no longer any influence upon it. He illustrates
this view by a case in which Glonoin, given for a neuralgia
because of the presence of some of its characteristic physio-
logical effects, caused its well-known throbbing headache,
without aggravation-and rather with amelioration-of the
troubles for which it was administered. He thus extends the
omni dosi of Dr. Imbert-Gourbeyre's formula to the other
extreme also of the scale. A similar thing appears in provings.
You will see ever and anon in Hahnemann's pathogeneses the
term "curative effect" applied to a symptom. This does not
mean (save sometimes in the quotations from authors, as under
Iodium) the result of the administration of the drug in disease.
It means that the prover who took it, though otherwise in good
health, was morbid in this particular, and that the medicine,
while causing pathogenetic effects elsewhere, finding disorder
already present here, reduced it to order. To take an indisput-
able instance. One of the most constant effects of iodism, as
observed in the sensitive Genevese patients, is palpitation; but
"in a case altogether exceptional," Trousseau writes, " M. Rilliet
has seen palpitation cease, instead of appearing or increasing,
under iodism; the patient was one habitually subject to it."
This mention of dose brings me to yet one other feature of
the kind of action of drugs, in which it plays an important part.
But I will reserve this portion of the subject for another
lecture.
LECTURE V.
THE GENERAL PRINCIPLES OF DRUG ACTION.
(Continued.)
Upon the last occasion of our meeting, we discussed several
of the features of the kind of action produced by various drugs.
To-day I have to bring before you those modifications of their
influence-real or supposed-which are brought about by
difference of dosage.
You will find Dr. Sharp, in his later essays, insisting much
on a fact which he denominates "antipraxy," by which he
means that large and small doses of drugs exert a precisely
opposite effect. He does not mean merely that they do this in
health and in disease respectively, which would only be describ-
ing the apparent working of the law of similars; but he affirms
that the opposition holds good in health, so that, whatever be
the effect of a large dose, a small dose may be found whose
action shall be of a precisely contrary kind. It was early
pointed out* that, so far as this double action of medicines
existed, it belonged to those primary and secondary effects long
ago discovered in them by Hahnemann, and employed by
Fletcher, Drysdale, Dudgeon, Reith and others to explain the
action of homoeopathic remedies. Dr. Jousset thus states the
doctrine in relation to dose: (†)
"I. Every medicine produces on the
successive actions, primary and secondary.
are always opposite one to another.
"2. The stronger the dose of the medicine the less marked is
the primary action. If the dose is excessive, the secondary
action only is developed.
((
3. The weaker the dose the more manifest the primary
action."
As Dr. Sharp now teaches that between the large and the
healthy body two
These two actions
* See Brit. Fourn. of Hom., xxxi., 756.
† L'Art Médical, xlv., 182.
68
GENERAL PRINCIPLES OF DRUG ACTION.
small dose, with their opposite actions, there is an intermediate
point at which the medicine produces the two effects in succes-
sion, his doctrine becomes harmonious with that of his pre-
decessors and colleagues.
I entirely subscribe to it, and teach it you from this chair, as
a feature of the action of certain drugs. But I cannot go with
Dr. Sharp, or indeed with Dr. Jousset, in affirming it of the
action of all drugs. Hahnemann admitted two qualifications
of his general statement as to the opposite primary and
secondary action of medicines. The first was, that there were
some (of which he specifies the metals, as arsenic, mercury, and
lead) which “continue their primary action uninterruptedly, of
the same kind, though always diminishing in degree, until after
some time no trace of their action can be detected, and the
natural condition of the organism supervenes." The second is
expressed in a phrase he uses in the Organon-" the exact
opposite condition to the primary effect, if there be an opposite
condition." Truly, there is much virtue in this "if." It is
obvious that opposition can only be predicated of functional
states which admit of a plus and minus, as excretions and
secretions, sleep, muscular and nervous tone, and the like.
These are the conditions which vegetable drugs-being mostly
neurotics and eliminants-influence, and hence Hahnemann's
description of primary and secondary actions applies chiefly to
medicines of this order; while the metals, which rather produce
inflammation and other organic changes, do not manifest such
phenomena. "The possibility, then," writes Dr. Carroll
Dunham," of classifying symptoms into primary and secondary
on the basis of the relative nature of the symptoms, is not co-
extensive with symptomatology; it is partial, confined to a
moderate number of conceivable morbid phenomena." I
quote from a paper published by this physician in the Hahne-
mannian Monthly for May, 1876, and reprinted in his Homœo-
pathy the Science of Therapeutics (1877), to which I would
direct the attention of all who desire to have clear thought
upon the subject.
Regarding then, as I do, the whole group of actions at
present under discussion as limited in their sphere, I cannot go
with those who explain by means of them the action of homœo-
pathically-selected remedies. I am under the misfortune of
disagreeing herein with my much-esteemed colleague in this
School, Dr. Dyce Brown. Maintaining as he does (with Dr.
Sharp) the opposite action of all drugs in health according to
the quantity in which they are given, he would argue that
when we give in disease small doses of a substance which in
GENERAL PRINCIPLES OF DRUG ACTION.
69
large doses has caused a similar condition to that before us,
we are administering an agent whose influence is in direct oppo-
sition to the morbid state. The curative process is thus anti-
pathic, though the principle of selection is homœopathic. Now
here I must recall the distinctions we have already established.
In those functional exaltations and depressions which many
a drug causes, common to it with others, and producible at will
if a certain quantity is administered-in such a region we may
have primary and secondary actions, we may have opposite
effects from different doses; and our cures may be wrought by
counteracting secondary states in disease with primary states
caused by the drug, or by opposing the action of one dose to
morbid conditions similar to those producible by another.*
Such antipathic medication, whether practised under homœo-
pathic appearances or without them, may accomplish. all we
require. But I think that plus or minus functional states like
these, though frequent enough in pathogenesy, are far from
being common occurrences in the actual disorders we have to
treat. When existing at all, they are often indications of some
nutritive disturbance at their root, or single features of a complex
state similarly induced. How rarely is paralysis, for example,
a purely "functional" disorder! Nearly every form of it is
traceable to inflammation or softening of the nervous sub-
stance; even the diphtheritic variety, which did seem to have
no lesion associated with it, has been found on deeper investi-
gation to be connected with definite central alterations. So
that, although the antipathic cure of functional excess or defect
is easier of conception, and perhaps more in accordance with
fact than the homoeopathic, I do not think that we are there-
fore justified in inferring that all or even the greater part of
apparent homœopathy is real antipathy. When we come to
nutritive disturbances-to those alterations which in their full
development are inflammation and fever, we have entered a
different region. There is no plus and minus of opposition
possible here, no conceivable reverse action of large and small
doses in health. We have got beyond dose as an important
element in the result: if the contingent susceptibility be
present, the drug will cause disorder in almost any quantity,
and cure it in almost any. You have only to read a few
detailed provings, and a chapter or two of Rückert or Beauvais,
to see that this is so. Such a law as that propounded by Dr.
Yeldham about the curative dose being as little below the
physiological as possible fails here, however it may hold good
in the absolute region; for there is no physiological dose for
* See Camphor.
70
GENERAL PRINCIPLES OF DRUG ACTION.
contingent effects. It is very significant that Dr. Sharp admits
that he has not yet touched the subject of infinitesimals; all
his statements about "large" and "small" apply to differences
between grains and hundredths of grains. In like manner I
think he will find that he has not yet touched the subject of
nutritive as distinct from functional disorder. While in the
latter the curative operation of apparently homoeopathic
remedies may be antipathic, in the former I can see no room for
such working and no evidence but against it. Aut simile, aut
nihil; there is no trace of anything but homœopathy from the
surface to the deepest root.
And there is yet one caution more to be observed. All
these theories of primary and secondary action, and of the
opposite effect of large and small doses, impose a limitation on
the class of pathogenetic effects which we can employ in
homœopathic practice. If homoeopathy means opposing morbid
conditions answering to the secondary effects of drugs by in-
ducing the primary action of the latter, we must use such
secondary phenomena only in selecting the simile. If we are,
by giving a small dose, producing an opposite action to that
of a large one, we must only take the effect of large doses into
account. But facts are entirely against such limitation, and it
would be disastrous to work by it. Hahnemann held just the
contrary view, and believed that only the primary effects of
drugs could be used in homœopathising. He therefore took
special care to obtain such primary effects in his provings,
and used small doses accordingly, as he himself tells us. Con-
sequently, the pathogeneses he has furnished us, and which
constitute the very core of our Materia Medica, are quite
unsuited for the purposes of those whose views I am now con-
sidering. Upon Dr. Sharp's principles, he ought to give large
doses instead of small to patients presenting groups of symp-
toms analogous to those found in Hahnemann's provings.
That he does not do so, but gets excellent results from follow-
ing an opposite course, shows (I submit) that his theory fails,
at least in being conterminous with homoeopathic action.
Moreover, upon Dr. Sharp's showing, all those opposite effects
of the same drug-constipation and diarrhoea, sopor and
insomnia, excitement and depression, and so forth—which we
find in nearly every pathogenesis, must be either primary and
secondary actions of a single dose, or the effects of large and
small doses respectively. Hahnemann, however, clearly perceived
that this was not so. He would use none but primary actions
for homoeopathic application, as Dr. Sharp would use none
but secondary; but he soon found that the primary action of
GENERAL PRINCIPLES OF DRUG ACTION.
71
many drugs included two opposite states, either or both of
which might be induced by it in the small doses used in his
provings, and either or both removed by it in the still smaller
quantities he administered to the sick. Such oppositions
(antinomies, we might call them) he styled "alternating effects,"
and distinguished them sharply from the mere "secondary
effects" of functional exhaustion, which last he considered
unavailable for homeopathic purposes. I think that his dis-
cernment was entirely sound, and that Dr. Sharp is unduly
limiting the range of the treatment by similars in fixing it to
one set of oppositions in the action of each drug. Veratrum
album, for instance, causes diarrhoea in large doses, and checks
it in small, because (he thinks) in the latter it constipates.
But he would find it-in smaller doses still-an excellent
remedy for the kind of constipation itself causes; and this
cannot be because these smaller doses purge. It is wiser,
therefore, to say with Hahnemann that constipation and
diarrhoea are alternating effects of the primary action of
Veratrum,—that action probably being a depression of the
functional activity of the intestinal nerves; and that either, if
the other symptoms coincide, may be used in prescribing
homœopathically. The same thing is true when opposite effects
occur in succession as part of the primary action of a drug.
They are then to be reckoned as part of the order and sequence
of such action, and are to be fitted to corresponding successions
occurring in disease. Thus, Aconite causes both the chill and
the heat of fever; it is, therefore, homœopathic to fevers con-
sisting of chill and heat, and in either stage. Here, too, the
explanation is probably the same, that it sets up in the healthy
that essential change of which the febrile heat and chill are
the complementary expression, and neutralises the same
change when present in disease.
In two lectures "On the Rationale of Homœopathic Cure,”
delivered at our Hospital in February, 1877, and printed in
the Monthly Homeopathic Review for the March and April of
that year, I have gone more fully into these questions of the
primary and secondary actions of drugs, and of the opposite
effects of large and small doses. I have examined the views
propounded on these subjects, and the endeavours to explain
by them the action of similar remedies, of Hahnemann and
Fletcher in the past, and of my living colleagues, Drs. Drysdale,
Dudgeon, Bayes, Sharp, Pope, and Dyce Brown. To those
lectures I must refer you for my reasons in detail for being
unable to agree in toto with the doctrine of any of them. The
only further contribution which has been made to the subject
72
GENERAL PRINCIPLES OF DRUG ACTION.
since their appearance is the paper "On the Double and Op-
posite Action of Drugs," which was read by Dr. Drysdale at
the British Homoeopathic Congress of 1877.* I fully agree
with the criticisms he there makes upon Dr. Sharp's argu-
ments, and am pleased to find him stating that he and I agree
in our present views more nearly than I had supposed. I may
quote the following passage in evidence thereof. "At the
same time," Dr. Drysdale writes, "I admit that the bare prin-
ciple of a primary excitation, followed by a secondary collapse
or exhaustion, is insufficient, per se, to explain numerous and
important qualitative changes in the living matter produced
by the exciting causes of disease, and by drugs, and which are
met by the homoeopathic law of cure. Here, I think, we had
better still rest the homœopathic law on an inductive basis,
viz.: that it simply expresses a general fact established by a
sufficient number of experiments. . . . . In diseases of mere
plus and minus of vital action, on the other hand, the Brunonian
theory of excitement and exhaustion gives an à priori expla-
nation of the double and opposite action of drugs, and of the
homœopathic law of cure."' This is in complete accordance
with the distinction between functional and nutritive disorders
which I was drawing a few minutes ago.†
I must now say a few words upon another part which dose
has been made to play in drug-action. I shall be here on
common ground with those whose views I discuss as to either
of two opposite effects of a drug being available for thera-
peutic comparison. But I must inquire how far they are
warranted in maintaining that the opposite phenomena dis-
played by certain medicines are dependent upon difference
of dosage, and that corresponding variations must be made
in the quantity administered when we come to apply them to
the treatment of disease.
})
The advocates of this doctrine are three of our American
colleagues-Drs. Hering, Hempel, and Hale, who, however,
differ considerably in their way of putting the matter.
1. Dr. Hering distinguishes primary and secondary symp-
toms only as those occurring earlier or later in the provings,
and states that observation will show the effects of the more
attenuated doses to correspond, not to the primary, but to the
secondary action of larger quantities. He would, accordingly,
advise the administration of the higher potencies when the
symptoms of the case before us have more resemblance to the
later symptoms of the drug, of the lower when the similarity is
between them and its earlier working.
* See Monthly Hom. Review, xxi., 656. † See p. 69.
GENERAL PRINCIPLES OF DRUG ACTION.
73
2. Dr. Hempel takes a somewhat similar view, though going
further in the interpretation of the phenomena. Let me cite a
short passage from one of his lectures.
"I shall have frequent occasion to show you that drugs seem to affect
the organism in two opposite ways, and may therefore be homœopathic
to two pathological conditions, holding towards each other relations of
antagonism. We may illustrate this point by the well-known condition
of fever. The first stage of an inflammatory fever is not a full and
bounding pulse, a hot and dry skin, flushed face, and so forth; an
opposite group of symptoms occur. The patient experiences a chill or
cold creepings along the back; he looks pale, hollow-eyed, the hands
and feet are cold, the pulse is thin, feeble, rather slower than naturally;
or, at any rate, not much accelerated. This condition is soon super-
seded by the opposite group of phenomena generally designated as
fever. The chill is the primary effect of the disease; the fever consti-
tutes a secondary effect, or the re-action of the organism. In selecting
a remedial agent for this derangement, it should be homoeopathic, not
only to the primary chill, but also to the secondary group, fever. Aconite
is such a remedy. Aconite is homœopathic to the chill, which marks
the first invasion of the disease, and to the fever which marks
the beginning of the organic re-action. We are seldom called to a
patient during the primary invasion of the disease; the organic re-
action is generally fully established when we first see the patient.
Nevertheless we prescribe Aconite, knowing full well that the inflamma-
tory stage must have been preceded by a chill.
“We say that Aconite is homœopathic to the chill, and we prove this
experimentally by taking a large dose of this drug, of course within
conservative limits, which will uniformly cause a more or less per-
ceptible chill, coldness of the skin, depression of the pulse, all which
symptoms disappear after a certain interval of time, and are followed by
the opposite condition, fever. A small dose of Aconite will not produce
the primary chill, but will at once excite the organic re-action
characterised by the usual phenomena of heat, flushed face, dryness of
the mouth, &c. This shows the importance of proving drugs in massive
doses. It is massive doses that develop the primary drug-symptoms;
small doses do not develop these primary symptoms, because the
organic re-action very speedily supersedes them.
"In practice it is of the utmost importance that we should discrimi-
nate between the primary and secondary action. If we are called upon
to prescribe for a group of symptoms corresponding with the primary
action of a drug, we give a larger dose than we should do, if we had to
prescribe for a group corresponding with the secondary action, or
organic re-action."
Dr. Hempel adds as illustrations of the possibility of a
medicine being homœopathic to two opposite conditions, that
"Aconite and Nux may be used as true homoeopathic reme-
dies in paralysis as well as tetanus; Ipecacuanha may remove
perfect atony as well as spasmodic irritability of the stomach;
Opium cures diarrhoea as well as constipation, excessive
wakefulness as well as drowsiness and stupor; Mercurius will
check as well as promote the secretory action of the pancreas;
74
GENERAL PRINCIPLES OF DRUG ACTION.
Secale answers in uterine hæmorrhage from atony of this organ
as well as in spasmodic uterine contractions."
3. And now of Dr. E. M. Hale. In consulting the work of
this author entitled New Remedies, which I have already
brought before you, you will find frequent references to what
he calls his law of dose. This law he states as follows:
((
'In any case of disease we must select a remedy whose
primary and secondary symptoms correspond with those of
the malady to be treated.
"If the primary symptoms of a disease are present, and we
are combating them with a remedy whose primary symptoms
correspond, we must make the dose the smallest compatible with
reason; and if we are treating the secondary symptoms of a
malady with a remedy whose secondary symptoms correspond,
we must use as large a dose as we can with safety." Under
the latter circumstances he speaks of drugs as "secondarily
homœopathic" to the morbid condition present; and by means
of this qualification maintains that we are still practising the
method of Hahnemann though we should treat relaxed states
with the ordinary doses of astringents, and states of excite-
ment with those of narcotics.
Proceeding now to an examination of these views, it will be
seen, in the first place, that we must be agreed as to what are
primary symptoms. We have hitherto understood them-
with Hahnemann and all who have followed him-to be the
least possible effect of a drug, the expression of the direction
in which the function affected by it deviates from the right
line. It is obvious that an increase of the disturbing influence
would but push it farther and farther still on the same side of the
normal path, and that in proportion as it did so a pendulum-
like swing to the opposite side would (when its action was
over) become more and more apparent. Thus the re-active
and secondary phenomena of the drug-when it exhibited any
-would be opposite to its least possible effect, while Drs.
Hering and Hempel would make them parallel thereto.
I think, nevertheless, that there can be no doubt of the
reality of the facts to which they have directed attention; and
that Dr. Hempel's explanation of them is the true account of
their meaning. This organism of ours into which we introduce
drugs to prove them is a living one: it does not merely pas-
sively suffer under what is done to it, but re-acts thereupon.
If the impression made by a foreign agent is sufficiently potent,
it bends before it, with such subsequent recoil as the case
demands. But it is readily conceivable that the impression
may be so slight that the only notice taken of it by the
-
GENERAL PRINCIPLES OF DRUG ACTION.
75
J
organism is, so to speak, a resenting push in the opposite
direction; and this also may be the earliest response to the in-
fluence of a drug, while, as its action gathers force, it bends.
the function it modifies in its own way. I think that in this
way are explained those temporary phenomena of excitation
under paralysing agents-such as curare-which led Claude
Bernard to the generalisation that "every substance which in
large doses abolishes the property of an organic element
stimulates it if given in small ones," and again, that “ all those
causes which exhaust the vital properties of a tissue or of an
organic element commence by exciting them." I cannot,
indeed, think him warranted in further maintaining that “they
are paralysers because they are first excitants that exhaust;"
for the period of excitation is so short and its symptoms so
slight that it cannot be conceived of as causing a collapse
which should account for the long-lasting paralysis which
ensues. Dr. Hempel's view that it is a re-action of the
organism seems to me exactly to explain it; and it puts it
accordingly with all phenomena of the same kind in a separate
class by themselves, standing on the hither side of the true
primary action of drugs, in which the organism does not act
but only suffers.
I therefore accept Dr. Hale's view as to what is primary and
what secondary in the action of drugs, following here in the
track of all the older observers. I agree with him also that
"in any case of disease we must select a remedy whose
primary and secondary symptoms correspond with those of the
malady to be treated," always adding the proviso that there be
such a succession of opposite states in either or both, which
does not by any means hold good in all cases. But when I am
told I must make a difference in dose according as the
primary or secondary stage of the disease is present, I pause,
and ask why? The only answer it seems possible to give is
that in the one case I shall be administering a remedy whose
action is the same direction with that of the disease, and which
therefore might aggravate if the doses were too large; while in
the other I should be as it were pushing the morbid process
the opposite way, and must increase my force accordingly to
the utmost point consistent with the safety of the organism at
large. That is, in plain words, in one I shall be practising
homœopathy, in the other antipathy.
It is well to perceive the true position to which we are led
by this proposed rule of Dr. Hale's. It has more than one
aspect in relation to our present subject. It suggests that even
in the functional states of plus and minus of which I have
76
GENERAL PRINCIPLES OF DRUG ACTION.
spoken-and to which alone I conceive it to apply--there
may be a real and not merely an apparent homœopathy prac-
tised. Our attention has been already called to this point by one
among ourselves, of the same name phonetically though not
literally as our Chicago colleague: I mean Dr. Hayle, of
Rochdale. In his Presidential Address at the Congress of
1876, he pointed out* that Dr. Sharp's explanation of apparent
similars as being real opposites could not hold good if both
the double actions of medicines are to be used for homœopathic
application. Nux vomica might cure paralysed conditions by
its power of stimulating; but if it be also useful in spasm and
irritation we cannot invoke any such opposite influence,
especially as we have to give it in smaller doses. Thus the
practitioners who habitually employ attenuated medicines are
in all probability homœopathising really and not apparently
only; while the remedies Dr. Sharp would give-he having,
as we have seen, hardly entered the field of infinitesimals-
may be such as are actually antipathic to the condition present,
though on the surface seeming to be similars.
So far I think we can fully accept Dr. Hale's canon. But
it is another thing to affirm that we should use all the secon-
dary reactions which are observed in drug-effects as homoeo-
pathic indications, even though remedies so chosen should
have to be given in the most substantial doses. It is obvious
that such a mode of proceeding would lead us into the whole
sphere of antipathic treatment, without even the appearance of
homoeopathicity about it. It would be impossible to convince
others, difficult, I should think, even to satisfy ourselves, that
we were practising the method of Hahnemann in giving (say)
twenty grains of ergot to contract a flabby uterus after par-
turition. Dr. Hale would argue-The primary action of ergot
is indeed to induce contraction of the womb; but after a time,
by the law of action and re-action, this over-rigid condition
must be succeeded by one of relaxation. Ergot is therefore
primarily homœopathic to the former, secondarily homœo-
pathic to the latter; and we are quite within the sphere of the
law of similarity in giving it to induce contraction, while the
dosage must be such as is sufficient to effect the purpose.
I shall certainly not teach you to apply the idea of homoeo-
pathy to such practices as these, but shall frankly acknowledge
them to be what they are. At the same time I entirely assent
to Dr. Hempel's statement that a medicine may be homœo-
pathic to two apparently opposite conditions. It may be
(as I have already suggested in the instances of Aconite and
* See Monthly Hom. Review, xx., 668.
GENERAL PRINCIPLES OF DRUG ACTION.
77
Veratrum album) a similar to the underlying vital disturbance,
of which these two states are the successive or the alternative
expressions. It may produce one class of effects by acting on
one element of the part, and the opposite of these by acting
on another; and so it may homoeopathically cure either. It
may begin its action by increasing the secretion of an organ,
but its prolonged influence may cause so much congestion
that secretion is diminished or arrested. In these and in
many other ways, of all which we have had or shall have ex-
amples, a medicine may be a true similar to two apparently
opposite states. Nux vomica, as well as Veratrum, is applic-
able to both constipation and diarrhoea: Secale will check
some forms of menorrhagia and counteract a certain form of
uterine exhaustion: Scilla will arrest diuresis and restore the
diminished secretion of acute renal dropsy. But in all these
cases no difference of dose is necessary in the two spheres of
action, or at least no such difference as that contemplated by
Dr. Hale. We are really practising homoeopathy, not induc-
ing the physiological action of our remedy under its guise;
and our posology can be determined by the considerations
which guide us in all other cases.
There are, indeed, only two ways of employing in disease
the power which a drug has of disordering the healthy body.
You may use it either to induce this physiological action in
the patient, or to neutralise such action if it be already pre-
sent. The former is (to use Hahnemann's nomenclature)
antipathy or alloeopathy, according as you are acting on the
disordered part or not: the latter, and this alone, is homœo-
pathy. For the former purpose some such dosage is required
as is sufficient to develope the change in question in the
healthy for the latter no such quantitative administration is
When, therefore, to take an
necessary.
instance from
another writer-Dr. Jousset tells us that for cardiac dropsy
Digitalis has to be given in spoonfuls of a decoction repre-
senting not less than two grains of the powdered leaves, but
maintains that such practice is homœopathic, because the drug
causes an “asystolia" similar to that which is present in such
cases, we must pause before assenting. And a very little
inquiry, I apprehend, is needed to show that such asystoliain the
case of Digitalis is but the functional exhaustion consequent up-
on the precisely opposite effect of the drug, and that to admini-
ster it for a similar condition in full doses is merely to induce
such a contrary state in your patient as by the same means
you could set up in the healthy. If this is homoeopathy, I
know not what is antipathy.
G
-
78
GENERAL PRINCIPLES OF DRUG ACTION.
Of Dr. Hering's and Dr. Hempel's rules of dose, I can say
little. They seem based upon the view that the larger the
dose which produced the pathogenetic effect, the lower should
be the attenuation given to counteract its simile in disease.
Of this, however, we have no certain evidence.
I have now, I think, said sufficient to acquaint you
with the principles as to drug-action which will regulate
the teaching on the subject I shall give in this place.
Very often, indeed, I shall have simply to present the phe-
nomena of pathogenesy to you, and to state their thera-
peutic applications. But wherever analysis and inter-
pretation are possible, they will proceed upon the physio-
logical and pathological bases now laid down. How far
they are absolutely true, I cannot say; they are the best at
which I can arrive at present, and that is all I can do. Our
comfort is, that however they may shift in the progress of time
and knowledge, homœopathy, as a mode of the art of healing,
is not dependent on them. The relation it establishes is
between the observed facts of drug-action on the one hand,
and of disease on the other; and no alteration in our view of
the meaning of either can affect it one whit.
LECTURE VII.
HOMEOPATHY-WHAT IT IS.
I must yet detain you a little longer on the threshold of
our subject. I have spoken of several things pertaining to
homœopathy; but I have said nothing as yet about homoeo-
pathy itself. It seems desirable that, before I begin to tell you
how to study and use medicines in the homoeopathic manner,
I should explain to you what that manner is, as I myself under-
stand it. It is the more necessary that I should do so, as you
will soon discover (if you have not already done so) that there
are two distinct ways of conceiving and applying the method of
Hahnemann prevalent among those who adopt it. You ought
to know from me what is the position I take up in the con-
troversy between the advocates of these two views, and on
what principles I propose to conduct the present course of
instruction.
Now both the homœopathies which exist at the present day
find their origin in Hahnemann himself, though both are de-
partures from his stand-point-the one diverging under the
attraction of modern science, the other prolonging his own
line of advance into regions unknown and undreamt-of by him.
I can best present them to you, therefore, by tracing the
history of the master's own mind, from his first conception of
the new method to his final elaboration of it. Let us dwell,
then, upon the history of homœopathy.
In the year of our Lord 1790, when the eyes of all Europe.
were fixed upon the rapidly evolving drama of which France
was the theatre, there was a man in Germany intent upon far
different matters. This man was a physician, in the prime of
his life; his name was Samuel Hahnemann. An accomplished
scholar, both in medical and general letters; a profound
chemist; the friend of the illustrious Hufeland, he was
utterly dissatisfied with the state of therapeutics in his day.
One of its few bright spots seemed to him to be the treatment
of ague by bark. He pondered much over the rationale of
this curative action—so simple, so direct, so effectual. How
80
HOMOEOPATHY-WHAT IT IS,
could other medicines be so used? How could other diseases
be so treated? It occurred to him to try the effect of this
bark in health: he experimented on his own person. He
found that it set up a fever very like that which it cured: the
relation between its disease-producing and disease-curing pro-
perties was that of similarity. Its operation, therefore, was
an instance of that "similia similibus" which Hippocrates
had recognised as occasionally holding good, and whose
claims to notice and possibilities of fruitfulness as a therapeu-
tic principle had been noticed by more than one writer. If it
obtained in the present notable instance, the inference was
obvious. Was it not possible that other cure-work like that
of bark in ague might rest upon such relationship between
drug and disease-might have been got from it occasionally
in the past, might be got from it continuously in the future?
The question was a reasonable one; but it was only a
question. It had to be answered by observation and experi-
ment—by reviewing the cures on record, and endeavouring to
obtain new ones. Both were fully carried out. Hahnemann's
Organon (the systematic exposition of his method, first pub-
lished in 1810) contains a copious list, drawn up from medical
literature, of cures of disease effected by drugs which on no
less satisfactory testimony were declared capable of causing
similar conditions in the healthy. And his own experience,
which was published from time to time, showed him that the
power of similarly acting medicines was most undoubted, and
their manner of curing greatly preferable. He now considered
that the question had been answered affirmatively, the in-
duction deductively verified; and, after suggesting it as a new
method in 1796,* in 1806† he confidently put forth similia
similibus, öµοionalɛía, as the cardinal principle of therapeutics.
G
He had not gone far, however, in working out the method,
when he found that to do so properly required a much fuller
knowledge of pathogenetics than that possessed at the time.
Records of poisoning and over-dosing were not scanty; but
they referred only to a small number of very active substances,
and to the large and crude effects of these. A few typical
and severe diseases were here pictured, and served for the
early application of the method. But if it was to be carried
out systematically, if the great variety of morbid conditions
* In his "
Essay on a new principle for ascertaining the curative.
power of drugs" (Hufeland's Journal, vol. ii. See Dudgeons's
translation of his Lesser Writings, p. 295).
+"The Medicine of Experience" (Hufeland's Journal for 1806.
See translation, p. 497).
HOMOEOPATHY-WHAT IT IS.
81
which come before the physicians were to be "covered" by
corresponding drug effects, his knowledge of the latter must
be indefinitely increased. With Hahnemann, to perceive this
need was to feel the obligation of supplying it; and to feel the
obligation was to fulfil it. He at once set to work to "prove"
medicines on his own body and that of other healthy persons.
In 1805 he had collected sufficient material of the kind for
publication; and it appeared in his treatise Fragmenta de
viribus medicamentorum positivis, of which I have already
spoken to you, and which contains (as you will remember)
pathogenetic effects of twenty-seven drugs, obtained from the
ingestion of single full doses.
But yet another step had been taken before this time. In
prescribing medicines according to the rule similia similibus,
Hahnemann of course gave them singly, and without the
complex admixtures so common in his day. He administered
them, however, in the usual doses. It is not surprising that
his patient's symptoms, even though ultimately removed, were
often in the first instance severely aggravated. It needs no
argument to show that the ordinary doses of Arsenic, against
which even a healthy stomach needs to be shielded, would
increase the irritation of one already inflamed-for which,
nevertheless, the homœopathic principle would direct its being
given. So Hahnemann found, and he reduced his doses.
accordingly. He did so by mixing his solutions or tinctures
with definite proportions of some menstruum, as water or
alcohol. The now well-known advantages of dilution came
out in this process; and he found that attenuation could be
carried to an extent hitherto undreamt of without the
remedial power of the drug being lost. Accordingly, in his
treatise on the Cure and Prevention of Scarlet Fever, published
in 1801, we find him recommending Belladonna, Opium, and
Chamomilla in fractional quantities about equivalent to our
third centesimal dilution, and defending his practice in Hufe-
land's Journal of the same year.
His complete method, constituted as now described, is set
forth in the luminous essay entitled “The Medicine of Experi-
ence," published by him in the same journal for 1806. He
there expresses his conviction that "as the wise and beneficent
Creator has permitted those innumerable states of the human
body differing from health, which we call diseases, He must at
the same time have revealed to us a distinct mode whereby
we may obtain a knowledge of diseases that shall enable us to
employ the remedies capable of subduing them; He must also
have shown to us an equally distinct mode, whereby we may
G
82
HOMOEOPATHY-WHAT IT IS.
discover in medicines those properties that render them suit-
able for the cure of diseases." To obtain this practically
useful knowledge of disease, he maintains, we must abandon
all speculation as to its essence, and content ourselves with a
faithful and detailed picture of its manifestations, with their
predisposing and exciting causes when these can be dis-
covered. To ascertain the properties of medicines we must
experiment with them on the healthy human body, noting the
symptoms which result in their order and connection. We
must, then, if we wish a permanent and curative effect,
administer in disease that drug whose effect most nearly
resembles the morbid condition before us. To give, as is
ordinarily done, remedies whose primary action is opposed to
the diseased state we have to treat (as opium for sleepless-
ness), is mere palliation, and useful and necessary in but
few cases. Finally, curative-because similarly acting-reme-
dies must be given in comparatively small doses, lest excessive
aggravation or undue reaction should occur; and so sensitive
is the diseased body to their influence, and so purely dynamic
their mode of operation, that doses of extreme minuteness-
even to a millionth part of those ordinarily given—will often
suffice for the end proposed. Such medicines, also, should be
given singly; and the doses should not be needlessly repeated
-each being left to work within its ascertained term of action.
"If," he sums up, "as is not unfrequently the case when there
is a sufficient supply of well known medicines, a positive
remedy perfectly appropriate to the accurately investigated
case of disease be selected, administered in a suitably small
dose, and repeated after the expiry of its special duration of
action, should no great obstacles come in the way (such as
unavoidable evolutions of nature, violent passions, or enormous
violations of regiminal rules), and should there be no serious
disorganisation of important viscera, the cure of acute and
chronic diseases, be they ever so threatening, ever so serious,
and of ever so long continuance, takes place so rapidly, so
perfectly, and so imperceptibly, that the patient seems to be
transformed almost immediately into the state of true health,
as if by a new creation."
d
The facts, dates, and quotations I have thus brought before
you present several aspects for consideration.
I. It would, I think, be impossible for any unprejudiced
person at the present day, standing in the light of the medical
knowledge now enjoyed, and having some acquaintance with
the doctrine and practice current in Hahnemann's time, to
doubt that the reform thus proposed by him was a real and
HOMOEOPATHY-WHAT IT IS.
83
most beneficent one. Pathology, at the end of the eighteenth
and the beginning of the nineteenth century, was a tissue of
the most baseless hypotheses: the therapeutics associated with
it were a mixture of violence and confusion. Men were treat-
ing, as Hahnemann says, unknown morbid states with
unknown medicines," opposing fancies about the one to fancies
about the other. In the stead of this most unsatisfactory
system he proposed a method alike simple, intelligible, and
innocuous. It consisted, as we have seen, in the following
elements :-
((
1. The apprehension of disease by its symptoms, ie., as we
say at the present day, by its clinical characters and history.
2. The ascertainment of the powers of drugs by experi-
mentation on the healthy human body.
3. The application of drugs to disease by a principle which
at least insured directness of aim.
4. The administration of remedies singly, instead of in com-
plex admixture.
5. Their prescription in doses too small to aggravate exist-
ing troubles or cause extraneous ones.
Who can doubt the blessing it would have been to mankind
had such a method been adopted when Hahnemann promul-
gated it? Who can reckon the thousands that would have
been saved from the murderous and poisonous doings univer-
sally prevalent in the days when bleeding and mercurialisation
reigned supreme in therapeutics? If the profession can go no
farther with Hahnemann; if even they feel his system im-
perfect for fully dealing with disease in all its forms, let them
at least admit the vast advance it made upon the practice of
its day, and its anticipation of much that is now regarded of
unquestionable importance.
But the point to which I wish especially to direct your
attention is the relation of Hahnemann's first conception of
his method, as now described, to the homoeopathy practised in
the present day.
The great majority of those known as homœopathists, at least
in the old world, have been converts from the recognised
modes of practice. The expositions of the system which have
satisfied their reason, the cures which have established their
faith, have been of the kind we have seen in the earlier
writings and practice of its founder. They have accepted his
method as he himself then conceived it-with its law of simi-
larity, its provings of medicines on the healthy, its single
medicine, and its small dose. But they do not think they need
follow him in the rejection of the pathology of their day, as he
84
HOMOEOPATHY-WHAT IT IS.
in that of his. They find him allowing the existence of certain
specific diseases, always essentially identical, for which fixed
remedies can be ascertained; and they think that the advance
of knowledge has identified many more of the same kind.
They prefer to work the rule similia similibus with patho-
logical similarities where these are attainable; though in their
default, and to fill in the outline they present, they thankfully
use the comparison of symptoms. Accepting his statement
that attenuation within the millionth degree hardly weakens
the power of a drug for good, while it robs it of power to harm,
they freely use such fractional quantities; but they rarely go
beyond this limit, and as a rule steer closer to the other end
of the scale. They do not mix medicines, but they often
alternate them; and (besides the occasional use of antipathic
palliatives, which Hahnemann at this epoch recognised as
sometimes allowable) they supplement them more or less freely
with such agents as-lying outside the range of pure homœo-
pathic medication—are commonly called auxiliaries.
On the other hand, there are many-especially in America
—whose views of homoeopathy have been formed upon the
later teachings of the master, of which I shall subsequently
speak; and some of these have become more Hahnemannian
than was Hahnemann himself. Among these colleagues of
ours there has often displayed itself an intolerant spirit towards
such as occupy the more independent position I have de-
scribed above. Hard words
Hard words are used of them, of which
"mongrel" seems the favourite; and they are bidden to depart
from the associations of the true followers of Hahnemann, and
to profane the name of homoeopathy no more. Homœo-
pathists of this kind are also exposed to considerable animad-
version from their brethren of the old school. They are
accused of sailing under false colours, because their practice is
not exclusively of the kind denoted by their name, and are
called upon-if they would vindicate their honesty-to with-
draw from all fellowship from the societies, hospitals, journals,
and other institutions which are consecrated to homœopathic
therapeutics.
Now I maintain that great injustice is done to such men (who
indeed form the great bulk of the homoeopathists of the pre-
sent day) by the attack of either side. It is not their fault
that they, and the associations to which they belong, are known
by a distinctive name. It is the fault of those who have refused
to allow the views denoted by that name to be advocated,
tested, and freely practised within the bounds of ordinary
professional fellowship. Grant to homoeopathy the same
HOMOEOPATHY WHAT IT IS.
85
liberty which is accorded to all other ways of thinking, how-
ever novel and unlike those ordinarily received, and the raison
d'être of homoeopathic institutions will have disappeared.
But, till then, it must not be supposed that men who do believe
in homoeopathy, however little they make it the exclusive rule
of their practice, will consent to put themselves in positions
where all employment of and reference to it is tabooed. They
join themselves to homœopathic societies and journals because
there alone do they find the liberty of opinion and action they
require. And why should their stricter colleagues be impatient
of their fellowship? Their practice is surely good practice as
far as it goes-far superior to that of one who rejects the
master's teachings altogether. Pathological similarity must be
better than no similarity at all. It may be a pity to alternate,
but it is less injurious than to mix. Auxiliaries may be used
more freely than is needful; but that is better than using no-
thing else. Of course, there may be so frequent an employ-
ment of extraneous measures, and so little cultivation of the
method of similarity, that homoeopathy ceases to be the pre-
dominant feature in a man's practice; and in that case the less
he is connected with the name the better. But this is a rare
occurrence; as a rule, the adoption of homoeopathy leads, by its
own intrinsic value, to a subordination of all other methods of
treatment, which is as evident to the observation of others as to
the consciousness of the practitioner.
Hitherto I have been vindicating the legitimacy of the
homoeopathy taught by Hahnemann up to 1806 to be called by
that name, and to be practised by professed acceptors of the
system. But it is another question whether it is wise to pause
there; and whether, in declining to follow him further in the
elaboration of his method, there may not be involved the
neglect of a more excellent way.
It will be remembered that, when he wrote the Medicine of
Experience, Hahnemann was only fifty-two years of age. In
the ordinary course of things, supposing health and strength
to be spared, there were at least twenty years of work
remaining to him ere age should begin to dim his perceptions
and enfeeble his faculties. Such work, moreover, if less
original than that of earlier life, ought to be more matured;
it should naturally contain the ripest fruits of a man's thought
and observation. Now the twenty-two years which followed
1806 were those of Hahnemann's greatest activity as a practi-
tioner and a writer. To this period belong the first four
editions of the Organon, the first and second of the Reine
86
HOMOEOPATHY-WHAT IT IS.
Arzneimittellehre, and the first of the Chronischen Krankheiten.
He is at Torgau from 1806 to 1810, and at Leipsic from 1810
up to 1821, in both enjoying large opportunities of practice;
while from 1821 to 1828, at Cothen, he has leisure to weigh
the results of his experience, and to consider the problems of
chronic disease presented by the sufferers of this kind who
resorted to him there for treatment. It can hardly be doubted
that whatever practical developments his method received
during such a series of years are entitled to the most respectful
consideration of those who accept that method in its essence.
There are four points, it seems to me, at which we discern a
distinct advance and elaboration on Hahnemann's part at this
time.
1. The first has regard to the principle on which selection
by similarity should be carried out. Of course, wherever all
the symptoms of a disease are reproduced in the pathogenesis
of a drug, there is no difficulty; and where no drug has them
all, cæteris paribus the one which possesses the greater number
would have the preference. But Hahnemann found after a
time that this cæteris paribus involved a good deal. A mere
quantitative dealing with symptoms proved insufficient: they
must, he saw, be weighed as well as counted; they must be
treated qualitatively. And now, in seeking to appreciate the
relative value of symptoms, he was led to two important con-
clusions: viz., that peculiar and unusual features, both of
drugs and diseases, should count for more than common ones;
and that subjective symptoms-and especially those of the
mind and disposition-should preponderate over such as were
objective and physical. These views led him to attach less
importance than he had formerly done to the disease-as
nosologically or pathologically defined-which was before
him, and to think more of the special sufferings of each
patient. The result was the doctrine expressed in the phrase
"individualisation," with the provisoes I have mentioned as
regards the relative value of the symptoms present.
2. Up to 1806 Hahnemann had affirmed nothing more
about the minute doses he had been led to employ, than that
they hardly lost any of the efficacy of the medicines, while
they robbed them of power to injure. But as he went on
attenuating the more potent drugs employed, and as he
applied the same process to substances comparatively or ab-
solutely inert, he seemed to find a real development of power
to be brought about. While all physical and chemical
qualities disappeared, such as odour and colour, alkalescence
or acidity; while all actively poisonous properties were lost,-
S
HOMOEOPATHY-WHAT IT IS.
87
the medicines gained a penetrating energy as curative agents
hitherto unknown to him, and a much wider range of action.
Some of them retained this even up to the 30th or decillionth
dilution; some seemed to act best in other potencies of the
scale, as from the 2nd to the 24th; very few were the better
for no attenuation at all. Hahnemann's second point, as
made at this period, was the positive efficacy of infinitesimal
doses, as prepared according to his manner; and their general
superiority for the homœopathic treatment of disease.
*
3. Hahnemann had already warned against the needless
repetition of doses. In the Medicine of Experience he had ad-
vised the duration of each drug's action to be ascertained, and
the dose to be repeated accordingly. In the first edition of
the Organon (1810) he substitutes for this rule, as based on an
uncertain quantity, one which directed that the effects of a
first dose should be allowed to subside ere another (if
necessary) was given. But, whether by one plan or the other,
treatment by single doses became increasingly Hahnemann's
ideal throughout this period. It shows itself in every piece of
practice he mentions, and in every case he records."
4. It may be thought strange that I should name, as a
fourth step of advance on Hahnemann's part, his doctrine of
chronic diseases. It would be so, did I mean by so doing to
endorse the psora-theory, in its definite dependence on the
entity itch. Hahnemann was indubitably in error about the
pathological significance of this disease, as was Autenrieth
and many another before him and after him. But, stripping
his doctrine of all reference to this particular disease, it
remains, in its essential substance, a most valuable induction
from observation and guide to practice.† It is the affirmation
that when disease becomes chronic it is because of some
morbid diathesis, some constitutional taint; that the manifesta-
tions of this condition must not be treated as if they were
mere local affections; that even the ordinary internal specifics
of homœopathy are mostly insufficient for their cure, and
must be supplemented by new medicines, of a profound reach
and long duration of action. It was this thought which led
Hahnemann to introduce the so-called "anti-psorics" into
medicine-which enriched the Materia Medica with Alumina,
Baryta, Calcarea, Graphites, Kali carbonicum, Lycopodium,
Natrum muriaticum, Sepia, and Silica.
What I have said about the distinction between the specu-
lative theory and the practical doctrine of chronic diseases
applies to much else in Hahnemann's work at this time. His
* See Appendix, "Hahnemann's Dosage." See Sulphur.
8&
HOMEOPATHY-WHAT IT IS.
discovery of the efficacy and sufficiency of infinitesimals, for
example, was mixed up with hypotheses of all disease being
a derangement of the "vital force," and of a "dynamisation
effected in medicines by the processes of trituration and
succussion to which he subjected them. All this may be
rejected, as it generally has been rejected; but the discovery
remains. It is thus with the various explanations he suggested
of likes being cured by likes. Few receive these, but that
similia similibus curantur is acknowledged by all his disciples.
Dismissing, therefore, the theories of the master as of
doubtful value and only speculative interest, let us fix our
attention upon him in the sphere of his true greatness, and
consider his practical rules. I can but very briefly indicate
the facts and arguments by which they have been substantiated.
In so doing, I shall draw chiefly on the writings of Dr. Carroll
Dunham. I feel that I am indebted to him for the conviction
of the reasonableness of Hahnemann's fuller doctrine, as I
was to Dr. Madden many years ago in respect of homoeopathy
generally.
""
1. And first, as regards individualisation. It is pointed out
that while a few leading symptoms are sufficient to enable us
to diagnose the nature of a case, and for this purpose we may
ignore the rest, it cannot be so when we are to treat it by the
method of similarity. Every appearance the patient presents,
every sensation he experiences, every circumstance of ameli-
oration or aggravation of his sufferings, must have some patho-
logical basis, and must be taken into account in the choice of
a remedy. Just in proportion as a drug has been found
capable of causing all these concomitants and characteristics,
will it be the rapid and certain cure for the case in which they
occur. If it is otherwise, then, although the drug may have
produced the actual disease, nosologically speaking, by which
our patient is attacked, yet it may not be essentially homoeo-
pathic to the form of the disease now before us. It may be
fever we are treating, and our medicine may be truly pyreto-
genetic. But suppose that the pyrexia it causes is accom-
panied with great restlessness and anxiety, while the febrile
sufferer under our care lies dull and listless, there is a lack of
true homoeopathicity between disease and drug. Adherence
to the "totality of symptoms" would set us right, though we
could not define or explain the difference between the two
cases. Again, our patient may have rheumatic joints; but
their painfulness may be either increased by continued motion
or the reverse. It is obvious that this distinction may depend
on the presence or absence of an inflammatory condition of the
W
HOMOEOPATHY-WHAT IT IS.
89
parts, and may modify accordingly our whole management of
the case. But, even though we knew not its significance, it
would symptomatically guide us to the choice between Bryonia
and Rhus as the medicinal remedy.
The individualisation of each case, therefore, by the totality
of its symptoms, is the only certain method of arriving at the
true similimum for it among medicines.
The more we gene-
ralise, and refer it to a class, the less happy we shall be in our
drug-selection for it. And, should there be no drugs which
correspond to it as whole to whole, we should select that one
which has caused any peculiar features it may have, if we have
good reason to believe such remedy suited to the essential
malady present. Correspondence at such special points indi-
cates a very close relationship between disease and drug-far
more so than if common characters only were in question.
Subjective symptoms outweigh objective ones in such differ-
entiation, for they present less of the common than of the
peculiar features of a case. They are, moreover, of great value,
as being the earliest signs of disorder, before organic change
has begun; they constitute the main phenomena of a malady
at a stage in which it is still curable. I should have liked, had
time permitted, to have read you an extract from the Address
on Medicine, delivered by Dr. Russell Reynolds before the
British Medical Association in 1874, enforcing the importance
of subjective and mental symptoms. "We are bound to re-
member," he concludes, "that there are many affections of
which they furnish the earliest indication, and there are not a
few of which they are throughout the only signs.
))*
2. And now as to the infinitesimal doses of this period, by
which I mean the dilutions from the 2nd to the 30th. Evi-
dence as to their positive efficacy, and as to the comparative
inertness of many medicines unless thus attenuated, is abun-
dant. The best proof of the latter point is that in the practice
of those who confine themselves to the lowest potencies such
remedies find little estimation or use. But a good deal of
consideration is also due, I think, to the position of those who
affirm the relative superiority of infinitesimal over more sub-
stantial doses. Besides Hahnemann himself, this class includes
Dunham, Hoppe, von Grauvogl, and Chargé; and—to some
extent at least, as evidenced by their practice-Tessier and
his foremost disciple Jousset. The first-named has shown,
from the comparative statistics of Wurmb and Caspar's
-
* See also Dr. Madden, " On Subjective Symptoms," in Brit. Fourn.
of Hom., xxvii., 458; and Dr. C. Dunham, in Homeopathy the
Science of Therapeutics, p. 89–92.
90
HOMOEOPATHY-WHAT IT IS.
Hospital, that in pneumonia the action of the 30th decimal
dilution was more certain and more rapid than that of the
15th and the 6th, while of the two last the 15th bore away the
palm.* There is, moreover, in the general tone of those who
employ highly attenuated medicines, a confidence in their
remedies, an habitual sense of power and success, which can-
not be disregarded.
-
3. Regarding the use of single doses, instead of a series of
them, allowing the medicine thus given to act undisturbed for
a reasonable length of time, I can say little at present. When
we find so scientific a physician as Professor Hoppe main-
taining the reasonableness of this practice,† and a veteran like
Jahr saying that his best cures have been achieved in this
way, which he truly says-was that of Hahnemann and all
his disciples for the first twenty years of homeopathy, it
merits our best consideration.
4. And, lastly, as to the doctrine of chronic diseases. I
think there can be no doubt of the immense benefit which has
resulted therefrom in the past, in the tendency it has given us
to look to the possible constitutional origin of local and super-
ficial affections, and to treat them accordingly. This view,
and our possession of the "anti-psoric" medicines, has placed
us on the same vantage-ground towards all such affections, as,
e.g., the knowledge of the syphilitic origin of many examples
of nervous disease has afforded in general medicine. There is
a tendency in a certain school of homoeopathists to think of all
disease as local, and to neglect medicines which have not an
absolute physiological action dependent on dose. Such, for
instance, would be the result of Dr. Sharp's system, if it were
allowed to embrace the whole sphere of therapeutics. We
need, I think, to be recalled to Hahnemann's sounder stand-
point if we are not to lose many of the triumphs over chronic
disease which have hitherto waited on the steps of those who
have adopted his method.
The second of our two homœopathies is now before us. It
is that which Hahnemann taught and practised between 1806
and 1828. With the further modifications which took place
subsequent to the latter date I have nothing at present to do.
The new points which a man makes after seventy-four have
no à priori recommendation in their favour; and that the first
of them here was the fixing the 30th attenuation as the uniform
* See Op. cit., p. 240.
+ See his article in Hirschel's Neue Zeitschrift, ii., 3, transl. in
Brit. Journ. of Hom., xx., 369.
HOMOEOPATHY-WHAT IT IS.
91
dose of all medicines, whether for provings or for curative pur-
poses, does not invite us to welcome the rest. To make the
Hahnemann of 1830-43 our guide is, I think, to commit our-
selves to his senility. But the second homoeopathy which I
have just been expounding is the fruit of his ripest manhood,
and I think it ought to be more cultivated than it is in
England at this time. I doubt whether it is, at least in all
hands, applicable to the exigencies of every-day practice and
For this pur-
the treatment on a large scale of acute disease.
pose I commend to you rather the earlier and simpler method
I have previously exhibited. But when there is more leisure,
and especially when chronic disease comes before you, I think
that your best hope of making certain and speedy cures,
whose brilliancy shall recall the earlier days of our history, will
lie in your adherence to that (shall I call it ?) higher homœo-
pathy which the genius and toil of its discoverer have
elaborated for us.
It is under these convictions that I shall set about teaching
you Materia Medica and Therapeutics from the homoeopathic
point of view. I must avow at once that my ordinary stand-
point is that taken up by the followers of Hahnemann's earlier
method. It must almost necessarily be so. Lectures on
Materia Medica, like those on the Practice of Medicine, must
contemplate diseases as their objects, while the purer homoeo-
pathic therapeutics regard rather the sick person in his indi-
viduality. The similarities, moreover, which I shall seek to
establish between drug-action and disease will be in the main
pathological. When, again, I see reason to conclude that any
recognised use of a drug-as that of Amyl nitrite in angina
pectoris, and of Belladonna in nocturnal enuresis is anti-
pathic and palliative only, I shall not therefore advise you to
reject it from your practice. I shall also tell you of many
applications of remedies which, though truly homœopathic, are
(in my judgment and according to experience) best carried out
with appreciable doses. On the other hand, I shall be far from
ignoring such subjective and peculiar symptoms of drugs as
may aid in the task of individualisation: I shall frankly accept
the efficacy of infinitesimal doses, both in pathogenetic and in
therapeutic action; and I shall assume the soundness of
Hahnemann's psora-doctrine, as I have now explained it, and
devote much attention to the new and recondite remedies
which it has led him to introduce to our notice.
M
The homœopathy you will learn from me will thus be no
narrow or imperfect thing, but will embrace the whole range
of Hahnemann's progress as a thinker and discoverer, while
92
HOMOEOPATHY-WHAT IT IS.
content to receive some modification of its form from the
advances of modern investigation. It will be such as he (I
apprehend) would not fail to recognise as his offspring, while in
no disciple of the scientific medicine of to-day will it be likely
to excite repugnance or contempt.
LECTURE VII.
HOMEOPATHIC POSOLOGY.
G
There is one more topic on which I must enlarge ere we
begin our detailed study of the Materia Medica. I have
spoken of the modifications imposed upon this course of in-
struction by the fact of its being delivered in a School of
Homeopathy. But I find that I have omitted any special
notice of what to many minds would seem the most peculiar
feature of that which I shall say. I refer to the minute dosage
with which I shall so often have to deal. The pharmaceutic
processes I have described as characteristic of homoeopathy
have for their main objects the reduction of the drug to frac-
tional proportions, of which the third degree already repre-
sents the millionth part of a grain or a drop, while I shall have
to speak familiarly of the sixth, the twelfth, and even the
thirtieth. You will be warranted in demanding of me some
explanation and vindication of such unwonted dosage; and it
will be my pleasure as well as my duty to give it you.
Now the first and chief reason of my dealing with these
minute quantities of drugs is that their use is a fact in the
history of homoeopathy. I have already told you how Hahne-
mann early followed up the enunciation of his new principle
by a reduction of the dose of medicines given in accordance
with it, and how in later times he pushed the attenuation of
his remedies to the elevated degrees I have just mentioned.
If any of you desire to follow him step by step in his progress,
from 1796 to 1839, you will find the means of doing so in the
article on the subject contained in the British Journal of
Homœopathy for April, 1878.* As it was not till after 1811
that he began to make professional converts to his system, it
came to them all with the infinitesimal dose as a part of it,
and was by them all carried out therewith. Most of them,
moreover, went on with their master in his further develop-
ment of attenuation, and some have since pushed far beyond
him in the process. The result is that the great bulk of the
* Reprinted in the Appendix to this volume.
94
HOMEOPATHIC POSOLOGY.
homoeopathic experience on record has been obtained by means
of minute dosage, and no little of its pathogenesy owns a
similar origin. I, as a teacher in a School of Homœopathy,
have to deal with it historically-as it actually is and has
been; and, whether I myself approved of them or not, infinite-
simals must necessarily play a large part in the lessons it is
my duty to give.
But I am fully prepared to maintain the tenableness in
itself of the homeopathic posology, and to advocate it as a
most important and beneficent part of Hahnemann's thera-
peutic reform.
In the first place, comparative smallness of dosage is the
logical and obvious corollary of similia similibus curantur. It
needs no argument, as I have said, to show that the ordinary
doses of Arsenic, against which even a healthy stomach needs
to be shielded, would increase the irritation of one already
inflamed, for which, nevertheless, the homoeopathic principle
would direct its being given. The quantity administered
must be reduced accordingly. Nor are Hahnemann and his
avowed followers the only witnesses to the practical necessity
of this proceeding. Whenever a piece of homœopathic prac-
tice has been borrowed by the practitioners of the old school,
the small dose has always gone hand in hand with the similar
remedy. Drops of Ipecacuanha wine were unknown to the
ordinary posology until the drug began to be used to check
vomiting instead of to cause it; and similar novelties in the
way of dosage abound in the Therapeutics of Dr. Ringer, and
in the like-minded communications of Dr. Dessau to his New
York colleagues. I may appeal to such facts as the best
answer to the argument lately advanced by Dr. Decaisne in
France, and Dr. Barr Meadows in this country, that the aggra-
vation caused by similarly-acting remedies in the ordinary
quantities proves their unsuitableness, and that the diminution
of dose merely evades the difficulty by reducing their action
to nullity.
*
But this argument, valid as it is, establishes only the relative
smallness of the homoeopathic dose. We must go farther to
ascertain what its positive littleness may be, and to warrant
any measure of the astonishing exiguity it has actually
attained.
Now I would here suggest that dose is, to begin with, a mere
arbitrary matter. There is nothing in nature corresponding to
drachms and scruples and grains, and there is no reason why
that particular number of molecules which go to make up the
* New York Medical Record, July 28, 1877.
HOMEOPATHIC POSOLOGY.
95
"}
iast-named quantity should be designated by a whole number,
while all below it must be expressed by fractions. Yet the
result of its being so is that in the grain we seem to have got
to the ultima Thule of ordinary smallness, and any further
division strikes us as strange. Again, it is evident that all our
notions of dosage are derived from the quantities of drugs it has
been found necessary to give to produce their physiological
effects on the system-to set up purgation or emesis, the seda-
tion of an aching nerve or the relaxation of muscular spasm.
If the so-called "alterative medication had attained a larger
place in therapeutics, these notions might have been modified.
It has always been recognised that a different posology holds
good with regard to remedies of this kind; that, as no physio-
logical effect was sought, but only a gradual extinguishment
of the morbid state, the dose necessary to be given was purely
a matter of experience. Now it cannot be too clearly recog-
nised that all homoeopathic remedies are "alteratives" in this
sense; and hence that any standard of dosage taken from such
medication as aims to produce physiological effects is inap-
plicable to them.
Further, it is obvious that, even without taking such distinc-
tions into account, dose is a shifting quantity. It varies, as
every one admits, within certain limits, according to age and
sex, the strength or weakness of the patient, and the amount
of medicinal susceptibility he possesses. It varies through a
still wider range with the different drugs we administer. Take,
for instance, two remedies renowned of old in the treatment
of cutaneous disease-Dulcamara and Arsenic. Carrére, the
introducer of the former, administered it in tablespoonfuls of a
decoction made in the proportion of an ounce to a pint; while
the latter is given in small doses of a solution (Fowler's) which
contains only I part in 120, sometimes requiring (as in a case
of Mr. Hunt's) that even minims of this shall be broken up
into fractions, which yet prove curative. So, when another
potent substance-Phosphorus-is introduced (as lately by
Mr. Ashburton Thompson) into the ordinary practice, no one
is surprised at his recommending its employment in hundredths
of a grain. With the alkaloids we get further still in the realm
of minuteness, even as regards physiological action. Take the
influence of atropia in dilating the pupil. The "atropised
gelatin " prepared by Savory and Moore under the direction
of Mr. Ernest Hart purports to contain but roooooth of a grain
in each disk; yet it answers its purpose excellently well. Pro-
fessor Donders (cited in the fourth edition of Pereira's Materia
Medica) finds that in dogs the attenuation of atropia may be
96
HOMOEOPATHIC POSOLOGY.
carried up to 700000th before the effect beeomes doubtful; and
it is possible, from the experiments of Rossbach and Frölich,
that the doubtfulness arose from contraction being produced
by the drug when reduced below the dilating point. Professor
Donders, moreover, adds :-"The sensitiveness of the eye to
atropia, indeed, excites astonishment, when we consider that
of the single drop of attenuated solution which suffices to
produce dilatation probably not a fiftieth part is absorbed."
Nor is it the pupil only that these dilute applications to the
eye can affect. Dr. Harley records an observation of “conges-
tion of the entire conjunctiva, with dryness of the membrane
and dull aching pain in the eyeball, lasting for several hours,"
occurring after the instillation of twelve drops of a solu-
tion of one part in 400,000 of water. We have only to
go somewhat lower in the scale of fractional minuteness to
see the drug affecting the whole organism from within. Dr.
Ringer finds the 200th of a grain of Atropia, subcutaneously
injected, sufficient to dry up the whole surface of the body,
even when freely perspiring in the Turkish bath; and Dr.
Harley writes of this substance—" An infinitesimal quantity—
a mere atom—as soon as it enters the blood originates an
action which is closely allied to, if it be not identical with, that
which induces the circulatory and nervous phenomena accom-
panying meningitis, enteric, or typhus fever." Aconitine carries
us a step farther. The 300th of a grain of this alkaloid was
found by Dr. Milner Fothergill sufficient actually to kill a
rabbit of three lbs. weight; while guinea pigs are so extra-
ordinarily sensitive to its lethal influence that one weighing a
pound died in three hours and a half after the administration
of 13th of a grain. After these experiences you will not be
surprised to hear that Professor Arnold, of Heidelberg, found
tetanus readily produced in frogs by Tobooth of a grain of
strychnia. Even the 1000000th caused increased reflex excita-
bility; and in one of these creatures, which the day before had
been tetanic for some hours, after Tooth had been adminis-
tered to it, but had quite recovered, a slight attack came on in
half an hour after receiving the 1000000th, which ended, after
some hours, in its death.
65
With these poisons and alkaloids, then, we have clearly got
far on the road to another standard of dosage. The French
milligramme—i.e. (about) th of a grain-is found the most
convenient unit for them, and even this (as M. Gubler has
announced in regard to aconitine) has to be further divided.
We have got a long way towards infinitesimals, even for the
production of physiological effects; and it would be very
HOMEOPATHIC POSOLOGY.
97
unwise if we refused to look ahead, and see what further reduc-
tion may be necessary when we seek for pure therapeutic
results on the principle of similarity. If drop doses of Ipecac-
uanha wine are sufficient to check vomiting, while drachms are
needed to cause it, then, if "an infinitesimal quantity—a mere
atom" of atropia will originate the pyrexial process in the
blood, how minute must be the quantity which, on the same
principle, will be appropriate to extinguish it!
Yet again. There are many substances which are inert in
their crude state, but which, when rubbed up with some in-
different vehicle so as to insure a fine division of their particles,
become active enough. We have a familiar instance in Mer-
cury, which as pure quicksilver may be swallowed by the
pound, but which, when intimately mixed with confection of
roses or with chalk, becomes a potent drug. It is now recog-
nised that the amount of oxidation which takes place in the
preparation of blue-pill and grey powder is very small, and
that minute subdivision is the essence of the process. Now
Hahnemann, as you are aware, has largely developed this
mode of preparing drugs, introducing the improved method of
a graduated trituration with sugar of milk. The metals-
gold, silver, platinum, zinc, together with such neutral sub-
stances as charcoal, flint, and lycopodium, are awakened to
energy by this potent process, and show themselves capable of
no little influence upon the organism. It is obvious that since
in this way a real development of power is effected, there must
be a certain stage in the process at which the drug, inert in its
crude state, begins to be active, and another at which this
newly-awakened energy is at its height, after which all further
attenuation must have a contrary effect. At this second stage
the triturated substance stands on the same level with a medi-
cine of similar character which is active from the first; so that
a grain of Silica 2 may be equal to one of Hepar sulphuris 4,
though in actual quantity of the drug the latter is to the
former as 10,000 to 1. Thus, with the medicines made such
by trituration a very minute fraction may be the unit of their
strength and the standard of their physiological activity;
while a still more infinitesimal quantity will be appropriate
when they are used as remedies upon the homœopathic prin-
ciple. I have mentioned the second trituration here because
it was in those from the first (as Aurum and Argentum) to
the third (as Carbo) that Hahnemann proved medicines of
this kind.
We have arrived, then, at the conclusion that, when admin-
istered in conditions similar to those which they cause, medi-
H
98
HOMOEOPATHIC POSOLOGY.
cines must be given in smaller doses than would be necessary
for such causation; and that the exiguity thus required may,
from the natural activity of the substance, or from the degree
of attenuation at which its energies begin to appear, be very
considerable, reaching sometimes to such fractions as the
thousandth, the ten-thousandth, and even the millionth of a
grain. It may have to go thus far, but it need hardly go
farther. To attenuations of this degree Hahnemann was led
when first (in 1799) he began to use infinitesimals; and for
some years after he seems to have remained at the same point,
more often descending below it than rising above it. To such
potencies, moreover, a number of his followers-and these not
of least eminence-have confined themselves, when they have
found it necessary to ascend above the mother tincture or the
crude drug. Drysdale and Kidd, Yeldham and Black in this
country; Trinks and Arnold in Germany; Cretin in France;
Gray in America-these are homœopathists of no small note,
who tell us that in the first six decimal potencies they find all
the attenuation they need, when they need any at all. On the
other hand, the reasonableness of so far diluting potent drugs,
when homœopathically employed, is denied by none. Dr.
Ringer may recommend his hundredth-of-a-grain doses of
corrosive sublimate in dysentery, and Mr. Hunt may come
down to the 480th of a grain of Arsenic in psoriasis, and no
one will gainsay them. One of the latest critics of Homœo-
pathy-Dr. Rogers, in his Present State of Therapeutics, says:
"I can well imagine that certain energetic remedies may
act more or less in doses of the 1st, 2nd, or 3rd dilutions of the
decimal scale," ie., in the tenth, hundredth, or thousandth of a
grain.
So far you have, I imagine, followed me without difficulty.
There is nothing in reason, nothing in the nature of things to
render doubtful the apparent testimony of experience, when it
speaks of the efficacy of similarly-acting medicines in the
attenuations from the 3rd or 2nd downwards. If homoeopathic
posology had only taken this range, I should have had nothing
further to urge, and could now have left the subject in your
hands, confident of your acceptance of my position. I wish
indeed that I could have done so, and that the method of Hah-
nemann had not been weighted with anything in the way of
dosage less defensible than the thousandths and millionths
with which I have been dealing. But here again I must
remind you that my duty is not to express my own preferences,
but to teach you homoeopathy as actually existing and his-
torically developed, I must, therefore, take into account that,
HOMOEOPATHIC POSOLOGY.
99
1
from 1808 onwards, Hahnemann is found raising the potencies
of several of his medicines far above the 3rd, dealing with
billionths, trillionths, quadrillionths, octillionths, at length
reaching the decillionth, and in 1829 fixing this last propor-
tion as most suitable for all drugs. I must recognise the fact
that the majority of his disciples have followed him in the
employment of these higher fractions, and are using them
more or less largely in their practice at the present day. Nor
can I shut my eyes to the later development of attenuation up
to the 200th dilution; and to the knowledge that potencies of
this strength, of undoubted pharmaceutic reality, have been
warranted as active by such men as Bönninghausen, Dunham,
Tessier, and von Grauvogl, and by the first two at least
esteemed of more efficacy-both in acute and chronic disease
-than any lower dilutions. I cannot ignore these facts; and
more, I do not feel justified in presenting them to you as a
mere recorder, with such unsympathetic reluctance as to
influence you against their acceptance. Much as I regret the
necessity of employing the higher infinitesimals, I cannot but
acknowledge it. The testimony in their favour is overwhelm-
ing; the evidence of their efficacy undeniable. My own
experience of such dilutions as the 6th and 12th, and (with
some remedies) of the 30th, is such as to make me join with
unquestioning acclamation in their praise. I have no practical
knowledge of the 200ths; but if I had no other fact before me
than their constant use by so scientific and successful a physi-
cian as Carroll Dunham, I should be content to acknowledge
their legitimacy.
But here, too, we must inquire how far the apparent testi-
mony of experience is supported by reason, by science, by
observation.
I. I fear that reason has nothing to say in our favour. We
have good logical ground for reducing our dose below the
point at which it can aggravate the existing malady, or injure
healthy parts; but we have none for carrying our attenuation
further than this. We seem, therefore, to have effected all
reasonable ends, even with the most potent poisons, when we
have reached the thousands and millionths of which I have
hitherto spoken; and the same may be said of the inert sub-
stances whose properties are first elicited by trituration and
dilution. Unless some evidence should be brought before us
to prove that we actually develope power, as we go on atten-
uating after the Hahnemannian method, reason must certainly
frown upon the higher potencies. I shall examine presently
the theories of "dynamisation" which have been put forward
100
HOMEOPATHIC POSOLOGY.
to support this conclusion, and I fear I shall not be able to
endorse them. I must, then, for myself at least, give up any
countenance from the side of reason for this part of my
position.
2. The relation of science to us, however, is at first sight
very encouraging. No one can have followed the researches
of the last thirty years, and considered the sizes dealt with in
thermal and luminous undulations, and in the molecules and
atoms of matter, without feeling that infinitesimals of a most
minute character are acquiring undoubted place and reality in
the world of being. All the work of the universe, all the
actions of life, are seen to be carried on by these tiny exis-
tences; in their little microcosm forces of all kinds play, and
in them begin all changes whether normal or morbid. It
seems at first sight, I say, that we are only following in the
same track when we present our drugs in a state of the finest
molecular subdivision, when we seek to counteract abnormal
motions of the ultimate particles of matter by vibrations as
minute as their own.
And to a great extent we are, I think, quite justified in
claiming the support of science for our proceedings. The
existence and the energy of the infinitely little have been
substantiated thereby, and no one is now warranted in reject-
ing effects because their supposed causes are inappreciable by
coarse sensation. But I fear that if we make too much of the
analogies of the minute quantities with which scientific specu-
lation deals, we shall find we have enlisted a dangerous ally,
one who will leave us when most we need assistance. It must
be remembered that the conception of the atomic constitution
of matter, while suggesting how infinitesimally small are its
ultimate particles, implies also that it is not infinitely (in the
strict sense of the word) divisible. You must come at last to
atoms (à, réµvw)-particles which can be divided no farther;
and then any subsequent attenuation can but reduce their
number until all trace of them disappears from the vehicle.
Now molecular science has so far advanced that it has seemed
practicable to estimate approximately the size of the ultimate
atoms of matter. Sir W. Thompson, Clerk-Maxwell and
others have attacked this problem, and, though their solutions
of it differ pretty widely, none have gone further than the
affirmation that a trillion of such atoms may be contained in
a space of both of an inch cube.* Now, making all allow-
ance for the molecular contraction which, as Jolly has shown,
1000
* See Monthly Microscopical Journal, March 1876, p. 113.
HOMEOPATHIC POSOLOGY.
ΙΟΙ
attends upon all attenuation of chemical solutions,* this will
hardly carry us beyond our 12th potency. At higher degrees
than this the presence of any atoms of matter whatever must
become increasingly doubtful.
<<
This is the latest word of theoretical science on the subject,
and its practical observations point in the same direction.
Chemical tests, applied to those substances which are readily
recognised thereby, follow them up with decreasing clearness
to the third attenuation, and there or thereabouts-lose them.
The spectroscope carries our vision further still; but the 9th
dilution is the highest point from which any response has been
forthcoming to this potent detector. The microscope, used
upon the triturations, has yielded similar results.† Under a
power of 300 diameters, Dr. Mayrhofer has traced metallic
particles up to the 10th, 11th, and (in the case of precipitated
tin) even the 13th and 14th attenuations, but no further.
'Moreover, the visible particles of the substances," he says,
"become gradually smaller and fewer as the triturations
advance, and at last cease altogether." Up to a certain point,
then, we gain by this process. "A patient who takes a grain
of the 3rd trituration of tin or arsenic, swallows no less than
576,000,000 particles, each of which possesses all the properties
of the metal, and from their minute size can freely penetrate
to all parts of the organism, and develope their peculiar effects
on every part." But, if trituration is carried on, "the atoms,
becoming always smaller and more mobile, at length come to
be so much so that they elude the triturating force." If, on
the other hand, they are (according to our usual plan) mixed
from this point with a fluid menstruum, either they are sus-
pended therein, when it is obvious that their number must
decrease a hundredfold with each successive dilution, or they
undergo a true solution, when they are as divisible as matter
itself, but no farther.
When now we turn to observations on the animal body,
corresponding conclusions have to be drawn. M. Davaine, in
experimenting with septicæmic blood, was led to try in what
fractional proportion it still retains its virulence. He found
that by employing the graduated Hahnemannian method of
dilution, he could reproduce the disorder by inoculating other
animals (rabbits) with the millionth, the billionth, the trillionth,
and at last the ten-trillionth of a drop of blood. Above this
* See v. Grauvogl's Text-book of Hom., pt. ii., § 221.
Dr. Conrad Wesselhoft's recent examination of our triturations
has yielded results still less favourable; but his work is regarded as
still sub judice.
102
HOMOEOPATHIC POSOLOGY.
point, however, no effects were produced. Again, therefore,
science goes a long way with us. It shows that matter can be
carried by the homœopathic process of attenuation above the
9th centesimal degree without ceasing to be present or losing
the activity proper to it. But at this point it leaves us in the
lurch, and without denying it-gives no warrant to the sup-
position that the same thing will hold good at further stages
of the process.
From science as such, then-science unconnected with
Medicine-we receive countenance for our infinitesimals so
far, that up to about the 12th centesimal dilution we can
depend upon the presence of some particles, however few or
small, of the original drug. But the very support which it
gives us up to this point turns into opposition when we go
beyond it; for, if every test finds less and less response as we
mount higher in the scale of dilution, it implies that there is a
progressive diminution in the quantity and energy of the
matter present, and that we must at last get to an end of it.
And, again, if when we have reached the ultimately visible
particles of matter, we see them diminishing in number as we
attenuate farther, must it not be so with those still smaller
particles into which matter is ultimately divisible? At the
12th dilution we are a good way off from the 30th, and there is
a great gulf between us and the 200th. How are we to bridge
it over? how fill up the yawning void? Now at this point
come in the theories of "dynamisation" which have attracted
so much attention in the homoeopathic controversy-much
more, indeed, than their intrinsic importance deserves. They
imply that the processes of trituration and succussion with which
our attenuations are made more than compensate for the re-
duction of the mass of the medicinal substance, that they
actually develope power, and this to an indefinite extent, so that
the higher dilutions are more potent as medicines than the
lower, the 30th than the 3rd, the 200th than the 30th, and so
on ad infinitum. By some of Hahnemann's followers, who are
more imaginative than philosophical, this dynamisation has
been supposed to result from a transference of the whole thing
from the realm of matter to that of spirit.* I can only say that
* I must admit that his own language in later days favours the same
idea, but I think that he used the term "spiritualisation" metaphori-
cally. He supposed matter to be infinitely divisible, saying in the last
edition of the Örganon (1833): "A substance divided into ever so many
parts must still always contain in its smallest conceivable parts some-
what of this substance, and the smallest conceivable part does not
cease to be some of this substance, and cannot possibly become
nothing."
HOMEOPATHIC POSOLOGY.
103
It
I know nothing of such conceptions as applied to natural
things: they are to me alike uncongenial and unintelligible.
Others, with a more just idea of the matter in hand, have
endeavoured to apply to it the doctrine of the correlation of
force, and have argued that the energy put forth by the
triturator or succusser must be converted into increased force
on the part of the drug so treated. But they have not shown,
on the one hand, that it may not be accounted for by the heat
and electricity developed in the process, and on the other, that
the power of drugs to affect the organism is a "force," in the
sense that heat and light and such like are forces, so that it has
equivalence and correlation with other modes of motion.
seems rather to be a fixed and inalienable property, peculiar to
each substance possessing it. The same objection holds good
to the hypothesis advanced by my friend Dr. Allen,* that the
energy of the drug is transferred to the vehicle, so that although
no particles of the original substance remain therein the medi-
cinal force is not lost. If, moreover, it were so, it is obvious
that no further potentisation would be possible when once the
drug had attained its ultimate subdivision, and, parting with its
force to the surrounding menstruum, disappeared from the scene.
From about the 12th to the 18th dilution, then (if the calcu-
lations I have specified are correct), all capacity of change must
cease, and we have in hand nothing but a medicated water or
spirit, incapable of further dynamisation. Dr. Allen refers to
the French observations with septic blood as illustrating this
transference of energy to a vehicle. But he forgets that after
the ten-trillionth (i.e., 19th decimal) dilution had been reached,
which is about the estimated extent of the divisibility of
matter, no further effect was manifested.
I may refer you to a short but able paper by Mr. Proctor in
the thirty-first volume of the British Journal of Homœopathy,
on "The Theory of Dynamisation," as a complete examination
and, I think, refutation of these ideas.
You will observe that I have said nothing about the potencies
lately employed in America, in which the 1000th becomes a
new unit, and the scale is run rapidly up until now the
millionth and ten-millionth are supposed to have been reached.
I must reject these, not upon the grounds of science and reason,
bu. upon those of pharmacy. They are simple impossibilities.
It is easy to calculate that, if Hahnemann's directions are
followed, upwards of 2,000 gallons of spirits of wine would be
required for making the millionth potency of a single medicine,
to say nothing of a million clean bottles; and, as not more
* See New York Fourn. of Hom., ii., I.
104
HOMOEOPATHIC POSOLOGY.
than four potencies could be made in a minute, each receiving
its due number of shakes, that incessant labour at the rate of
twelve hours a day, and six days a week, would yet occupy
more than a year in the process! Even if machinery be em-
ployed, the time taken could not be reduced much more than
one half, and as power of some kind must be supplied, con-
siderable expenditure would be incurred. Whenever, accord-
ingly, we are able to learn the process by which these potencies
are prepared (and the tendency is to keep it a secret), we
always find it other than that recognised among us, and
illegitimate in itself. Jenichen's preparations, which first
broke ground in the new field, are now believed to be simply
succussions of an ordinary attenuation without further dilution
-ten of such shakes being reckoned as producing a potency
one step higher in the scale. The preparations which go
under the names of Fincke and Swan are manufactured by
what is called "fluxion," i.e., by allowing a stream of water to
be propelled with some force into a phial containing a hun-
dredth part of a drug, each emptying of which is reckoned as
diluting it one step farther in the centesimal scale. Even in
this way an immense time must be taken to produce such
potencies as are named; and how utterly untrustworthy is the
result! My advice to you, therefore, is to keep altogether
clear of these obscure and objectionable practices, and to set
down any results which seem to have been obtained by medi-
cines so prepared to their being other than what they assume
to be.
*
†
Putting these, then, out of sight, and limiting ourselves
to such attenuations as have been, and can be, prepared in a
proper way, our conclusion must be that while we are fully
warranted in expecting action from those below the 3rd, and
are not without countenance in similar hopes from those up to
the 12th, beyond this range we have nothing to depend upon
* Jenichen purported to produce the 60,000th potency. Dr. Dudgeon
has shown that, working five hours a day, and allowing a second for
each shake, it would take him five weeks to raise-according to his
method-a single drug to this height.
† Dr. Burdick, of New York, who has eminent scientific qualifications,
has lately shown, by calculation and microscopical investigation, that
the potency which Dr. Swan represents as m.m. (i.e., thousand thou-
sandth, or millionth), "cannot exceed the tenth centesimal of Hahne-
mann, and is liable to be much lower" (Hahn. Monthly, Nov., 1877).
It has been cruelly suggested (and not without warrant) that the
reason why these preparations have been found so efficacious is that
they are really much lower attenuations than their adopters have been
accustomed to employ.
HOMEOPATHIC POSOLOGY.
105
but observation and experience. While we are not, therefore
to ignore curative results obtained from 30ths and 200ths, we
must be wary about admitting them, requiring the warrant
either of the capacity of the observer, or of a full statement of
the facts of each case. Upon these principles I shall act in
dealing with the materials of my present course. They are
applicable also, and with even greater force, to provings which
purport to have been made with infinitesimal doses, many
of which will come before us as we proceed. The altered
sensibility to stimuli of diseased organs, and the similarity of
the action of the drug to the morbid cause, combine to
suggest that homœopathic remedies may cause aggravation,
and that their doses should be small and may be minute. Upon
the healthy there is no such à priori probability of the action
of infinitesimals: it is a pure question of fact.
Well I can
here also affirm that, in my judgment, the facts bear out the
doctrine that such quantities may produce effects. Let me
mention three crucial instances:
1. Dr. Imbert-Gourbeyre, whose bibliographical and per-
sonal collections of the effects of Arsenic will connect his
name indissolubly with this drug, has recorded several in-
stances of its physiological action in infinitesimal doses.*
Among these are, from the fourth trituration (gr. 1000000),
pruritus, erythema, papules, and burning of the eyes with
lachrymation; from the eighth (gr. 100000000000000) a confluent
miliary rash with great malaise (this was in a healthy prover,
a medical student).
2. Dr. von Grauvogl, to whose transcendent ability his
Lehrbuch der Homöopathie bears unquestioned witness, proved
the same drug on himself. The 3rd and 10th decimal attenu-
ations made him ill: the 30th decimal did not do this, but it
brought on the insatiable thirst which he subsequently ex-
perienced when suffering from the stronger doses, and which
ĥe therefore knew to be arsenical.f The 30th decimal = the
15th centesimal attenuation; i.e., a drop of it represents the
quintillionth of a grain.
3. Arsenic is a virulent poison in its crude state. But of the
drugs which, inert thus, develope energy in the process of
trituration we have a typical example in Natrum muriaticum.
This substance was re-proved in Vienna, under the super-
intendence of Dr. Watzke, a most competent observer, and
with all his prejudices the other way. But he writes—“ I am,
* See especially his "Etudes sur quelques symptômes de l'arsenic "
in the Gazette Medicale for 1852.
† Text-book of Hom. (trans. by Shipman), ii., 59.
106
HOMOEOPATHIC POSOLOGY.
alas! (I say, alas! for I would much rather have upheld the
larger doses which accord with current views) I am compelled
to declare myself for the higher dilutions. The physiological
experiments made with Natrum muriaticum, as well as the
great majority of the clinical results obtained therewith, speak
decisively and distinctly for these preparations."
In the face of such facts (which might easily be multiplied,
both from the Austrian* and the later American provings) we
are not justified, I think, in rejecting symptoms purporting to
be obtained by infinitesimal doses of drugs, as such. They
possess, however, in enhanced degree the uncertainty which
hangs about all provings on the healthy subject. Dr. Hamil-
1 ton showed us some years agot how many slight deviations
from the norm will occur in a man presumably healthy, who
notes his own feelings and doings for a few days. Dr. Conrad
Wesselhoft, of Boston, has recently shown the same thing on
a larger scale by a crucial experiment. Having to conduct a
re-proving of Carbo vegetabilis, he began by furnishing his
fellow-workers with a number of blank powders of sugar of
milk. No inconsiderable array of symptoms were reported to
him as the result of the ingestion of these placebos, before a
single particle of the drug had been. absorbed. Except,
therefore, where care has been taken to eliminate this source
of error, we must accept with considerable reservation the
results purporting to be obtained from infinitesimal doses,
especially when they are of the subjective and fleeting cha-
racter which mostly belongs to them. When, as in Dr. Imbert-
Gourbeyre's cases, they are objective, or when, as with Dr. von
Grauvogl's, they are marked and recurring, there need be no
doubt of their reality.
I believe these to be reasonable grounds on which to pro-
ceed in dealing with the difficult subject of Homœopathic
Posology.
* See Brit. Fourn. of Hom., vi., 10.
+ See Ibid., xxix., 565.
See Transactions of the American Institute of Homœopathy for 1877.
LECTURE VIII.
ACIDUM BENZOICUM, CARBOLICUM, FLUORICUM, HYDRO-
CYANICUM, MURIATICUM.
We now proceed to the consideration of the several substan-
Various
ces constituting the Homoeopathic Materia Medica.
classifications of drugs have been adopted by teachers and
writers of the old school, as the order in which they should
be discussed. I venture to think that all these, whether based
on natural history, on physiological action, or on therapeutic
properties, assume more relation between drugs than really
exists. In homoeopathy we are led to regard each drug as an
individual, and it will be more in accordance with the genius.
of this system to adopt an order which assumes nothing as to
the action of its constituents. This is, obviously, the alphabet-
ical.
Most homoeopathic authors, in adopting this plan, begin
with Aconite, and at once plunge therewith into the very
thickest of the fight. I shall ask your previous attention to
the acids used in our practice. By Hahnemann and Jahr these
were named after the substance which yields them, as Nitri
acidum, Sulphuris acidum; and took place in their alphabetical
catalogues accordingly. Dr. Allen has them similarly scattered
throughout his volumes, through their being called Benzoicum
acidum, Fluoricum acidum, and so forth. I much prefer
grouping them all together, with their adjectiva in the second
place their names will then stand first on our list. We shall
gain this advantage thereby, that several minor yet not un-
important medicines will have come under our notice, and
will have initiated us in the study of Materia Medica on
homœopathic principles, ere we grapple with one of the most
eminent of the series.
The first medicine we shall consider, therefore, is—
Acidum benzoicum.
This acid is obtained by sublimation from benzoin, a
balsamic resin which exudes from the incised bark of the
108
ACIDUM BENZOICUM.
Styrax Benzoin. It is dissolved in rectified spirit, or tritu-
rated.
Nothing was known of the physiological effects of Benzoic
acid (save the alteration of the urine which it causes) till it
was proved by the American Institute of Homœopathy. The
report of these experiments, by Dr. Jeanes, is contained in the
Materia Medica of American Provings. Another pathogenesis
of the drug was then published by Dr. Petroz, and may
be found in his colleeted writings. An "arrangement" of our
knowledge concerning the drug forms one of Hering's Ameri-
kanische Arzneiprufungen, and may be read in English in
Dr. Shipman's translation of v. Grauvogl's Text-Book of
Homœopathy. It contains many additional observations. Dr.
Allen's article includes all these materials, but is somewhat
spoiled by a commingling of clinical with pathogenetic symp-
toms, the former being not always distinguished by their
proper mark.
The pathogenesis of Benzoic acid does not lend itself
readily to interpretation or analytic statement. It is one of
those which are utilised therapeutically rather by the à posteriori
than by the à priori method of homœopathising. The account
to be given of it is therefore the statement of what application
has been made of it to practice.
After taking Benzoic acid in quantity, hippuric acid appears
in the urine. This seems merely a chemical change, as
hippuric acid under the influence of acids is converted into
Benzoic acid and gelatine sugar, and the opposite transforma-
tion has every opportunity and material for its occurrence. It
was supposed, however, by Mr. Alexander Ure that in this
process the lithic acid of the urine disappeared; and hence he
proposed to use Benzoic acid in gouty subjects to prevent
concretions and calculi. Later investigations have not con-
firmed this observation as to lithic acid, nor Dr. Garrod's
statement that under these circumstances the urea is dimi-
nished. But Lehmann has demonstrated that the Benzoic is
one of the few acids which manifestly increase the acidity of
the urine. It has accordingly been used, with decided tem-
porary benefit, in cases of irritable bladder with alkaline urine
and muco-purulent or phosphatic deposits.
The dynamic properties of the drug seem to centre at the
same spot. Dr. Jeanes has found a deep red (almost brown)
colour of the urine, and a great intensification of its natural
odour, an almost unfailing characteristic for the drug. A
minute dose even will change these features of the secretion,
and therewith ameliorate the morbid conditions associated
ACIDUM BENZOICUM.
109
with them. Among these he mentions especially syphilitic
and gonorrhoeal affections occurring after suppression of the
primary symptoms, but also recurring quinsy and nephritic
colic, infantile diarrhoea (the stools being pale and fœtid),
ulcerations of the mouth and tongue, and rheumatic and gouty
arthritis. In all these, Benzoic acid, prescribed mainly because
of the presence of the characteristic urine, relieved greatly or
cured. Subsequent experience and testimonies are in the
same direction. In the enuresis of children* and old persons
where this condition is present; in dysuria similarly accom-
panied;† and in acute articular rheumatism having the same
feature, ‡ the drug has been found of the utmost value. Dr.
Guernsey states that the odour of the urine is more character-
istic than the colour, and that it must be present when the
urine is freshly voided.
These are the main uses of Benzoic acid; but a few miscel-
laneous observations must be added.
1. Benzoin and other balsams-as those of Peru and Tolu-
are regarded as having a specific influence upon the mucous.
membranes, especially that of the respiratory tract, which (say
Trousseau and Pidoux) they affect as the turpentines that of
the urinary organs. They are used to check excessive expec-
toration. Now although, when swallowed in substance, their
resinous constituents might have much to do with this action,
yet the more common mode of applying them to the bronchial
membrane is by fumigation, and here it is the acid they
contain which becomes the active agent. In the case of
benzoin this acid is, as we have seen, our present drug; which
thus appears to exert a special action on the respiratory
mucous tract. Accordingly, we find that when Schreiber had
taken in two days about half an ounce of the acid, he noted-
among other effects—an increase of the pulse-rate amounting
to thirty beats per minute, with increased secretion and excretion
of phlegm; while Pereira states that he has repeatedly tried
the acid in bronchial affections, but has more frequently seen it
augment than relieve the cough. Perhaps in the smaller doses
we should use it would prove more beneficial.
2. Dr. Hering says that "the more Benzoic acid is used in
*
North Am. Journ. of Hom., iii., 334. Marcy and Peters, p. 14.
Stillé says that incontinence of urine, without an altered condition of
the secretion, has been treated successfully by means of benzoic acid;
but Bartholow thinks that in such cases the urine was too alkaline.
† See Brit. Fourn. of Hom. xxvi, 489.
+ Von Grauvogl's Text Book (Engl. transl.), ii., 127. It is much
used in this disease in the Leopoldstadt Hospital at Vienna (Annals,
iv., 514).
IIO
ACIDUM CARBOLICUM.
gout the more it will be prized." The swelling of the fingers
noted by Nusser, one of his provers, who took eighty grains of
the second trituration in one dose, points in this direction;
and the facts we have just mentioned suggest the drug in
gouty bronchitis.
3. Dr. Bayes states that he found it rapidly curative in a
case of tendinous swelling at the back of the wrist of long
standing; he does not say in what dose. I have myself
frequently obtained much reduction in size of ganglia situated
in this region by its external application in an ointment con-
taining five grains to the drachm. But Dr. Turrel has com-
municated to the eighth volume of the Bibliothèque Homœo-
pathique (p. 354) five cases in which such tumours were
dispersed by the medicine given internally in the dilutions
from the 12th to the 30th. He mentions that horses are liable
to an analogous affection ("wind-galls"), and suggests that it
may be owing to the considerable proportion of Benzoic acid
which exists in their forage. This latter fact may account for
the uric acid in their renal secretion undergoing that modifi-
cation which has given it the name "hippuric," and which
accounts for the strong odour of horse-urine. In one of Dr.
Turrel's cases the urine had a remarkable fœtor.
There is no homoeopathic medicine I can compare with
Benzoic acid.
Its chemical action on the urine seems attainable with
about ten-grain doses. Its homœopathic uses have been
carried out with quantities varying from gr. th to the 3rd and
(as we have seen) higher dilutions.
I have next to speak of the product of the distillation of
coal-tar known as
Acidum carbolicum.
The Pharmacopoeial preparation is a solution in rectified spirit.
Some excellent provings of this substance (mainly with the
medium dilutions), in which upwards of thirty persons took
part, have been made in America. Their results, together
with a good many effects of poisoning, are given by Dr. Allen.
Some of the provings are related at length, together with some
clinical experience obtained with the drug, in the fourth
volume of the Pathogénésies Nouvelles appended to the
Bibliothèque Homeopathique, which you will find in the library
ACIDUM CARBOLICUM.
III
of this School. There is a good account of its crude physio-
logical effects in Dr. H. Wood's treatise.
It is needless to speak here of the action of Carbolic acid as
an antiseptic and as a local anesthetic. These are properties
of the substance which medical men of all schools can and do
utilise. Our present interest is with its dynamic influences
and specific remedial powers.
The most marked symptoms of poisoning by this acid are
those of the nervous centres, which are congested and pros-
trated by it, so that coma (with contracted pupils) and
paralysis result. In animals clonic convulsions are not un-
common, which seem to be epileptiform in seat and character.
In the provers these effects take the milder form of languor of
mind and body, with headache and vertigo, and sometimes
spinal pain and tenderness. The headache implies great
fulness of the cerebral vessels, being generally compared to a
sensation as if a tight band were stretched around the forehead
and temples. Sometimes it becomes neuralgic in character,
and is then especially felt over the right eye. We next have
marked effects upon the stomach. Vomiting is often produced,
even when the acid has been absorbed from a wound; and
flatulent distension, causing frequent sighing or belching, is a
constant symptom with the provers. One of these speaks of
himself as suffering throughout his experiments from a verit-
able acute dyspepsia, though the doses he took were too small
to produce any local caustic effect. These are the main seats
of its action in the provers; but experiments on animals give
us also fatty degeneration of the liver and kidneys, with epithe-
lium and albumen in the urine; keratitis and conjunctivitis;
and-post-mortem-pseudo-membranous and purulent inflam-
mation of the bronchial tubes, with disseminated lobular pneu-
monia or else congestion of the lungs. It is not certain how
far the human body is susceptible of these actions.
—
Of the therapeutic powers of Carbolic acid we know little
as yet; but, so far as they go, they correspond with its patho-
genetic action. It is especially in gastric affections that it
has been found useful,—in vomiting (H. C. Wood) and flatulent
distension (Ringer) in the old school, and in some complicated
dyspepsias in homoeopathic practice. Migraine, moreover,
when the pain is seated above the right eye, has yielded to
its use.
Its physiological influence on the skin is uncertain,
though itching and vesiculo-pustular eruptions occasionally
appeared among the provers. But it has been found very
useful, not only in such forms of cutaneous disorder, but also
(by my friend Dr. Guerin Ménéville, of Paris) in psoriasis.
112
ACIDUM FLUORICUM.
It can hardly be doubted that more has yet to be made of
this potent agent. What it can do against purulent forma-
tions and malignant febrile and inflammatory conditions is
probably due to its antiseptic influence, and needs material
doses of the acid itself or of the sulpho-carbolates. My col-
league Dr. Cooper has communicated to me an excellent cure
of hepatic abscess and dysentery thus effected. A female
prover experienced great relief from a lumbo-sacral pain which
had long troubled her. The head symptoms, moreover, are so
strikingly apoplectic that some use ought to be made of the
analogy. It seems once at least to have cured acute hydro-
cephalus, and might be useful in uræmic coma. Davidson and
Bähr esteem it highly in diphtheria.*
Carbolic acid compares with Gelsemium in its action on the
nervous centres, with Carbo vegetablis and (naturally) Kreosote
in the gastric sphere.
Its homoeopathic cures have been effected with the dilutions.
from the first to the third.
The next in order is-
Acidum fluoricum.
This acid—more strictly hydrofluoric-is peculiar to homœo-
pathic practice. The primary dilutions of it are, of course,
prepared with water; and, owing to the solvent action of the
acid upon glass, must be kept in gutta-percha bottles.
The homoeopathic school possesses an exhaustive proving
of the dilute acid. It was conducted by Dr. Hering, assisted
by thirteen others, and its results may be read in the Materia
Medica of American Provings, or in Allen's Encyclopædia.
This is another pathogenesis of which no general account
can give an adequate idea. But the main curative sphere of
Fluoric acid has been ascertained by applying certain of its
indications to practice. It may be defined as consisting in
chronic irritations of mucous membrane, and in morbid condi-
tions of the more lowly organized tissues. Cases are on record.
in which the acid, in dilutions from the 5th decimal upward,
has proved curative of chronic diarrhoea, of secondary syphilis
of the throat and tongue,† and of osseous caries. These are
from the late Dr. Laurie's pen; but in Hering's article we read
* See Oehme's Therapeutics of Diphtheritis, p. 24.
† See Brit. Fourn. of Hom., xxiv., 154.
‡ Laurie's Elements of Hom. Practice of Physic, p. 609.
ACIDUM FLUORICUM.
113
how under the use of the drug whitlows have been blighted,
fistula-lachrymal and dental-have closed, varicose veins
have shrunk to half their size, fresh hair has grown on a bald
head, and moist palms have regained their healthy dryness.
Chronic rhinitis also has been cured, and rectal troubles
alleviated. Other directions in which it may profitably be
applied will probably appear. My own experience with it in
old cases of varicosis of the leg, such as we see at the hospital,
is very favourable.
The following seem to be prominent among its physiological
effects:
1. Disagreeable and inimical mood.
2. Sense in the brain as if on the verge of being struck by
apoplexy. (After smelling the strong acid. The first effect
was to irritate the throat: then an influence seemed to pass to
the brain.)
3. Retinal excitement, with red photopsia.
4. Urine of strong odour (once with purple sediment).
5. Great excitement of the sexual instinct in men, and in a
woman premature appearance of the catamenia.
6. Pains in the bones generally.
7. Numbness and lameness of the hands.
8. Itching and redness of old cicatrices of the skin.
9. Perspiration, glutinous or sour.
M. Maumené has been led from his observations and
experiments to believe that the cause of goitre is the presence
of fluorides in drinking water. He asserts that they are
peculiarly abundant in the water of goitrous districts. In
corroboration of his views he cites an experiment in which a
true and permanent bronchocele was established in a dog by
a five months' course of fluoride of potassium. This is a hint
not to be neglected.
I have already mentioned the doses in which this acid has
been given in homoeopathic practice. It is a close analogue
of Silica, of which we shall have hereafter to speak.
I have now a more familiar drug to introduce to you,—
prussic acid, or
Acidum hydrocyanicum.
"Equal measures of the officinal acid" (which contains 2 per
cent. of anhydrous prussic acid) "and rectified spirit will make
the first centesimal dilution :" so writes the British Homoeo
pathic Pharmacopœia.
I
14
114
ACIDUM HYDROCYANICUM.
Hydrocyanic acid has not been experimented with in the
school of Hahnemann. But an excellent proving of it has
been furnished by Professor Jörg, in which five persons tested
the acid itself, and sixteen the distilled waters of the two
natural substances which contain it most largely—the bitter
almond and the cherry laurel. Some of the numerous cases of
poisoning by this agent have been collated, and their physio-
logical and therapeutical significance analysed, in a paper on
the acid by Dr. Madden and myself in the twentieth volume
of the British Journal of Homeopathy, to which reference may
be made for more details than can find place here. Dr.
Allen's pathogenesis embraces the above materials and many
other symptoms from poisonings.
This potent poison, reputed in many disorders since its
discovery in 1782, appears in Ringer's Handbook as sometimes
relieving pain and vomiting in chronic gastric diseases; and
that is all. Stillé allows also some power on its part over
nervous coughs, including pertussis. In homœopathic prac-
tice it is very rarely mentioned. I venture to think that this
is undeserved neglect; and that we have in Hydrocyanic acid,
given according to the law of similars, a very useful medicine.
It should be so, indeed, according to its physiological
action, which pictures several severe diseases.
I. The first of these is epilepsy. There is a large consensus
of authority as to the essential similarity between the pheno-
mena of poisoning with this acid and the epileptic paroxysm.
Pereira, Christison and Taylor all affirm it, and it need not be
argued afresh here. The first case of poisoning we have cited
in our paper was taken by the medical attendant for an
epileptic fit; and there is nothing surprising in the mistake.
The sudden falling and loss of consciousness, the subsequent
laryngismus, empurpled face, foam at the mouth and convul-
sions together form a perfect picture of the attack of this
disease. Excitation of the cervical sympathetic, which is now
regarded as (through the contraction of the cerebral arteries it
produces) the proximate cause of epilepsy, was undoubtedly
present in this case, as indicated by the dilated pupils, with
prominent, glistening eyeballs. Pereira's statement seems to
be correct, that "whatever be the precise pathological condi-
tion of the brain in poisoning by this drug, it is probably
identical with that which occurs during an epileptic paroxysm,
and with that produced by loss of blood."* The sensations in
* This argument will be found more fully drawn out in a paper con-
tributed by me to the World's Convention of 1876, and published in its
Transactions.
ACIDUM HYDROCYANICUM.
115
the head described by provers are in entire harmony with this
view, and forcibly suggest the epileptic vertigo.
The homœopathic inference from these facts must be that
Hydrocyanic acid ought to find a very prominent place
Its use in this affection
among anti-epileptic remedies.
hitherto has been only limited. It was hardly to be expected
that it should play any large part in the old-school thera-
peutics of epilepsy: nevertheless, some experience of the kind
is on record. Hartlaub and Trinks, in the preface to their
proving of Laurocerasus, mention that Gremmler found the acid
diminish the frequency and severity of the paroxysms, though
he could not effect a radical cure with it; and that Remer
praises it in the epileptic convulsions of pregnant women.
They also refer to a cure of epilepsy by cherry-laurel water,
communicated by one Müller to Hufeland's Journal. I find
that the patient here was a woman of twenty-two, who had
had the fits for seven years, often twice a day. Aqua laurocerasi
was prescribed, in doses increasing from twenty to eighty
drops daily. By the time that four ounces had been taken,
the patient was quite cured. Frank, in the first volume of his
Magazin (p. 320), relates three of Gremmler's cases, which seem
to warrant a more favourable account than that given of them
by Hartlaub and Trinks; and also one from Koehler, in which
a complete cure was effected. In his fourth volume he cites a
narrative from the Bulletin of the French Academy of
Medicine, which tells how an epileptic dog, being delivered
over to be poisoned, instead of being destroyed by the prussic
acid given him with this intent, lost his fits and became quite
healthy.
In homoeopathic literature I know of no record of the treat-
ment of epilepsy by this drug. Baertl, in the exhaustive
collection of cases of the disease which he communicated to
the Vierteljahrschrift in 1863 (translated in the twenty-second
volume of the British Journal of Homeopathy), finds no place
for Hydrocyanic acid. He mentions, indeed, some favourable
results from Ferrum hydrocyanatum; but this compound
seems to have none of the active properties of the acid. `I can
only, therefore, speak from my own experience with the
medicine.
Dr. Madden and myself were so struck with that homoeo-
pathicity to epilepsy which I have now claimed for it that we
proceeded to use it largely in the treatment of the disease.
Our results at first were encouraging, and we hoped to be able
to communicate many instances of cure from its administra-
tion. But in all save recent cases the fits soon returned.
116
ACIDUM HYDROCYANICUM.
We thought that Dr. Russell had noted a fatal weakness in
the medicine when he pointed out the evanescent character of
its action, and we supposed that thus our fleeting successcs
were explained.
Save, then, in recent epilepsies-as from fright—I made
little use of Hydrocyanic acid until 1875. Having then
to lecture on the drug at the London Homœopathic Hospital,
the fresh and more extended survey of the facts which I made
led me to think that I had been hasty in abandoning it as an
anti-epileptic. I thought it likely that some part of our
failure had arisen from not giving the medicine strong enough
or long enough, and that thus the evanescence of its effects
might obtain compensation. I altered my plan accordingly,
and am much better pleased with my results. It is my prac-
tice now to give from five drops of the 3rd decimal attenua-
tion to three drops of the first centesimal three times a day.
Drs. Croucher and Holland have recently reported cases of
epilepsy cured by the acid where the sudden cry so character-
istic of poisoning by it has ushered in the paroxysms.
2. Secondly, Hydrocyanic acid causes undoubted tetanus.
There is not, as with Strychnia, evidence of increased reflex
excitability; but, as with Aconite and Cicuta, persistent tonic
spasm. This it produces by direct action upon the spinal
cord; for, when the cord was divided (by Wedemeyer)
between the last dorsal and the first lumbar vertebræ, and
prussic acid introduced into one of the hind legs, these, as
well as the forelegs, were immediately convulsed.
We have thus in our medicine another anti-tetanic. The
only instance of its use of which I am aware is a case of the
traumatic form of the disease successfully treated by Dr.
George Moore with drop doses of Scheele's acid.* The
curative action here seems undoubted.
3. The tonic spasm excited by Hydrocyanic acid is
nowhere more marked than in the organs of respiration. This
also is the general testimony of toxicologists. "Spasmodic
respiration" is noted by all observers of acute poisoning,
Boehmt pointing out that it is to the expiratory stage that
this character especially belongs; and Wood mentions among
the chronic effects of the vapour "difficult respiration, constric-
tion of throat, feelings of suffocation." "The only marked
post-mortem phenomenon," he writes, "is a universal venous
congestion, proving that the circulation had been arrested in
the lungs."
* Brit. Fourn. of Hom., xxiv., 506.
+Ziemssen's Cyclopædia, xvii., 509.
ACIDUM HYDROCYANICUM.
117
Now it is in spasmodic disorders of the respiratory organs
that, next to gastric affections, Hydrocyanic acid has obtained
its chief reputation. In whooping-cough Dr. West says that
"it sometimes exerts an almost magical influence, diminish-
ing the frequency and severity of the paroxysms almost
immediately." In recent and uncomplicated asthma I have a
high opinion of it: it is to this disease as to epilepsy. Dr.
Russell, in his work on Epidemic Cholera, relates a case in
which it gave great and speedy relief to an intense spasmodic
oppression of the chest, which came on in a cholera patient;
and Dr. Sircar, from his Indian experience, speaks highly of
it in such conditions.
4. Any poison which through the nervous centres can affect
the respiration is capable through the same channels (pneu-
mogastric and others) of disturbing the action of the heart.
Hence the palpitations, anxiety, diminished pulse, and ten-
dency to syncope, noted alike in poisonings and provings by
this acid.
The value of prussic acid in cardiac affections is fairly stated
in this sentence of Dr. George Wood's. "In palpitation and
other irregularities in the function of the organ, of no very
energetic character, whether purely nervous or associated with
organic disease, I know no medicine better calculated to
alleviate the disturbance of the function, and afford ease and
comfort to the patient." It has been recommended in angina
pectoris, which is indeed of a piece with the gastrodynia and
enterodynia in which it has proved so useful. There are
testimonies extant to its efficacy. I had an interesting case
some time ago, in which epilepsy and angina pectoris coin-
cided in the same patient. Hydrocyanic acid was of very
great benefit for both disorders.
*
5. The curative power of Hydrocyanic acid in pain at the
stomach and vomiting must also, I think, be traced to its
homoeopathicity thereto. "An overdose," writes the late Dr.
Elliotson, one of its warmest advocates, "will in every person
occasion nausea, vomiting, and pain and tightness at the
præcordia. Even applied externally, it has caused nausea,
vomiting, vertigo, and syncope. It appears therefore," he
concludes, "to act specifically upon the stomach." It is
evident that here, as often elsewhere, "specifically" means
homœopathically. And, indeed, some such action seems re-
quired to account for the brilliant and permanent cures of
gastrodynia and enterodynia recorded by this physician, and
* " New Materia Medica," by Drs. Marcy and Peters, appended to
North American Journ. of Hom., p. 25.
118
ACIDUM HYDROCYANICUM.
also by Pereira and Granville. Here also, as in whooping-
cough, is displayed that contingent character which belongs to
all the best homoeopathic medication. Its beneficent effects
are sometimes astonishing, while at others there is utter
failure. When benefit does result, it is exceedingly rapid,
so that there is no need to persist in the use of the drug for
many days; and, as its action is of very short duration, it may
be repeated pretty frequently. Whether in the instances of
success the pains are from spasm, and therefore the acid
homœopathic, while in those of disappointment they are
neuralgic, I cannot say if it were so, I should apply the same
principle to the treatment of angina pectoris. The gastralgia
which indicates this medicine I find always worse when the
stomach is empty, and relieved by food.
There is good evidence of the action of Hydrocyanic acid
on the solar plexus. Sir B. Brodie applied one drop of the
essential oil of bitter almonds to his tongue. He immediately
felt a remarkable and unpleasant sensation at the epigastrium,
with such weakness in the limbs and loss of power in the
muscles, that he thought he should have fallen. I have fre-
quently removed by it the distressing feeling known as "sink-
ing at the stomach," when this has been unconnected with the
climacteric age.
The outline of the sphere of Hydrocyanic acid is now very
clearly before us. It affects the whole cranio-spinal axis and
associated sympathetic ganglia, setting up that disturbance
which induces tonic spasm in the muscles. Hence the phe-
nomena of head, heart, lungs, stomach, and trunk in general;
and hence its therapeutic value in similar idiopathic conditions.
It will be a profitable task if any one will undertake from study
of the provings and from clinical observation to fill in this
outline, and define for us the precise place of the medicine in
specific therapeutics.
You may ask-is this description of prussic acid warranted
by toxicology? It is commonly supposed to be a paralysing
rather than a tetanising agent; and is set down in ordinary
classifications of the Materia Medica as a pure sedative. But
a few cases of poisoning will dissipate the first notion,* and
will show you that the second arises from observation of its
curative action only.
* See also Stillé (ii., 252, 254-5):-"the immediate consequences of a
fatal dose of the acid are general spasm of the muscular system, and
death from an arrest of the action of the heart and lungs; " and Boehm
(loc. cit., p. 505)—" we consider the convulsions of prussic acid poi-
soning the result of a transient but energetic irritation of the central
apparatus of the brain and spinal cord.”
ACIDUM HYDROCYANICUM.
119
For its action on the spinal cord Hydrocyanic acid may be
compared with Aconite and Cicuta. As an epileptifacient, its
only analogue is Enanthe crocata.
I have generally used Hydrocyanic acid in the dilutions
from the third to the sixth decimal. The experience of the
ordinary practice would seem to show that in whooping-cough
and gastrodynia the first attenuation may be used with
advantage.
As the salts of Hydrocyanic acid and the plants containing
it owe their active properties to its presence, it will be well
to consider here any that demand our notice. I shall speak
only of the cyanide of potassium among the former, and of
the cherry-laurel among the latter: others are probably con-
formable to these types.
Kali cyanatum.-As a poison this salt seems identical with
Hydrocyanic acid. It has been proved, in the first, second,
and third attenuations, by two members of the Massachusetts
Homœopathic Society (1861-2): the record of their experi-
ments may be read in the twenty-second volume of the British
Journal of Homœopathy (p. 496). Lembke also has experi-
mented with it. The results obtained by these provings, with
effects of poisoning, enable Dr. Allen to present a pathogene-
sis of 228 symptoms. It presents little that is noteworthy,
save as it covers the same ground as the acid. My only
reason for mentioning the drug is that in the hands of the
late Dr. Petroz it effected a remarkable cure of disease of the
tongue, which may be cited here:-
"In 1829 a woman living in the Rue St. Nicolas, whose family was
known to me, came to ask my advice about a disease of the tongue, for
which she had been under the care of Dr. L'Herminier. The organ
was profoundly altered by an ulcer, which appeared to me cancerous,
and which occupied its right side; the edges, especially posteriorly,
were indurated, raised, and knotty; speech was difficult, indistinct, and
accompanied' with much pain. The patient could only take liquid
nourishment. Distrusting my own diagnosis, I sent her to Professor
Marjolin. She brought me back the following judgment: 'Cancerous
ulcer; no chance of cure but from operation; and this impossible, for
the base of the tongue is involved.'
"In the presence of so grave a disease, I turned my thoughts to
diminish her sufferings. I prescribed the oth of a grain of hydrocya-
nate of potassa, to be repeated every fourth day. After fifteen days I
again saw the patient. She suffered less; the tongue appeared to me
not so thick, the edges less hard, the speech easier. The medicine was
continued in the same way. Fifteen days later the patient, whose
countenance had lost its grey hue and drawn features, said to me with
joy, 'I begin to be able to eat a crumb of bread.' The hydrocyanate
was continued for a month longer, when the cure was complete. It is
now eighteen years ago, and there has been no relapse."
I 20
ACIDUM MURIATICUM.
Laurocerasus. The cherry-laurel has found a place of its
own in homœopathic medicine, from having been proved in
an elaborate manner by Professor Jörg and eleven of his
pupils, and subsequently by Drs. Hartlaub and Trinks. The
article on the drug in the first volume of the latter's Arznei-
mittellehre contains Jörg's symptoms and their own, with many
observations of poisoning and overdosing; Dr. Allen's patho-
genesis is a reproduction of this, Jörg's provings being trans-
cribed from the original. A tincture is prepared for homœo-
pathic practice; but the distilled water (Aqua laurocerasi) is
generally the favourite preparation.
I am myself unable to see in either the pathogenetic or the
curative effects of Laurocerasus anything specifically distinct
from those of Hydrocyanic acid. It has, moreover, the dis-
advantage of very uncertain strength. Nevertheless, Dr.
Phillips seems to have used it with good effect in the gastric,
cardiac, and respiratory affections for which the acid itself is
recommended. His doses are from five to thirty minims of
the distilled water. It has been very little used in homœo-
pathic practice. Dr. Guernsey considers the sense of tight-
ness about the heart and chest which prussic acid causes a
characteristic indication for Laurocerasus; and mentions that
it has been very beneficial in his hands for the cyanosis of
childhood, when a little exercise produces gasping for breath
and increased blueness. A gurgling sound in the oesophagus
when swallowing is regarded as indicating this medicine in
gastro-intestinal disorders.
Last, on the present occasion, we come to
Acidum muriaticum.
This is of course the acid now called hydrochloric. The
attenuations are necessarily aqueous,-10 minims of the acid
of the British Pharmacopoeia with twenty-one minims of dis-
tilled water making the 1* dilution.
X
Nothing is known in extra-homœopathic literature of the
physiological action (save the local poisonous effects) of Muria-
tic acid. Hahnemann's first proving of it appears in the fifth
volume of the Reine Arzneimittellehre, containing (in the second
edition) 61 symptoms of his own, 196 from six fellow
observers, and 22 from authors. A later pathogenesis in the
fourth volume of the Chronic Diseases adds 295 symptoms more,
contributed by Hahnemann himself and two others (Rummel
ACIDUM MURIATICUM.
121
and Nenning). Dr. Allen reproduces this last, adding a few
symptoms from poisonings.
I have already explained why I can make no use of the
symptoms of the Chronic Diseases. Moreover, since the
attenuations of the acid are directed to be made with diluted
alcohol for the first, and undiluted subsequently a process
which would go far to change it into ether, even the symptoms
of Hahnemann and his fellow provers in the Materia Medica
Pura are somewhat vitiated as indications for the use of true
Muriatic acid. Again, the twenty-two symptoms (made into
twenty-four in the later pathogenesis) from authors are
strangely irrelevant for their purpose and incongruous with
their surroundings. Hahnemann himself tells us of some as
the effect of "aqua oxymuriatica," i.e., solution of chlorine
(Schmidtmuller, Crawford, Sachse, Humboldt), of others as
the troubles of workmen in salt-mines (Ramazzini); while
sneezing and cough with hemoptysis are the local effects of
inhaling the acid in gaseous form (Theiner, &c.).
Happily, our clinical experience is sufficient to define pretty
closely its sphere of action. This may be said to be a low
febrile condition of the blood, with ulceration of mucous mem-
branes and eczema of neighbouring cutaneous surfaces. Its use in
low fever is common to both schools of medicine. Of old,
its action in these cases was ascribed to a power of modifying
a supposed putrescence of the fluids; and the medicine was
given also in malignant scarlatina and putrid sore throat.
Now-a-days its use seems pretty well confined to true "fever,”
and it is considered to act by neutralizing superabundant
alkali (Richardson) or by supplying deficient acid (Chambers).
I am disposed to believe that its (undoubted) action in this
malady is, after all, dynamic; for it is certain that Muriatic
acid, in doses too small to exert any chemical action, has a
very high reputation in homoeopathic practice as a remedy
for low fever. Dr. Trinks* warmly commends it (in the first
dilution) in the type known of old as "nervosa versatilis,"
where it does great things in calming and cooling. Its homoeo-
pathicity to the erethism of the circulation and nervous centres
present in this stage is evident from Stillé's description of its
physiological effects. "In small doses," he writes, "medicinal
generally some quickening of
the pulse,
flushing of the face, and an increased How
of urine. In larger doses it excites the brain in a peculiar
manner, causing giddiness, confusion of the senses, a sort of
intoxication, in fine." Teste extols it later on, to modify the
muriatic acid occasions
* Brit. Fourn. of Hom., xxix., 203.
I22
ACIDUM MURIATICUM.
intestinal ulceration, over which he thinks it has as much
power as when the same morbid condition exists in the mouth
or throat. He says that "the almost constant and frequently
immediate effect of this drug is to modify the character of
the intestinal secretions, and to take away their foul smell;
and, after this result is accomplished, almost all the other
symptoms improve, and the course of the malady is consider-
ably shortened." With this coincides, from another point of
view, the testimony of Dr. George Johnson.* He thinks that
the diarrhoea of typhoid may well be increased by the mineral
acids (usually the hydrochloric) commonly given; and ascribes
its diminution at King's College Hospital to their discon-
tinuance.
Bähr, Guernsey, Bayes and Espanet concur in commending
Muriatic acid in typhoid; and add to the above as indications
for it slipping down to the foot of the bed, tendency to invo-
luntary evacuations, utter aversion to food, and copious urina-
tion, with putrescent phenomena.
A similar condition of blood and mucous membrane exists
in malignant scarlatina and perhaps in diphtheria. In the
former disease Muriatic acid is of great value for the affections
of the nose and ears, especially when they occur as sequela;
and it vies with Mercury in the ulcerations of mouth and
throat. About its action in true diphtheria I cannot speak
with any confidence, though I think (and herein Dr. Kidd con-
firms met) that it has some efficacy when symptoms of blood-
poisoning are prominent. The following case by the late Dr.
Russell will show what it can sometimes do here; and we
should not forget the value set upon it by Bretonneau as a
local application.
"The case was that of a lady about sixty years of age, who had been
ill for two days. He found the pulse very small and quick, as high as
130. There was great prostration; the expression of the countenance
almost like that of cholera, from the sunken, exhausted look-very
remarkable, considering the shortness of the illness, and indicating the
action of some poison. There was great foetor of the breath, and on
examining the fauces the whole surface was of a dark red, approaching
violet hue, and spotted over with white membranous deposit. He
gave a drop of the 1st dilution of Muriatic acid every hour, and next
day found great improvement. From the first dose the patient was
sensible of benefit, which continued till she got well. The disease had
been increasing up to the time of the administration of the medicine, and
from that time declined."‡
Muriatic acid also plays an important part in ulcerations of
* Practitioner, Jan., 1875.
† Brit. Journ. of Hom., xxviii., 742.
† Annals, i., 231.
ACIDUM MURIATICUM.
123
the mouth and throat independent of these acute discases,
though probably connected with similar constitutional condi-
tions, as indicated by the "low" character of the local mischief.
Mercurial sores and aphthæ often come under this category.
It seems to have a special affinity for the tongue. To this
attention has been called by Dr. Cooper.* The symptoms of
Letocha in Hahnemann's pathogenesis, which he cites, are not
to be found at the place referred to; and, until verified, can
hardly be relied on as dynamic effects of the acid. But his
cases of cure are quite valid; and, embracing as they do indu-
ration, fungous swelling, ulceration, and that so-called psoriasis
linguæ which so often proves incipient cancer, encourage us to
confident use of the acid in affections of this organ. In a letter
of Hahnemann's, which is on record, we find him prescribing
Muriatic acid for cancer of the tongue;† and I have myself
employed it in recurring ulcers of the organ with the best
effect.
Several other uses of the drug, but all falling within the
general description I have given, are mentioned by Dr. Marcy
in the New Materia Medica. His, too, are the fullest state-
ments of its usefulness in cutaneous affections, where itching
papules or vesicles seem to indicate it both internally and ex-
ternally. Its employment in dyspepsia, so well defined by
Dr. Ringer, seems beyond the sphere of its specific operation.
It acts here either by locally checking excess of formation of
gastric juice, or by supplying deficient acid to the digestive
process. It is esteemed by some in piles and other troubles at
the anus, when a great sensitiveness of the parts is present.
There may also be much itching, and a paretic condition of the
sphincter, in which case it is doubly indicated.
Nitric acid is the only medicine with which, as it seems to
me, Muriatic acid can be advantageously compared; though
it has some points of contact with Baptisia, and perhaps with
Rhus.
There seems no advantage in raising Muriatic acid above
the 3rd attenuation, and the 1st and 2nd are those most com-
monly used.
* United States Med. and Surg. Journal, ix., 268.
† See Brit. Fourn. of Hom, xiii., 149.
LECTURE IX.
ACIDUM NITRICUM, OXALICUM, PHOSPHORICUM, PICRICUM,
SALICYLICUM, SULPHURICUM.
The acid with which we begin to-day is one of the most im-
portant members of our group-
Acidum nitricum.
x
Ten minims of the acid of the British Pharmacopoeia with
sixty minims of water make our 1* attenuation, which is thus
of about the same strength as the ordinary dilute acid. The
subsequent attenuations must, of course, be aqueous.
Our only pathogenesis of Nitric acid was first published in
the second edition of the Chronic Diseases. It contains 1426
symptoms, of which about 130 were supplied by fellow provers,
and 30 taken from authors, the remaining 1260 being Hahne-
mann's own. Dr. Allen's additions are chiefly toxicological.
The reasons I have alleged for ignoring the pathogeneses of
the Chronic Diseases press with double force in the case of
Nitric acid. Hahnemann's age and practice at the time make
it certain that his symptoms-six sevenths of the whole-were
observed on patients; and his globules of the 30th have but a
doubtful relation to Nitric acid, as alcohol was used to make
the dilutions from the 2nd upwards. His cited symptoms,
moreover, are rarely pure; being too often observed upon
syphilitic subjects. An exception to this statement is formed
by the symptoms ascribed to Scott, which-as they constitute
almost our only genuine proving of the medicine-I will give in
some detail from the original.*
Mr. Scott, an Indian army surgeon, suffering from chronic
hepatitis, was led to think that Nitric acid might be an effec-
tive substitute for the usual mercurials in his case. He took
accordingly a drachm daily of the strong acid, in divided doses.
* Duncan's Annals of Medicine, 1796, i., 375.
ACIDUM NITRICUM.
125
On the third day the gums began to be somewhat red and
enlarged. He slept ill; but could lie for a length of time on
his left side, which the disease of the liver prevented him
from doing for many months previous to this period. He
also felt a pain in the back of his head,* resembling what he
had commonly experienced when taking mercury. On the
fourth day his gums were a little tender; headache and pain
about his jaws still troubled him; but the symptoms of his
liver complaint had already left him. The acid was continued
on the fourth, fifth, and sixth days, the soreness of the mouth
increasing, and salivation taking place. On the seventh day
he felt his mouth so troublesome that he took no more.
Other observers have confirmed this effect of Nitric acid
upon the mouth, adding looseness of the teeth and bleeding
from the gums to the symptoms mentioned by Scott. The
action is not a local one, as Richter has found it produced by
baths containing the acid. It is ordinarily unaccompanied
by the foetor of the breath or the tendency to ulceration of the
gums which characterises the mercurial sore mouth; but
Prioleau has seen these symptoms also, with swelling of the
sub-maxillary glands, occur under its use, when given for
syphilis. All these observers, moreover, find it somewhat
diuretic.
Save these effects on the mouth, then, we know little about
the dynamic pathogenetic action of Nitric acid. Clinical
experience with it, however, is large and definite; and allows
its sphere to be assigned with much precision.
1. I would first speak of its action on the muco-cutaneous
outlets-those parts where mucous membrane is exposed to the
external air, and where skin is so shielded and moistened that
it approximates in character to mucous membrane. Its
ptyalism and gingivitis suggest its Mercury-like affinity for
the mouth, which is very strong: it antidotes its analogue
here, and cures ulceration of the buccal mucous membrane.
Dr. Ringer recognises this "further action " (ie., beyond the
chemical) "on the mucous membrane of the mouth," and re-
commends it where this is reddened, inflamed, and glazed, in
connexion with irritation of the digestive organs. The same
thing may be said of it as regards the throat. Then, leaping
over the intermediate digestive tract, it exhibits a singular power
over the rectum and anus: it is reported to have cured pro-
lapsus, fistula, and especially fissure. The evidence of its
* A case of chronic headache seated in the occipital protuberance,
cured by Nitric acid, may be read in the New York State Hom.
Society's Transactions, iv., 365.
126
ACIDUM NITRICUM.
power over this last-named trouble is quite satisfactory: the
sharpness of the pain excited by stool is most felt at the time
of passing. In the respiratory tract it controls the ocular,
nasal, and laryngeal mucous membranes. Dr. Goullon, in his
treatise on Scrofula, assigns it a high place in the treatment of
obstinate strumous ophthalmia, and considers it useful in super-
ficial ulcers of the conjunctiva corneæ, and indispensable in
ophthalmia neonatorum. Jahr praises it in gonorrhoeal
ophthalmia. It has been commended for the affection of the
nose which obtains in malignant scarlatina, for ozæna, and for
chronic laryngeal affections. Acting on the genito-urinary
membrane, it is a valuable remedy (according to Dr. Marcy)
for chronic vaginal leucorrhoea, which may be tenacious, and
flesh-coloured or green, in cachectic subjects; and has cured a
long-lasting itching of the urethra left behind after gonorrhoea.
Dr. Guernsey recommends it for pruritus vulvæ.
*
Dr. Hempel truly says that "Nitric acid is principally
adapted to disease depending upon the presence of some
virulent miasm, especially the scrofulous, syphilitic, and mer-
curial." But it is chiefly when these muco-cutaneous outlets
are the seat of the mischief that it proves an antidote: it hardly
penetrates deeper. As regards syphilis, it supplements Mer-
cury in soft chancres occurring in weakly or scrofulous subjects,
and often supplants it in secondary ulcerations of the mucous
membranes (Jahr extolling it also for inflamed bubo). It becomes
the prime remedy when even a hard chancre begins to sprout
into vegetations, and for the "mucous patches" which occur
at this stage of the malady, and which always haunt its favourite
seats of action. We are thus led to that curious offset or ally
of syphilis which Hahnemann distinguishes as " sycosis,” whose
local manifestations are condylomata. Whether he was right
or wrong (and he is not alone) in thinking this a separate
discasc, at least we do well in following him as to its remedies;
and these are Thuja and Nitric acid.† I shall have more to
say on the subject when we come to the former medicine.
2. Next in importance to the foregoing is the action of
Nitric acid on the liver. The experiments of Scott, which
first brought it into notice, related to its power over hepatic
disease: it was only later that they suggested its use in
syphilis. He cured with it chronic hepatitis and the "liver-
* New Mat. Med.,p. 54.
"Small syphilitic warts and condylomata, kept constantly moist
with a wash of diluted nitric acid, are removed certainly and painlessly.
A drachm or two of the dilute acid to a pint of water is sufficient"
(Ringer.)
ACIDUM NITRICUM.
127
D
cake" of ague; and it has always continued a favourite
medicine in Indian practice. Of late, the combination with
Muriatic acid has been preferred for this purpose. Dr. Horatio
Wood praises this Nitro-muriatic acid for hepatic congestion,
"biliousness," non-obstructive jaundice, and commencing
cirrhosis; he says it should always be freshly prepared. It is
also used in baths and compresses. Considering its virtues
in oxaluria also-in which, since Golding Bird's time, it has
been considered almost specific-it deserves a good proving.
Dr. Allen gives a short pathogenesis of it, obtained by three
provers, using small doses; and in his supplement cites an
observation by Scott of its effect when used as a bath. It pro-
duced on him the same beneficial influence on the liver, and
the same irritation of the mouth and salivary glands which he
experienced from Nitric acid; but the sensations of the
stomatitis extended down the gullet, and in the buccal
cavity and on the tongue small superficial ulcerations ap-
peared. Sometimes, he says, the compound acid "very
suddenly increases the secretion of bile." It also (in him)
increased the perspiration.
3. Of late years, Nitric acid has come to the front as a
remedy for cough. The late Sir Duncan Gibb wrote a book
on pertussis expressly to extol its virtues. Dr. Bayes says—
"Another affection in which Nitric acid has proved service-
able is a chronic laryngeal cough, without expectoration, which
is characterised by a stinging or smarting sensation, as if a
small ulcer were there, and is generally felt on one side. The
3rd dilution of the medicine often speedily arrests and cures
this cough." I have myself long used it with benefit in
laryngeal coughs, dry and violent. But Dr. Dyce Brown has
led us to extend the sphere of this acid in coughs. He com-
mends it in several forms of disease in which this symptom is
the prominent feature, and especially when there is much
general physical depression. He even extends its use to
pneumonic phthisis after the more active symptoms have been
removed by other means. A good many typical cases are
related in his communication, which you will find in the
eighteenth volume of the Monthly Homeopathic Review.
I myself have certainly been led by it to prescribe Nitric acid
more largely in chronic coughs; and have found it very
beneficial, both to these and to the gastric irritation and
general cachexia which often accompany them.
Dr. Brown mentions constipation as a marked indication for
the acid in cough cases; and adds that he has found this ysmp-
tom so often to disappear under its use that he has been led to
128
ACIDUM NITRICUM.
use it as a remedy for the trouble itself, and with such success
that he now places it in the front rank of available means in its
treatment. Dr. Wilde has communicated some confirmatory
evidence. Hahnemann (as Dr. Brown notices) expresses himself
to just the contrary effect, saying that “it is more suitable to
those chronic patients who are disposed to looseness: it is very
seldom useful to those who suffer from constipation." It is
possible that infinitesimal doses of the acid, prepared accord-
ing to his method, may have an action of their own. But
there is another intestinal affection in which Nitric acid may
prove useful, and this is dysentery. "The dysenteric process,"
says Rokitansky, "offers the greatest analogy to the corrosion
of the mucous membrane produced by a caustic acid ;" and
in the present instance we have evidence that the action is
not local only. Wunderlich observed a case fatal on the
eighth day after the ingestion of a teaspoonful of the strong acid,
in which the usual lesions were found in the mouth, fauces,
œsophagus, and stomach, but the small intestine was sound.
The colon, nevertheless, was "intensely and deeply ulcer-
ated.”*
Dr. Ludlam, speaking of Nitric acid as indicated generally
"in those hæmorrhages from the mucous surfaces which
depend upon the destruction and desquamation of the invest-
ing epithelium," commends it highly in menorrhagia following
upon abortion or continued dysmenorrhoea; and says that
a similar condition sometimes exists at the climacteric age,
and is to be treated in the same manner.†
Dr. Guernsey's indications for Nitric acid are chiefly offen-
sive urine, smelling like that of horses, restlessness after
midnight, and (in women) violent downward pressure in the
pelvis, with pain in back and thighs. Amelioration from
riding in a carriage is also mentioned by him, and of this Dr.
Hoynet gives a curious illustration.
Nitric acid compares with Muriatic acid, with Mercury, and
with Thuja.
Dr. Brown advises two or three drop doses of the first
decimal dilution; and with this or the potencies near to it all
the successes of Nitric acid have been obtained, save those in
the rectal and anal troubles. Here the 30th Hahnemannian
attenuation is reputed to have effected the cures.
* Stillé.—Boehm, who also mentions this case, adds that the symp
toms of acute morbus Brightii were present.
+ Diseases of Women, 2nd ed., p. 565.
Clinical Therapeutics, i., 455.
ACIDUM OXALICUM.
129
For our next acid we have once more the advantage of a
good pathogenesis; it is
Acidum oxalicum.
This well-known acid is almost unused in ordinary practice.
For homœopathic use it is triturated or dissolved in rectified
spirit.
Our toxicological knowledge of Oxalic acid is both extensive,
from its frequent use in suicide and ingestion by mistake for
Epsom salts,(and precise, from the full experimentation to
which it has been subjected, chiefly by Drs. Christison and
Coindet.* It has received a full proving (by six persons
taking the 1st and 2nd triturations) under the auspices of the
American Institute, and Koch and Reil also have experi-
mented with it. Arrangements of these materials exist, from
Dr. Neidhard in the Materia Medica of American Provings,
from Dr. Hering in his Amerikanische Arzneiprufungen, and
from Dr. Allen, who adds numerous symptoms from
poisonings.
Oxalic acid is an irritant poison; and the great body of the
symptoms induced by its ingestion in bulk are due to inflam-
mation of the alimentary mucous membrane. There is, how-
ever, no evidence of intestinal irritation when the poison is
otherwise introduced into the system; so that we have here a
local rather than a specific effect. Oxalic acid would thus be
truly homoeopathic to irritation of this tract only where it was
of local origin, and would need to be given in semi-material
doses. A Dr. Nardo, of Turin, is reported by Marcy and
Peters to have used it (in grain doses) with uniform success for
many years in gastritis; and it has been useful in glossitis and
chronic angina.

When absorbed into the system, its elective affinities mani-
fest themselves in the sphere of the lungs and of the nervous
centres. The former present-post mortem-either scarlet
patches or a uniform scarlet redness over their anterior sur-
face, but without effusion; and the provers had lancinating
pains through them, especially on the base of the left side.
The trachea also has been found reddened after death; and
the provers experienced some irritation in it. Marcy and
Peters mention some experience suggestive of its value in
chronic inflammations of the respiratory mucous membrane,
and even in phthisis pulmonalis.
But the most important action of the poison is that
* Edinb. Med. and Surg. Journ., xix.
K
130
ACIDUM OXALICUM.
which it exerts upon the nervous centres. The facts are as
follows:-
When administered to animals in such a manner as that it
can be absorbed, "the first unequivocal sign of its action is
generally a slight permanent stiffness of the hind legs and
increased frequency of the pulse. About the same time there
appears a slight sudden check in inspiration, from the respira-
tory muscles contracting before the chest is fully expanded.
Gradually several of these come together, so as to constitute
paroxysms of short, hurried breathing, with intervals of ease.
Meanwhile the stiffness of the hind legs increases; they be-
come likewise insensible, and often the spasm gives place to
paralysis; he jerks the head occasionally backwards, walks
with a peculiar stiff gait, and assumes very odd postures, from
inability to regulate the motions of the limbs. As the poison-
ing advances, the motions of the chest during the paroxysms
become more and more confined by spasms of the muscles;
and at last there is a period towards the close of each
paroxysm, when the spasm is so great as completely to sus-
pend the respiration. This is commonly accompanied with
more or less extension of the head, tail, and extremities,
sometimes amounting to violent opisthotonos.
The
insensibility, hitherto limited to the hind legs, now extends to
the trunk and fore-legs, and lastly to the head. As the insen-
sibility increases, the breathing diminishes in frequency, the
spasmodic paroxysms become more and more obscure, and
then cease altogether. For some time, however, they may be
slightly renewed, by striking the back and limbs; but at last
the animal falls into a state of deep pure coma, with complete.
relaxation of the whole body. The heart can now scarcely be
felt; the breathing is low, regular, and short, and becomes
gradually more obscure, till finally life is extinguished without
a struggle." If the dose be larger, “the fits of spasm come on
early and with great violence, the intervals are marked by
remissions only, and the animal expires in a paroxysm, before
the stage of insensibility begins.
Death may be pro-
duced in this manner in three, five, or ten minutes. If on the
other hand the dose be much diminished, there may be stiff-
ness of the hind legs, much dulness, drooping of the whole
body, and a sort of somnolency, without insensibility, or even
without spasmodic paroxysms, and then the animal will com-
monly recover.”
This summary is taken from the original paper in the
Edinburgh Medical and Surgical Journal by Drs. Christison
and Coindet. The former, in his Treatise on Poisons, adds the
ACIDUM OXALICUM.
131
following as regards the effects of the acid on the human sub-
ject. "The best instance yet related of the development of
nervous symptoms in man is a case described by Dr. Scott of
Cupar, of a girl who swallowed by mistake a solution kept for
cleaning brass, and containing about two drachms. She did
not vomit until emetics were given, but complained much of
pain, which was succeeded by great lassitude and weakness
of the limbs, and next morning by numbness and weakness
there as well as in the back. This affection was at first so
severe that she could hardly walk upstairs; but in a few days
she recovered entirely. There is also evidence to the same
effect both in Mr. Hebb's patient and in Dr. Arrowsmith's
The first thing that the former complained of was acute
pain in the back, gradually extending down the thighs, occa-
sioning ere long great torture, and continuing almost till the
moment of his death. Dr. Arrowsmith's patient had the same
symptoms, complained more of the pain shooting down from
the loins to the limbs than of the pain in the belly, and was
constantly seeking relief in a fresh change of posture. Mr.
Fraser's patient had from an early period a peculiar general
Boehm adds "formica-
numbness, approaching to palsy."
tion both on the trunk and on the extremities," and "numb-
ness and anæsthesia of the finger tips."
case.
I think there can be no doubt that the phenomena thus
described are those of inflammation of the membranes and
substance of the cord. In no post-mortem has the spinal
column been opened for examination; and we thus want
ocular evidence. But the stiffness of the limbs and paroxysms
of spasmodic dyspnoea point plainly to irritation of the spinal
meninges; and the anesthesia, neuralgia and loss of power
indicate a similar affection of the spinal marrow itself. I once
had the painful duty of watching a chronic case of this disease
until its termination in death; and the symptoms I then
observed come vividly back to my mind as I cite these
descriptions of poisoning by Oxalic acid. I hope that some
use may be made of the analogy. I am myself learning to
depend with great confidence on the drug as a means of
checking the tendency to spasmodic constriction of the chest
which manifests itself in several forms of spinal disease.
Dr. Burnett has recently given us* an excellent study of
Oxalic acid. As regards its physiological action, he shows
that later German experiment has brought out in greater
relief the paralysing action on the heart which Christison
noted. He also mentions three cases in which it caused loss
* See Brit. Fourn. of Hom., xxxv., 309.
132
ACIDUM PHOSPHORICUM.
of voice, and suggests its use in aphonia. But the most inter-
esting thing in his paper is a series of cases treated by him in
which anomalous pains in the head and spine, like those it
causes, have disappeared under its use, and in which its elective
affinity for the left lung near its base was utilised by treating
congestion and inflammation with it when localised there.
In these last instances it manifested remarkable powers,
obviously touching the mischief when the ordinary remedies
had failed. Dr. Burnett takes exception to my view that
the lungs are specifically irritated by Oxalic acid, suggesting
that the hyperæmia found in them post mortem may have been
secondary to disorder of the nervous centres or the heart.
His own clinical observations are, I think, the best facts I can
adduce in support of my statement. Unless the poison can
directly inflame the lungs in health, it could not have cured
pneumonia and pulmonary congestion in the way it did in his
hands.
Christison says that in minimum doses the effect is mainly
on the brain; and most of the provers seem to have felt it
acting there, especially on the vertex and forehead, where it
causes (and has removed) a dull headache. The following
symptom was produced by it, and has been verified in prac-
tice: "immediately after lying down in bed at night, palpita-
tion of the heart for half an hour, three nights consecutively."
Colic about the navel, with difficult emission of flatulence, and
irritation of the genito-urinary tract, with diuresis, are other
marked symptoms of the proving; to which may be added
great exhilaration of spirits.
Oxalic acid has more analogies with Arsenicum than with
any other drug in the Pharmacopoeia.
The 2nd and 3rd triturations seem to have been those
mainly used, though Dr. Marcy speaks well of the 12th. Dr.
Burnett gave the 3rd in his cases.
The acid I am now coming upon is a special favourite of
my own. It is
Acidum phosphoricum.
The "dilute phosphoric acid" of the British Pharmacopoeia
forms our I attenuation, and water is used for subsequent
dilutions up to the 2nd centesimal.
The original proving of Phosphoric acid is in the fifth
volume of the Materia Medica Pura. It contains (in the
second edition) 268 symptoms from Hahnemann himself, and
ACIDUM PHOSPHORICUM.
133
✔
411 from twelve fellow observers. A later pathogenesis
appears in the fifth part of the Chronic Diseases. It is increased
by 139 symptoms, most of which are credited to Hering, and
were probably observed on the patients mentioned in the
preface as cured by him with the acid. Five persons have
proved it since, one in the pure substance, four in the dilu-
tions their symptoms are incorporated with Hahnemann's by
Allen.
Hahnemann's directions in the Materia Medica Pura for
the attenuation of Phosphoric acid are not so destructive as
those for the other acids, as the dilute alcohol of the Ist
potency is to contain nine parts of water to one of spirit.
Perhaps the provings were made with this preparation.~ At
any rate, they impress one with a greater sense of reality than
those of the others; and Hahnemann characterises them as
"remarkable, pure symptoms of artificial disease elicited by
Phosphoric acid in the healthy body." They will well repay
study and analysis. I shall best help this here by sketching
and characterising the therapeutic action of the drug.
The chief sphere of this is the nervous system; and the con-
dition it influences here is one of debility without erethism (in
this contrasted with China). When we find brain* or cord,†
sight or hearing thus affected-as from continued grief, over-
exertion of mind or body, sexual excess, or drain on the
system, or remaining after typhus or typhoid‡-Phosphoric
acid is an invaluable remedy, well deserving the name of
"tonic." Failure in memory is reputed a special indication
for it in cerebral depression: the emotional condition is one
of apathy and indifference. It is to "nervous debility" what
iron is to anæmia. In virtue of this action (as I believe) is
its curative power in its two chief local spheres, the renal and
the male sexual organs.
1. Phosphoric acid has no known action on the kidneys
themselves; but it exerts a remarkable control over those
changes in the composition of the urine which arise farther
back than the secreting organs. Dr. Sutherland has directed
attention to its usefulness in phosphatic deposits;§ it is obvi-
ously indicated for these when, as commonly, depending on
waste of nervous tissue or on alkalinity of urine from nervous
depression. It cures, as Hering|| and Chapman¶T have pointed
* Brit. Journ. of Hom., vii., 391. Hahn. Monthly, Aug., 1876.
† Bayes, Appl. Hom., 138.
Monthly Hom. Review, x.
§ Brit. Fourn. of Hom., vi., 410.
|| Preface to pathogenesis in Chron. Diseases.
¶ Brit. Journ. of Hom., vii., 391.
-
134
ACIDUM PHOSPHORICUM.
"3
out, those derangements in children connected with a milky
state of the renal secretion; and would probably help (unless
the affection be a mere mechanical leaking) in the West
Indian "chylous urine," whose constitutional symptoms are
very characteristic of the drug. But it is in diabetes that
Phosphoric acid has won its greenest laurels. Not only in the
"insipid" form-"chronic diuresis " or "polyuria as we
should now call it—but in true glycosuria cure has repeatedly
resulted from the administration of this acid.* It is possibly
a similar to the essential symptom of the disease; for Dr.
Pavy† found saccharine urine to result from its injection into
the general venous system, or introduction into the intestinal
canal, and Griesinger, who gave it in diabetes to the ex-
tent of an ounce a day, found the sugar rather increased
thereby. But the frequent origin of diabetes in the nervous
centres (as suggested by Claude Bernard's well-known ex-
periment) commends it still more forcibly; and in the only
case out of those I have myself recorded in which I have
needed it to re-inforce the nitrate of Uranium the disease
obviously began in this way. It will therefore be in diabetes
of nervous origin that we shall expect to get the best results
from Phosphoric acid; and this continues to be my own ex-
perience with it. Moreover, since Bernard found albuminuria
to result from a central nervous lesion hard by that which
occasions glycosuria, there may well be cases of this malady in
which Phosphoric acid is indicated. Two cures by it are on
record,-in one of which the albuminuria was associated with
chorea, and in the other followed upon typhoid.|| The
presence of simple diuresis-especially when quantities of
colourless urine are passed at night-is an indication in favour
of the choice of the medicine in morbid conditions in general.
2. It is the nervous apparatus of the male sexual organs
which is influenced by Phosphoric acid. It has no relation to
* Brit. Fourn. of Hom., xxiv., 260; xxxvii., 371.-The last reference
is to Dr. Black's elaborate and interesting essay on diabetes. He there
shows that we must not lay much stress upon the evidence I have cited
above as to the causation of glycosuria by the acid: he also demonstrates
that the remedy was known in the old school twenty years or more
before it was employed in homoeopathic practice. I do not think, how-
ever, that his criticism, judiciously sceptical as it is, has robbed Phos-
phoric acid of the laurels with which I have ventured to crown it in
respect to this disease. The cases collected by himself suffice to
show its power; and for my own part I rarely prescribe it without satis-
faction.
† On Diabetes, p. 82.
Brit. Journ. of Hom., xxxi., 369.
§ Hempel, ii., 46.
|| Monthly Hom. Rev., x., 527.
ACIDIUM PHOSPHORICUM.
135
their inflammatory states; but in simple debility and relaxa-
tion-even to impotence of these organs, resulting from
excess or unnatural use, it is the most important of remedies.
Frequent weak emissions and dragging aching in the testes
may also be removed by it.
This action on the nervous system, peculiar to the Phos-
phoric among the mineral acids, is probably due to the nature
of its base. From the same source may come its action on the
blood and on the bones. In low fevers, indeed, it is indicated
when the nervous system rather than the blood is affected by
the poison, and only in milder cases here,-standing on the
same level as Muriatic acid in their respective spheres ;* but it
has more than once proved curative in purpura and passive
hæmorrhages. As regards the bones, it is spoken highly of
by German writers of the old school as a remedy for caries,
and our own Hartmann recommends it strongly in rachitis.
Its physical relation to osseous tissue is obviously an intimate
one; and there is good reason to believe that such facts may
be used as suggestive of medicinal affinities.
In all these affections, the Phosphoric acid patient is charac-
terised by tendency to passive flux from skin and mucous.
membrane. The medicine (which herein may be compared
with China and Iodine) often first displays its power by
checking these, as the perspiration of phthisis and the diarrhoea
of rachitic or otherwise weakly children: the diarrhea, I should
say, is painless, and the stools are grayish-white. It has even
cured ague when this condition, in the shape of profuse sweat,
was the prominent feature of the case. I knów not whether
the ozæna, and the thin and acrid leucorrhoea, in which Dr.
Marcy has found it curative, come under this head; or the
falling of the hair, as from debility after fevers, in which I
have often seen it successful. Dr. Hoyne says it is equally
good when the loss of hair results from depressing emotions.
This writer also praises it for the pressive headache on the
vertex which so often accompanies cerebral anæmia, and for
which we shall see Cactus and China recommended. Dr.
Guernsey commends it for physometra, and mentions pain in
the hepatic region during the menses as a noteworthy indica-
tion for it in women.
Phosphoric acid works side by side with Phosphorus
throughout its action. Besides this, it touches at some points
Fluoric acid and Silica; China; Anacardium; Ignatia; and
the mineral acids in general.
* See Brit. Journ. of Hom., xii.,23.-Jousset also commends it here,
and thinks that I hardly sufficiently value it.
† Annals i., 457; Monthly Hom. Review, xiv., 544.
136
ACIDUM PICRICUM.
In nervous affections, in milky urine, in nutritive derange-
ment, in fever, and in passive fluxes, Phosphoric acid seems to
act well in the attenuations from the 3rd to the 12th.
But as
a sexual tonic, in purpura, the phosphatic diathesis, diabetes
and caries, it does best in doses of several drops of the 1st
decimal dilution.
I have now to introduce you to two new members of our
group of acids—the picric and the salicylic.
Acidum picricum
(or, as it used to be called, carbazoticum) is the product of
the action of nitric acid upon several substances, among which
I may mention (as suggesting one of its relationships) carbolic
acid and salicin. It forms in whitish-yellow prisms; and is
soluble in alcohol, which will accordingly be its pharmaceutical
vehicle, unless triturations are preferred.
Dr. Allen is able to give us a pathogenesis of Picric acid
containing 469 symptoms, obtained by 18 provers. Three of
the observations laid under contribution are from an old-
school source (Parisel), seven are from the provings instituted
by Dr. L. B. Couch in 1874,* and five from some very thorough
experiments made at the Michigan University by Professor
S. A. Jones. The latter has furnished from time to timet
some elaborate analyses of the drug's effects, more especially
of those which it causes in the blood and the urine. Drs. Couch
and Jones have unhappily fallen out of late over their off-
spring; but their controversy, though personally lamentable,
has elicited still farther the action of the new remedy.
Our fullest information as to the toxic influence of Picric
acid is contained in an essay by Erb, of Würzburg, entitled
Die Pikrinsaüre, ihre physiologischen und therapeutischen Wirk-
ungen (1865). The conclusions arrived at by this experimenter
are stated by him as follows:
"1. Picric acid, in combination with potash or soda, is
absorbed into the blood, enters nearly all the tissues of the
animal organism, and is in most part excreted with the urine.
"2. The entrance of large doses of an alkaline picrate into
the blood brings about the destruction of a great part of the
red blood-corpuscles, and a consequent increase of the colour-
less (artificial leucocythæmia).
* See New York Fourn. of Hom., ii., 145.
+ See North Amer. Fourn. of Hom., xxiii., 443. Transactions of
World's Convention, vol. ii. Amer. Hom. Observer, xiv., 395.
See Hom. Times, April-July, 1878.
ACIDUM PICRICUM.
137
"3. Under the same circumstances, a transitory icterus is
produced.
((
4. Small quantities of the alkaline picrates are borne
quite well for a long time: larger doses, after long use, cause
death with the phenomena of inanition: very large doses
produce (probably through destruction of the blood) a collapse
which after a short time ends in death."
(
Dr. Jones, in soine experiments made upon two students,
found Picric acid to cause increase of the uric and phosphoric
acids in the urine, and diminution of the sulphates and
chlorides; ¿.e., it diminished oxidation. He connected this
action with Erb's observations of the destructive influence of
the alkaline picrates upon the red corpuscles (the oxygen-
carriers) of the blood; and when lecturing on former occasions
I have followed him in so doing. Dr. Couch, however, has
objected that Erb's results were obtained equally when the
picrates were mingled with blood outside the body; and no
alteration was found in the blood in dogs poisoned by him-
self with the pure Picric acid crystals. He justly infers,
therefore, that the action is a chemical one only, and is
probably due to the action of the alkaline bases rather than to
the acid with which they were united. But I cannot follow
him when he goes on to impeach Dr. Jones' own experiments
as failing to evidence any real power on the part of the drug
to cause sub-oxidation. He argues that the deviations from
the normal standard discovered in the provers' urine were not
greater than occur in health. But if you will look at the
tabular views given of these, in the case of the principal
prover, in Allen's Encyclopædia, I think you will come to a
different conclusion. They display the proportion of the con-
stituents of the urine, first, in health; secondly, whilst taking
the acid; and, thirdly, for some time afterwards. It is quite
apparent that although the increase of uric and phosphoric
acid, and the diminution of the chlorides, which occurred
during the medication, might not exceed the oscillations of
average health, they greatly exceeded those of the health
of the prover in question. Moreover, Dr. Jones has verified
his experiments by therapeutic results. He joined his earlier
provers in testing the acid, being at the time out of health;
*
(C
markedly indisposed to either mental or physical exertion;
easily fatigued; readily blown by walking up hill; inclined to
day-sleepiness," with poor appetite and a general sense of tor-
S
* In_the_table at p. 528, the decimal point of the mean chlorides
during medication is put in the wrong place. Instead of 76'911, the
figures should stand as 7·6911.
138
ACIDUM PICRICUM.
pidity. The effect of the drug on his urine was the precise
opposite of that experienced by his two fellow-provers, who
were in good health. Uric acid and phosphoric acid were
diminished: urea increased to the extent of two grammes per
diem: the sulphates and chlorides were in excess. Therewith
was experienced "an improved appetite, a general feeling of
well-being, a renewed vigour in the morning, and an ability to
rise much earlier than usual." In a later communication* he relates
a still more striking case. It was one of profound anæmia,
with prostration and vomiting: uro-hæmatin was discovered
in the urine, which showed also the evidences of sub-oxidation
mentioned above. Under the third trituration of Picric acid
improvement speedily set in; and in a few weeks strength
and colour had returned, and the same changes had occurred
in the urine as those experienced by Dr. Jones himself, though
in a greater degree.
Dr. Couch, indeed, states that his experiments on animals
show, from small doses of the acid, a primary increase of all
the constituents of the urine, with secondary diminution,-
from large doses, the converse sequence of phenomena. What-
ever be the value of these observations, they cannot outweigh
Dr. Jones' provings on the human subject, confirmed as they
are by the therapeutic results obtained from the drug when
given as a remedy in accordance therewith. They give us
sub-oxidation as its essential and fundamental action upon nutri-
tion, which can be used upon the principle similia similibus for
curative purposes; and they thereby add another potent
weapon to our armoury.
Dr. Couch's earlier experiments on dogs, however, brought
to light another action of the acid, viz.: that which it exerts
on the nervous centres. These were found post mortem soft,
pulpy, and apparently completely disorganised,—the focus of
the mischief being from the mesocephale to the upper cord,
but extending more or less forwards and backwards. The
symptoms during life were of the paralytic character which
might have been expected. In later investigations† of the
same kind, entire anesthesia and analgesia of the posterior
extremities was noted. The poison was also found to pro-
duce "spasms, both tonic and clonic, which had a striking
resemblance to those produced by strychnia." This may seem.
curious, when it is added that "under the influence of the
drug the animals betray great weakness and lassitude;
especially is this noticeable of the hind legs, they being
* See Hom. Times, June, 1878.
+ See Ibid, April, 1878.
ACIDUM PICRICUM.
139
scarcely able to support the already attenuated body, which
sways. constantly from side to side; the tail, too, is as limp as
a wet rag, and cannot be made to either wag or curl." But
Drs. Ringer and Murrell have recently adduced considerations
which tend to account for this apparent anomaly.* They
maintain that tetaniform phenomena are due to a diminu-
tion or destruction of the resistance of the cord, "so that an
impression conveyed through an afferent nerve can spread
throughout the reflex portion of the central nervous system,
and produce tetanus. Such diminished resistance may
coincide with unimpaired functional activity of the cord, as
with strychnia; or with more or less paralysis of it, as they
have ascertained in relation to Gelsemium and the buxus
sempervirens, and as Dr. Couch seems now to have shown
with Picric acid.
")
The symptoms of the provers show a very similar condition,
though of course of lower grade. Their legs were cold, weak,
and heavy like lead; and they experienced a feeling of great
lassitude and debility, which with one was accompanied by
cold clammy sweats. Nor does the marked excitement of the
sexual organs, shown by priapism and profuse emissions,
and finding its parallel in Dr. Couch's dogs, contradict these
indications, when we remember how often such a condition
exists in the early stages of chronic disease of the cranio-
spinal axis, or as the result of injury to it.† Everything points
as Dr. Jones argues-to a profound depression and anæmia
set up in the nervous centres, going on to softening.
Little use has yet been made of this action of Picric acid.
It has served me very well to complete the cure of a case of
spinal exhaustion following acute disease, which Phosphorus
had begun. I gave it in the twelfth dilution. It should be
helpful in white softening of the cord. Dr. Jones mentions a
cure of satyriasis of three years standing effected by it, given
in the third trituration; and Dr. Couch relates a case of
masturbation, in which the 30th dilution, given to "cool the
blood," proved (according to the patient) "altogether too
cooling." It will probably play an important part ere long in
the treatment of central nervous disease. In this connexion,
the severe headaches it causes must be taken into account.
They all begin in the occipital region, and thence extend
forwards and downwards. Dr. Hale has found it very useful
in headaches so localised, when the slightest excitement or
* See Medico-Chirurgical Transactions for 1876, and Journal of
Anatomy and Physiology, vol. xi.
+ As in a case recorded by Harley, Old Vegetable Neurotics, p. 50.
140
ACIDUM SALICYLICUM.
even use of the brain would bring on the attacks; and I have
in one instance verified his experience. Here, too, I should
mention its effects upon the visual organs. In two of the
provers the sight was much obscured; and in the dogs poisoned
with it the veins of the retina were found (ophthalmoscopi-
cally) much enlarged. In one, examined by Dr. Norton, “im-
mense white patches of exudation were observed, with some
hæmorrhagic spots." On post-mortem examination, the
lesions thus manifested were found to be seated in the nervous
elements of the eyeball, both nerve-entrance and retina showing
infiltration and extravasation. Such phenomena suggest the
possible usefulness of the drug in albuminuric and syphilitic
retinitis, while the optic neuritis displayed completes the
evidence of its homoeopathicity to organic brain-mischief.
In two provers Picric acid caused "small, painful, reddish
elevations, like furuncles" on the face, going on to suppura-
tion; and Dr. Houghton, writing of that troublesome affection,
boils in the auditory neatus, says :-" during the last year I
have used Picrie acid here with the greatest satisfaction, and
find it nearer to a specific for the disease than any other
medicine."
Dr. Jones very justly compares Picric acid with Phosphorus
and Argentum nitricum.
I have mentioned the doses in which it has hitherto been
successfully used. The provings seem to show it as active in
the 30th as in the Ist attenuation, and to produce effects of a
similar kind.
My other new acid is
Acidum salicylicum,
which, as its name imports, is obtained from salicin, an active
principle contained in the bark of the willow (Salix). It is
not yet officinal in our Pharmacopoeia; but will form either
dilutions with alcohol (in which it is quite soluble), or tritura-
tions. The latter form would be most suitable for salicin
itself; and the salicylate of soda, which has been much used as
a substitute for the acid, and exerts similar properties, is best
prepared in aqueous solution.
Salicin has been proved to some extent on the healthy sub-
ject by Ringer and a few others in the old school, and by Mr.
Nankivell in our own ranks. The physiological effects of the
acid, and of its compound with soda, we know mainly from
observations of overdosing. These, with the results of such
ACIDUM SALICYLICUM.
141
provings as we have, may be found collated in Dr. Allen's
Encyclopædia and its supplement under the heads of Salicinum,
Salicylicum acidum, and Natrum salicylicum.
Salicylic acid was first introduced as a rival of the carbolic
in point of antizymotic power, and for internal administration
with this view-as in cases of fermentation of the food in the
stomach—is preferable to that substance, having no offensive
odour or actively toxic properties. The popular repute of
willow-bark, and the proved efficacy of salicin in malarious
fevers, then led to the employment of salicylic acid therein.
It was found to exert an undoubted, though not extensive, in-
fluence upon cases of this kind; and the interesting fact came
out that (as we shall see presently) it resembled quinine in
pathogenetic as well as curative action. It thus came to be
tried, like that drug, as an anti-pyretic in general, and especi-
ally in febrile states presumably depending on a zymotic
process, or on the development of disease-germs. It exerted a
certain amount of influence over these also, but hardly suffi-
cient to give it any recognised place in their treatment, unless
it be in septicemia. Its most striking effects were manifested
in a non-contagious fever, which had hitherto been classed
separately from the zymoses: I speak of acute rheumatism.
As a remedy for this malady it has received the warmest com-
mendation from all quarters. It seems to find its opportunity
when the temperature is high, and joint after joint is being
involved, with severe pain: its administration at this time
rarely fails to bring down the fever and relieve the pains in the
space of 36 or 48 hours. Salicin, in Dr. Maclagan's hands,
has yielded results as good as those obtained with the acid,
without the occasional unpleasant effects of the latter;* and
the combination with an alkali-as in the form of the salicy-
late of soda-seems in no way to weaken its properties, while
it gives a more soluble preparation.
In the face of these facts, we disciples of Hahnemann had to
consider what we ought to do. The results of our treatment
of acute rheumatism, though satisfactory enough, were certainly
not so good as those claimed for this remedy; so that, even
could we not recognise its action as an instance of the law of
similars, we should have felt bound-as being physicians, and
not mere homoeopathists-to have entertained the question of
its employment. At first this seemed to be the position of
affairs. The acid was found by Fürbringer to cause no eleva-
tion of the temperature in healthy animals, and Dr. Ringer
found the same negative results from salicin in the human
*Sec Practitioner, Nov., 1877, and Lancet, June 21, 1879.
142
ACIDUM SALICYLICUM.
subject. Of late, however, some observations on the other
side have appeared. Dr. Wheeler, in a paper communicated
to the British Homœopathic Society,* relates a proving of Mr.
Nankivell's on himself, in which ten grains of salicin on two occa-
sions brought on a feverish attack of twenty-four hours duration,
in the first of which the temperature rose to 101°. He also cites
a case of acute rheumatism, treated with this substance in such
large and frequent doses that in the four or five days the patient
was under its influence he must have taken at least 1,400 grains.
Under this medication the temperature steadily rose until death
occurred, when the thermometer registered 1110. Two Nea-
politan physicians, moreover, have lately ascertained on
dogs and rabbits that Salicylic acid, both free and in the state
of salicylate, lowers the temperature, but within restricted limits.
In a somewhat larger dose, it not only does not lower the
temperature, but sometimes considerably increases it.†
Now as it is in febrile rheumatism that the drug displays
its great powers, there is some suggestion in these facts of its
possible homoeopathicity thereto. A similar conclusion follows
from the small dosage which sometimes proves sufficient.
Those of our own school who have used it, and have reported
successes surprisingly good in comparison with those to which
they had been accustomed-among whom I may name Drs.
Hale and Lilienthal in America, besides Dr. Wheeler among
ourselves-have all found doses of from two to five grains of
the soda salt sufficient for their purpose. On the other hand,
I apprehend that such results are exceptional, and that it is
only occasionally that the drug is truly homoeopathic to the
disorder. Its employment in the old school seems to me to
rest upon an altogether different basis. There are three ways
in which acute rheumatism has been and can be treated, and
the medicines which have been in repute for it fall into three
classes accordingly. You may endeavour to neutralise chemi-
cally the presumably acid materies morbi, as by alkalies,
neutral salts, or lemon juice. You may seek to check the
formation of this peccant matter: such, I apprehend, must be
the action of such medicines as the colchicum and propylamine
of old-school practice, and of our homœopathic remedies (as
Bryonia). Or, thirdly, you may forcibly (as it were) repress
fever and deaden pain, while leaving untouched the specific
morbid process present. I suppose that a good deal of the
success obtained from Aconite by Lombard and Fleming is to be
thus explained; and I am sure that in this way Briquet and his
* Annals, viii., 363.
† See Lond. Med. Record, April 15, 1878.
ACIDUM SALICYLICUM,
143
Y
imitators gained their results with full doses of quinine.
Salicin and its derivatives, I consider, act in acute rheumatism
like the last-named drug; and the necessary dosage has
similar inconveniences. It has been said that "cerebral rheu-
matism" was almost unknown in France until the quinine
treatment of the original malady became fashionable. Acci-
dents of this kind have been common enough under the free
use of salicylic acid and its compounds, and have more than
once ended fatally. The great defect of such remedies, more-
over, is that, leaving the essential malady untouched, and only
hushing up its expressions, they favour the tendency to
relapse-strong enough already in rheumatic fever, and so
unduly protract the illness. That it is so with the salicylates
was the conclusion reached at the discussion of the subject at
this year's meeting of the British Medical Association,* and
has since been shown by the statistics of the Middlesex
Hospital.†
While, then, I cannot give to our present drug any important
place in the homoeopathic therapeutics of acute rheumatism,
indications for uses of it of this kind are sure to result from the
symptoms of overdosing with it now so often reported. Dr.
Ringer's experiments on the human subject with salicin show
that it affects the head like quinine. "The aspect," he writes,
"of a patient under full medicinal doses is very characteristic,
being in many respects similar to that of a patient suffering
from cinchonism." Amongst other symptoms of this state he
mentions-" The patient, made more or less deaf, often com-
plains of noises in the ears." This effect, noted by Dr.
Tuckwell from salicylic acid, has been most definitely de-
scribed by Dr. Gowers, of University College Hospital, as
occurring during the administration of salicylate of soda; and
he, besides the deafness and tinnitus, found vertigo to exist.‡
We have thus, as Dr. Gowers perceived, the essential features
of Meniere's disease ("auditory nerve vertigo"). He himself
curiously enough made some tentative prescriptions of the
drug in this very affection. Dr. McClatchey, of Philadelphia,
initiated the systematic application of drug to disease in the
homœopathic school by reporting§ a striking cure with it,——
the salicylate being given in two-grain doses. Dr. Dyce
Brown has since followed up with others, in which the
dilutions from the 1st to the 3rd decimal seem to have done
* See Brit. Med. Fourn., Aug., 25, 1879, p. 283.
† See Lancet, Sept. 20, 1879.
See Brit. Med. Fourn., April 21, 1877.
$ Hahn. Monthly. Aug. 1877.
144
ACIDUM SULPHURICUM.
everything that was required;* and Dr. Claude reports from
Paris that the third trituration of salicylic acid is becoming
quite a favourite medicine with him for simple deafness with
tinnitus. My own experience has been quite as favourable
with it in this class of cases.
The power of the drug to disorganise osseous tissue has
also been utilised by Mr. S. H. Blake in a case of scrofulous
caries.†
I have already mentioned Quinine as the analogue of our
present drug, and suggested the dosage in which it will
probably have to be given.
The last of my group is
Acidum sulphuricum.
"Ten grains by weight of the officinal acid of the British
Pharmacopoeia, mixed with sufficient distilled water to measure
cighty minims, will constitute our 1 preparation." I quote
the British IIomoeopathic Pharmacopoeia.
X
The only pathogenesis of Sulphuric acid we have is that
contained in the second edition of the Chronic Diseases. It
contains 513 symptoms from Hahnemann and five fellow-
observers, and 8 from authors.
The first dilution of this acid is here directed to be made
with distilled water, and the subsequent ones with alcohol.
If we could suppose the former to have been used for the
proving, we might attach some importance to the symptoms
recorded; but the epoch of their appearance compels us to
refer them to the category of those supposed to result from
globules of the 30th. Of the eight symptoms from authors
five are those of a typhoid from which the patients taking it
were suffering. The only valid ones are S. 148 (“salivation "),
151 ("aphtha in the mouth ") and 198 ("hiccough "-this
repeatedly recurred after the administration of clysters con-
taining the acid).
We thus know next to nothing about the dynamic physio-
logical effects of Sulphuric acid; and, judging from its thera-
peutic position in homœopathic practice, these are probably of
more limited range than in the case of the other mineral acids.
It has been mainly used in disorders of the alimentary canal.
Hahnemann‡ speaks of "a very small dose of a high dilution "
* Monthly Hom. Review, Sept. and Oct., 1878.
† Ibid, xxii., 415.
‡ Organon, note on p. 10 of Dudgeon's translation.
ACIDUM SULPHURICUM.
145
as curative of acidity of stomach. Dr. Bayes mentions a form
of gastralgia in which he found it very useful; and Dr.
Schneider commends it in obstinate hiccough, to which it is
certainly homœopathic. Its undoubted power, now so gener-
ally recognised, over diarrhoea is also a homoeopathic action;
for it is admitted by all therapeutists that its continued usc
tends to loosen the bowels.* The same may be said of its
influence over cutaneous disorder: “occasionally writes
Christison of acute poisoning by it "eruptions break out over
the body." Pereira says that "no remedy is so successful in
relieving the distressing itching, tingling, and formication of the
skin of lichen, prurigo, and chronic urticaria, as sulphuric acid
taken internally." Teste has cured syphilitic maculæ with it.
در
But there are those who would have it that our use of
Sulphuric acid has been too limited hitherto. Among these
are Drs. Espanet and Cooper. The former thinks that it is
the antiphlogistic of cachectic subjects, as Aconite is that of
the robust. The lattert considers that Sulphuric, like Phos-
phoric, acid shares the virtues of its base, and is an anti-
neuralgic and a possible anti-periodic. He gives a good case
of chronic gastralgia cured by it. The special relation of this
acid to cutaneous affections seems to support his position :
it was, indeed, on this ground that it was first used in them.‡
It must also be mentioned that later observation shows that,
in poisoning by Sulphuric acid, some absorption into the blood
does take place, leading to a great increase in the elimination
of sulphates in the urine, and the setting up of an acute paren-
chymatous nephritis thereby, manifested during life by album-
minuria and fibrinous casts. In several cases, moreover, there
have been observed during convalescence from the immediate
local effects "neuralgic affections of the intercostal and
abdominal nerves; also, in isolated cases, extended and severe
hyperæsthesia over the whole trunk." §
Dr. Guernsey considers Sulphuric acid indicated by a
general sense of tremulousness, without actual tremor; and by
a hurried feeling on the patient's part. The former symptom
seems connected with general debility (“the weaker the patient
>>
* Dr. Ringer moreover says, "A small dose often benefits diarrhoea,
whilst a full one, by increasing the acidity of the canal, may even
aggravate it; and Stillé-"A caution should be observed in treating
bowel affections with sulphuric acid, which is, not to persevere in it if
the first few doses fail to mitigate the symptoms, for in that case it is
almost certain to aggravate them.
† Brit. Fourn. of Hom., xxix. 699.
‡ See Med. and Phys. Journ., iv., 484.
$ Ziemssen's Cyclopædia, vol. xvii., sub voce.
10
146
ACIDUM SULPHURICUM.
is, the more tremulous she becomes "); otherwise its association
with hurriedness would suggest an incipient stage of the tremor
and festination of multiple cerebral sclerosis.
The Sulphuric may be compared with the other mineral
acids, and with Sulphur. The 2nd and 3rd decimal have
been its usual attenuations.*
1
* A comparative view of the action of some of these acids, by Dr. H.
V. Miller, may be read in the Hahn. Monthly, Nov., 1877, and Mon.
Hom. Review, xxii., 30.
LECTURE X.
ACONITE.
The survey we have now completed of the acids used in our
practice has exhibited the weakness as well as the strength of
Homœopathy as it at present exists. But in the medicine we
have now to study its strength alone is seen, and that at its
full. If Homœopathy had done nothing for therapeutics but
reveal the virtues of
Aconitum,
it might even die content.
The Homœopathic tincture is prepared from the Aconitum
napellus. By Hahnemann the whole plant was used. The
British Homœopathic Pharmacopoeia directs the employment
of the leaves and flowering tops, freshly collected, with the
fresh or dry root. This is the tincture ordinarily dispensed;
but an alternative (and of course much stronger) one made
with rectified spirit from the dry root alone can be had if
ordered.
1
Hahnemann's proving of Aconite is contained in the first
volume of his Materia Medica Pura. It contains (in the latest
edition) 541 symptoms, of which 431 are from himself and
seven fellow-observers, and 110 from authors. Aconite was,
moreover, one of the medicines selected for re-proving by the
Austrian Provers' Society. Their work was carried out in the
most thorough manner, sixteen persons co-operating in it, two
of whom were women: the record of the experiments is con-
tained in the first volume of the Oesterreichische Zeitschrift
für Homöopathie. These two provings, with all additional
matter available, are collated by Dr. Dudgeon in the first part
of the Hahnemann Materia Medica, and by Dr. Allen in his
Encyclopædia. There are also (besides the well-known treatise*
of Fleming from the other school) studies of Aconite by
St
*An Enquiry into the Physiological and Medicinal Properties
of the Aconitum Napellus. 1845.
148
ACONITUM.
Hartmann;* by Reil (in the form of the first prize essay of the
German Central Verein),† and by Carroll Dunham in his
Lectures. Hempel and the New Materia Medica give numerous
cases of poisoning; and all the systematic writers devote large
space to the discussion of the action of the drug.
It is impossible to begin to speak of Aconite without a
thrill of gratification and pride. The inestimable benefits
which are daily being obtained from this remedy as an anti-
pyretic and antiphlogistic, and which are now-at least in
this country and America-obtaining general recognition, are
the direct result of homoeopathy. Fleming indeed, in 1845,
was led by his experiments to infer that Aconite was an
arterial sedative, and to recommend and employ it accord-
ingly in fever and inflammation. But, as might have been
expected, so indiscriminate a use of the drug made little way;
and the place it occupies in Pereira's great work as a mere
benumber of pain, and its rejection as dangerous and useless
by Trousseau and Pidoux, sufficiently characterise its recep-
tion in the old school twenty years ago. When, ever and
anon, our brethren without have caught a glimpse of its
precious virtues, it has been from its use by homoeopathists
that they have done so; though they have generally (Liston
being a noble exception ‡) proclaimed them in the medical
journals with a sneer at the source of their information. The
present English use of the drug is not handed down from
Fleming, but is the result especially of the persistent teaching
of Dr. Ringer, whose inspiration is not dubious. But this
writer had to say, as late as 1874, first, indeed, that "perhaps
no drug is more valuable than Aconite," but then, that "its
virtues are only beginning to be appreciated."§
On the other hand, the therapeutics of homoeopathy exhibit
a continuous use of Aconite as an antipyretic and antiphlo-
gistic from the earliest years of the present century down to
this day. The knowledge of this property of the drug it owes
to Hahnemann himself; and the history of his discovery is of
importance, alike as vindicatory of his own fame and as illus-
trative of the working of his method.
On his first mention of the plant-in his "Essay on a new
*Practical Observations on some of the chief Homeopathic
Remedies, trans. by Okie. First Series, 1841.
† Translated into English by Millard. 1860.
† See Lancet, April 13, 1836.
§ Handbook of Therapeutics, 4th ed.-Dr. Ringer's first memoir
on Acunite appeared in the Lancet for Jan. 9th, 1869, and closely
fol'ows the article on it in the first edition of this Manual, which was
published in 1867.
ACONITUM.
149
principle for ascertaining the curative power of drugs," pub-
lished in Hufeland's Journal in 1796—he evidently knew no
more of it than was known by the toxicologists and therapeu-
tists of his day. He describes its familiar poisonous effects,
and suggests that, upon the "new principle" of similarity
which he was now advocating, it might be given in rheumatic,
paralytic, convulsive and eruptive affections, in some of
which he states that it had already displayed no trifling efficacy.
When, however, in the first edition of his Materia Medica
Pura (1811) he publishes a pathogenesis of Aconite, he pre-
fixes thereto the following remarks:-
"There is hardly any vegetable medicine but Opium whose
primary action is characterised by the production of heat;
and so those medicines serve just as effectively in acute
diseases, whose primary action is compounded of several
alternate states of chill (or coldness) and heat. To plants of
this class belong Aconite, Ignatia, and some others. Since,
moreover, the action of Aconite is of very short duration, and
nearly always over in twenty-four hours, it thus becomes intel-
ligible, that for the most part it is in acute diseases only that
this plant can be permanently helpful; and that it but seldom
suffices in chronic disorders, which are subject to far fewer
of those alternations of condition which constitute the main
essence of the action of this substance.
"Where Aconite is suitable as regards the rest of its symp-
toms, it becomes nevertheless so much the more helpful as the
state of the patient's disposition presents at the same time a
predominant resemblance to that which is expressed in its
symptoms."
This is entirely a new thought about the drug, and is the
germ of our present knowledge regarding it.
When we
enquire how Hahnemann came to this thought, the answer is
plain. In the year 1805, he had issued his Fragmenta de
viribus medicamentorum positivis, which contained pathogenetic
effects of a number of substances obtained by provings on the
healthy human body. Among them was Aconite, and in a
note to his article upon it Hahnemann had written: "through
the whole course of action of this plant, its effects of the first
and second order were repeated in short paroxysms two, three
or four times before the whole effect ceased, which it did in
from eight to sixteen hours." And these effects he describes
thus" coldness of the whole body, and dry internal heat;
chilliness. Sense of heat first in the hands, then in the whole
body, especially in the thorax, without sensible external heat.
Alternating paroxysms (during the third, fourth, and fifth
150
ACONITUM.
hours); general sense of heat, with red cheeks and headache,
worse on moving the eyeballs upwards and laterally, then
shuddering of the whole body with red cheeks and hot head;
then shuddering and lachrymation with pressing headache and
red cheeks."
It was from his provings, then, and upon the the principle
of similarity, that Hahnemann inferred the usefulness of
Aconite in acute diseases, in which it had hitherto found no
employment. In what forms of these disorders it would be
serviceable he does not indicate at present, save that he points
to the mental and moral symptoms of the drug as those
especially to be looked for in the patient. When, however, we
next hear from him on the subject, he is able to be much more
explicit. I quote from the preface to the pathogenesis of
Aconite in the first volume of the second edition of the
Materia Medica Pura, published in 1822.
"Although the following symptoms do not yet express the
whole significance of this most valuable plant, they neverthe-
less disclose to reflecting homoeopathic physicians a prospect
of help in morbid conditions, in which the ordinary practice
employs its most dangerous means, viz., copious venesections
and the whole antiphlogistic apparatus,-measures very often
injurious, and nearly always followed by disastrous after-
effects. I mean the so-called pure inflammatory fevers, in
which the smallest dose of Aconite renders unnecessary all the
antipathic measures hitherto in use, and cures rapidly and
without sequela. In measles, in purple-rash, and in the most
intense pleuritic fevers its remedial power is something
miraculous, when-the patient observing a somewhat cooling
regimen, and avoiding everything else of a medicinal kind,
especially vegetable acids—a dose of a small part of a drop of
the octillionth" (ie., the 24th) "attenuation is administered.
Seldom is a second dose, thirty-six or forty-eight hours after
the first, required.
"But to remove from our conscientious method all influence
of the ordinary practice, which is too ready to be regulated by
(often imaginary) names of disease, it is necessary also that in
all morbid conditions in which Aconite is indicated, the princi-
pal symptoms of the patient, as well as those of the (acute)
disease, should suitably correspond as likes to likes with those
of the remedy.
"The result is then surprising.
"It is just in the cases where Allopathy most prides itself,
in the great inflammatory fevers where they look to bold and
free blood-letting as the only means of salvation, and consider
ACONITUM.
151
that herein they have a huge advantage over homoeopathic
modes of help, that they are most utterly mistaken. Just here
appears the infinite superiority of homoeopathy, that—without
the need of spilling a drop of that precious life-juice, so irre-
parable, which Allopathy relentlessly sheds in streams-it not
seldom transforms those frightful fevers to health in as many
hours as the life-reducing proceedings of Allopathy require
months for the full restoration of the patient, if perchance he
has escaped actual death, and has only had to struggle with
the chronic sequela which have been artificially produced.
'It is sometimes necessary, in these acute attacks of
disease, to have recourse to an intermediate homoeopathic
remedy for the symptoms which remain after Aconite has
acted for twelve or sixteen hours, and still seldomer (as I have
said) to a second dose of Aconite after this intermediate
remedy.
>>
"When the careful employment of Aconite is practised in
the morbid conditions mentioned, four hours will not have
passed ere all fear for life has been removed, and the excited
circulation then returns from hour to hour to its habitual
tranquil course.'
He goes on to say that it is occasionally a useful auxiliary
even in chronic diseases where tension of the fibre is present;
and that most of the symptoms in the appended list which
seem contrary one to the other are really alternating states,
either of which can be used as curative indications, although
those of a tonic" character are of most value. Lastly, he
repeats his admonition as to the importance of securing simi-
larity in the symptoms of the mind and disposition.
Eight years more gave him little to add upon the subject.
The preface to Aconite in the third edition of the first volume
of the Materia Medica Pura (1830) is almost identical with
that of the second, save that for the 24th he substitutes the
30th dilution, and mentions the value of the remedy in pre-
venting the injurious effects of fright or vexation when occur-
ring in women during the catamenial flow, which these
emotions are very apt to suppress. He also inserts one other
new paragraph which must be transcribed. "So also," he
writes, "is Aconite the first and chief remedy (in the attenuated
doses mentioned) in inflammation of the windpipe (croup,
angina membranacea), in several kinds of inflammation of the
throat and gullet, and in like manner in acute local inflamma-
tions elsewhere, especially when, with thirst and rapid pulse,
an anxious impatience, an unappeasable restlessness, and an
agonised tossing about are conjoined." These last are evi-
152
ACONITUM.
dently the "symptoms of the disposition" (Gemüths-sympto-
men) on which Hahnemann had always laid so much stress as
indications for its choice.
And when again we enquire how Hahnemann came to these
applications of Aconite-how from a general fitness for acute
diseases he was led to see its especial appropriateness to active
states of fever and inflammation, we find that it was (in all
probability) from these very mental conditions that the dis-
covery was made. Dr. Quin-the honoured pioneer of
Homœopathy in this country-was well acquainted with
Hahnemann, and has related how "in 1826 he asked him how
he had discovered the great antiphlogistic power of Aconite,
as that was not evident from the proving. Hahnemann
replied, that he had not directly discovered this property from
the proving, but that whilst treating some inflammatory dis-
orders he was led to the employment of Aconite from the
similarity of some of the concomitant symptoms with some in
the pathogenesis of Aconite, and he had found its administra-
tion followed by a great diminution in frequency of the pulse,
and a cessation of the febrile state."*
From the facts and dates now brought forward the follow-
ing conclusions seem to result :
Ist. The antipyretic and antiphlogistic properties of Aconite
were an original discovery of Hahnemann's, made by him
many years before any thought of the kind occurred (if it ever
did occur at first instance) to a practitioner of the old school.
2nd. The discovery was made by pure induction from the
symptoms produced by the drug when proved upon the
healthy human body, applying these to disease according to
the relation of likes to likes.
3rd. The application which led to the discovery was regu-
lated primarily by the similarity of the mental symptoms of
the drug to those of the morbid condition present.
4th. The antiphlogistic and antipyretic virtues of Aconite
were first ascertained and obtained by means of infinitesimal
doses.
But although the actual discovery of the power of Aconite
over fever was made by means of the associated mental
symptoms rather than by the febrile phenomena themselves,
yet there can be no doubt of the real homœopathicity of the
drug to the latter also. It is true that a hasty glance at the
symptoms of poisoning by this plant has led to its being
set down as a mere cardiac depressant. But a closer look
reveals that the condition set up is one answering to the chill
* Brit. Journ. of Hom., v., 387.
ACONITUM.
153
of fever and ague and the collapse of cholera. The pale face,
the quick and contracted pulse, the general coldness within
and without; the signs (should death result) of extreme
venous congestion-these speak of a corresponding excitation
of the vaso-motor nerves throughout the body. Had the
thermometer been applied, it is probable that here as there*
the temperature would have been found already on the rise.
That this is the true explanation of the symptoms appears
from what follows. For mark, that, should reaction take
place, the condition of febrile heat succeeds that of chill: as
Dr. Geo. Wood states, "the circulation, respiration, and
general temperature are somewhat increased." The same
statement is made and illustrated by Fleming (pp. 34, 148).
This is well seen in such a case as the tenth of Hempel's
series. The pulse, at first collapsed, became fuller, and rose to
100; the skin being hot and dry and the tongue coated, with
headache and sleeplessness. His twelfth case exhibits a
similar succession of phenomena. But the power of Aconite
to induce fever is still more evident in the provings, and
especially those of the Austrian Society. One of the latter
experimenters was so distressed by the febrile heat induced,
that, not knowing what drug he had been proving, he com-
menced taking Aconite to obtain relief. The fever in these
subjects was generally accompanied by signs of arterial con-
gestion of the head and chest. If further confirmation of the
pyreto-genetic power of Aconite had been needed, it would
have been supplied by the experiments of Professor Schroff.‡
Their main interest to us lies in the evidence they afford of
the influence of Aconite upon the trigeminal nerve.
But
repeatedly in their record we meet with expressions like these
-"much febrile movement," "general internal and external
heat, with quick pulse," "the whole body was burning," "he
passes from the midst of cold to the midst of heat," "alter-
nately hot or cold." Dr. Mackenzie, also, as the result of his
recent experiments on animals, states that Aconite increases
the temperature until asphyxia sets in,-the thermometer in
the ear of a rabbit rising from two to four degrees Fahrenheit
under its influence.
That the temperature is rising during the collapse of cholera is
proved by Erman's observations (see London Medical Record, i., 580).
I need not argue the point with reference to fever and ague.
† See Symptoms 777-782 in Dr. Dudgeon's arrangement.
Translated from the Präger Vierteljahrschrift and Journal
für Pharmakodynamik, in L'Union Médicale for June and July,
1854. Reil also gives the earlier set of experiments in extenso.
154
ACONITUM.
I maintain, then, that it is in virtue of its power of setting
up the essential phenomena of fever, of its action upon the
same parts and in a similar manner, that it controls this con-
dition when already present. It is febrifuge because it is
febrigenic. But it is not every kind of fever which Aconite
can remove. Like every other specifically acting drug, it has
its proper sphere, beyond which it is less useful. The sphere
of Aconite may be defined by two negations.
First, it has little control over the fevers resulting from
morbid poisons. Its use in typhus and typhoid is mere waste
of precious time. In variola it will not lower the circulation
until the eruption comes out; nor will it touch the high
temperature of pyæmia. It is more frequently useful in
measles and scarlatina, though in the latter only when of a
sthenic type, i.e., when the blood-poisoning is but slight. I
need hardly say that it will do nothing to prevent the
recurrence of the paroxysms of hectic or of the malarial
fevers.
Secondly, Aconite will do little for a fever which is sympto-
matic of an acute local inflammation. The excellent cases of
pneumonia which Tessier has put on record* well illustrate
this: it is most interesting to notice how the pulse defied
Aconite, but went down rapidly when Bryonia or Phosphorus
touched the local mischief. There are, indeed, a few inflam-
mations in which Aconite may alone effect a cure, as being a
specific irritant of the part affected. These are especially, as
we shall see, the rheumatic inflammations. But even in non-
rheumatic pleurisy, in its plastic form, and also in some kinds
of croup and angina tonsillaris, Aconite is, as Hahnemann has
said, a potent remedy. With these exceptions, it may be laid
down that in proportion as true inflammatory changes in a
part have actually begun, it ceases to exert remedial influence;
and a medicine homoeopathic to the local mischief must take
its place.†
These negatives suggest the positive we desiderate. The fever
in which Aconite is specific is neurotic, not toxæmic or sym-
pathetic in nature. It is the "synocha" of the old authors,
* Récherches cliniques sur le traitement de la Pneumonie et du
Choléra, suivant la méthode de Hahnemann. Paris, 1850.
† Dr. Ringer supplies another contra-indication to the use of
Aconite in inflammation, viz., the absence of increased temperature,
as shown by the thermometer. When this obtains-as in some forms
of angina—the remedy will be ineffectual. Dr. Imbert-Gourbeyre, in
pre-thermometric days, had shown the same thing symptomatically
(Brit. Fourn. of Hom., xiv).
ACONITUM.
155
the "pure inflammatory fever" indicated by Hahnemann, the
fever in which the fibrin of the blood is in excess (so that its
clot would be buffed and cupped), while the corpuscles are
unpoisoned and the tissues are yet intact. It is the kind of
fever which follows in some sensitive persons upon the passing
of a catheter, or which any one may experience from exposure
to (especially dry) cold. Let the morbid impression known
as a chill" be made upon the vascular nerves; let the
arterioles under their influence first contract to produce the
cold stage, and then dilate for the hot stage of simple fever;
and we have the everyday occurrence for which Aconite is the
unfailing remedy. Whether the chill or the heat be present
the medicine is no less indicated; and let the storm of arterial
excitement be ever so high, a few doses will quiet its fury.
"In as short a time as four hours after the administration of
Aconite in the morbid states in question, all danger to life is
past, and the excited circulation returns from hour to hour to
its more tranquil course." So (as I have reminded you) wrote
Hahnemann in 1822, pointing out to us this most important
use of our medicine. Indeed, it may be laid down, that unless
a fever (not being rheumatic, of which more anon) has greatly
abated within twenty-four hours of commencing Aconite, it is
one for which the remedy is unsuited.
The relation of Aconite to inflammation and inflammatory
fever is well stated by Teste;* and still more fully by Dr.
Dunham. He (the latter) well points out its accordance with
the symptomatic indications given for the drug by Hahne-
mann himself, i.e. (as you will remember) when "in conjunc-
tion with thirst and a rapid pulse there are present an anxious
impatience, a restlessness not to be quieted, distress, and an
agonised tossing about." These are the symptoms of inflam-
matory fever before it has well localised itself. When
exudation has set in at the affected part, the tension of the
circulation and nervous system diminishes; and such fever as
continues is sympathetic, and of like character with the local
changes. He illustrates the phenomena by the passing of a
tempest over a village, which may subside to perfect calm; but
which may leave behind it a cottage on fire, that shall be in its
turn the centre of agitation and mischief. Aconite will subdue
the storm; but it will not put out the conflagration. The
same symptomatic indications admirably harmonize with the
relation of our drug to the essential fevers. The condition of
the patient in typhoid and other toxæmic pyrexiæ is one of
* It is, he says, "in phlegmasiæ primarily general, and only second-
arily localised" that Aconite is curative.
156
ACONITUM.
heaviness and oppression, rather than of the anxietas charac-
teristic of Aconite.
""*
It is right to add that all these observers-Hahnemann him-
self, Tessier, Teste, Dunham (and I may add Dr. Guernsey in
the same strain)-speak of the action of the higher dilutions
of the medicine, which alone they were accustomed to employ.
Those who have used stronger preparations seem inclined to
give it a wider range. "The power of this drug over inflam-
mation," writes Dr. Ringer, "is little less than marvellous ;
and Hempel seems to know no limit to its action here. Dr.
Bayes speaks highly of it, in the first decimal dilution, in acute
otitis, to which it has no proved homœopathic relation.
Wurmb, who gave it high, allows it no place in typhoid; but
Trinks, who used the lowest dilutions, thinks it of real service
in the incipience of the less asthenic forms. It is here as
elsewhere. Infinitesimals, at least in the higher grades, act
only when the homœopathicity is perfect; though they then
display such brilliant powers that one may well become
cnamoured of them. A nearer approach to the crude drug
widens the range of action, and enables us to be content with
a simile instead of searching for an often unattainable and
still more often illusory similimum. But, on the other hand,
the farther you get from the punctum saliens of minute symp-
tomatic resemblance, and increase your doses accordingly,
you are in peril of coming to employ the drug in quantities
large enough to induce its physiological action as an "arterial
sedative," in which it ranks with Digitalis, Tartar emetic, and
other drugs, like them retarding the heart's action through the
vagi, and relaxing the system through the induction of nausea.
It is such an application of the drug which was advised by
Fleming (in 1845) on the strength of his experiments with it;
and it is this, mainly, which, through Ringer and Phillips, has
come into vogue again now. It is not without its merits; but
I am anxious to impress upon you that it is not homœopathy,
and that you must not claim it as such. It is not that anti-
pyretic and antiphlogistic use of Aconite which was dis-
covered by Hahnemann before 1822, and which has ever
since constituted (as you may see by Reil's and Dudgeon's
quotations) one of the most cherished practices of his school.
The condition, then, to which Aconite is homœopathic, and
which makes it our great febrifuge, is one of tension of the
nervous and arterial systems, manifesting itself by restless
* This was his language in 1874. In his seventh edition (1879) he
employs more qualified language, and inclines to the views expressed
above.
ACONITUM.
157
anxicty in the one, and chill and heat, with thirst, in the other.
It is easy to see that a large class of acute affections beyond
those hitherto specified may thus come within its range. In
active hæmorrhage, especially hæmoptysis; in acute congestion
of almost any part; and in recent febrile dropsy, Aconite will
always commence and often complete a curc.
The same
thing may be said of acute sthenic erysipelas and puerperal
fever, and (as I have said) of the " urethral fever" which in
some subjects ensues upon catheterism. . In cholera infantum
Dr. Madden found it indispensable in Australia;* and Dr.
Guernsey writes of it-"if a child is suffering from a watery
diarrhoea, is crying and complaining very much, biting his fists,
and is sleepless, Aconite will usually settle this trouble in a
short time." In the collapse of Asiatic cholera itself, where
the chill is so deadly that were it not for the consecutive fever
its true nature would be hardly recognisable, but where (as in
ague) the temperature is already rising, Aconite will assert its
power. It is due to Dr. Hempel to say that from early times
he has maintained the homoeopathicity and potency of the
medicine here. In the epidemic of 1865, a French physician
(Dr. Cramoisy) reported twelve severe cases recovering under
this remedy alone, given in drop doses of the mother tincture.†
It is especially when collapse comes on very rapidly, with
little or no premonitory illness, and unattended by copious.
evacuations, that Aconite is indicated. Arsenic is the medicine
generally prescribed in such cases; but its sphere and that of
Aconite intersect and overlap each other at this point, and the
greater rapidity of the action of the latter would seem to turn
the scale in its favour.
The power of rectifying the disordered balance of the cir-
culation shown in these instances gives Aconite an important
place in the treatment of many morbid conditions not strictly
febrile. In apoplexy and in puerperal convulsions, where there
is much arterial excitement, Aconite will do everything for
which the lancet used to be thought indispensable. In sup-
pression of the menses from a chill, with its accompanying
congestive phenomena, there is no more valuable medicine.
Again, where the tension is in the nervous system alone,
Aconite (especially in the higher dilutions) is of signal service.
Dr. Bayes speaks well of it in the insomnia of aged persons,
and Dr. Guernsey in erethistic states occurring during denti-
tion and parturition; while Hahnemann writes" It produces
Annals, v. 57.
+ Bull. de la Soc. Méd. de France, 1865, pp. 604 and 652. See
also Dr. Cramoisy's further experience in L'Art Médical, xlviii.,
414.
158
ACONITUM.
all the morbid states which are manifested in persons whose
minds have been excited by fear, joined with vexation; and it
is also the surest means of curing them rapidly." Fear itself
(especially the fear of death), when urgently present, has been
found an unerring indication for it.
This leads me to say a few words upon the action of Aconite
in the musculo-motor sphere of the nervous system.
We find
here a similar tension induced to that already seen in the vaso-
motor division. Not paralysis, but spasm, is excited, and that
nearly always of a tonic character. Trismus is a common
symptom in cases of poisoning; the sufferers frequently com-
plain of constriction at the throat, of local cramps and spasms,
and of stiffness and difficulty of moving the limbs; and there
are several cases on record in which complete opisthotonos
existed, and the pseudo-tetanic state was induced as completely
as by Strychnia. There is, however, none of the reflex ex-
citability present which characterises that medicine.
These statements as to the musculo-motor action of Aconite
(which I have always made) are of course in direct opposition
to the common notions about the poison, which assume it to
be a pure paralyser. They are fully borne out, however, by
the most recent experiments with it on animals-those of Drs.
Harley* and Mackenzie.† The former infers from his obser-
vations that Aconite affects the cranio-spinal axis from the
centres of the third nerves to the origin of the phrenics, as
Strychnia does the whole; and exhibits well the spasmodic
dysphagia and dyspnoea which result from its administration.
Dr. Mackenzie extends the statement to the whole sphere.
under consideration. "In the earlier stage of aconitism," he
writes, “the irritability of the muscles and motor nerves is
augmented; their excessive functional activity induces a period
of exhaustion, which disappears, however, if they be allowed
time for recuperation."
Correspondingly, Aconite has considerable power over some
spasmodic affections. Its usefulness-generally in alternation
with other more locally acting medicines-in the incipience of
the neuro-phlogoses we call croup and whooping-cough is
probably to some extent of this kind. In the asthmatic
paroxysm, and in that of the so-called "spasmodic croup
(not real laryngismus stridulus), when excited by cold dry air,
it will often give relief. In simple trismus and many other local
cramps and spasms, especially when owning a similar origin,
it should always be thought of: Teste relates. a striking case
* St. Thomas' Hospital Reports, vol. v.
† Practitioner for 1878-79.
>>
ACONITUM.
159
of the kind in which the pectoralis muscle was at fault, and
simulated cardiac disease. But, above all, it bids fair to be a
valuable medicine in tetanus. There are seven cases of the
traumatic form of the disease now on record, in which Aconite,
in ordinary doses, was the main remedy used; and in six
recovery was the result. It would be still more suitable to the
idiopathic form of the disease, from exposure to cold and wet;
and to the "tetany" described by Trousseau. The numbness
and tingling with which the spasms of the latter begin, their
probable rheumatic origin, the occasional presence of febrile
symptoms, and the benefit observed from blood-letting-all
point to Aconite.
We come next to the action of Aconite in the sensory sphere
of the nervous system. To the mind of a physician of the
old school, this is a very simple matter. In poisoning by the
drug, he would say, and in experiments with it upon animals,
loss of sensibility is one of the most obvious phenomena.
Aconite, accordingly, is a paralyser of the sensory nerves; and
may often prove useful in neuralgia and other simple pains, to
which-when the affected parts can be reached-it is best
applied locally.
But a little further enquiry will show that such a conception
is simple only because of its poverty, and that it fails to
embrace the whole series of facts under notice. In experi-
ments on animals, indeed, loss of sensibility of the skin is
always noted. But no better instance can be given of the
inadequacy of this mode of pathogenetic research than the
present. You have only to read a few cases of poisoning by
the drug to find that, while the surface of the patient's body
is insensible to external impressions, it is not so to his own
consciousness. He will complain of at least an uneasy sense
of numbness and tingling, or of pricking and burning; and
not seldom of actual pain. The condition set up is evidently
a dysæsthesia, and not a mere impairment of sensation. Still
more evident is this when we come to deliberate provings on
the human subject. Those of Professor Schroff have most
bearing on the point. “Aconitine," he says, "produces a pecu-
liar feeling of drawing and pressure in the cheeks, the upper
jaw, the forehead-in a word, in the parts supplied by the
trigeminal nerve. This feeling increases little by little in in-
tensity, and is transformed at first into a remittent pain which
shifts its place, later into a continued pain of considerable
severity." In one of his provers the extract of Aconitum
neomontanum caused "drawing and tension in the range of
the fifth nerve, which soon gave place to a lancinating pain,"
160
ACONITUM.
and Rothansel, in the Austrian experiments, experienced a
similar effect.*
The action of Aconite upon the sensory nerves is thus to
develope in them that morbid condition which shows itself in
neuralgic pain. Nor need its production, of anæsthesia be
regarded as in any way inconsistent with this statement. It has
often been shown (and by none better than the late Dr. Anstie)
that pain is not hyperæsthesia, but something entirely different
if not opposite; and that neuralgic pain especially is nearly
always associated with diminution of healthy function, and
may even exist in the presence of almost entire destruction of
the nervous substance which is its seat. That Aconite causes
anæsthesia, therefore, is in favour of rather than against its
development of neuralgia; and, therapeutically, it suggests its
appropriate place to be in those instances where the two con-
ditions most obviously coincide.
use.
And now again,-if Aconite showed itself useful in neuralgia
only when applied to the painful nerve, its operation might
be conceived of as a mere local benumbing. But its chief
reputation in this disease has been obtained by its internal
In an article in the Gazette Médicale de Paris for 1854,
Dr. Imbert Gourbeyre has collected numerous testimonies to
its efficacy; and at the present day Professor Gublert declares
it "almost specific" in facial neuralgia, especially of con-
gestive form, saying that he has yet to see a case in which it
fails to be of at least some benefit, even if it does not cure. Dr.
Ringer concurs with him that it is where the fifth nerve is
affected that it proves most useful; and this exactly corresponds
with Schroff's statement, that "Aconite, as also aconitine,
given internally, appears to have an elective and special action
upon the trigeminal nerve, producing in all parts animated by
the sensitive branches of this nerve peculiar sensations, most
frequently painful." But the general pains experienced by
many subjects of its influence show that it has in some degree
the same action everywhere; and Dr. Imbert Gourbeyre's
collection of evidence proves that its efficacy is not limited to
prosopalgia. It has proved very useful, for instance, in sciatica.
C
The kind of neuralgia to which Aconite is homœopathically
appropriate has been sufficiently exhibited. It is most suic-
able to recent cases, occurring in comparatively young subjects,
and especially when traceable to cold draughts. Dr. Gubler's
experience, however, may lead us to trust to it—especially in
the form of aconitine-in more chronic and deeply-rooted
cases.
* See Allen, s. 419. † Bulletin de Thérapeut que, Feb. 25, 1877.
ACONITE.
161
*
The numbness and tingling of Aconite may have another
significance: they may suggest that which, felt in the extremi-
ties, is so frequent and grave a warning of impending apoplexy
or paralysis. Dr. Hempel has laid much stress upon this; but
I confess that I rather thought of the anesthetic influence
of the drug as being exerted upon the extremities of the
sensory nerves, reaching them through the blood which bathes
them. Liegois and Hottot, however, seem of late to have
demonstrated that it produces the effect by acting upon a
supra-spinal sensory centre-possibly the optic thalamus.
this be so, we have in aconitism a condition precisely similar
to that which obtains in threatened hemiplegia, into which in two
of the older records of poisoning cited by Hahnemann-those
of Matthiolus and of Richard-it seems to have actually
developed; and Dr. Hempel is quite justified in urging us to
use it as a homœopathic remedy in corresponding morbid
states. He relates several cases of cerebral paralysis, immi-
nent or present, in which its use was of the utmost advantage.
If
You will also think of Aconite whenever you meet with
anææsthesia as such, general or local, at any rate when it is
complained of. It would hardly be suitable to the form of it
met with in hysteria, which has of late excited so much interest
in connection with the "metallo-thérapie" of Burq; for here
the patient is unaware of the loss of sensibility till it is ascer-
tained from without. But whenever an "anæsthesia dolorosa"
is present, give its subject the benefit of Aconite.f
Yet another application of the elective action of Aconite on
the trigeminus has been made by Dr. Dekeersmaecker, of
Brussels, when he reports its efficacy in incipient glaucoma. It
is when the ocular affection is associated with anesthesia or
neuralgic pain in the parts supplied by the fifth that he finds
it so useful; and these symptoms obviously suggest its de-
pendence on disorder at the origin of that nerve.‡
-
I cannot pass from this part of my subject without pointing
out to you how beautifully the facts which have just come
before us illustrate the method of Hahnemann. By the
proving on the healthy human body which medicine owes to
him the modus operandi of a valuable piece of practice is ascer-
tained, and hence rendered more sure and definite for the
future; while, by applying the results obtained according to
* The later experiments of Drs. Ringer and Murrell lead them to a
similar conclusion.
† See a case of my own in vol. viii. of the Annals, p. 491. This
patient has since continued almost entirely free from her ailment.
‡ See L' Hom. Militante, i., 271.
M
162
ACONITE.
the rule of similarity he has enunciated, other uses of the
medicine are gained which give us a remedy for morbid con-
ditions, one of which is of the utmost importance.
*
We pass now to another great sphere of the action of
Aconite,-its anti-rheumatic virtues. It cannot be said that
these also were proclaimed by Hahnemann, or are discoveries
of the law of similars. The names of Störck, Lombard† and
Fleming are most prominent as advocates of Aconite in this
connection. The first found it curative in many old rheuma-
tisms, improvement generally setting in with critical sweats or
eruptions. The second ascribed to it a specific action against
acute articular rheumatism. And the third says of its use in
the same affection that the average time required for cure is
from five to six days; that the drug seems to protect the
patient from cardiac complications; that the convalescence is
very short; and that much less stiffness of the joints is left
than under the ordinary treatment.
Nevertheless, though otherwise arrived at, the anti-rheu-
matic virtues of Aconite are truly homoeopathic. Aconite is
an irritant as well as a neurotic poison; and the tissues its
irritation affects (when introduced into the circulation) and the
kind of trouble it causes are distinctly those of rheumatism.
Pains in the joints, muscles, and fibrous tissues generally, of a
cutting, tearing, and shooting character, are very frequent in
the provers; and they are attested by Ringer and Schroff.
Schneller, in the experiments of the Vienna Proving Society,
developed genuine muscular rheumatism in his own back and
loins. One of the Austrian provers had, alternating with his
articular sufferings, painful palpitation of the heart and
præcordial anxiety; and Dr. Jousset says that he has intro-
duced into the circulation of rabbits increasing doses of the
extract, with the invariable result of producing lesions of the
mitral valve. Very painful hyperæmia of the eyes has been
more than once observed,§ and looks like rheumatic ophthal-
mia. Lastly, in post-mortem examinations decided evidences
of inflammation of the pleura and peritoneum have been
found; and the symptoms elicited by some of the provers are
in full harmony therewith.
All this is in closest analogy with the action of the rheu-
matic materies morbi; and in the hands of those who avail
*
Exp. et Obs. circa usum internum Stram., Hyosc., et Aconiti.
1762.
+ Gazette Médicale de Paris, 1835.
‡ Brit. Fourn. of Hom., vi., 271.
§ See case 7 in the New Materia Medica, and Cases XV. and XVI.
in the Appendix to Fleming's monograph.
ACONITE.
163
themselves of the lower potencies, Aconite is reckoned the
prime homœopathic remedy for acute rheumatism. In higher
attenuations it seems to have less power, and is thus little
favoured by Wurmb: there is indeed none of the nervous
tension here which seems indispensable if it is to act well in
infinitesimal doses. But there is fever, with which is increase
of the fibrin of the blood; it is (ordinarily) of synochal type,
and would by itself demand the remedy. It is as yet unknown
whether Aconite can subdue the dangerous hyper-pyrexia
sometimes observed in this disease; but I should think it
likely to impede its supervention by moderating the ordinary
rise of temperature, which it unquestionably does. The rheu-
matic being a toxæmic fever, and not departing in its character-
istic perspiration, cannot be expected to disappear under the
Aconite in a few hours; but it will yield in good time. It is
obvious, moreover, that the supervention of any of the common
complications of acute rheumatism would not render this
medicine less truly indicated; for we have seen it acting simi-
larly on the heart and the serous membranes. It may, how-
ever, be sometimes aided by medicines acting more powerfully
upon the tissues affected, as Bryonia in pleurisy, Colchicum
in pericarditis, Spigelia in endocarditis.
In acute local rheumatisms, moreover, Aconite is often most
effectual, as in stiff-neck or lumbago resulting from a draught,
and in sciatica where the sheath of the nerve is affected. It is
also of great value in the primary stage of rheumatic ophthal-
mia. It is not so effective in iritis as in what we used to call
sclerotitis. We are now taught that the sclerotic is rarely
inflamed, and that the redness of its hyperæmia appears in
patches. But clinically I mean by sclerotitis a painful inflam-
mation of the eyes, brought on by exposure to cold, and
presenting a crimson and straight-lined injection of the ball
instead of the scarlet network of catarrhal ophthalmia.
Here Aconite-meipso teste—is most effective. It is also
highly praised by oculists of both schools for its power of
checking incipient inflammation of the eye after mechanical
injury, whether accidental or operative. Look out, says Dr.
Vilas, for the ciliary zone, and directly it appears put in your
Aconite. Homœopathy has hardly put it to the proof in those
chronic rheumatic conditions for which Störck and his fol-
lowers have so lauded it; and what are the nature and condi-
tions of its action here remains to be seen.
*
I have only yet to speak of the action of Aconite on the
*See the experience of Dr. Cade in Fourn. des conn. med.-chir.,
1856, Nos. 9 and 10.
164
ACONITE.
heart. It has hitherto been generally assumed that it de-
presses and ultimately paralyses this organ. But such con-
clusions have been arrived at from cases of poisoning, and
from experiments on animals with large quantities. Schroen,
Arnold and Sharp* in the homœopathic school concur to
testify that in small doses it quickens the cardiac action in
man, at any rate at first; and Rudolph Boehm has lately
obtained similar results from fractions of a milligramme of
aconitine in frogs.† The acceleration cannot be, he says, from
removal of inhibition through paralysis of the vagi; as atropine,
which effects this, leaves the number of beats unaltered in the
frog. It can only be, therefore, from excitation of the motor
nervous supply of the heart. This is further confirmed by the
second stage of the phenomena resulting from these minute
quantities. Spasms of the heart set in, and these "far more
decided and outspoken than with larger doses." The ultimate
stage is, indeed, diastolic absence of motion; but this, he says,
is clearly a cessation from weariness,-the heart showing all
the characters of an organ semi-paralysed and tired out by
excess of activity and irritation. He calls attention, moreover,
to the remarkable consonance between the action of higher
degrees of heat (as observed by Cyon) and that of aconitine
upon the heart. The "palpitation" so constantly noted by
the provers of Aconite points in the same direction; and the
whole phenomena are precisely analogous to those observed
by Dr. Mackenzie in the muscles generally.
Aconite is thus perfectly homœopathic to the condition of
the heart which obtains in the sthenic fevers; but it also has
an important place in primary disorder of that organ. Of its
value in the cardiac inflammations of acute rheumatism I have
already spoken. It is very useful in all diseases of the heart
characterised by increased action, especially where the left side
is chiefly involved. Its continued use gives much relief to the
distress of hypertrophy. In one case of the rare spasm of the
heart I saw almost instantaneous relief follow its administra-
tion; and in palpitation, where the heart retains its vigour, it
is the best soother.
The therapeutic powers of Aconite have now been passed
in review. The conclusion is that-beyond many other appli-
cations-it is the precious remedy which fills that important
*
Dudgeon, p. 27, note. Monthly Hom. Rev., xvii., 603.
C
† Brit. Journ of Hom., xxxi., 194. The full account of these ex-
periments gives a very different impression from that conveyed by Dr.
H. C. Wood's résumé of them.
ACONITE.
165
place so long occupied by venesection. It was Aconite which,
in days when the lancet was in universal use, enabled Hahne-
mann and his disciples to dispense with it; and it is Aconite
only which will prevent its revivification now.
Ten years ago
I should have said that the revival of venesection was far from
improbable; for, save our present drug, no such potent anti-
pyretic exists. Wilks and Ringer had merely repeated what
Fleming and Routh in their time had proclaimed; and with
these as with those it seemed likely that, from want of know-
ledge how to use the remedy, they would let it go again. But
a deeper and wider impression seems now to have been made;
and it may be trusted that throughout the prefession the con-
viction is growing that in Aconite we possess a remedy which
has all the energy without the inconveniences of bleeding, so
that by it the place of the lancet is irrevocably taken.
As regards allied medicines, it seems to me that Aconite is
perfectly unique in its action in the sphere of the circula-
tion, and the same thing may be said as to its action upon the
sensory nerves. In the musculo-motor sphere, it may be com-
pared with Cicuta and Hydrocyanic acid. Its relation to rheu-
matism classes it with Bryonia and Actœa racemosa; and in its
influence upon the heart it resembles somewhat Cactus
grandiflorus, Naja, and Spigelia—which last acts like it upon
the fibrous tissue of the eye-balls.
And now as to dose. I cannot deny that Hahnemann and
his immediate successors seem to have found success from the
plan recommended by him, of administering in fever a single
dose of a high dilution of Aconite (18th to 30th), and allowing
it to act. But it is no less certain that the homoeopathic
practice of the present day in all countries is to give frequently
repeated doses of (generally) a low dilution until the fever
departs in perspiration. I have myself never adopted any
other practice than this; so that I have no other to recom-
mend to you.
The dilutions I use are the 1st, 3rd, and 6th of
the decimal scale. The first I prefer in high fever, in acute
rheumatism and rheumatic or other inflammations, in cholera,
croup, cardiac spasm, and tetanus: also in neuralgia, where I
often give Aconitine (3rd decimal) with advantage. The 3rd
is sufficient in less violent febrile conditions, or when the anxietas
of Aconite is very marked, in whooping-cough and asthma,
and when the symptoms requiring the drug occur in young
children. The 6th I think best in the febrile chill, in sub-acute
circulatory disturbance connected with menstruation, in chronic
heart disease, and generally where the medicine has to be
taken continuously for some time. I have also, like Dr.
detaly
166
ACONITE.
Bayes, used with advantage in nervous excitement the 12th
and even the 30th; and Dr. Hempel has shown that in such
dilutions it should be used even as an antipyretic when the
patient's strength has been much reduced by depleting
measures.
LECTURE XI.
ACTÆA, ÆSCULUS, ÆTHUSA, AGARICUS, AGNUS CASTUS,
AILANTHUS.
We begin to-day the consideration of a series of minor
medicines which, in our alphabetical order, follow upon
Aconite.
The first is the
Actæa racemosa.
By this, its Linnæan name, I venture still to designate the
plant; though it is now more commonly called-less beautifully,
and with no pleasing suggestiveness-Cimicifuga.
""
A tincture is made from the root. The " concentrated
preparation, cimicifugin or macrotin (which is a resin obtained
by evaporation of or precipitation from the tincture), seems to
contain most, if not all, of the virtues of the plant: it is
triturated, or dissolved in alcohol.
Actea has been fairly proved, and by many persons. Some
of the original experiments may be read in the third volume
of the North American Journal of Homœopathy, and in Dr.
Hempel's Materia Medica. Dr. Allen gives a full pathogene-
sis of it, containing 447 symptoms derived from twenty
distinct sources; and Dr. Hale, in the second volume of the
fourth edition of his New Remedies, supplies a complete
account of its therapeutic virtues. Both call it Cimicifuga.
Drs. Phillips and Horatio Wood concur in saying that we
have little or no knowledge of the physiological action of
Actæa. This is an ignoring of the labours of homoeopathists,
because such, which is hardly creditable to either, and which
ignorance cannot palliate in the former, as he refers to Dr.
Hale's book. Perhaps it would not be welcome to either to
admit that restlessness is so markedly caused by it; for it was
first introduced into ordinary practice as a remedy for chorea,
and upon the prevailing theory of medicinal action it ought
I 68
ACTÆA RACEMOSA.
to exercise a sedative rather than a disturbing influence upon
the nervous centres. There is, however, abundant evidence
from provings and overdosings to show that the latter is its
real action. Agitation and pain are the signs of its influence
everywhere. The head aches severely, with especial involve-
ment of the eyeballs; the mind is irritable and distressed, and
even a condition resembling delirium tremens has been
induced. There is great bodily restlessness, which is next
door to jactitation, with pains in the spine, the muscles (in-
cluding the heart), and the joints. One prover had sharp
pleurodynia more than once during his experiments; and
another, examining his urine, found urea and uric acid in con-
siderable excess.
Now, if the principle of homoeopathy be sound, Actæa
ought to prove a remedy for some forms of rheumatism, and
especially when the nervous centres and the muscles are the
seat of the disorder. On the other hand, since it causes no
febrile symptoms, it cannot vie with Aconite in rheumatic
fever. Well, this is just what experience has established. In
the acute and local muscular rheumatisms, as pleurodynia,
lumbago, and torticollis, Actæa has gained commendation
from all. The only exception is Dr. Ringer; but he extols it
highly in some of the sub-acute articular forms of the disease.
He specifies rheumatoid arthritis, especially when of uterine
origin, and when the pains are worse at night and in wet or
windy weather. It relieves these, and the cramps which often
accompany them, to a very considerable extent. Another
form simulates gonorrhoeal rheumatism, but without any
history of gonorrhoea. Here not only may the pains be almost
immediately relieved, but the joints may become supple and
useful again. This by the way; but I am persuaded that it is
in muscular rheumatisms that Actæa will best sustain its
reputation. Among these must be included the sufferings
which the heart and the uterus often undergo from the influ-
ence of the rheumatic poison. The provings recorded by Dr.
Hempel the experimenter was a pupil of his-make it
evident that Actæa affects the heart very powerfully. When
rheumatism attacks this organ, not setting up inflammation,
but as it does other muscles, we have a valuable remedy in
our present drug. In a case of the kind cured by Dr. Hale
the symptoms resembled angina pectoris, the attacks of pain
recurring several times a day. Last, it is here (I think) that
we must place the undoubted power of Actæa over chorea.
The frequency of the rheumatic origin of this disorder is well
known; and Dr. Ringer actually states that it is only
ACTÆA RACEMOSA.
169
when chorea owns this causation that he finds the medicine
curative.
He might, however, have extended its efficacy to cases
having the uterus for their starting-point. Actæa has an un-
doubted action upon this organ; though in the absence of
female provers we can say only that it is abortifacient and
ecbolic, producing miscarriage without the inflammatory irri-
tation of Sabina, and exciting in labour less unremitting con-
tractions than Secale. But its therapeutic virtues in this
region are numerous and well established. It is especially
when the uterus is presumedly rheumatic that it influences it
for good, relieving dysmenorrhoea and after-pains, checking
the tendency to abortion, and facilitating parturition. When
the "irritable uterus" is traceable to this origin, Actæa helps
it greatly. But beyond this, when morbid uterine conditions
show themselves elsewhere than in the organ itself by the
pains and agitations characteristic of the drug, it comes
potently to their relief. It cures uterine epilepsy and hysteria;
puerperal melancholia (the case published by the late Sir
James Simpson is a brilliant instance); the nervousness of
pregnancy; and the restless and unhappy state of mind so
often seen in uterine patients.* The co-existence of sleepless-
ness is said by Dr. Hale to be a special indication for it in
these mental states. It dissipates the infra-mammary pain in
unmarried females, which is to the uterus what pain in the
shoulder is to the liver; and also pains in the mammæ them-
selves so arising. It is above all useful in the sufferings of the
climacteric age, relieving the sinking at the stomach (which is
one of its marked pathogenetic symptoms), the pain at the ver-
tex and the irritability of disposition better than any other
medicine.
While connecting the influence of Actæa on muscular tis-
sue with that of rheumatism, I have no idea of limiting its
remedial power to rheumatic myoses. It has removed simple
myalgia when not traceable (as with Arnica) to fatigue. Of
this Dr. Madden has recorded some instances; and one of very
striking character in which the diaphragm was the seat of the
affection, and where he was not only physician but patient.
The malady had lasted nine years; and the narrative of its
diagnosis and cure is one of the most interesting things in
medical literature. It is to be read in the twenty-fifth volume
of the British Journal of Homœopathy (p. 493).
It may
The same remark applies to the nervous centres.
be only rheumatic chorea in which Actea is curative, but there
* See cases in Brit. Fourn. of Hom., xxvi., 168, 662; xxviii., 159, 248.
170
ÆSCULUS HIPPOCASTANUM.
are certainly other nervous affections in which no such origin
can be traced, and in which nevertheless the medicine acts
perfectly well. We have seen this in the uterine neuroses;
but it holds good no less elsewhere. Thus Dr. Hale has seen
it useful in what he calls "chorea of the heart," in the sleepless-
ness of children from dentition, and in melancholia of all kinds,
and Dr. Phillips in the hypochondriasis of spermatorrhoea : it
has also more than once removed the spasms of cerebro-spinal
meningitis.
Last, as to the eyes. I have mentioned before the severe
aching pain in the forehead and eyeballs caused by the drug;
this is, indeed, the characteristic symptom of actæism. Dr.
Hale commends it in headaches resulting from loss of sleep
or mental strain and worry. It would seem to be the muscles
of the eyes in which its pains are situated, and it would be
indicated when these were aching from undue exercise or from
rheumatic influences. Dr. Angell has been led to use it largely,
in the form of macrotin, in accommodative and muscular
asthenopia, to remove the evil consequences of prolonged exer-
tion of eyes thus affected, as hyperemia and photophobia. It
should be useful (as Dr. Hale suggests, and as its influence on
nervous system plainly indicates) in the ocular hyperæsthesia
which Mr. Hutchinson has lately described so well, when it is
use of the eyes which brings on the aching. I know not if
"muscular rheumatism" ever affects its appropriate parts in
the optical apparatus: if it did, Actaea would be quite in place
in its treatment.
Actæa may be compared with Caulophyllum and Secale in its
uterine relations, and with Aconite in its influence over rheu-
matic disorders. Its effects on the nervous system somewhat
resemble those of the last medicine, and of Ignatia, but they
are sui generis. Physiologically, Dr. Bartholow considers that
it acts on the circulation and the unstriped muscular fibre
much like Digitalis and Secale respectively, but less actively
than either; and Dr. Stillé compares it to Colchicum.
It is used in homoeopathic practice mainly in the dilutions
from the first decimal to the third centesimal.
We have next to speak of the
Esculus Hippocastanum.
This medicine-the horse-chesnut-is known only in ho-
mœopathic practice. A tincture is prepared from the nut,
ZESCULUS HIPPOCASTANUM.
171
and is certainly efficacious. Pharmaceutically, however, it
would seem better to make triturations; which indeed were
mainly used in the provings.
Esculus was first proved-on seven persons-by Dr. Buch-
mann; an account of his experiments is translated from the
Hom. Vierteljahrschrift in the eighteenth volume of the British
Journal of Homœopathy. In the second edition of Dr. Hale's
New Remedies six more provings are detailed, and the many
reports of its clinical use which have appeared in Homœo-
pathic journals are brought together. Æsculus also forms
the first of a very instructive series of "Studies in the
Materia Medica" which Dr. Dyce Brown has contributed to
the Monthly Homeopathic Review for 1876 and the subsequent
years.
The region most constantly and strongly affected by the
horse-chestnut is that of the rectum and anus.
No prover
escaped its influence there; and beyond the many forms of
distress experienced by others-dryness, fulness, constriction,
sense as if a foreign body were there, heat, itching, in two, one
of whom had never had piles before, these morbid growths
were produced. Correspondingly, Esculus has acquired a high
reputation in the homoeopathic school as an anti-hæmorrhoidal
medicine. I have several times affirmed and illustrated its
value;* and Dr. Hale cites numerous testimonies of like im-
port. The form of the disease in which I have found it specially
efficient is that in which the only connected symptom or
appreciable cause is constipation, and where there is much
uneasiness and pain but little bleeding. Dr. Hale, who agrees
with me in the latter qualification, disputes the former, main-
taining that the hæmorrhoids of Æsculus belong to congestion
of the liver and portal system, in which he is supported by
Dr. Hart, of Wyoming.† Dr. Minor, of New York, too, gives
"absence of constipation" as an indication for Esculus,
distinguishing it thereby from Collinsonia.‡ Putting all these
things together, it would seem that our medicine has a very
wide range of anti-hæmorrhoidal activity. I think, too, that
we may carry it a point farther. The older authors used to
describe an hæmorrhoidal diathesis, of which the local occur-
rence of these excrescences was but the main feature. Dr.
Jousset, in his Eléments de Médecine Pratique, maintains that
we have suffered loss by losing sight of this conception, and
* Brit. Journ. of Hom., xxiii., 294, 485; xxv., 428. Manual of
Therapeutics, (1st ed.), p. 280.
† Amer. Hom. Observer, xi., 208.
Brit. Journ. of Hom., xxxv., 141.
172
ÆSCULUS HIPPOCASTANUM.
draws a picture of the "hæmorrhoidaire." Now if side by side
therewith you will read Dr. Brown's description of the "person
under the influence of Esculus," you will observe a close
correspondence to one aspect of the hæmorrhoidal diathesis,
viz.: that which in its depression, irritability, portal congestion
and catarrh of mucous membrane approaches to the gouty.
The other elements of the picture-the varicosis and hæmorr-
hages-are supplied by Hamamelis, which takes the place of
Æsculus in bleeding piles. We may then add these two
medicines to Nux vomica and Sulphur as remedies for the
hæmorrhoidal diathesis.
Aching in the lumbo-sacral region is very marked in the
provers of Æsculus, and is a well-known concomitant of
hæmorrhoids. Dr. Guernsey attaches great importance to
this pain as a “key-note" for the remedy. He considers it
situated in the sacro-iliac symphysis. "The pain," he writes
“in this region is not severe, more a sensation of painful
weakness, and is brought on by exercise and relieved by rest.
When attempting to walk about or attend to usual occupa-
tions the back' gives out,' and the patient is obliged to rest.”
When this symptom occurs in connection with disorder of the
rectum or the sexual organs, we are (he says) to think of
Æsculus.
When first writing about Asculus I called attention to its
action on the throat, where it has caused a dark-red con-
gestion of the fauces, with dryness and soreness, similar to
that which is set up in the rectum. I mentioned then a case
in which it had removed such a condition when occurring
idiopathically; and Dr. Meyhoffer has since put another on
record, in which constipation and hæmorrhoids co-existed,
and all yielded to the remedy.* The case was one of follicular
pharyngo-laryngitis; and Dr. Meyhoffer mentions that other
means were required to remove the granulations. In the
Monthly Homœopathic Review for September, 1877, Dr. Brown
highly commends Esculus in this affection of the pharynx;
and, with an interesting consilience of thought, Mr. Clifton
contributes to the same number a series of eleven cases of the
disease, occurring as a recent affection and within a short
space of time, where he was led by the similarity of the
symptoms to give the horse-chestnut, and with rapid success.
Angine granuleuse," I may mention, is one of the local
manifestations, according to Dr. Jousset, of the hæmorrhoidal
diathesis.
((
The paper to which I have referred, by Dr. Hart, of
Brit. Journ. of Hom., xxvii., 549.
ATHUSA CYNAPIUM.
173
Wyoming, has some interesting remarks on Æsculus. He
extends its sphere to all active abdominal and pelvic conges-
tions, especially when characterised by a sense of throbbing;
and speaks warmly of its value herein.
Esculus seems to act the better for dilution to some extent.
The second and third potencies have been those I have used,
and Dr. Hart gets his results with the sixth.
I have next to speak of the
Athusa cynapium.
This is the "garden hemlock," the "fools' parsley " of popular
nomenclature. The tincture is prepared from the whole fresh
plant for homœopathic practice, in which alone it is used.
A pathogenesis of thusa was published by Hartlaub and
Trinks in the fourth volume of their Annalen (1833). An
analysis of this, with the sources of the cited symptoms in full,
is given by Dr. Roth in the second volume of the Révue de la
Matière Médicale Specifique. In 1847 Dr. Petroz published
another pathogenesis, consisting of symptoms observed by
himself. Dr. Roth has combined the two collections, with
revision and additions, in his Materia Medica (I. 169). His
article is translated by Metcalf. The cases of poisoning on
record are pretty fully given by Hempcl; and Allen, in his
supplement, adds some new provings.
The result of Dr. Roth's examination of the pathogenesis of
Hartlaub and Trinks was to discredit it sadly; as nearly all the
symptoms were supplied by Nenning, whose contributions to
the Materia Medica are in his eyes of very dubious value. But
Dr. John Harley would leave us still more destitute. In an
article in the fourth volume of the St. Thomas's Hospital
Reports he examines the recorded cases of poisoning by
Æthusa, and records sixteen experiments of his own in which
large doses of the juice were entirely inoperative; coming to
the conclusion that toxicologists have hitherto been under a
delusion, and that the fools' parsley is a harmless plant. I
must confess that his experiments have much negative force,
and they have been repeated with similar results by Dr. Allen.†
I do not, however, feel satisfied with the principles on which
he determines the validity of the poisoning cases, and must
think the question still sub judice. However it be settled, the
* See his Etudes de la Thérapeutique, and also Teste's Materia
Medica.
† Encyclopædia, x., 262.
174
ÆTHUSA CYNAPIUM.
therapeutic virtues of the drug may yet be believed; and you
must allow me for the present to connect them with its
physiological effects as hitherto accepted.
Supposing this acceptation to be well-founded, Æthusa is a
poison of no mean intensity. One of the narcotico-acrids of
toxicology, its irritant influence is manifested not so much by
inflammation as by pain, which is generally very severe. The
nervous symptoms are convulsive, somewhat epileptiform in
character; in one case (in a child) it is noted that the thumbs
were bent inwards, and the eyes turned downwards. The
lower jaw is tetanically fixed. In less severe cases there
is much complaint of headache; the face is usually red, and
in one instance the eyes were painfully inflamed and the
cheeks oedematous. As regards the provings, I have
nothing to say of those of Hartlaub and Trinks. No in-
formation is given as to the manner in which Petroz'
observations were made; nor is there anything very specific
about them, except pain and swelling in the axillary and
other glands. Dr. Allen's provers experienced little but
gastric disturbance. Æthusa has been seldom used in practice.
From Petroz' experience it would seem most useful in sub-
acute inflammations of the ocular and palpebral conjunctiva,
associated with swelling of the glands and cutaneous eruptions,
—in a word, in mild cases of strumous ophthalmia. Dr. Roth
also reports a cure of this malady. The action of Ethusa on
the eyes deserves further investigation. Kallenbach speaks
very highly of its value in intolerance of milk in children.*
I agree with Mr. Cliftonf that the inference as to this from the
pathogenetic symptoms is a misunderstanding; but it may be
a true action nevertheless. Dr. Guernsey entirely confirms it,
and esteems Æthusa highly in cholera infantum. He says
that "this remedy is one of the most important in the Materia
Medica, and is not so well known as it should be." He gives
as indications for it, great anguish and crying; disposition to
jump out of bed or escape from the room; great anxiety
expressed by the face, often accompanied with the linea
nasalis; regurgitation of food an hour after it has been taken;
swelling of external glands with lancinating pains; startings
preventing sleep; heat without thirst. It should be of service
in the convulsive affections of childhood: Mr. Clifton reports
it useful in these, when gastro-enteric irritation is present.
*
Hahnemann mentions facts about thusa which suggest
that it has some action upon the brain. After saying that it
* Gazette Hom. de Paris, 1850, No. IX.
† Monthly Hom. Review, xii., 399.
AGARICUS MUSCARIUS.
175
specifically produces imbecility, and should be of use in this
condition, he goes on to state that once when he found him-
self, from much mental work of various kinds coming upon
him in rapid succession, distracted and incapable of reading
any more, he took a grain of a good extract of it, prepared by
himself. The effect was an uncommon disposition for mental
labour, which lasted for several hours, until bed time; but had
passed off by next day.*
Æthusa is comparable with Cicuta virosa and Enanthe
crocata in its toxic effects; with Cistus, Bovista, Clematis, and
Sulphur in its finer actions and curative powers.
The 6th dilution seems to have been that mainly used.
And now, of
Agaricus muscarius.
This is the mushroom popularly known as fly or bug agaric;
it is the fausse orange of the French, the amanita of the
Italians. For homeopathic practice (in which alone it is now
used) a tincture is made of the fresh, or triturations of the
dried fungus.
The pathogenesis of Agaricus appears first in the second
edition of Hahnemann's treatise on Chronic Diseases. He
acknowledges ten fellow-observers; and the 715 symptoms
recorded belong almost exclusively to these. They are in-
deed, as Dr. Hering shows,† a selection from several provings
of various kinds, previously published. There are but twenty-
one symptoms from authors; so that little use has been made
of observations of poisoning by the fungus. In the tenth
volume of the Vierteljahrschrift Dr. Roth has analysed the
pathogenesis with condemnatory results, and has given a
schema of what he considers the genuine effects of the drug.
Since then, it has been re-proved by the Austrian Society in
their usual exhaustive manner, under the auspices of Prof.
Zlatarowich. Nineteen persons took part in these experi-
ments, the record of which appeared in the Zeitschrift d. Ver.
d. Hom. Erzte Est. for 1863. An account of them is given
by Hempel (in his second edition); and in Allen's Encyclopædia
* Lesser Writings, (trans. by Dudgeon), p. 318.
+ Guiding Symptoms, i., 144.
Trans. in Brit. Journ. of Hom., xviii., 268.-Dr. Roth shows
that five of the symptoms were supposed to have resulted from hold-
ing a solution of Agaricus 9 or 30 in a full glass before the opened
right eye of the patient!
176
AGARICUS MUSCARIUS.
the symptoms obtained are incorporated with Hahnemann's
and those of poisonings (the last fully given by Marcy and
Peters), making a grand total of 2495. Upon this im-
portant pathogenesis Dr. Brown has given us another of his
valuable studies.*
:
Agaricus appears, from the poisonings and Austrian prov-
ings (which alone I feel able to use as materials), to exert its
chief influence upon the nervous centres. Upon the brain it
acts as an intoxicating agent, like alcohol, opium, and has-
chisch it is used for the purpose by the Kamschatkans. The
drunkenness is more vertiginous at the outset, and more
delirious afterwards than that induced by alcohol: it is often
accompanied by increased muscular force. The disordered
exaggeration of function ending in suspension, which intoxi-
cation implies in the cerebral centres, is also manifested in
the other divisions of the nervous system. Neuralgic pains.
are experienced as though sharp ice touched the parts, or cold
needles ran through the nerves-in this contrasted with the
Arsenic neuralgia, in which the imaginary needles are red-
hot or again, the sensory nerves lose their elasticity and
power of resistance, so that when even feeble pressure is
applied to a spot, it pains a long while after. The motor
centres suffer quite as severely. Tremors and choreiform
twitchings are produced by it; convulsions of epileptiform
type are not uncommon in poisonings; and in several of the
provers were developed symptoms of a profound affection of
the spinal cord. Here are the symptoms obtained by Baum-
gartner-while taking some of the lower decimal attenua-
tions he had pain between the eighth and ninth dorsal
vertebræ, heaviness and langour in the lower extremities, and
a sensation of coldness in the glutei muscles. Under large
doses of the mother tincture the latter symptoms increased,
the gait became unsteady, and formication was felt in the
feet. The pain was then felt also in the region of the first
and second lumbar vertebræ, and in the sacrum. Next
followed paralytic weakness of the sphincter ani and involun-
tary dribbling of the urine. Three hundred drops caused,
among other symptoms, " lassitude and trembling of the lower
extremities; coldness and insensibility of the glutei muscles;
continual twitching in the small of the back and the lower
extremities; sensation as if a cool current of air were passing
from the spine over the whole body." The prover experienced
a fulness and a sensation of weight, with pressure, in the small
of the back, a creaking in the fingers and toes when moving
Monthly Hom. Rev., xx., 334.
AGARICUS MUSCARIUS.
177
-
them, with stinging pains in the same, and in the integuments
generally. Another prover, after taking ten drops of the
mother tincture, was suddenly attacked with a violent stitch
in the small of the back, attended with vertigo and nausea, so
that he had to vomit; the pain gradually extending along the
whole spine, as far as the medulla oblongata. On touching
the vertebral column, it was painful in several places. Prof.
Zlatarovich himself had "crawling and pricking sensation in
the nerves, a feeling of painful tension in the fascia of the
thigh, painful sensitiveness of the spinal column, drawing and
tensive pain in the spinal cord, and occasional fugitive pains
in the track of the spinal nerves."
There are many other characteristic symptoms induced by
Agaricus, which as yet defy classification. Thus the mucous
membranes are found coated with a yellow mucus; on the skin
a lichenous eruption (lichen pilaris urticatus) has been de-
veloped, with crawling, stinging, and burning; the liver is
seen in autopsies greatly enlarged; pains, as though innumer-
able splinters were in them, are felt in the muscles, especially
in the deltoid, where a small abscess even developed itself;
and great constriction was complained of in the chest. The
testicles were much retracted in several provers; and the
urine often had a whitish sediment, which one tested and found
to be phosphate of magnesia.
The employment of Agaricus has been hardly commensurate
with its physiological importance. It is quite disused in ordi-
nary practice, though formerly reputed in epilepsy, to which it
is homœopathic enough. In our practice it has often cured
chorea, to the idiopathic form of which it is a precise simile:
it is said to be especially indicated when the twitchings cease
during sleep, but this they almost always do. Drs. Allen and
Norton commend it highly in spasmodic affections of the eye-
lids and muscles of the eye-ball, especially of the internal recti.
Dr. Roth, from his study of its toxicological effects, recom-
mended it in ataxic typhus ; and Dr. Drysdale has recorded two
cases of this form of the fever in which it proved effective in his
hands.* Dr. Simmons has communicated a still larger experi-
ence of the same kind; and an American writer has followed
suit. All agree that tremor, restlessness and constant desire
to get out of bed are the indications for it; and that the
mother-tincture must be used for the purpose. Some of its
spinal symptoms point to congestion of the cord; but most of
them, I think, belong to that ill-understood condition which
we call spinal irritation. I am glad to find that in this
* Brit. Fourn. of Hom., xxi., 401.
N
178
AGARICUS MUSCARIUS.
opinion I have the concurrence of Dr. Brown. Mr. Clifton, in
some interesting observations on Agaricus,* speaks of having
gained much advantage from its use in this complaint. He
also commends it from experience in delirium tremens and its
non-alcoholic analogue, in enlargement of liver and spleen,
and in chilblains. It is thoroughly homoeopathic to the last-
named trouble, judging from S. 492, 1947, and 2250 of Allen's
pathogenesis, which show such a condition of skin in ears,
hands and feet; and Dr. Guernsey considers chilblains a key-
note for the remedy. Hahnemann says-" Apelt has found
this drug serviceable in pains of the upper jaw-bone and the
teeth; also in pains of the bones of the lower extremities (as
if in the marrow), in confluent eruptions of itching papules of
the size of a millet-seed, and in lassitude after coition."
Dr. Brown's article is very suggestive in respect of further
uses of Agaricus. Amongst other things, he thinks it likely
to be useful in spasmodic conditions of the respiratory organs,
with some irritation of the mucous surface, herein resembling
Ipecacuanha. I cannot quite follow him in expecting good
from it in the "douleurs fulgurantes" of locomotor ataxy;
the inflammatory induration which is at the basis of these
pains lies, I think, beyond the range of the action of the
drug. The pains of Agaricus radiating from the cord seem
rather those of" spinal irritation."
The medicines most allied to Agaricus seem to be Actæa,
Cannabis Indica, Hyoscyamus, and Opium.
The lower medium dilutions (3-6), and not uncommonly the
mother tincture, have been employed.
Before leaving Agaricus, I must say a few words about the
alkaloid which has been recently obtained from it and called
Muscaria. It had been noted of old† that in some cases of
poisoning by fungi the power of the vascular system was
remarkably depressed. The provers, also, invariably report
reduction of the frequency of the pulse. Physiological experi-
mentation has now proved that this property resides in
the muscaria of the fungus, and that its rationale is excitation
of the inhibitory nervous apparatus, slowing the heart's action,
and ultimately arresting it in diastole. The irritability of the
organ itself is unimpaired; and a dose of atropine, which
depresses the inhibition, sets it going again. M. Prevost, of
* Monthly Hom. Review, xii., 400.-In a later communication (vol.
xxiii., p. 255), he speaks of obtaining continued success with it in
splenic congestions and enlargements.
† See Pereira, ii., 59.
•
AGNUS CASTUS.
179
Geneva, has lately instituted experiments on animals which,
confirming these results, show that muscaria has much power
over the secretions, increasing the lachrymal, salivary, hepatic,
and pancreatic, but diminishing the renal to entire suppres-
sion. Atropine is antidotal to it on all sides in this sphere
also; so that the whole action is neurotic, and probably con-
nected with variations in the blood-pressure, which atropine
increases, and muscaria lowers.
Still more recently,* Drs. Ringer and Morehead have experi-
mented with muscaria, and on the human subject, injecting
fractions of a grain subcutaneously. They confirm M. Prevost's
results as regards lachrymation and salivation, but find that it
also acts as a sudorific, producing perspiration almost as con-
stantly and as profusely as Jaborandi. Not much influence
was noted on the pulse. The pupils were contracted; but,
when a ten per cent. solution was locally applied, they became
widely dilated. In this respect muscaria corresponds with
Gelsemium, and differs from pilocarpia-the alkaloid of
Jaborandi-which contracts the pupil whether internally or
externally exhibited. Its internal administration, however,
has not so potent an effect of this kind as has that of muscaria.
The pupillary changes of the latter drug are unaccompanied
with disturbance of vision, so that it probably has little action
on the accommodative apparatus. In animals great dyspnoea
has been observed from muscaria, and Dr. Brunton has found
the pulmonary blood-vessels strongly contracted, the lungs
blanched, and the right heart much distended; but no disorder
of respiration was noted in the four men on whom Drs. Ringer
and Morehead experimented. On the whole, muscaria pos-
sesses properties closely analogous to those of pilocarpin and
eserin the alkaloid of Physostigma, and antagonistic to those
of atropine.
No application has yet, to my knowledge, been made of
these properties of muscaria. The drug ought to be a useful
antipathic palliative for palpitation.
My next medicine is
Agnus castus.
This plant is only used in homoeopathic practice. A tincture
is made from the berries in the usual way.
The pathogenesis of Agnus castus is in Stapf's Beiträge;
and it is prefaced by a summary of all that is known concern-
ing the drug. The provers were Hahnemann and six others.
* Lancet, Aug, 11, 1877.
F
180
AILANTHUS GLANDULOSA.
The name of this plant hints at its special action; and its
history points the same way. It was used by Athenian
women during religious solemnities, and by mediæval monks,
to repress carnal desire. Its provings show that it really has
this property, depressing sexual instinct and energy without
previous excitation. It is even reported to have caused in one
case permanent extinction of virility. Its therapeutic use has
accordingly been directed against atonic conditions of the
sexual organs. In the hands of Drs. Stapf and Marcy it has
cured simple impotence in males; and Dioscorides states that
it promotes menstruation and the secretion of milk. Its
elective affinity for the sexual organs seems even to render it
effectual against their local diseases; for it is said to have
been occasionally curative of gonorrhoea, gleet, induration of
the testes, and leucorrhoea. Dr. Guernsey considers as cha-
racteristic of Agnus castus a mental state in which the patient
thinks that it is of no use to do anything, as death is sure to
come soon (this is different from what obtains with Aconite,
where there is fear of immediate death). It might thus be
useful in some cases of sexual melancholia.
Camphor, Conium, Kali bromatum, Nuphar luteum and Phos-
phoric acid are the medicines which in the sexual sphere invite
comparison with Agnus castus.
Drs. Marcy and Stapf both report the 6th dilution as that
with which their success was obtained.
I have last to introduce you to the
Ailanthus glandulosa.
A tincture is prepared from the flowers of this "tree of
heaven," as it is popularly called.
Some few provings of Ailanthus have been made, and are
collected in the article on it in Allen's Encyclopædia. But its
real history as a medicine is to be found in the three papers
to which I shall presently refer.
The story of Ailanthus is a very interesting one. One of
our most accomplished American physicians, Dr. Wells of
Brooklyn, supplies its first chapter.* A child of his own was
seized with all the symptoms of the invasion of malignant
scarlet fever. There was "violent vomiting; severe headache;
intolerance of light; dizziness; hot, red face; inability to sit
up; rapid, small pulse; drowsiness, and at the same time great
restlessness; much anxiety; two hours later, the drowsiness
* Amer. Hom. Review, iv., 385.
AILANTHUS GLANDULOSA.
181
had become insensibility, with constant muttering delirium ;
and she did not recognise the members of her family. She
was now covered, in patches, with an eruption of miliary rash,
with efflorescence between its points, all of a dark, almost a
livid colour; the eruption was more profuse upon the forehead
and face than elsewhere." Dr. Wells gave up his child for
lost. But in a few hours a change came about which gave a
new aspect to the case; and inquiry ascertained that she had
largely sucked the juice of the stalks of the Ailanthus. Dr.
Wells ends his tale by suggesting that we have here a pos-
sible aid in those frightful cases of scarlatina which prove fatal
in the first stage, with the symptoms of cerebral toxication.
This was written in 1864. But, published in a journal
little known, it seemed to have made no impression. In 1867,
however, Dr. Pope, discerning the significance and value of
these facts, called the attention of English readers to them.*
His remarks soon bore fruit. In 1868, Dr. Chalmers found
himself in the midst of an epidemic of malignant scarlatina.
New at that time to the use of homoeopathic remedies, he was
disappointed (as we all have probably been) at their action
here; though the traditional practice had nothing better to offer
him. His attention was then called to Dr. Pope's paper. He
procured the Ailanthus, and at once found that he had the
agent he needed. The fever was characterised by a dark-
coloured and partial eruption; and the effects of the medicine
were constantly shown in the change of this to a rash more.
bright-hued and general. With this there was a marked
diminution in the frequency, with more regularity and firm-
ness, of the pulse, along with restoration to consciousness.
"The result of the treatment by this drug was, and is, to me
he writes " a source of sincere gratification and thankfulness."t
I have seen no records of the use of Ailanthus since; but
from private information I have reason to know that it fully
answers expectation. Dr. Madden used to tell me-and
there was (alas! that it should be "was ") no better observer
-that from what he had seen of its action in London, he had
no doubt of its direct specificity and eminent value. Dr.
Fischer, of Sydney, who was present the last time but one that I
lectured on this drug, informed me afterwards that he had had
large experience with it in scarlatina, and could entirely
corroborate the favourable reports of its use which I had
mentioned. He said, however, that he found it necessary to
discontinue it when once the eruption had began to decline,
* Monthly Hom. Review, xi., 286.
+ Ibid, xii., 713.
در
182
AILANTHUS GLANDULOSA.
under the penalty of causing a pemphigoid rash to annoy the
patient during or after desquamation.
I should have let this main use of Ailanthus stand by itself,
illustrating so vividly as it does the fruitfulness of the law of
similars. But Dr. Dyce Brown, who has made the drug the
subject of one of his "Studies,”* has directed our attention to
the symptoms it produced in several of the provers, as forcibly
suggesting its probable usefulness in some forms of cerebral
and spinal congestion. Its effect on the head and mental
faculties is very like the dull heavy headache, with confusion
and incapacity for labour, which arises from brain-fag or over-
worry; while the pains in the back, all up the spinal column,
the contractive feeling in the chest and abdomen, and the
numbness and tingling in the upper and lower extremities are
the symptoms of spinal congestion, and give us another remedy
for it in addition to Gelsemium. Dr. Brown also suggests
it in bad cases of measles, where the eruption fails to come
out, or retrocedes suddenly, or is livid; in diphtheritic and
other low forms of sore throat; and in epidemic cerebro-
spinal meningitis. Such an action as that which it displays
in malignant scarlatina certainly ought not to stand alone.
In Dr. Chalmers' cases, and by Dr. Madden, the first
decimal dilution was used.
* Monthly Hom. Review, xxi., 288.
LECTURE XII.
ALLIUM CEPA AND SATIVUM, ALOES, ALUMEN, ALUMINA,
AMBRA, AMMONIUM CARBONICUM AND MURIATICUM, AMYL
NITRITE, ANACARDIUM, ANGUSTURA.
You may be amused when, as my first medicine to-day,
I mention the common onion. You will find, however, if you
read Dr. Hering's preface to its proving, that this vegetable
was highly esteemed as a remedy by the ancients, and was
credited with considerable pathogenetic activity. We pre-
pare the
Allium Cepa
by making a tincture from the mature bulb of the red onion,
Dr. Hering proved the onion, chiefly in the mother tincture,
on some dozen persons in 1847. His results, with the state-
ments of old authors about it, form one of the pathogeneses
of his Amerikanische Arzneiprufungen, and are translated
therefrom in the fifth volume of the American Homeopathic
Review, and in Allen's Encyclopædia.
It is evident from this proving that the well-known irrita-
tion of the eyes and nose produced by the emanations from
the onion are specific effects, as they also result from the
internal use of the tincture. It is hence recommended for
fluent coryza and other nasal defluxions,-Dr. Guernsey says,
with acrid secretions. Whether it is needed to occupy a place
in the treatment of these conditions which Euphrasia,
Arsenicum and Kali iodatum do not already fill, experience
only can decide. Dr. Dunham describes clearly* a catarrhal
condition which he considers suitable for it,-a dry cough
causing splitting sensation in the larynx being its most note-
worthy feature.
The medicines I have named are the analogues of Cepa in
its relation to the conjunctival and nasal mucous membranes.
Dr. Hering thinks it occupies a middle place between Aconite
and Ipecacuanha. ·
* Lectures, ii., 105.
184
ALLIUM SATIVUM.
The transition from onions to garlic is as natural as it is
alphabetical. We will speak of
Allium sativum.
A tincture prepared like that of Allium Cepa is used in
homœopathic practice.
A pathogenesis of garlic, with clinical remarks, was pre-
sented by the late Dr. Petroz to the Société Gallicane in 1852,
and published in the third volume of its journal. It is trans-
lated, with additional symptoms and therapeutic notes, by
Teste in his Materia Medica; and some further additions are
made by Allen.
Eructations with salivation; profuse whitish urine, which
becomes cloudy on the addition of nitric acid; much cough,
with glutinous mucus and pains beneath the ribs; swelling
and tenderness of the mammæ, and severe pain in the con-
joined psoas and iliacus muscles when put in action-these seem
the most characteristic symptoms of Allium sativum. It has
cured chronic cough, with profuse mucous expectoration ; and
morbid sensibility to the influence of cold air. Petroz wrote
of it-" Allium sativum has been of remarkable service in
cases where the herpetic diathesis has manifested itself in the
respiratory or digestive mucous membrane." He considered
a pale red appearance of the tongue, with effaced papillæ,
pathognomonic of this affection. The old authors esteemed
garlic an excellent remedy for "phlegm."
The 6th dilution was most probably that used by Petroz
and Teste.
My next medicine is one familiar to you as a purgative,
though new as a specific remedy. I speak of
Aloes.
Of the best Socotrine Aloes we make a solution in proof
spirit for our tincture.
A copious pathogenesis of Aloes, obtained from twenty-
four provers, mainly with material doses, is contained in
Hering's Amerikanische Arzneiprufungen. Some fresh provings
are incorporated in Allen's Encyclopædia, where the medicine
has 1180 symptoms
Although, as I say, you have hardly thought of Aloes as a
specific remedy, you yet know a good deal about its specific
ALOES.
185
action. You know that it is no mere aperient, but has
peculiar properties. That it purges, however introduced into
the system; that it affects the large intestine only, especially
the rectum; that here also it excites the action of the muscular
coat rather than the secretions of the mucous membrane,
being thus (as Dr. Druitt calls it) "eccoprotic;" that it not
unfrequently irritates the rectum and anus, causing heat,
tenesmus, and even hæmorrhoids; and that the determination
of blood it induces towards the lower bowel extends itself also
to the other pelvic viscera, so that the bladder becomes irritated,
and menstruation excited,-these are the teachings of every
work on Materia Medica. Our provings confirm them in
every particular. They add evidence that the sexual instinct
also is excited: that the whole abdomen shares though to a
less degree in the congestion of the pelvis, becoming distended
and tender; and that, probably in sympathy with the latter
affection, a heavy headache is caused by the drug.
They also support what Wedekind and Giacomini have
maintained, but which is much forgotten at the present day,
that Aloes has a decided action upon the liver. Uneasiness,
heat, pressure and tension are occasioned there; and the
stools betray evidence of increased secretion of bile, which
indeed Dr. Rutherford has lately ascertained to be the effect
of Aloes on animals. They enlarge, moreover, our knowledge
of the action of the drug upon the rectum, showing its ten-
dency to produce such weakness of the sphincter ani as leads
to involuntary stools. "The diarrhoea of Aloes," writes
Dr. Dunham, "occurs especially in the morning, say from
2 A.M. to IO A.M.: the desire for stool is sudden and extremely
urgent, being felt in the hypogastrium and in the rectum, and
being so urgent that the patient can scarcely retain the fæces
long enough to effect the necessary strategic 'change of base':
during this brief interval, he fears to evacuate wind by the
anus, or to make any physical exertion, or even to strain to
pass water, lest he should have an involuntary evacuation of
the bowels. . . There is also a similar frequency or urgency
of the desire to pass urine, with a similar uncertainty in the
tenure of that excretion."*
The use of Aloes in the homoeopathic school has been
mainly carried on in the treatment of hæmorrhoids, of diarrhoea
of the kind above described, and of dysentery. Heat, rawness.
and soreness of the parts, with loose motions, indicate it in
piles; and in dysentery it is preferable to other medicines
where the rectum is much affected, the tenesmus severe, and
* Lectures, sub voce.
186
ALUMEN.
where there is faintness after each stool. Dr. Holcombe
writes-" Aloes 3rd, a single pellet, once cured for me almost
instantaneously a tenesmus which had endured for a week or
ten days after recovery from dysentery." The want of confi-
dence in the sphincter ani of which I have spoken is a
characteristic symptom for it, if present, in all these affections;
and a similar condition is a sense of insecurity in the bowels,
as if diarrhoea might occur at any minute, for which Dr. Wells
recommends it, and which he says is especially prevalent
during an epidemic of Asiatic cholera. The same physician
has found it useful in the kind of headache it causes-a
peculiar, heavy, dull, pressing pain in the forehead, of no great
severity, but which indisposes to or even incapacitates for all
exertion, especially for intellectual labour. Dr. Dunham had
a case in which such a headache, prevailing in winter time,
alternated in summer with the characteristic Aloes diarrhoea;
and the remedy cured both. He mentions also a feeling as if
it were necessary to contract the eyes and make them very
small in order to see as characteristic for it here.
Aloes should, I think, be more used in hepatic, abdominal,
and pelvic congestions than it has been. I have recorded a
case in the twenty-seventh volume of the British Journal of
Homœopathy in which the last-named yielded very satisfac-
torily to its use. It is a sub-acute condition which it sets up,
and heat is its chief subjective symptom. Dr. Guernsey com-
mends it in what might be called rectal catarrh, i.e., where
masses of mucus come frequently away by stool.
Teste promulgates some curious experience relative to the
power of Aloes in causing and curing falling of the hair, but
it does not seem to have been confirmed by others.
Esculus, Collinsonia, Nux vomica and Sulphur compare
with Aloes.
In dysentery, the potencies from the Ist to the 3rd have
been used; but Drs. Dunham and Wells have obtained their
successes from the 200th.
We have next the well-known sulphate of aluminium and
potassium,
Alumen,
or, as commonly called, alum. It was prepared by tritura-
tion in the provings, but the British Homoeopathic Pharmaco-
pœia directs aqueous solutions to be made.
Alum has been proved by ten persons in the third and
ALUMINA.
187
higher attenuations. The symptoms obtained were published
by Dr. Hering in his Materia Medica, and are also to be found
in Allen's Encyclopædia.
Of this proving I cannot say much as yet; and little use
has been made of the medicine in homoeopathic practice. I
should not have thought that it had any action beyond that
which it exerts as an astringent, were it not for the high com-
mendation it receives from many quarters in lead colic and
constipation, where it must surely act as a simile. It is not as
a chemical antidote to lead that it operates, for it is praised by
others as a remedy for simple constipation and for enteralgia in
general. It should be tried for the disorder in small doses,
should Opium ever fail in our hands. The rectal symptoms
of the drug also seem worthy of attention.
I can; of course, say nothing at present of allied medicines
or dose.
And now for
Alumina,
the oxide of aluminium. It is prepared by trituration.
Alumina was proved by Hahnemann for the second edition
of the Chronic Diseases, where it has 1161 symptoms from
himself and five fellow-observers. I think you will learn most
of the drug's sphere of action by reading the clinical remarks
of Teste, of Marcy and Peters, and of Hoyne, in their articles
upon it.
Alumina seems to affect chiefly the sexual system and the
mucous membranes. Teste says, "I have often derived the
greatest advantages from the use of this drug in the case of
aged females, against diseases that had been apparently
seated in the sexual system, but whose primary symptoms had
disappeared with the complete cessation of the menstrual
periods." It has cured in his hands chronic gonorrhoea and
leucorrhoea, chronic post-gonorrhoeal induration of the testicles,
and “raised itching spots" in the vulva and vagina. In the
mucous membranes, the characteristic feature indicating
Alumina seems to be dryness with more or less irritation.
Thus it has proved curative in morbid sensitiveness of the
nasal mucous membrane to cold; in chronic dry catarrh of the
conjunctiva, even when it is granular; in chronic pharyngitis
where the membrane looks dry, glazed, and red; in dry hack-
ing coughs from pharyngeal or laryngeal irritation; in dys-
pepsia from deficiency of gastric juice; and in constipation
188
AMBRA GRISEA.
from lack of intestinal secretion. It has also cured a frequent
desire to urinate during the night, occurring in an old
paralytic. All the affections to which Alumina is suitable
are of a chronic character, and occur in old people, or in dry
and thin subjects. I have little experience of the drug myself:
it is but rarely used. Dr. Guernsey says that great difficulty
in the expulsion of stools, even when soft, is characteristic of
it; also an inability to pass water except when straining at
stool. It is commended by him when a similar condition to
that of the rectum exists in the oesophagus, causing dysphagia.
Dr. Hoyne has some good illustrations of its value in violent
dry coughs,-Dr. Dunham recommending it for these when
excited by an elongated uvula. He himself affirms that" for
the sore-throat of clergymen and other public speakers who
are thin in flesh there is no remedy equal to it," and says the
same of the constipation of infants, whether naturally or
artificially nourished.
Its analogues are Baryta, Conium, and Plumbum, and, as
regards the rectum, Veratrum album; and its dilutions those
high in the scale.
We will now speak of ambergris,
Ambra grisea.
The substance, as met with in commerce, is triturated for
homœopathic uses.
The proving of Ambra is in the sixth volume of the Materia
Medica Pura: the symptoms (490 in number) were furnished
by Hahnemann himself and von Gersdorff. Dr. Marcy, in
the New Materia Medica, contributes some therapeutic infor-
mation concerning the drug.
Ambergris is one of those strongly scented substances, like
musk, castor, and valerian, which disturb sharply but super-
ficially the functions of the nervous system. The symptoms
of its pathogenesis all answer to this description. "Choking
and vomiting can hardly be avoided when hawking up phlegm
from the fauces;" frequent tenesmus, whatever be the cha-
racter of the stool; frequent micturition of pale and copious
urine; some sexual excitement (it was esteemed of old as an
aphrodisiac) and irritation of the female genitals—are symp-
toms of this kind. Ambra is obviously what the therapeutists
of the old school call a "nervine : it finds its place in the
treatment of nervous and hysterical affections. Depression,
with anxiety, sleeplessness, diminished sight and hearing from
>>
AMMONIUM CARBONICUM.
189
mental trouble, spasmodic choking and convulsive cough in
hysterical subjects,-are some maladies of this kind which
Ambra is reported to have cured. Dr. Lawrence Newton has
communicated a case in which Ambra relieved retention of
fæces, from nervous causes, after parturition.* Ambra is also
much commended for nervous vertigo, especially in old people.
Dr. Guérin-Méneville has recently given us, in the fortieth
volume of L' Art Médical, an interesting study of Ambra.
But he has made a mistake in directing our attention to an
article in the Gazette des Hôpitaux for 1871, by Dr. Révillout,
in which "ambre" is much praised as a subduer of excited
reflex action. The author is speaking there of amber
(succinum), not of ambergris. We are indebted to Dr.
Ozanam for pointing out this error, into which I confess
myself to have fallen, though I consulted the original article in
the Gazette. He is to the point, however, when he calls atten-
tion to the irritation of the skin caused by Ambra, and refers to a
case of Croserio's, where an obstinate prurigo was cured by it.
The pudenda seem especially affected in this way by the
drug, and Dr. Guernsey commends it in pruritus vulvæ. I
am also indebted to this writer for another indication for
Ambra, viz., tendency to sanguineous flow on the least provoca-
tion during the menstrual intervals, which led me to it with
great advantage in a troublesome case.
As I have already suggested, Ambra is closely allied with
such medicines as Asafetida, Moschus, and Valerian.
Hahnemann recommends the third potency, and Marcy the
sixth and twelfth.
I have now to give you some account of the homœopathic
uses of ammonia and its salts. The specific properties of
these substances are few compared with those of a chemical
nature: hence they play a far less important part in homoeo-
pathic therapeutics than in those of the old school. Never-
theless, they exert some dynamic action, of which we must
take cognizance.
There are two salts of ammonia which have been proved,
and of which we have some slight clinical knowledge. The
first is the carbonate,
Ammonium carbonicum,
of which we make at first watery and subsequently spirituous
dilutions.
* Brit. Fourn. of Hom., xxvii., 364: See Hahnemann's S. 185.
190
AMMONIUM CARBONICUM.
i
A pathogenesis of Ammonium carbonicum appeared in the
first edition of the Chronic Diseases, containing 159 symptoms.
It was subsequently proved by Nenning on several persons;
and 479 symptoms from him, including a few from the editors,
appear in Hartlaub and Trinks' Arzneimittellehre. In the
second edition of the Chronic Diseases the foregoing observa-
tions are united with some fresh ones from Hahnemann himself
and three others to make a total of 789. The drug has since
been proved by Professor Martin of Jena on himself and
eleven pupils. The results may be read translated from the
Vierteljahrschrift in the eighteenth volume of the British
Journal of Homeopathy. The symptoms from all these
sources are incorporated in Allen's article, making a total of
IOIO.
Very little result followed the doses of a few grains of the
salt taken by the last-named provers. The elective affinities
of Ammonium carbonicum appear to be with the mucous
membranes of the respiratory tubes and of the small intes-
tines. Wibmer found it to cause, on himself, an irritative
cough and increased secretion of bronchial mucus; and
bronchitis is a frequent occurrence in poisonings by ammonia,
even where there has been no inhalation of the fumes. In
both schools of medicine it is in repute for bronchitic condi-
tions: its cough is an incessant one, excited by a sensation as
of down in the larynx. A specific action on the small intestine
has been ascertained by Mitscherlich in his experiments with
it on animals; but has not been utilised in practice. It con-
verts, he says, its epithelium into reddish mucus.
The power of this salt in moderate doses over scarlatina is
vouched for by so many practitioners that there can be no
doubt of its reality; and homœopathists have not unfrequently
used it with advantage in this disease, especially where throat
symptoms of a malignant character were prominent.
Dr. Hoyne commends it in the coryza of children, when the
nares are seriously obstructed.
Carbonate of ammonia in full doses causes headache;* and
in small ones relieves nervous forms of the malady, particu-
larly when (Dr. Guernsey says) increased by closing the teeth.
This well corresponds with the fact that the tension and
throbbing of the headache ammonia causes is chiefly felt in
the temples.
The lowest dilutions have been generally employed.
The other ammonia salt whose proving has given it a place
* See Allen, x., 286.
AMMONIUM MURIATICUM.
191
in the Materia Medica of Homœopathy is the chloride, sal-
ammoniac, or, as we call it,
Ammonium muriaticum.
A trituration of the crystals or a solution in rectified spirit is
used in our practice.
The pathogenesis of Ammonium muriaticum is in the
second edition of the Chronic Diseases, and consists of 397
symptoms from Hahnemann and three fellow-observers.
Some other experiments with it have been used by Dr.
Allen, bringing the number in his Encyclopædia to 600.
From the experiments of Gumpert it would appear that
sal-ammoniac has the property, in large and long-continued
doses, of causing a morbid increase in the secretions of all the
mucous membranes in the body, a “status pituitosus," as the
Germans call it. This is accompanied with chilliness; lassi-
tude, sluggishness, and prostration; loss of appetite; and
profuse sweating and urination. Later on, a true intermittent
fever was induced, having the curious character of recurrence
every seventh day. From Böcker's researches it would appear
that Ammonium muriaticum greatly increases the elimination
of urea.
Many of the uses of Ammonium muriaticum, though in
large doses, are certainly dynamic. It exerts great power
over the chronic catarrhs (the mucous flux of Chambers)
which its pathogenetic effects so much resemble. As Dr.
Ringer writes, "All the chlorides of the alkalies increase con-
siderably the secretion of mucus from the digestive mucous
membrane, and, indeed, do so from all the membranes of this
class. They may even excite catarrh. This is notably the
case with chloride of ammonium.
These sub-
stances, and especially sal-ammoniac, are not uncommonly
used to remove catarrhal conditions of the intestines." It is
in considerable repute for neuralgia of various kinds, particu-
larly migraine, clavus, and prosopalgia; and, if the German
physicians are not mistaken, it exerts an influence upon the
liver which is doubtless of a specific character. Dr. Anstie
found it very useful in the pain in the liver, with great de-
pression of spirits but no other symptoms of functional dis-
order of the organ, which he calls hepatalgia. He also
esteems it highly in myalgia. In these four spheres the action
of the drug needs investigation, and its trial in small doses
might be essayed. Dr. Dunham speaks of having had great
success with it in sciatica, where the pain was worst in sitting,
192
AMYL NITROSUM.
relieved somewhat by walking and entirely by lying down,
Dr. Guernsey considers sense of contraction or actual con-
traction of the legs a prominent indication for its use. This
physician also mentions loss of blood by stool during the
catamenia as a special sympton calling for it.
Sal-ammoniac has some repute against intermittent fevers:
it should be useful in those seven-day agues which are some-
times left after the suppression of quotidians by quinine.
In its action on the mucous membranes, Ammonium muria-
ticum closely resembles Antimonium crudum and Pulsatilla.
Its dosage is undetermined.
The acetate of ammonia-Ammonium aceticum, as we should
call it—has not been proved; but I would suggest that its
remarkable power of relieving dysmenorrhoea, as shown by the
authorities cited by Marcy and Peters, is of a specific character.
It may be given in the well-known "Spiritus Mindereri."
The plain solution of ammonia-Ammonium causticum-is
rarely used but in veterinary practice. Mr. Moore seems to
esteem it highly in acute bronchial and pulmonary affections
of a severe type occurring in animals.
I have next to speak of the nitrite of amyl—
Amyl nitrosum.
This now well-known substance-prepared by the action of
nitric acid on fusel oil-is dissolved in rectified spirit for inter-
nal administration.
The history of Amyl nitrite as a remedy exhibits well the
working of the two cardinal principles of therapeutics-the
antipathic and the homoeopathic method; and for both is
contained in the literature of the dominant school.
Amyl nitrite, when inhaled, was found to cause (after the
fashion familiar to us in Glonoin) a rapid dilatation of the
arteries in the head and also throughout the body, with
quickened but weakened circulation. It was at once per-
ceived that it might be useful in those morbid conditions in
which the blood-vessels are spasmodically contracted. Such
is the epileptic paroxysm and the cold stage of intermittents,
and such are some forms of angina pectoris and of migrainė.
The inference was acted upon, and with most gratifying
success. Angina is for most sufferers robbed of half its terrors
by this means of relief. Migraine and other neuralgiæ accom-
panied with cold pallor of the surface are often arrested in
their progress by it. When the epileptic aura precedes by an
AMYL NITROSUM.
193
appreciable interval the actual paroxysms, and when the
petit mal and even the grand mal are recurring frequently, a
resort to this medicine does much to avert the mischief. The
shivering aguish subject warms up under its influence, and
his paroxysm is materially shortened. Its use has been occa-
sionally beneficial in other spasms, as in asthma and spas-
modic gastrodynia and dysmenorrhoea.
All this is pure antipathy, and affords an exquisite example
of the method, both in its strength and in its weakness. In
its strength-for the relief afforded is great and rapid; in its
weakness-for it is palliative and temporary only. The amyl
arrests or mitigates the paroxysms; but it does little to pre-
vent their recurrence-to cure the disease. It has generally to
be given in ever-increasing doses; and though sometimes the
reverse holds good, and the attacks gradually diminish in
frequency, as a rule its influence is in time worn out, and it
ceases to benefit. Nevertheless, such as it is, we thankfully
avail ourselves of its aid. It is an utter mistake to suppose
that we of the school of Hahnemann debar ourselves-it is an
utterly false assumption to say that we are debarred-from
using any remedy, whatever be its modus operandi, which pro-
mises good to our patients. We are as free as others to use
antipathic palliatives: only we know them for what they are,
and do not allow their fascination to lead us to abuse them, or
to neglect to seek a more excellent way.
*
This better way is the homoeopathic and curative; and in
the case of nitrite of amyl it has been trodden for us by Dr.
Ringer. There is a paroxysmal affection whose essence is not
contraction, but dilatation, of arteries. It is the "flushing"
so common in women at the change of life, but occasionally
troubling them at other times also. This is just the condition
which amyl nitrite causes; and-administered in ordinary
doses in the attack itself-it certainly would not benefit. But
given every three hours, and in minute quantities, Dr. Ringer
has found it of the utmost service in preventing the recurrence
of the flushings. What he says about dose is very interesting.
"The author began with a minim dose, but was obliged to
reduce this quantity, and he ultimately found that, for the
most part, these patients can bear one third of a minim
without any disagreeable symptoms, but that a tenth, nay
even a thirtieth, of a minim will in some patients produce the
* I am glad to see that the veteran Constantine Hering, generally
reputed of the "straiter sect" of homoeopathists, speaks out boldly in
favour of the palliative use of amyl nitrite (North Amer. Fourn. of
Hom., Feb., 1879).
O
194
ANACARDIUM ORIENTALE.
desired effect on flushing." This is just the experience of
Hahnemann and his school with medicines generally.
Among ourselves amyl nitrite has found the ground of
flushings pre-occupied by the similarly-acting Glonoin, and
by Lachesis. Nevertheless, it may have a shade of difference
in its action peculiar to itself, and so help us in an occasional
non-plus. Dr. Edward Blake, who was quick to perceive its
suitableness to the affection in question,* has obtained very
good results from it therein. He has also lately communi-
cated to the Practitioner a case of exophthalmic goitre, in
which great relief has been given to the patient's subjective
sufferings by the remedy. Of a piece with this is Dr. Conrad
Wesselhæft's testimony to its usefulness in tumultuous
though feeble action of the heart, such as that which it causes.†
This physician has given us several provings of the drug
administered internally in diluted form.
"?
In naming Glonoin I have mentioned a very close analogue
of Amyl nitrite. I defer comparison between them till I come
to speak of the former drug.
The drug I have next to introduce to you is one of the
many of high repute of yore which had fallen into disuse,
but which the Hahnemannian method has restored to its due
place in medicine. It is the product of the marking-nut-tree,
Anacardium orientale.
This must not be confounded with the cashew nut (A.
occidentale). The oily, dark substance which separates the husk
from the kernel, and in which the active virtues of Anacardium
seem to reside, is triturated with sugar of milk.
A pathogenesis of Anacardium appeared in the second
volume of the Archiv (1823), containing 484 symptoms ob-
tained from the powdered bean and tincture by Stapf and seven
others, among whom was Hahnemann himself. The latter
has reproduced these provings in the second edition of his
Chronic Diseases, adding 138 fresh symptoms obtained in his
later manner. Dr. Allen supplies some observations from
three other sources as to the effects of Anacardium when
applied to the skin, and some further information on this head
is supplied in the New Materia Medica of Drs. Marcy and
Peters.
The ancient reputation of Anacardium was as a remedy for
* Monthly Hom. Review, xv., 166.
† New Engl. Med. Gaz., xi., 387.
ANACARDIUM ORIENTALE.
195
weakness of the mind, memory, and senses: a preparation of
it was known as the "confectio sapientium." Noack and
Trinks mention that Caspar Hoffman called it rather "con-
fectio stultorum," because many had lost their memory and
become mad on account of using it too often and incon-
siderately. They, therefore, fairly claim its remedial powers
for homœopathy. Our provings and therapeutic records con-
firm these observations of the old physicians. Anacardium
appears from its pathogenesis to depress the cerebral centres
(especially as regards memory) and the organs of special
sense; and it has frequently proved remedial in weakness of
the brain caused by onanism, or remaining after acute diseases.
Dr. Bayes writes" When in Cambridge I found it very
useful in steadying the nervous system in funk previous to
examination, as also in removing nervous exhaustion induced
by over-study. In sexual debility it is invaluable; also in
cases of nervous prostration following seminal emissions
(whether involuntary or not)." He gave the 12th dilution.
It is an important remedy in dementia, and in too rapid loss
of memory and mental vigour in old persons; also in ambly-
opia and nervous deafness. It has removed an hallucination
of a dyspeptic, which took the form of a belief that a demon
was pursuing him; and is said to have cured “paralysis of
the tongue "-whatever that may be.
Later researches have shown that Anacardium has a re-
markable influence on the skin. When taken internally,
indeed, it has not been proved to do more than cause the
burning itching noted by Hahnemann. But the effects of its
external application, however slight or limited, are so exten-
sive as to leave no doubt of its being a specific cutaneous
irritant. Dr. Yeldham has recently recorded a case in point,
which you may read in Dr. Allen's supplement; and where,
while the earlier part of the narrative exhibits well the derma-
titis induced by the drug, the last paragraphs show the
mental symptoms coming in. When painted locally on the
skin, in its slightest degree of action it causes the appearance
of wheals like those of urticaria tuberosa, with itching, burning,
'and swelling, terminating in desquamation. When operating
more intensely it developes eczematous vesicles, and even
bullæ.
I am not aware that Anacardium has been used much as
yet as a cutaneous remedy* ; but it deserves attention in some
forms of nettle-rash, eczema, and pemphigus,—perhaps also in
* A cure of eczema by it is mentioned in Brit. Fourn. of Hom.,
xxxiii., 546.
196
ANGUSTURA.
erythema nodosum and vesicular erysipelas. Dr. Sircar, after
relating some instances of dermatitis provoked by the juice,
mentions that in Hindoo medicine it has some repute against
leprosy; while yet the native doctors are afraid of handling
the drug for fear of getting this very disease, which, he has
been told by his friends among them, has actually occurred in
some instances. He adds that he has been using the drug in
leprosy (in the 6th dilution), and can report remarkable benefit
from it.
Dr. Allen emphasises a sensation felt in several parts of the
body by Gross-" dull pressure, as of a plug being forced in "
-as characteristic of Anacardium. Dr. Dudgeon has com-
municated a cure of gastralgia by it,* and Dr. H. N. Martin
praises it highly in dyspepsia, when the symptoms disappear
during eating, and return again in two hours.
In the cerebral sphere Anacardium resembles Phosphoric
acid and Zinc, in its action on the skin, Apis, Croton, Mezereum,
Rhus, and Urtica.
Both high and low dilutions seem to have been used with
advantage.
I have last to say a few words upon a medicine with which,
were it not one of Hahnemann's, I should not have burdened
your memory by introducing it here. It is
Angustura.
By this name I intend the Angustura vera, or cusparia, the
bark of the galipæa officinalis. The "vera" is necessitated
because of the occasional substitution of an Angustura spuria,
which is pretty certainly identified with the bark of the
strychnos nux vomica, or some allied species having the same
physiological action. Hahnemann, saying that the true An-
gustura likewise possesses great medicinal powers, cites in
illustration the symptoms of a case of poisoning by it, which
are evidently those of the spurious kind!
The true Angustura was proved by himself and eight asso-
ciates: the 299 symptoms obtained are recorded in the sixth
volume of the Reine Arzneimittellehre. Dr. Allen adds some
from two other sources, but of equally unexplained origin.
There is little that is distinctive about any of them, nor has
Angustura any recognized therapeutical place. It is used in
its native marshes as a substitute for Cinchona in the treat-
*Brit. Fourn. of Hom., xxxvi., 159.
ANGUSTURA.
197
ment of remittent and intermittent fevers. Homœopathy has
nothing to add to this, save one case of prosopalgia cured by
it (in the first dilution) recorded by Dr. Marcy in the New
Materia Medica. Indications for it in spinal affections-as
those of Noack and Trinks-are untrustworthy, being based
upon the effects of the spurious bark. Angustura vera has
no spinal action.
It is prepared in tincture, but the Pharmacopoeia recom-
mends triturations as preferable.
LECTURE XIII.
ANTIMONIUM CRUDUM AND TARTARICUM, APOCYNUM.
Having now run rapidly through our minor medicines, we
will address ourselves for the main portion of this lecture to
the important remedies afforded by the preparations of Anti-
mony.
Of these we have two in common use, the ter-sulphide,
Antimonium crudum; and the potassio-tartrate, Tartar emetic.
The former may be considered to represent the various pre-
parations of the metal-"butter" and "glass of antimony,"
"crocus metallorum," "kermes mineral," and so forth-which
gained its repute of old, and are still in use in France and
Italy. The latter, while partaking of these properties, has a
field of action all its own.
First, then, of
Antimonium crudum.
The purified ore is triturated for our use.
Antimonium crudum is the subject of one of the new
pathogeneses of the second edition of the Chronic Diseases.
But this is not therefore to be ignored; for more than four-
fifths of it are taken from an earlier pathogenesis, contained
in the first volume of the Arzneimittellehre of Hartlaub and
Trinks, and the symptoms therein are stated to have been
observed on healthy persons taking fractional doses of the
crude drug triturated with milk-sugar. These, therefore
(appearing under the guarantee of Hartlaub and Caspari), may
be accepted; while the additions of Hahnemann and Lang-
hammer may be passed by for the present. Hahnemann's
pathogenesis also contains 71 symptoms from authors (of
which 50 were collected by Hartlaub and Trinks). These are
from various preparations,-most commonly from the so-called
((
glass of antimony," a sulphuretted ter-oxide, containing
silica. They must be used with caution, as being too often
ANTIMONIUM CRUDUM.
199
the mere mechanical effects (as deafness and hernia) of the vio-
lent vomiting induced by the drug. With the pathogenesis of
Antimonium crudum may be read a proving of the golden
sulphide, in doses varying from gr. to gr. x, by Dr. Mayer-
hofer. It is translated from Hirschel's Zeitschrift (xix, 27) in
Allen's Encyclopædia.
The condition set up by Antimonium crudum seems to be
one of depressed vitality of the mucous membranes and the
skin. The action hardly goes on to inflammation. The
mucous membranes are loaded with mucus, giving rise to slow
digestion with fermentation of the food, nausea, and occasional
vomiting; alternate constipation and diarrhoea, with mucous
discharge from the anus; much hawking and expectoration
of phlegm; and irritability of the bladder with mucous sedi-
ment. The secretions and the flatulence are of a foul odour ;
and there is drowsiness. and loss of flesh and strength. This
is the "mucous flux" I have already spoken of while upon
Ammonium muriaticum; but here there is no tendency to
fever. The condition of mucous membrane described finds its
parallel in the cutaneous disorder caused by Antimonium
crudum. Parts readily become sore; and pimples, tubercles,
and pustular eruptions are developed. When these gastric
and cutaneous affections appear in practice, Antimonium cru-
dum will often prove an excellent remedy. I have the utmost
confidence in it in chronic gastric catarrh, where the tongue is
thickly coated with a milky or granular white fur. Eructa-
tions tasting of the ingesta are a symptomatic indication for
it here. It is useful, says Dr. Hempel, in that "diseased con-
dition of the intestinal lining in children which favours the
development of worms;" and Dr. Guernsey esteems it in
diarrhoea when amidst the watery evacuations there is fre-
quent passage of solid hard lumps. Among skin affections it
has cured nettlerash when dependent on gastric disorder; the
sore eyelids, ears, and nose of scrofulous children; and not
unfrequently eczema.* Dr. Clotar Müller speaks of "its
extraordinary efficacy in affections of the skin. I have
reason to think," he writes, "that Antimonium crudum is an
invaluable remedy in all cutaneous affections where pimples,
pustules, pocks, or furuncular elevations arise primarily or
secondarily, especially when at the same time there is severe
continued pricking itching of the skin, and after rubbing ten-
derness and soreness." It is particularly useful, he adds,
See two cases of eczema impetiginodes cured by it in Brit.
Fourn. of Hom., xxiv., 312.
+ Brit. Journ. of Hom., xxxii., 241.
200
ANTIMONIUM TARTARICUM.
when such phenomena occur on the face or the genitals, as in
impetigo scroti. We shall see that these are the favourite.
habitat of the specific eruption of Tartar emetic.
A curious symptom recorded by Caspari is—“large horny
places on the skin of the soles of the feet, close to where the
toes commence, which pained like corns, and always returned
after having been cut out." Hahnemann lays stress on a
tendency to these callosities as indicative of Antimonium
crudum; and Hartlaub and Trinks mention several instances
of their cure by it. A striking case of the kind is recorded by
Dr. Alvarez Gonzales, where one of twenty years' standing,
involving the entire sole, and very sensitive, was soon cured
by the drug.*
*
Antimonium crudum may yet find a place in some of those
syphilitic and other constitutional affections for which the
antimonial preparations were of old reputed as alteratives, and
which gave the metal its "currus triumphalis " in spite of the
opposition of the profession.
Its analogues are Ammonium muriaticum, Kali bichromicum,
Petroleum, and Pulsatilla.
The attenuations from the 3rd to the 12th have been most
in use: I myself have generally employed the 6th.
And now of
Antimonium tartaricum.
Under this heading we will consider the "Tartar emetic,"
which is still the common name of the salt. As regards its
preparation," the 1, when required, must be a trituration, but
its solubility in water admits of I being a solution. Dilute
alcohol may be used after 2." So speaks the British Homœo-
pathic Pharmacopoeia. The "antimonial wine "of the old
pharmacy is a convenient form: it contains two grains to the
ounce, i.e., about one part in 240.
Tartar emetic has no place in any of our classical collections
of pathogenesy; but provings of it have been made from time
to time in our body, from Hahnemann downwards. These are
collected, together with numerous poisonings, in the article on
it in Allen's Encyclopædia, which has 970 symptoms. In addi-
tion to this, I would direct attention to the large collection of
facts about its over-action contained in the New Materia
Medica; to a study of its influence on the skin, by Dr. Imbert-
Gourbeyre, translated from the Gazette Médicale de Paris in
* Amer. Fourn. of Hom. Mat. Med., iii., 38.
G
ANTIMONIUM TARTARICUM.
201
the nineteenth volume of the British Journal of Homeopathy;
and to a monograph on Antimony, by Dr. Madden and my-
self, in the twenty-fifth volume, of the last-named periodical.
((
The best known action of Tartar emetic-that to which it
owes its name—is its power of producing nausea and vomiting.
The nausea which it causes is very intense and long lasting.
Dr. G. Wood thus describes the general condition, which, in
´addition to the peculiar sensation referred to the epigastrium,
is known as nausea." "The face," he writes, "is pale, the
skin cool, moist and relaxed,the pulse feeble, frequent, and often
irregular, the saliva flows copiously, and feelings are usually
experienced of gastric uneasiness, languor, and unusual weak-
ness, which are sometimes in the highest degree distressing,
so much so as, if long continued, to render the patient utterly
prostrate in body and mind, and indifferent to all things
around him, even to life itself." To these symptoms should
be added universal muscular relaxation. The vomiting of
Tartar emetic comes on comparatively late, though sooner
than from Ipecacuanha. When it once begins it is energetic,
effectual, repeated, and prolonged. The vomited matters are
often bilious, from extension of the action to the duodenum.
The emetic influence of tartarized Antimony appears to be
purely neurotic in its modus operandi. The numerous muscular
movements whose harmonious play produces the complex act
called vomiting are under the control of the nervous centres
at the base of the brain and in the medulla oblongata. That
Tartar emetic acts directly on these centres is shown by the
fact that it causes vomiting when injected into the veins or
rectum, or rubbed into the skin, as well as when introduced
into the stomach, and in the latter mode of administration is
emetic in doses too small to irritate the mucous membrane;
and, further, that (like Apomorphia, but unlike Ipecacuanha),
it produces the same effects when communication with the
stomach is severed by dividing both the vagi,* and even when
the stomach itself is replaced by a bladder.
How the complex
act of vomiting is brought about, and how the general condi-
tion called nausea is connected with it, are problems which
physiology has not yet solved, and with which, therefore,
pharmacology may not trouble itself.
Entirely independent of the above phenomena, though
moving in the same sphere, and sometimes consentaneous with
them, are the remarkable effects of Tartar emetic upon the
circulation and respiration.
When this drug is administered in large doses, there is either
* See Practitioner, xiii., 281.
-
202
ANTIMONIUM TARTARICUM.
It
an entire absence of nausea, vomiting, and purging; or, after
a short time during which these symptoms continue, the
system appears to become tolerant of the drug, and they sub-
side. Then the pulse is found to have fallen one fifth or even
one fourth of its normal number of beats, and the respiration
to be lowered in even a greater ratio. Trousseau has known it
fall from twenty and twenty-four times in a minute to six.
is rather curious that a corresponding effect on the respirations
was observed by Dr. Sharp on his own person from a dose of
the hundredth of a grain. Their number was reduced from
18 to 6 in fifty minutes, and they became "deep uncomfortable
sighings." The pulse was hardly affected.* "It is singular,"
writes Dr. Wood, "that under these circumstances of great
circulatory and respiratory depression the mind is wholly
unaffected, the muscles retain their strength, and the organic
functions, with the exception of the two referred to, appear
not to suffer. Thus it is seen that this condition differs toto
cœlo from that induced by nausea." It should be added that
the force as well as the frequency of the heart's action is
diminished by the drug, and that "sometimes, instead of being
reduced regularly, the pulse becomes at first irregular and
intermittent under its use," as is often noticed with Digitalis.
In seeking to explain these phenomena, we must obviously
look for some source of influence common to the cardiac and
respiratory movements, by means of which Antimony may
consentaneously reduce the frequency of both; and this we
have in the pneumogastric nerves. It is well known that a
moderately strong galvanic current passed through these
nerves towards the heart will retard and ultimately stop the
movements of the latter organ. It is not so well known that
a strong current passed centripetally along these same nerves
will stop the movements of respiration, the stimulus being
reflected upon the diaphragm and the muscles of expiration,
causing general tonic spasm. A less degree of the same
excitation will simply retard the respiratory movements. We
have only then to suppose that Tartar emetic excites centri-
petally the pulmonary and centrifugally the cardiac branches
of the vagi, and we have its circulatory and respiratory
depression explained. If it act upon the central origin of
these nerves, it cannot but affect the pulmonary branches,
which are centripetal, centripetally, and the cardiac branches,
which are centrifugal, centrifugally; and that it does act at
this spot we have already shown when speaking of its power
of producing vomiting.
* Essays in Medicine, p. 726.
ANTIMONIUM TARTARICUM.
203
The interest of these last phenomena is physiological rather
than practical. The "contro-stimulant" method of Rasori, to
which they belong, is rarely practised now; and in the school of
Hahnemann was excluded from the first. Nor does the
emetic power of the drug play so important a part in homoeo-
pathic therapeutics as might be expected. We use it, of
course, to check the kind of vomiting it causes; but this
rarely comes before us in comparison with that of Ipeca-
cuanha, of Kreosote, and of Apomorphia. Nevertheless, when
it occurs—as in cases recorded by Drs. Bayes and Nankivell—
Tartar emetic will do all that is required of it. The presence,
moreover, of nausea and vomiting in diseases otherwise
calling for it will always indicate it additionally; and these
will, as Dr. Ringer states in reference to bronchitis, be
amongst the first symptoms to yield to its use. But its most
important sphere of action for homeopathists lies in the
mucous membranes and the skin (herein resembling Antimo-
nium crudum, but acting much more sharply); and in the lungs.
I. There are two forms of morbid action set up by Tartar
emetic in the mucous membranes. The first is that peculiar
kind of inflammation we call catarrhal. In the second we
have on the mucous membranes the same pustular eruption
on an erythematous base which we shall see to be the specific
effect of the drug upon the cutaneous tissues.
Thus, in the alimentary canal (in poisonings and experi-
ments on animals) a catarrhal gastritis and enteritis are set
up, which Dr. Richardson has found to occur however the
drug is introduced into the system: the stomach and in-
testines are found after death lined with a whitish-yellow
viscid secretion. In two cases of poisoning observed by
Dr. Wood, the matters vomited and purged were white and
liquid, without a trace of bile, resembling opaque rice-water.
Post-mortem appearances show the stomach and small intes-
tines to be most affected; the glands of the latter, especially
those of the ileum, have not uncommonly been found en-
larged. The subjective sensations accompanying these effects
are best described by Dr. Mayerhofer, who took the drug in
increasing doses, beginning with the hundredth of a grain.
"When the quantity," I quote from Stillé, "was gradually
augmented until an emetic dose was reached, the following
effects were observed: the malaise and nausea, which had
before existed, increased, with frequent eructation, and retch-
ing followed by vomiting; the stools were frothy, and con-
sisted of mucus and bile; the abdomen was distended and
painful; the urine, which at first had been copious, became
204
ANTIMONIUM TARTARICUM.
1
scanty; the region of the liver was tender upon pressure;
rumbling and cooing sounds proceeded from the abdomen,
which was the seat of cutting, tearing, and griping pains;
there were pains also in the lower limbs. There was an
increased sense of warmth, alternating with chilliness, over the
whole body, and the skin itched. Anorexia was complete, and
if any food was taken, it renewed the nausea. The throat felt
raw, and deglutition was somewhat difficult and painful. The
tongue was covered with dirty mucus, and there was a pasty
and insipid taste in the mouth." On the other hand, the
pustular eruption characteristic of Antimony has been seen in
the jejunum, the stomach, and the lower third of the œsopha-
gus, but is most severe and constant about the mouth and
throat. In this latter region it begins with a feeling of tension,
and other disagreeable sensations, and a metallic taste;
patches of erythematous inflammation then appear, upon
which come aphthæ, vesicles soon going on to pustules, and
even false membranes. Upon the respiratory mucous mem-
brane the influence of Tartar emetic is almost purely of the
catarrhal character, though pustules are said to have been
seen in the larynx. The nares escape untouched; but the
inflammation, beginning in the larynx, becomes intense in the
trachea and bronchi. The production of this inflammation.
under the influence of Tartar emetic has been established, not
only by post-mortem appearances in animals, but by the
symptoms of the living, as in the experiments of Dr. Molin of
which I shall immediately speak. Irritation of the genito-
urinary mucous membrane is not marked among the effects of
Tartar emetic.
And now what of the lungs? Does the irritant influence
of Tartar emetic upon the respiratory mucous membrane
extend to the air-cells themselves, so as to set up pneumonia ?
The importance of the question is obvious, as its answer in
the affirmative would claim for homœopathy one of the most
cherished pieces of practice known. You are probably aware
that Majendie so answered it. In the dogs poisoned by him
he states that the lungs were always more or less affected :
they were of an orange-red or violet colour (according to the
age of the animal) throughout, destitute of crepitation, gorged
with blood, and in some parts hepatized. Before death the
respiration had been embarrassed and hurried. Lepelletier
independently confirmed these observations; and naïvely
remarked-"One would imagine that, admitting its action in
man to be similar, far from being useful, its administration
would be particularly pernicious in pneumonia; but it is
ANTIMONIUM TARTARICUM.
205
not so, for, instead of favouring engorgement of the lung,
it promotes its resolution."
Such facts were too unpalatable for reception, although
Majendie was an accredited observer, and his description of
the phenomena unmistakeable. Counter experiments were
performed by Rayer and Campbell, in which no pneumonia
was set up by Tartar emetic; and Ackermann has more
recently promulgated the same experience. But Dr. Molin of
Paris, in an able thesis on the subject,* points out that the
large doses used by Rayer produced death so rapidly that the
inflammation of the lungs had no time to develope itself.
His own experiments, in which the animals were slowly
poisoned, corroborate those of Majendie: the post-mortem
investigation showed pneumonia in its first or second stage,
together with an intense tracheo-bronchitis characterised by
abundant exudation. Still further to clear up the subject,
Dr. Molin instituted some careful provings on his own person
with small doses of the drug (gr. -). On two successive
occasions he developed in himself all the signs, rational and
physical, of the first stage of broncho-pneumonia, with marked
inflammatory fever.† Some experiments on rabbits by Dr.
Nevin, recorded by Marcy and Peters, corroborate those now
stated. He says "The lungs and trachea were frequently
congested, sometimes highly inflamed, the two lungs seldom
alike." I should mention that in Dr. Molin's experiments
the inflammation of the bronchial tubes was observed, even
where the animals died before the pneumonia had time to be
developed.
1
12
The facts seem proved; and Ringer and Nothnagel in our
own day accept them. Their moral is obvious. The well-
known curative action of Tartar emetic in bronchitis and
pneumonia is after all an instance of the law of similars.
You have hitherto in all probability been taught that it acts
in these cases by its general antiphlogistic power, in virtue of
its depressing influence upon the circulation and liquefacient
action on the blood. But were this its only or even chief modus
operandi, it ought to be beneficial alike in all inflammations,
wherever occurring. That it is not so, the therapeutists of
the old school freely admit. In inflammations of the respira-
tory mucous membrane it is invaluable; when other parts, as
* Des Specifiques en Médécine. 1847.
† An account of Dr. Molin's experiments is given in the sixth volume
of the Brit. Fourn. of Hom. Dr. Allen, who uses some subsequent
provings by the same physician made with the dilutions, seems to have
overlooked these.
206
ANTIMONIUM TARTARICUM.
the serous membranes, are affected, it does little or nothing.
Even from this alone it would appear that the drug has some
specific relation to this part of the organism. Nor will the
theory that its influence here, though direct, is antipathic hold
good. The "relaxed " condition we have seen it causing in
skin and mucous membrane is part of the nausea it excites;
while Dr. Bartholow expresses the general experience of the
practitioners of the present day when he says that doses from
the twentieth to the twelfth of a grain suffice here, " for it is not
necessary that nausea should be excited." Now as we have,
on the other hand, seen Tartar emetic acting as a specific
irritant of the trachea, the bronchi, and the lungs, we seem
warranted in concluding that it must be in virtue of its
homœopathicity that it proves curative-whenever it does so
-in tracheal, bronchial, and pulmonary inflammations. In
actual homœopathic practice it has not played so prominent
a part in the treatment of these maladies as in that of the old
school,-mainly, in all probability, because we have better
remedies for some of their forms and stages. But there is
very general agreement as to its value in the second stage of
bronchitis occurring in infants and aged persons, when the
mucus is profuse and the expulsive power feeble, so that
much rattling of phlegm is audible. As regards pneumonia,
Bähr's statement well expresses the general view.
"In un-
complicated pneumonia Tartar emetic is scarcely ever indi-
cated in the first stage, nor even at the beginning of the
second. The time for this remedy commences with the
resolution of the exudation. If this take place rapidly, and
the reabsorption be slow, the dyspnoea generally becomes
quite considerable, because the lungs are unable to remove
the copious contents from their cells. If now great dyspnoea
be present, and a spasmodic cough with expectoration that
affords some relief, Tartar emetic will have a fine effect.
This termination of pneumonia is generally characterised by
a sinking of the temperature with an increased frequency of
the pulse, great anxiety and restlessness, with a copious, cool
perspiration, cerebral congestion with a livid or at least a
strikingly pallid complexion. In contradistinction to Phos-
phorus, the indications for Tartar emetic point to a deficient
reaction; hence it is more suitable for old people than for
vigorous and young persons." In broncho-pneumonia Tartar
emetic is homoeopathic enough, but in acute cases of this
dangerous disease it yields in efficacy to Phosphorus. In
pleuro-pneumonia I should not have thought it applicable at
all, but Kafka scems to esteem it highly. The drug has also
1
ANTIMONIUM TARTARICUM.
207
I
several times proved curative, in the hands of Drs. Wurmb
and Caspar, of acute cedema of the lungs. I have myself
much confidence in its power of removing this condition
when occurring in the course of general dropsy. Tartar
emetic is also very useful in chronic catarrhal coughs, when
the expectoration is profuse and easy, and of a mucous
nature. Dr. Ringer recommends it, in doses of th of a grain
or less, for children in whom bronchitic asthma occurs fre-
quently; and Dr. Bayes praises it in catarrhal croup.
We have little experience of Tartar emetic in affections of
the alimentary canal. Dr. Dyce Brown has lately put on
record a case of acute catarrhal gastro-enteritis, in which its
curative action was manifest.* It should be serviceable in
aphthous, pustular, and other eruptive diseases of the mucous
membrane, perhaps in the aphthous mouth and throat o.
those dying from exhausting diseases, as phthisis. The
phenomena of over-dosing with it are-superficially—so like
those of the collapse of cholera, that it has been natural for
homœopathists to use the drug in choleraic affections. Save,
however, as regards cholera nostras, I think the resemblance
deceptive. The antimonial collapse is a result of extreme
nausea, while no such condition is present in cholera; and
again, its diarrhoea is caused by the catarrhal enteritis it sets
up, while cholera is non-inflammatory. Similar objections
hold good to its employment in cholera infantum," where it
is (according to my experience) of little service.
2. I have yet to speak of the action of Tartar emetic upon
the skin. You have been told of the peculiar pustular inflam-
mation which is excited by the local application of the drug.
If your memories need refreshing as to its characters, you will
find them described at length in our article. But it may be a
new idea to you, that this effect of Tartar emetic belongs to
it, not as a mere local irritant, but as a dynamic agent.
Nothing, however, can be more clearly demonstrated than is
this thesis by Dr. Imbert-Gourbeyre, in the paper I have
already referred to. He first quotes nineteen observations to
show that, when Tartar emetic is used locally, pustular erup-
tions are apt to occur on other parts of the body, especially
about the scrotum and labia, and the anus; and this without
the possibility of the mechanical transference of the ointment.
He then cites five instances in which eruptions, closely
resembling those produced by Tartar emetic ointment (and
that also which characterises variola), have appeared during
* See Monthly Hom. Review, xxi., 153.
208
ANTIMONIUM TARTARICUM.
the internal administration of the drug.* Lastly, he adduces
evidence to prove that the local effect of the drug is not pro-
duced till after a day or two, and sometimes does not appear
at all at the spot of application, but on some other part of
the body. Coupling these facts with the peculiar and specific
character of the eruption, and with the frequent occurrence
of similar pustules on the internal mucous surfaces under the
use of the drug, he comes fairly to the conclusion that Anti-
mony is a specific and dynamic "exanthematogenic,"—its
characteristic eruption being pustular. I shall have to tell you,
when I come to Arsenic, how these observations as to the
specific action of Tartar emetic upon the skin have been sup-
ported by the results of experiments 'on animals and micro-
scopical examination of the tissues as affected by it.
The precise form of cutaneous eruption to which Tartar
emetic corresponds is ecthyma. "The pustules," says Erasmus
Wilson, "following the irritation of tartarized antimony are
ecthymatous." A case of this disease cured by Tartar emetic
is given in the New Materia Medica. It is less suitable or
serviceable in impetigo, save in one form of the disease, the im-
petigo erysipelatodes; where I have found it as curative as it
is homœopathic. Dr. Dudgeon, however, has (Brit. Journ. of
Hom., xxiv., 311, and xxix, 405) recorded two excellent cases
of cure with it (given in the first and second triturations)
of those disfiguring pustular eruptions which haunt the faces
of young people. In the second case, the genitals also
were involved. But the deepest interest of Tartar emetic in
this sphere lies in its relation to variola. Not only does it
cause a specific pustular eruption closely resembling that of
smallpox, but its pathogenesis has also the vomiting, the
pustules of mouth and throat, the viscid mucus clogging
the air-passages, and the hypinosis of the blood, which no less
characterise the disease. Still further, the inoculation of the
lymph of Tartar emetic pustules appears to effect results
analogous to those of vaccination. The pustules produced
are precisely similar in appearance to those of cow-pock, and
they in their turn can excite fresh pustules by inoculation;
though I cannot accept the statement that they further confer
the same protection from smallpox. Correspondingly with
this close homœopathicity, the power of Tartar emetic as a
remedy for variola is very great. Testimonies to its value
are collected by Drs. Marcy and Peters; it is said to be especi-
ally useful in cases where the respiratory mucous membrane
* Two additional cases of this kind are cited in the New Materia
Medica, and Tardieu recognises the fact.
ANTIMONIUM TARTARICUM.
209
is much affected. I myself have invariably used Tartar emetic
(in the first trituration) as the medicine for smallpox, and have
rarely had occasion to substitute any other. I cannot say that
it cuts short the disease; it is doubtful whether any medicine
can. But it seems to me to conduct the cases through in a very
satisfactory manner, decidedly mitigating all the incidental
troubles, and leaving (even in non-vaccinated subjects) very
little pitting behind.*
I have now described the three great spheres of the action
of Tartar emetic, the medulla oblongata, the respiratory
mucous membrane, and the skin. There are other forms of
disease in which it is often curative. One of these is delirium
tremens, where much gastric disorder of saburral kind is pre-
sent, as when beer has been the intoxicating drink employed.
Another is lumbago, and similar so-called "muscular rheu-
matisms," in which Bähr and Lawrence Newton have praised
it highly. It is also reckoned by Dr. Angell a prime remedy
for photophobia; I have recently had a good opportunity of
verifying his recommendation. In connection with this it
may be mentioned that Dr. Ringer recommends it, in doses of
gr. to, in strumous ophthalmia.
1
M
36
The correspondences and divergences of the application of
Tartar emetic in the two schools respectively are surely very
instructive. The drug is known as an emetic, a depressant of
the circulation, and a specific remedy in acute pulmonary
affections. Ours is the direct opposite of the first of these
three uses; for we cure vomiting with the drug instead of
causing it. The second we reject utterly. The third we claim
for homœopathy, and, in the light of the law of similars, define
its range and precisionise its application.
Ipecacuanha is the medicine most closely allied to Tartar
emetic. Then we have, as acting like it on the medulla,
Digitalis, Lobelia, Tabacum, and Veratrum viride; on; the
respiratory organs, Phosphorus; on the skin, Antimonium
crudum and Clematis.
The success of old-school practice with Tartar emetic in
laryngitis, bronchitis and pneumonia shows that these diseases
do not need very infinitesimal doses of the drug. In these,
and in variola, the homoeopathic school has generally used
the second, rarely the third decimal potency. Higher
dilutions (12-15) seem to answer well in oedema pulmonum.
My next medicine in alphabetical order would be Apis. But
as I cannot begin so important a remedy at the fag end of a
* See case in Manual of Therapeutics, 2nd ed., i., 49.
P
210
APOCYNUM CANNABINUM.
lecture, I will skip it, and conclude our talk to-day with a few
words upon the
Apocynum cannabinum.
This plant is often called the "Indian hemp," but it must
not be confounded with the Cannabis Indica of Hindustan.
It is a Canadian herb, from whose root we make a tincture
with proof spirit.
Dr. Allen's Encyclopædia gives pathogenetic symptoms
obtained from Apocynum by four provers; and Dr. Hale's
New Remedies relates all that is known regarding its clinical
use.
And (almost) all that is known is just this, that Apocynum
has virtues of a remarkable kind in the treatment of all
varieties of dropsy. Anasarca, hydrocephalus, hydrothorax,
and especially ascites, of all kinds and from all causes, occur
repeatedly among the cases cured by it which Dr. Hale has
collected in his second edition. I am unable at present to
distinguish the precise form of action of Apocynum in this
sphere; and still less to suggest its rationale. It seems always
to require to be given in substantial doses, yet it is no diuretic,
that is, in healthy persons; and, when proved by Drs. Peters
and Marcy, it actually diminished the urinary secretion in
both. I have not found it of any service in the hydrocephalus
of tubercular meningitis or the ascites of hepatic cirrhosis-
conditions for which we sadly want medicinal help; but I
have seen simple hydrocephalus supervening upon typhoid
clear away very satisfactorily under its use. It is impossible
to read Dr. Hale's cases without feeling assured that Apocy-
num has a true place as a specific remedy for some forms of
dropsy. He himself thinks it permanently curative in renal
dropsy only; and supposes that it temporarily relieves other
forms of the disease by its action on the kidneys.
Apocynum has also cured menorrhagia, to which it seems
homœopathic, and "stuffy" colds in the head. I have found
it of occasional service in dyspepsia where there is much
bloating after meals, and a frequent sensation of sinking at the
stomach-these two symptoms being very marked in the
provings of Drs. Peters and Marcy respectively.
Apis and Helleborus seem the most analogous medicines.
As regards dose,-the mother-tincture, from one to five drops
at a time, has sometimes proved effectual; but more frequently
it has been found necessary to use the preparation known as
#
APOCYNUM CANNABINUM.
211
"Hunt's decoction," or to prepare an infusion from the fresh
root (an ounce to a quart of water).
[The supplement to Dr. Allen's Encyclopædia contains
several fresh provings of Apocynum, the mother-tincture or
an infusion being taken in every case. The most marked
effect was great relaxation of the bowels,—the abdomen seem-
ing to fill with wind and fluid, which must be hastily and
explosively discharged. Great and lasting weakness of the
sphincter ani was induced in connection therewith, somewhat
resembling that we have seen under Aloes; but the motions of
Apocynum are much more copious, and they occur after food
throughout the day, and not in the morning only. Apocynum
ought to find place in the treatment of diarrhoea.]
LECTURE XIV.
APIS, ARGENTUM METALLICUM AND NITRICUM.
We will begin to-day's lecture with
Apis mellifica.
This is the poison of the honey bee, and is (it need hardly be
said) peculiar to homoeopathic practice. It is prepared for use
in more than one way. A trituration of the whole becs, dried,
and a tincture prepared by macerating their hinder parts, after
killing them while in a state of excitement (which last is the
preparation of our own Pharmacopoeia), have been used, and
seem to contain the virtues of the medicine. A better pre-
paration still would be a solution of the virus itself in alcohol
or glycerine. It can be obtained, as Dr. Hering suggests, by
seizing the bee by its wings and causing it to eject its poison
upon a piece of sugar, or by grasping the sting of a stupefied
bee with a small pair of nippers, and gradually drawing out
the sting and poison bags together.
Apis has been proved, both in trituration and in the solu-
tion of the virus above mentioned, by the Central New York
State Homœopathic Society. The results, published in its
Transactions, appear in schema form in Metcalf's collection.
They are also published, incorporated with effects of bee-
stings and with new symptoms obtained on the healthy or
observed on patients taking the drug, in Hering's Ameri-
kanische Arzneiprufungen, and again in Allen's Encyclopædia.
Numerous clinical cases are appended to Metcalf's arrange-
ment; and others are to be read in Marcy and Peters, in the
eleventh and twelfth volumes of the British Journal of Homœo-
pathy, and in the Bibliothèque Homoeopathique for 1874-75.
We have, moreover, a special monograph on the therapeutic
virtues of the honey-bee by Dr. C. W. Wolf, which has been
translated into English.
The medicine now to be discussed differs in important
respects from the substances we have been accustomed to
APIS MELLIFICA.
213
regard as drugs. We have to believe that the symptoms
known to result from the sting of a bee are also in some
degree produced when the virus of the insect, in a diluted
form, is taken into the stomach. In noting, moreover, the
homœopathic indications for the remedial use of the virus,
we shall depend much upon the phenomena of bee-stinging;
and shall take it for granted that similar phenomena occur-
ring in disease are properly treated by the internal adminis-
tration of the poison. Such assumptions at one time raised
considerable difficulty, on the ground of the supposed inert-
ness of animal poisons when introduced through the digestive
mucous membrane: and on former occasions I have had to
discuss the subject. It is now needless to do so; for, as Drs.
Brunton and Fayrer state,* it has been clearly shown that
serpent-poison does act when introduced into the stomach, or
"The idea,"
when applied to a mucous or serous membrane.
say they, "that it is only effective when injected directly into
the blood is erroneous; though it is, no doubt, more certainly
and rapidly fatal when it enters the blood direct."
Let us consider the local effects of a bee-sting. The part
rapidly swells up, becomes more or less hot and red, with a
tense pain, and often considerable burning, tingling, and itch-
ing. This is the simplest and most characteristic form of the
pathogenetic influence of Apis. It is an acute ædema, the
cellular tissue being more affected than the skin. Whenever
a similar condition occurs idiopathically, whether on cutaneous
or mucous surfaces, Apis will be found curative. Acute
œdema occurring on the skin is a form of erysipelas; and in
this disease Apis is a prime remedy.
It stands between
Belladonna and Rhus, not controlling intense cutaneous in-
flammation like the former, or the tendency to form vesicles
like the latter, but acting most efficiently in its own sphere of
œdema. It is of course to traumatic erysipelas that Apis is
especially suitable, and Dr. Bojanus-our eminent Russian
confrére-highly eulogizes it here. "Since we have fully
known the virtues of this remedy," he says, "we have under-
taken plastic operations with much more confidence, all fear
of bad results from erysipelas being removed." Dr. Kafka
records a good case in which the disease followed upon cir-
cumcision, and was rapidly controlled by the remedy. Dr.
Wolf-who esteems it specific against erysipelas of all kinds
-suggests it in that fatal form of the malady which attacks
new-born children, spreading from the umbilical wound.
ga
* Trans. of Royal Society for Jan. 22, 1874, reported in Lond. Med.
Record, ii., 109. See also Monthly Hom. Review, xvi., 673.
214
APIS MELLIFICA.
Then there is a species of sore throat in which Apis is specific.
There is no very great redness or pain as with Belladonna, nor
is the parenchyma of the tonsils inflamed as when Baryta
carbonica is the remedy; but there is general œdema of the
submucous cellular tissue covering the tonsils, uvula, soft
palate, and even the posterior portion of the hard palate.
When you look at the throat it seems as if a bee had flown in
and stung the patient there. If the numerous cases of angina
cured by Apis which have been put on record be studied they
will be found to have been of this character. Such a sore
throat is not uncommonly an extension of erysipelas, as the
late Dr. Todd describes it in his Clinical Lectures. It is often,
also, the beginning of œdema glottidis, in which Apis is the
great remedy. It has proved curative in more than one in-
stance of this affection, where the cause was drinking boiling
water from a kettle.* Such cases are commonly fatal.
There are two specific diseases in which the throat is often
affected in the way of acute oedema, and to which Apis, thus
indicated, bears an important therapeutic relation. These are
diphtheria and scarlatina. Facts are accumulating which point
to Apis as a prime remedy in the former disease. Drs. Bau-
mann and Veith Meyer in Germany, Kallenbach in Holland,
and Jahr in France, have concurred in esteeming it the best
anti-diphtheritic we have ;† and my own experience points in
the same direction. In the last case I had I found it remove
everything but the coryza, which yielded to Kali bichromicum.
The great prostration, faintness, and even tendency to death
by syncope, noticed in those stung by bees, show that Apis
has more than local homoeopathicity here. In scarlatina
Apis is obviously indicated for the anginose form, where there
is more œdema than ulceration. But it has also the action on
the kidneys and skin characteristic of this poison. Dr. Chep-
mell narrates a case of bee-sting causing scarlatinoid rash and
anasarca, which is so instructive as to the action of Apis, that
I will read it to you, as it is not given by Allen.
“Mr. D——, a middle-aged gentleman, of a bilious sanguine tem-
perament, who rather prided himself upon his practical knowledge of
bee-keeping, had invited me to an inspection of his hives, warning me
at the same time that the bees were in a very excitable state, owing to
their having been disturbed some days before. Of this we soon had
experience; for on approaching the hives we were immediately warned
off by a swarm of bees hovering angrily about us. Under the circum-
* Monthly Hom. Rev., xiii., 364. Hom. World, xiv., 427.
† See Brit. Fourn. of Hom., xxviii., 613, 775.
‡ Ibid, p. 738.
APIS MELLIFICA.
215
stances we thought it best to beat a retreat, if haply we might escape
the penalty of our rashness. After a time I was fortunate enough to
get comfortably quit of some dozen bees, which were becoming more
familiar with my physiognomy than I quite liked; and so was my
friend, in respect of about an equal number similarly engaged upon his
own face, with the exception of one eccentric flaneur, which persisted
in a walking excursion behind his left ear. Annoyed by the obstinacy
of this insect, he at last succeeded in brushing it off by a sudden dash
with his hand. At the time he remarked to me that he was not quite
sure whether he had or had not been stung; but he seemed to think no
more about the matter when, shortly after, I took my leave. About
half an hour later I was hastily summoned to attend him, as he had be-
come seriously indisposed.
"I found my friend in bed, very anxious and alarmed about himself,
although at times he was in a half unconscious state, and slightly
delirious. He was swollen all over, but more especially about the face
and neck, the abdomen, and the upper and lower extremities. The
entire skin was covered with a red rash, very much resembling scar-
latina, only, if anything, of a less bright colour and somewhat
rougher to the feel than the common type of that exanthem (the smooth
scarlatina of Sydenham). The skin was hot and dry, the breathing
oppressed, and the pulse quick, but somewhat weak. He complained
of fulness and confusion in the head; the face was flushed, and the
eyes suffused. His wife informed me that, soon after I had left him, a
sudden dizziness came over him, and his head began to feel so full, that
he thought he was going to have a fit. These symptoms were suc-
ceeded by rigors, when he felt so ill and weak that he at once undressed
and went to bed, not without considerable assistance. There was reason
to believe that a suppression of the renal functions had also taken
place; for he made a useless attempt to urinate, and the swelling and
eruption almost immediately followed. I gave him, two or three times
in succession, three drops of camphor tincture, at intervals of a few
minutes; and then prescribed Bell. six drops, third solution, in doses
of a sixth part, at first every ten or fifteen minutes; then every half-
hour, hour, to two or three hours, according to circumstances. Under
this treatment a speedy and salutary reaction took place; so that when
I left him, at the end of an hour, he was quite comfortable and reassured
about himself. In the meantime, all the discomfort about the head and
the oppression of the breathing had ceased; and he had passed an un-
usually large amount of urine; after which (as I subsequently learnt) a
gentle diaphoresis followed, and the swelling (anasarcous as it really
was) seemed to subside as rapidly as it had arisen. He then fell into a
refreshing sleep, which lasted some hours; and, when he awoke, all
trace of his indisposition had vanished. I can only account for this
extraordinarily severe effect of the sting of a single bee on the supposi-
tion that the poison must have been immediately carried, undiluted,
into the cerebral circulation by the internal carotid artery. In what-
ever way this must have happened, the pathogenetic experiment is not
the less interesting or instructive."
Mr. Nankivell noticed in a patient affected by it that a
patch of skin on the arm remained white amid the surrounding
redness, and was informed that this spot had been a short
time previously the seat of the inflammation resulting from
216
APIS MELLIFICA.
the sting of a bee. Both these gentlemen, as well as others,
have used it here with success. It is especially indicated in
irregular and adynamic forms of the disease, as when the
eruption is repelled, or does not come out well: a typical case
of the kind is given by Dr. Chepmell in his Hints. Dr.
Guernsey says that the alternation of perspiration and dryness
of the skin is characteristic of it here. Dr. Wolf goes so far
as to say that "thanks to the curative powers of Apis, scarla-
tina has ceased to be a scourge to childhood.”
Other forms of acute œdema are inflammations of the tongue
and of the labia pudendi, in both of which Apis has been
found curative (glossitis has frequently resulted from bee-
stings in other parts of the body). Indeed, if this pathological
condition be borne in mind as the keynote of the medicine, it
will rarely be used in vain.
We have still remaining the burning, itching, and tingling
of our bee-sting,-features by no means common in idiopathic
oedema. They rather point to cutaneous dysæsthesia and
eruptions, into which, indeed, in the provers they are seen
developed. The exanthem induced (both in these and in
persons stung by bees) generally resembles urticaria, in which
disorder Apis is our great remedy. The following case is in-
structive in this connexion :—
C
"I was called to Mr. L. Stewart, banker, of this city, to see his little
son, who, the messenger stated, was suffering from a rash of some
kind.' Knowing it to be the first time a homoeopathic physician had
ever been called upon professionally by this family, I hastened to the
bedside of my patient, and found a little boy about ten years of age,
suffering from a severe attack of urticaria. He was covered from head
to foot with elevated, circular, and oblong blotches, which soon ran
together, forming one entire blotch over the entire back, arms, and
legs. The character of the eruption on its first appearance was white,
but on rubbing the parts the colour would change to a pinkish cast. The
eruption was accompanied with intense itching, stinging, and burning,
which caused the little fellow to scratch and rub himself continually;
the pulse was but slightly accelerated; tongue clean. The child ap-
peared to feel well apart from the symptoms caused by the eruption.
"Apis mel. seemed to be so plainly indicated that further investiga-
tion appeared to be useless, and I was about to prescribe, when Mrs.
S―― inquired as to the cause of urticaria. After making a satisfac-
tory explanation, I inquired of my patient as to what he had been doing
through the day. His reply was that he had done nothing except swim-
ming in the river, and that while dressing, a 'yellow jacket' had stung
him on the right hand, and that immediately he commenced itching
and burning all over, and when he got home 'he was all broke out,
and that was all he knew about it. This bit of information changed
the programme. Here was a part of the pathogenesis of almost the
very remedy I was about to prescribe. Înstead, therefore, of giving
Apis 4th, I prescribed Ledum pal., 5th, gtt. x. in half-a-glass of water,
APIS MELLIFICA.
217
a teaspoonful every half-hour. I called again after two hours, and find-
ing a decided improvement, I directed that a teaspoonful be given at
eight o'clock, and another at bed-time, and the medicine then discon-
tinued. Early on the following morning I was notified by a messenger
that my patient was entirely well, and that it would not be necessary
for me to call.'
""*
Apis has also cured cases of lichen and of erythema nodo-
sum; and is generally indicated in skin affections not going
on to destruction of tissue, but accompanied with excessive
itching, especially of a burning and stinging character.
Urticaria, like erysipelas, may manifest itself internally.
Here also we have acute oedema, but without the tendency to
suppuration belonging to the erysipelatous form. The dis-
tressing and sometimes even dangerous symptoms arising
from this cause have several times been successfully encoun-
tered by Apis.†
In acute cedema, erysipelatous and urticarious, we have the
pathological condition most characteristic of Apis; and upon
this I am desirous of fixing your attention. But both prov-
ings and therapeutic records credit the medicine with a range
far wider than this, as will appear from what follows.
1. The mucous membranes are not influenced in their gene-
ral extent by Apis; but at certain spots it manifests great
power. It has frequently proved curative in catarrhal and
scrofulous ophthalmia. It is where the cornea is much involved
that its most striking curative results are seen. Dr. Casal,
of Mentone, has recorded a case where the sting of a wasp
(which seems pathogenetically identical with that of the bee),
inflicted near the right eye, caused-after a lapse of some
days-a sub-acute keratitis, first on that side and then on the
other. Dr. Jousset expresses great confidence in Apis as a
remedy for strumous ophthalmia affecting the cornea; and finds
it important in these cases to use the solution of the virus, and
not the trituration of the whole bee. It causes hoarseness and
dry cough; and is often useful in subacute and chronic laryngo-
tracheal irritation, of a mild type (it may be compared here
with Rumex crispus and Carbo vegetabilis). It irritates the
stomach, and somewhat the bowels: it is one of the best
remedies for diarrhoea recurring every morning, the motions
greenish-yellow and painless (here again corresponding with
Rumex crispus). Dr. Wolf commends it highly in acute
gastro-enteric catarrh, and in dysentery. It is very decidedly
* Dr. F. B. Smith, in Hahn. Monthly for Sept., 1875.
† See Erasmus Wilson, Diseases of the Skin, article "Urticaria,"
and cases 14, 16, 28 in Dr. Metcalf's paper.
218
APIS MELLIFICA.
irritant to the kidneys and neck of the bladder (like Cantharis).
Dr. Marcy recommends it in incipient Bright's disease, in in-
flammation of the neck of the bladder, and in "irritable bladder."
2. Apis acts rather powerfully in the ovario-uterine sphere.
Few medicines cause so many ovarian symptoms; and it has
more than once provoked miscarriage when given to pregnant
women. It has proved curative in amenorrhoea, dysmenorr-
hoea, and menorrhagia, when resulting from active congestion
of the ovaries; and even in inflammations of the latter organs.
The presence of a "stinging" pain is said to indicate it here.
3. I come now to the important question,-what power has
Apis over dropsy, general and local? It is credited with
almost unbounded curative virtues in this disease; but I think
discrimination is needed. Its action on the kidneys is suffi-
cient to make it a most useful, because homœopathic, remedy
in acute febrile dropsy from a chill, in post-scarlatinal dropsy,
in that of incipient Bright's disease, and in that which some-
times appears in the later months of pregnancy and lays the
foundation of future puerperal convulsions. In all these forms
of dropsy Apis has been used successfully, its curative action
being generally announced by a great increase in the secretion
of urine. Absence of thirst is regarded as a characteristic symp-
tom for it in recent dropsies. Then there are the serous
dropsies, ascites, hydrothorax, hydrocephalus. These may
be mechanical, from obstruction of the circulation; as when
ascites results from cirrhosis of the liver. In such cases, I can-
not conceive of Apis dispersing the effusion; nor do I see
sufficient evidence that it has ever done so. It is otherwise
when the dropsy is the unabsorbed effusion remaining after
serous inflammation. There seems little doubt but that Apis
acts specifically upon the serous membranes. I do not know
that it has been much used in their acute inflammations; but
in ascites and hydrothorax remaining behind after peritonitis
and pleurisy it has over and over again proved curative, and
there is some reason to suppose that it has removed the
effusion in cerebral meningitis (probably non-tubercular). Dr.
Wolf speaks in the highest terms of it here. It must be re-
membered that in full doses Apis is diuretic, and in this way
may remove-at any rate temporarily-dropsical effusions
unconnected with the kidneys or the serous membranes, such
as cardiac and ovarian dropsies, both of which are reported to
have yielded to its use. Here, however, it must not be given
in dilution; and the Indian experience from which the remedy
was first obtained suggests an infusion or trituration of the
entire bee as the best preparation.
APIS MELLIFICA.
219
Apis seems to have the same action on the synovial as it
has on the serous membranes. A lady who took two doses of
15 drops of the tincture found next morning her second right
finger begin to swell, the middle joint especially being red and
hot. Several cases of acute synovitis have been reported in
which its curative powers were evident.* Whether, as Wolf
thinks, it will meet the synovitis of morbus coxæ and white
swelling of the knee, is a question.
Dr. Wolf
Apis has some repute in intermittent fevers.
declares it a universal specific for them. Dr. Nichol, of Mon-
treal, considers that it is rarely suitable for malarial intermit-
tents, but heads the column of the remedies with which we
combat those of non-malarial origin. Its chief indications
seem to be the commencement of the attack in the afternoon,
absence of thirst, and a sensation during the chill as if the
hands were dead. He relates a good case so characterised and
speedily cured by it.†
We have once more in the case of Apis the advantage of
one of Dr. Brown's "Studies." The only additional hint I can
cull from it, however, is his suggestion of the drug as a remedy
for dry catarrh of the nose and larynx, based on the view
that the oedematous condition characteristic of the drug is
present here.
I have indicated many of the medicines which in particular
spheres of action correspond with that of Apis. Thus Can-
tharis and Terebinthina in the urinary organs, and Rumex in
the morning diarrhoea and laryngeal symptoms, closely re-
semble the present medicine. For the cutaneous symptoms,
Anacardium, Belladonna, Croton, Rhus, and Urtica may be
compared; and for the affections of the serous membranes,
Apocynum, Mercurius corrosivus, and Bryonia. As a whole,
the action of Apis more nearly resembles that of Arsenic than
of any other drug.
The 3rd decimal dilution is that which I always employ in
acute oedema in all its forms. In dropsies, Dr. Marcy pre-
fers the lower dilutions, from the 3rd downwards; in cutaneous
affections, from the 3rd upwards; in irritation of the bladder
he says we ought never to go lower than the 6th. The most
striking cures of ophthalmia have been made with the higher
dilutions. Dr. Wolf uses the 3rd or the 30th according to the
sensitiveness of the patient, and in most acute affections advises
its alternation with Aconite to avoid excessive re-action.
* N. Engl. Med. Gazette, xii., 20: Jousset, Leçons, p. 478.
† Monthly Hom. Review, xxi., 175.
220
ARGENTUM METALLICUM.
1
Of the preparations of silver we use two, the pure metal
itself, and the nitrate. First, of
Argentum metallicum.
The finest silver leaf was the form in which metallic silver
was proved by Hahnemann. The precipitated metal is allowed
as an alternative form by the British Homœopathic Pharma-
copœia. Either is triturated for our use.
Metallic silver was proved, in the first trituration, by Hah-
nemann and seven others: the pathogenesis, containing 224
symptoms, appears in the fourth volume of the Reine Arznei-
mittellehre. Some later provings by Dr. Huber, in the poten-
cies from 1 to 6, are recorded in the second volume of the
Esterreichische Zeitschrift, and amalgamated with Hahne-
mann's by Allen.
Dr. Huber sums up his proving by suggesting that the chief
action of Argentum is on the articulations and their component
elements, bones, cartilages, ligaments, &c. It seems to pro-
duce arthralgia rather than arthritis; and might be serviceable
in hysterical joints. Dr. Sharp writes:-"a very long-lasting
and severe case of coxalgia in a young woman, and another
nearly similar affection of the knee, have been cured by it in my
hands." It also causes some diuresis; and—as Hahnemann
suggested-is occasionally useful in diabetes (not mellitus in-
deed, but insipidus). Another sphere of its action is the larynx,
where it has cured hoarseness and chronic laryngitis. Easy
expectoration, looking like boiled starch, is said to indicate it.
We have yet to learn the influence of Argentum on the
uterus, as there were no women among the provers. But
Pereira's statement, that “in uterine diseases, especially when
there are augmented discharges and great irritability, it has
been beneficial," suggests a specific action here; and Teste
has related an interesting case of uterine cancer, in which the
relief afforded by the drug was so great that for a time a cure
seemed about to result.
Aurum, Platinum and Selenium are analogues of Argen-
tum; less so Zincum.
I know of no recorded experience from which to suggest
the dose. Hahnemann recommends the 2nd trituration.
And now, of
Argentum nitricum.
This salt of silver is prepared in aqueous solution, and pre-
ARGENTUM NITRICUM.
221
served with the usual precautions-yellow actinic bottles
being recommended. It is sometimes triturated; but the pre-
paration must be uncertain.
Nitrate of silver only obtained a few symptoms in Hahne-
mann's hands, the 15th dilution being employed. But it has
received an exhaustive proving from Dr. J. O. Müller, of
Vienna, the record of which was published in the second
volume of the Esterreichische Zeitschrift, and may be read in
Hempel's translation of Stapf's Beiträge. Four men and two
women took part in it, using both the crude drug and the
attenuations. Some physiological experiments with fractions
of a grain (—) are related by Krahmer in his monograph
on silver,* and may be read in Allen's supplement. The
primary article in the latter's Encyclopædia adds to these
numerous symptoms from poisonings.
5
I would first speak of the local application of nitrate of
silver. Most of you would probably be loth to lose the advan-
tages of the practice, and would wish to know if homœopathy
forbids its continuance. She certainly does not; but, on the
contrary, claims it for herself. Let Trousseau be witness on
the point. "Solutions of nitrate of silver," he says, "at first
applied to the pharynx and mucous lining of the mouth, passed
into every-day use in the treatment of inflammations of the
mucous membrane of the nose, eyes, urethra, vagina, and even
of the intestines.
It was soon perceived that the
primary effect of this and similar agents was analogous to
that produced by inflammation, and it was easy to understand
that inflammation artificially induced in tissues already the
seat of inflammation led to a cure of the original inflammatory
attack. When this view was once acquired, there flowed from
it the great therapeutical principle of substitution, which, at
present, reigns supreme in medical practice." If we needed to
know what Trousseau meant by " substitution," we should find
it in what he says in his Matiêre Médicale :-“ if now arsenic
is employed" in inflammations" locally in very small propor-
tions, il agit homeopathiquement, c'est-à-dire, substitutivement."
Nevertheless, it is rarely that the disciple of Hahnemann
has to avail himself of such medication. To direct his " sub-
stitutive" agents to the parts affected, he uses the elective
affinities of drugs. He thus has a far wider range, and also a
more radical kind of operation. Local cure of inflammation
can be satisfactory only when the disease is of local origin.
If, as so often happens, the inflammation is but an expression
* Das Silber als Arzneimittel betrachtet, von Dr.L. Krahmer. 1845.
+ Clinical Lectures (New Syd. Soc.), ii., 19.
16
222
ARGENTUM NITRICUM.
of blood-changes farther back, it is poor practice to blight the
efflorescence while root and stem are untouched. A simile
which acts from without can do this only. But one which
acts from within will, if it be a true one, track the whole course
of the disease, and "cover" it from its first origin to its
ultimate manifestation; for after a like manner itself is wont
to behave. Hence, if it cures, it will do so thoroughly.
If, therefore, a beginner in homoeopathy should ask me
about the local use of nitrate of silver, I should reply, first of
all, that homoeopathy is affirmative, not negative. She forbids
nothing-not even bleeding and blistering: she ousts them
merely by curing without their aid. So, by all means, if you
have an ulcer or a local inflammation which you cannot cure
by specific internal medication, apply your lunar caustic.
But try the internal treatment first. I venture to predict that,
as that becomes perfected, the local treatment will cease to be
required; and the porte-caustique will take its place with
the phlebotomy lancet among the disused instruments of
torture.
We turn now to the internal use of our drug. What is
generally known of it is that it inflames the gastro-intestinal
canal, causing (in Pereira's words) "if the dose be too large,
gastrodynia, sometimes nausea and vomiting, and occasionally
purging;" and that, when absorbed, it disorders the nervous
centres, producing affections of a convulsive and paralytic
character. Its uses are according to the same authority—
to allay chronic vomiting, and relieve gastrodynia, while it
occasionally displays curative powers in epilepsy and chorea.
It is hardly necessary to argue that the virtues of the salt de-
pend upon the operation of the law of similars.
But homoeopathy requires more precision than this; and we
must look closer at both the irritant and the neurotic pheno-
mena. As regards the former,-locally the nitrate may, of
course, inflame and even ulcerate the whole alimentary canal.
There is no evidence, however, of its elective affinity for any
other parts of the tract than the mouth and throat, and the
duodenum, which last was found inflamed in Orfila's dogs
when the salt was injected into the veins. In provers the
throat looks dark red, and feels dry, and as if a splinter or
ulcer were there; the tongue is sore, and the papillæ elevated.
Tender and easily bleeding (but neither painful nor swollen)
gums have been observed in patients under its influence,
and in dogs treated by Krahmer like Orfila's. Other mucous
membranes feel its influence, especially that of the eye. Dr.
Müller himself had, from the second decimal trituration, a
ARGENTUM NITRICUM.
223
sharp attack of conjunctivitis, most severe in the canthi and
carunculæ ; there was even an approach to chemosis. Symp-
toms of urethritis were experienced by the same prover: the
canal was swollen, hard, and knotty to the touch, and the right
testicle was enlarged and hard.
Then as to the nervous centres and nerves. "Both convul-
sions and paralysis are present," writes Dr. H. C. Wood, “in
argyria, or silver-poisoning." The convulsions he describes
as reflex, excited by the least peripheral irritation; and as
persisting after the complete abolition of voluntary movements.
"Portal," says Stillé, "relates a case in which the exciting
cause of epilepsy appeared to be a poisonous dose of lunar
caustic." The paralysis is general, and is especially seen in
the pulmonary branches of the vagi-death ensuing from
asphyxia, with the same condition of the lungs as when their
nerves are divided. In the provers the neurotic effect of the
drug was manifest in headache deep in the substance of the
brain, with low spirits; vertigo; want of mental power; rest-
less, dreamful sleep; weakness of the spine, with pain at the
small of the back; and very marked debility of the lower
extremities, almost approaching to paraplegia. In Dr. Müller
this last was accompanied with emaciation of the legs.
Krahmer developed in himself a long-lasting (left) infra-
orbital neuralgia; but as this succeeded to much gastric weak-
ness and heartburn, it was probably sympathetic only.
*
But we have not yet exhausted the pathogenetic power of
nitrate of silver. Dr. Bogolowsky, of Moscow, has recently
experimented with it largely in rabbits, to ascertain its deeper
and more chronic effects. From these it appears that the
salt has a direct and primary influence on the red corpuscles
of the blood, causing their colouring matter to escape into the
plasma, and so leading at first to ecchymosis and effusions,
and later to interference with oxidation and ultimate chlorosis.
As a result of the deficient nutrition (so he thinks) there occurs.
catarrh of the mucous membranes generally, and degeneration
-rather of a granular than a fatty kind-of the renal and
hepatic cells, and of the muscles, including the heart. There
is also found a universal venous blood-stasis.
The therapeutic virtues of Argentum nitricum may be
ranged in the same three categories.
1. Its previous repute in affections of the stomach seems
well sustained in the present day, and some of it is echoed
from the homœopathic ranks. In chronic inflammatory states
of the organ its action must be local, and crude doses are
* See Virchow's Archiv, vi., 4, 1869; and Practitioner, iii., 65.
224
ARGENTUM NITRICUM.
required. Its virtues in the round ulcer of the stomach are,
as I shall show, no exception to this statement. But the marked
gastric sufferings of the provers seem to show that the drug
affects the nervous supply of the viscus, and may-in doses too
small for local effect-modify its functional derangements. The
same thing appears from the fact that many therapeutists
ascribe no less virtue to the oxide of silver than to the nitrate.
Dr. Bayes speaks highly of its power over what he calls "irrita-
tive flatulent cardialgia," where the wind comes away easily,
rushing upwards through the mouth.* Dr. Holland communi-
cates two excellent cases of cure by it of chronic dyspepsia dis-
ordering the heart's action. This was a condition strikingly
developed in Krahmer's provings. His chief trouble was
heartburn; and the excess of acid on which this symptom
usually depends was the prominent feature of two cases of
gastrodynia recorded by Mr. Harmar Smith as cured by the
nitrate.‡
The virtues ascribed by many writers to nitrate of silver
as a remedy in chronic diarrhoea-as that of phthisis-must
be referred to homoeopathy, as all admit that in full doses the
salt purges. But the action is probably, here as in the
stomach, local only, and substantial though moderate doses
are required. There is, however, a form of diarrhoea occur-
ring in young children, in which the motions are green, like
spinach in flakes; and in this Dr. Lippe finds the higher
infinitesimals perfectly efficacious.
The specific irritant influence on the conjunctiva which Dr.
Müller's experiments revealed led Dr. Dudgeon (in 1848) to
argue that its local application, as practised in the old school,
acted after a true specific manner, pointing out that, owing
to the chemical and mechanical action of the lachrymal
secretion upon it, the action of the caustic upon the eye is
but momentary, and its quantity infinitesimal.§
I myself
have been SO satisfied with even its internal effects in
ophthalmia neonatorum, that I have never had to resort
to any external measures beyond those needed for clean-
liness. The experience of our American oculists is quite
confirmatory of its power over such purulent inflammations
of the conjunctiva. Dr. Angell commends the remedy
“in affections of the lining membrane of the lids, and of the
lachrymal duct and sac, when there is an abundant discharge of
* Brit. Fourn. of Hom., xxx., 143.
† Ibid, xxxii., 85.
1 Ibid, xxv., 504.
§ Brit. Journ. of Hom., vi., 216.
W
ARGENTUM NITRICUM.
225
""
pus; and Drs. Allen and Norton write:-" The greatest
service that Argentum nitricum performs is in purulent ophthal-
mia. With large experience in both hospital and private
practice, we have not lost a single eye from this disease, and
every one has been treated with internal remedies, most of
them with Argentum nitricum of a high potency, 30th or 200th.
We have witnessed the most intense chemosis with strangulated
vessels, most profuse purulent discharge, even the cornea
beginning to get hazy and looking as though it would slough,
subside rapidly under Argentum nitricum internally."
It is possible that there may be other mucous tracts to
whose inflammations nitrate of silver is ordinarily applied
locally, but where it acts by elective affinity. Such is certainly
the throat, whose appearance and sensibilities in the provers
are very like those of the follicular pharyngitis in which it is
so much used, and probably the larynx, in whose chronic
(even tubercular) affections Dr. Meyhoffer praises the drug
given internally as well as by spray. Dr. Guernsey takes the
same view of ulceration of the cervix uteri, in which he often
gives the 200th dilution with marked results.
2. The anti-epileptic virtues of this salt have yet to be
defined. They are undoubted, though only occasionally seen.
Nor are large doses always required. A case of forty years'
standing is cited by Hempel, in which the cure was effected
by swallowing a silver coin which was ejected twenty months
later but little diminished in size. The only contribution
from the homoeopathic school is that of Dr. Gray, of New
York, who asserts that epilepsies originating in the brain may
be promptly and durably cured by a few small doses, while
those proceeding from abdominal irritation can be barely
palliated by large quantities. In the paralytic sphere, con-
siderable interest attaches to the medicine on account of its
having been strongly recommended of late in locomotor
ataxy. Some cases by Wunderlich and others have been
published (you may read them in the twenty-first volume of
the British Journal of Homeopathy), in which there appears no
doubt of the nature of the disease, nor of its cure or great
mitigation by the use of the nitrate of silver.* Trousseau,
however, states that he has been disappointed in it. Dr.
Bazire gave it in six cases: a very marked improvement took
place in one, and a less marked one in another, but no appre-
ciable result in other instances. Topinard, also, found an
entire failure in twelve cases out of seventeen; and in three
only of the remaining five was the improvement decided.
See also Ludlam's translation of Joussett's Clinical Lectures, p. 420.
Q
226
ARGENTUM NITRICUM.
Friedreich's experience is still more negative. It is certain,
therefore, that nitrate of silver is no specific remedy against
locomotor ataxy as such; nor is it homœopathic thereto, as
the proving points to a true paralysis of the legs as the effect
of the drug, rather than a disorder of movements with reten-
tion of energy. In simple paraplegia from exhaustion I have
more than once found it of signal service; and it has cured
this condition when resulting from concussion or alcoholic
excess, and also hysterical and diphtheritic paralysis. In dull
chronic headaches of literary and business men Argentum
nitricum is much commended. Dr. Guernsey indicates it in
giddiness on the least mental or bodily exertion, and when
time seems very long to the patient. Dr. Seip, of Alleghany,
has recorded several interesting cures by the drug of hypochon-
driasis in men, traceable to alcoholism or venery;* and Dr.
Woodyatt, of Chicago, speaks highly of it in paralytic weak-
ness of the ciliary muscle, causing imperfect accommodation
of vision.†
C
* See Brit. Fourn. of Hom., xxxiv., 347.
† Ibid, xxxii., 739; Monthly Hom. Review, xxii., 143.
BA
""
3. But a no less interesting and important sphere of our
medicine is that in which its influence on the blood and on
nutrition is brought to bear. Not long before Dr. Bogolowsky
published his results, Dr. von Grauvogl's Lehrbuch der Homö-
pathie had appeared in Germany. This able work is, by the
labours of Dr. Shipman, of Chicago, accessible to us in an
English dress. The author-now (alas!) taken from us-
considers that there are three principal" morbid constitutions ;'
that one of these is the carbo-nitrogenous, in which the oxida-
tion of the blood is obstructed, giving rise to accumulation of
carbon and nitrogen in excess; and that the chief remedy for
this condition is nitrate of silver. Whatever may be thought
of his pathological theory, the cases he gives amply bear out
his commendation of the remedy; and the experiments of Dr.
Bogolowsky supply the missing link by demonstrating its
homœopathicity. We have thus another true simile for
chlorosis and defective oxidation of the system; and from
what I have myself seen I believe that the medicine will fully
answer expectation in this direction. Shortness of breath
(without lung or heart affection), as observed by Dr.
Grauvogl, and sallowness rather than pallor of complexion,
have proved my special indications for it. It is here that Í
will speak of the action of the drug in gastric ulcer, in which
several of us think it almost specific. It is now well-known
that this lesion is not of inflammatory nature, but a local
ARGENTUM NITRICUM.
227
innutrition; and that the patients most liable to it are young
women who are the subjects of chlorosis. Upon this point I
would refer you to some excellent remarks by Dr. Cooper, in
connection with a case of the kind cured by our medi-
cine reported in the thirty-fourth volume of the British
Journal of Homœopathy (p. 485). He would, I think, quite
concur with me that Argentum nitricum is appropriate to
gastric ulcer just when it supervenes upon general chlorosis.
Argentum nitricum has obvious points of analogy with
Arsenic and Mercury; with Phosphorus; and with Hydrocy-
anic and (as I have pointed out) Picric acid.
The
The potencies from the third decimal to the third centesimal
have been those chiefly employed; but von Grauvogl gave
several drops of the first for a dose.
¡
LECTURE XV.
ARNICA-ARSENIC.
Our attention is first to be directed to-day to the "leopard's
bane,"
Arnica montana.
The tincture of the British Homœopathic Pharmacopoeia is
directed to be made either from the entire fresh plant, or from
the dried flowers. Dr. Hering has recently shown good
reason why the root, and this only, should be employed for
the purpose. It seems that an insect is in the habit of de-
positing its eggs in the flowers, and that these have a pecu-
liarly irritant effect on the skin; so that some at least of the
disagreeable effects occasionally produced by its use are to
be thus explained, and may be avoided by the exclusive
selection of the root for pharmaceutic purposes.
Arnica has been well proved. Hahnemann supplies a
pathogenesis of it in the first volume of the Reine Arzneimit-
tellehre, to which nine persons besides himself have contributed.
It contains (in the third edition) 638 symptoms, of which 47
are taken from authors, and are chiefly collateral or excessive
effects of the drug when given to patients. Then we have the
provings of Jörg and thirteen of his pupils, which were made
sometimes with an infusion of the flowers, sometimes with the
tincture of the root. Last come the experiments of Schneller
and other members of the Vienna Proving Society, of which
an account is given in the sixth volume of the British Journal
of Homœopathy. Dr. Allen unites the symptoms from all these
sources with many of its idiosyncratic effects upon patients in
his Encyclopædia. A valuable study of Arnica, by Dr. Imbert-
Gourbeyre, may be read in the forty-fourth volume of L'Art
Médical.
Of the physiological effects elicited in these provings I shall
best speak as I discuss the therapeutical powers of the drug.
Of these let us take first the best known,-its remedial action
in mechanical injuries.
ARNICA MONTANA.
229
1. This property of Arnica has come to be (in our own
But the
country at least) associated with homoeopathy.
method of Hahnemann cannot take credit for its discovery.
He himself tells us, in the preface to his proving, that it had
become known to the "common man," and the plant named
"Fallkraut" accordingly; and that two hundred years before
his time, a physician (Fehr) communicated this discovery of
domestic practice to the profession, who then named the herb
panacea lapsorum. The only credit homoeopathy can claim in
connection with Arnica is that she has kept the tradition
alive. Satisfied with Hahnemann's inference from his provings,
that "all the symptoms attending violent contusions and tear-
ing of the fibres are analogically produced by Arnica in the
healthy organism," and with the fact noticed by the older
observers that the pains of such injuries were always at first
aggravated by the full doses given, she has adopted the
popular remedy into her list of similars. With her adherents
to this day Arnica is to an injury what Aconite is to a chill;
and the most gratifying results are continually being obtained
from it. In contrast, it may be mentioned that Ringer and
Horatio Wood (in his first edition) omit Arnica altogether;
while Dr. Phillips “considers it a great pity that it has not
(1874) come into more general use" in this direction.
I have said that Arnica is to an injury what Aconite is to a
chill that is, it will almost infallibly obviate the ill-effects, if
given before organic mischief has been set up. It becomes
thus the great remedy to be administered in all cases of
concussion, sprain, or other suffering from violence. It
removes, as Hahnemann says, "the pernicious consequences
which often attend falls, contusions, blows, thrusts, straining,
twisting or tearing the solid parts of our organism." But,
unlike Aconite, it will follow up the cause to many of the
changes it effects, even when of long standing and profound
character. Such are those instanced by Dr. Bayes in his
interesting article on the drug, viz. the chronic muscular
stiffness-called rheumatism-of old labourers,* and the
cardiac hypertrophy of boating men. Mr. Nankivell has
illustrated the same thing by some of the thoracic affections
of the Cornish miners.†
The tissue affected in all these instances is the muscular;
and upon this Arnica specially acts. It is above all things a
myotic. I learn, from Dr. Imbert-Gourbeyre, that the great
organopathist, Rademacher, makes a similar observa-
* See also New York State Hom. Society's Transactions, viii., 473.
† Brit. Fourn. of Hom., xxiii., 177.
230
ARNICA MONTANA.
tion. It thus becomes the main remedy for those numerous
affections which Dr. Inman has so well described under the
term myalgia. Over-exertion of healthy muscles, or the
normal use of weak muscles, will bring on these pains; and
Arnica will almost infallibly relieve them. As their occur-
rence is very common, it is a medicine in daily use. I need
only specify two of them. One is the form of pleurodynia
known as spurious pleurisy. This may readily be induced by
over-exertion, as in the following case reported by Dr. Inman.
"A party of gentlemen on a severe pedestrian excursion were
all tired on the first day, and that was all; on the second day
some began to have frequent stitches in the side, could not
sleep on the side, but only on the back; on the third day the
pains in the side were terribly increased, with so much tender-
ness that they could not bear the weight of the clothes." In
this not uncommon form of pleurodynia-the "rheumatic
pleurisy" of the old writers-Arnica gives rapid relief. It
must be distinguished from the muscular rheumatism so
called, which yields much more satisfactorily to Bryonia or
Actæa racemosa. Another myalgia which I would specify is
one of the forms of pain after food. The pain comes on im-
mediately, even during the act of swallowing;* the patients
are weak and of lax fibre; and they often have or have had
myalgia elsewhere. Here too Arnica is an admirable remedy.
In this connexion I would recommend the perusal of an
excellent paper by Dr. Madden on "Myalgia," in the twenty-
fifth volume of the British Journal of Homœopathy. He, too,
places Arnica first among the anti-myalgics; and agrees with
Dr. Bayes in finding heart affections consequent on over
exertion amenable to its use. I may also mention that Dr.
von Grauvogl praised it highly for the "clergyman's sore
throat," or any other induced by loud speaking; and that
I myself have cured with it a chronic tenesmus of the bladder
produced by frequent long retentions necessitated by the
patient's business. Drs. Small and Hoyne have obtained
great relief from it in the passage of urinary calculi or
gravel. It is, moreover, serviceable against simple muscular
debility, such as shows itself in prolapsus and in involuntary
evacuations. It ought to be useful in asthenopia, from over-
exertion of the eyes.
But, though Arnica affects the muscles chiefly, we must not
limit its influence to these. It will check the hemorrhages of
mechanical violence; quiet the nervous startings of a fractured
limb; and obviate the danger of re-action in concussion of
* See Hoyne, i., 200.
ARNICA MONTANA.
231
the brain and sudden apoplectic extravasation. It seems,
moreover, to cover the whole remote effects of an injury. Give
it to one whose frame cannot forget the shock of a far-back
railway accident; and you and he will be alike delighted with
the effect.
In external injuries Arnica may be used locally as well as
inwardly; and will give speedy relief to pain, while promoting
the restoration of the bruised part to its normal condition.
Any one who has tried it when his finger has been jammed in
a door will bear witness to the statement.* How it effects
this is a difficult question. Dr. Garrod has shown that it has
no "absorbent" power over mere sanguineous effusion, such
as dry-cupping can produce. Violence seems always needed
to call forth its remedial powers; but then they are indubit-
able.
In old times, the use of Arnica in injuries was extended to
the suppurations and hectic therefrom resulting. Stoll declared
it most effective in such conditions, and Dr. von Grauvogl-
who was an army-surgeon-has revived its use and reputa-
tion. Let me read you what he says of it :—
"The results of Arnica provings on the healthy offer an array of
symptoms so similar to traumatic fever and septicæmia by purulent
infection, that hardly a better description of these states is to be found
in works on surgery and obstetrics, and where there is traumatic fever
there must have been previously, or still present, wounds; consequently
Arnica is indicated according to the law of similars in wounds, and not
only in their consequences, and in this respect it is an old renowned
homœopathic remedy. Traumatic fever runs its course at first without
any rise of temperature, which cannot therefore be accepted as the in-
variable sign of fever. It begins at once after every considerable
mechanical inquiry, with which the whole habitus of the wounded per-
son is shaken and often altered, so as to be unrecognisable. This
condition improves manifestly under the use of Arnica, as also all signs
of actual absorption of the decomposing elements of the secretions from
the wound. Of all the ordinary mechanical injuries, compound frac-
tures give the most profuse suppuration, and the attendant lacerations
of the soft parts, that are often very extensive, like large operation
wounds, predispose to the occurrence of pyæmic, or septicæmic fever.
We do not always see these cases at the commencement, in the country
generally not till after the lapse of several days, after the country doctor
has done his best, and then we meet with most extensive suppurations.
If here we give Arnica 30 x, four to five drops every hour, and apply
compresses moistened with the same dilution, the patient feels a
considerable alleviation of his pains in two, or at most four or five,
hours, and the following day the suppuration is manifestly diminished.
It decreases daily, and after a few days is reduced to a small quantity,
during which time the wounds become cleaner. Things go on much
more rapidly if we give every hour four to five drops of the 1 x dil., and
* See Brit. Fourn. of Hom., xviii., 132.
232
ARNICA MONTANA.
the same as a compress. On the following day, at latest in twenty-
four hours, the suppuration is, as a rule, reduced almost to nothing, and
the most favourable condition in every respect established. In the
military hospitals I directed the attention of the surgeons to the efficacy
of this treatment, and showed them that this favourable effect would at
once disappear, and a large quantity of pus be found on the bandages,
on leaving off the Arnica. This happened constantly, so that the very
next day the former quantity of pus was there, and the wounds of the
soft parts gaped again, after they had nearly closed, so that I could
not withhold any longer the employment of Arnica internally or ex-
ternally.
-
"The renewed employment of this medicine had the same effect as
before, and the cure took place in the shortest space of time, and to the
astonishment of the allopathic lookers on, without further suppuration,
granulation, or retraction of the edges of the wound, therefore quite
differently to what they had hitherto been taught and had observed. I
had ample opportunity of seeing the same thing done during the French
war, but I found no imitators. The effect of Arnica in all sorts of
wounds consists in this, that not only does the exudation of white cor-
puscles and the mortification of the injured parts, and consequently all
suppuration, cease, but that the intercellular fluid dries up by contin-
ually parting with water to the blood-vessels and lymphatics; that in
consequence of this, the inflammatory swelling of the wound generally
declines after a few hours; therefore all the wounded part consolidates,
and the edges, when they can be brought together, agglutinate very
rapidly, or when that is not the case, spontaneously approach ever
nearer to union, whilst the loss of substance is supplied without suppu-
ration or rank granulations. For these reasons the primary inflamma-
tion cannot extend, and where there is no inflammation there is no
fever; further, when there is no water there is no pus, no absorption of
injurious substances; thus diphtheria and septicemia cannot occur.
The relapse on leaving off the Arnica, especially externally, causes
erythema, with formation of vesicles; internally, in fractures of the
bones, it causes a soft and scanty callus. It is doubtful if Lister's
vaunted carbolic-acid method can show such favourable results as the
Arnica treatment.
""
2. The next most familiar action of Arnica is that which it
exerts on the skin. There is first an eruption, which in some
susceptible persons results from its external application. The
very scent of it is sometimes enough; and I have known the
eruption follow the internal use of the first dilution, while Dr.
Dyce Brown has seen it result from still more attenuated
doses.* It consists of a number of very fine vesicles on an
erythematous base, with much heat, pricking, and itching.
Dr. Phillips thinks that an aqueous infusion of the plant, by
excluding the arnicine and etherial oil (which are insoluble in
water), is preferable to a lotion made from the tincture for
external application, as being non-irritating.
The precise Arnica-erysipelas is rarely met with as an idio-
pathic affection, and hence the drug is little used in this com-
* Monthly Hom. Review, xxii., 171.
ARNICA MONTANA.
233
says that
plaint. Dr. Cooper thinks it unjustly neglected, and
he gets more decisive results from it than from any other
remedy. Hahnemann points out the resemblance of ano-
ther of its cutaneous effects to a boil; and recommends it
Dr. Müller
as preventive and curative in that complaint.
found compresses of a drop of the tincture to an ounce of
water very effectual to resolve these troubles. Teste cured
with it an angina which seemed to result from the retrocession
of boils, and von Grauvogl states that repeated doses will often
abort a carbuncle.
3. Less known is the action of Arnica on the nervous tissue.
It is reputed in Germany as a stimulant to the brain and
spinal cord; and seems to have cured in Collin's hands* many
cases of amaurosis and paralysis. Improvement was generally
preceded by peculiar sensations in the affected parts, as
tingling and electric shocks. The provers suffered from con-
gestive vertigo and headache; and from pains down the spine.
In one, the lower dorsal vertebræ became very sensitive, and
pressure on the last caused radiating pains and sense of oppres-
sion of the chest. Van der Kolk (according to Phillips) found
Arnica "invaluable in that condition of idiopathic mania
where, the first excitement having diminished, the head never-
theless remains hot, and where a tendency to imbecility or
to paralysis is shown." Hahnemann cured a chronic vertigo
with it; it was known of old by the name of "Schwindel-
kraut."
4. Arnica causes, according to both Jörg and Hahnemann,
violent urging to stool, with scanty and natural fæces, as if
the muscular coat only of the bowel was excited. This sug-
gests the homoeopathicity of its action in dysentery, for which
it has long been in repute-Stoll calling it a specific anti-
dysenteric. Hahnemann recommended it here himself; but
it had almost dropped out of use until it was revived in
America by a curious accident, and has been highly esteemed
there since.† Tormina and tenesmus would especially call
for it. It acts similarly on the stomach, causing contractive
pain, flatulent distension, and hiccough.
Arnica has yet some minor actions, which may be briefly
* Obs. circa morbos, iv. and v.
† See Philad. Fourn. of Hom., ii., 94, 179.
S. 261 of Hahnemann's pathogenesis ("purulent and bloody stool "')
must not be regarded as proving the homeopathicity of Arnica to
dysentery. It occurred in a child to whom Arnica was being given for
a fall from a height. The reporter regarded it as a sign of internal
contusion or extravasation.
234
ARNICA MONTANA.
}
mentioned. It causes two other marked gastric sensations,-
a sense of repletion, and a feeling of canine hunger with
(nevertheless) no appetite for food; also eructations, smelling
as of rotten eggs. It is recommended in whooping-cough,
when children begin to cry as soon as they feel the cough
coming on. It causes several kinds of hæmorrhage (especially
epistaxis), and often finds place in the homœopathic treatment
of this accident. It plays some part in the therapeutics of
intermittents; it was known of old as "le quinquina des
pauvres," and is often useful when that drug has been abused.*
It probably has some direct action upon the heart. Dr.
H. N. Martin recommends it in angina pectoris, and Dr.
Liedbeck confirmed in his own person Kafka's recommenda-
tion of it for the dyspnoea accompanying fatty states of that
organ. Dr. Guernsey considers it as truly indicated when
the patient feels " as if bruised," as when there has been actual
mechanical violence. He also specifies heat of head with cool-
ness of the rest of the body as a keynote for it, and recom-
mends it when pregnant women feel pain from the movements
of the child, in the varices which form in their vulvæ or vaginæ,
and in simple cases of painful nipples. I need hardly say
that he, in common with every homeopathic accoucheur,
invariably gives it immediately after childbirth, and testifies to
the good effects of so doing.
A sensitiveness of the body to pressure, so that everything
on which the patient lies seems too hard, is another recognised
symptomatic indication for Arnica. This feature is often met
with in low fevers, and the medicine was not without repute in
such disorders among the older homoeopathists. A tendency
to hæmorrhage is regarded as indicating it here.
Besides ordinary vertigo, Arnica has been suggested by Dr.
Ravel as suitable for that associated with disorder in the semi-
circular canals of the ear; ‡ and Dr. Brown has recorded a case
of the kind in which it was curative, being indicated by the
apparent origin of the symptoms in a fall.§ I have myself had
a similar case, in which I was led to try it by the circumstance
of the patient having had several falls in the hunting-field.
In its antidotal power against mechanical violence Arnica
is almost unique, finding only a point of contact here and
there with Rhus and Hypericum. In its action on the muscles
Bryonia and Actua resemble it somewhat; as a cutaneous
irritant it is allied again to Rhus, and to Croton.
See Brit. Fourn. of Hom., xxxiv., 719. † Ibid, p. 738.
L'Art Médical, xliv., 282.
§ Monthly Hom. Review, xxii., 595.
ARSENICUM.
235
-
In all recent affections Arnica may be given in small or
fractional doses of the mother tincture. But I must agree
with Dr. Bayes, that if we desire to get good from it in the
remote effects of injury, we must ascend to the region of
infinitesimals.
We have now to gird up our loins, and summon all our
strength, that we may master the greatest of medicines,
because the greatest of poisons,
Arsenicum.
By this name a homœopathist means arsenious acid, the
Arsenicum album of the old nomenclature. The British
Homœopathic Pharmacopoeia follows Hahnemann's original
directions, and directs the primary (first centesimal) solution
to be prepared by boiling. I incline, however, to think that
its compilers would have done better to have gone on with
him to his later practice, and to have ordered triturations to
be made. Either form can be obtained of the homœopathic
chemists.
The homoeopathic literature of Arsenic is very extensive,
and abounds in both original and collected material. Hahne-
mann published a proving of it in the second volume of the
Materia Medica Pura, and subsequently another in the second.
edition of the Chronic Diseases. The former, in its latest.
shape (1833), consists of 1079 symptoms, of which 697 are
from Hahnemann himself and seven fellow-observers, and 382
are cited from authors. Many of these last belong to records
of poisoning with arsenious acid itself, or with other prepara-
tions of the drug-as orpiment, realgar, and cobalt. But a
good many are vitiated by having been observed in sufferers
from intermittents treated by the drug, where it is very diffi-
cult to decide how much is ague and how much Arsenic.
The pathogenesis in the Chronic Diseases (1839) contains 202
additional symptoms, of which 79 are from a case of poison-
ing involving a whole family (Kaiser's), and the rest from
observations made on patients taking globules of the 30th by
Hahnemann himself and by Hering. Several studies and
supplementings of Hahnemann's pathogenesis of Arsenic
have been made. Dr. Wurmb has contributed one of the
former, which may be read in English in the third and fourth
volumes of the British Journal of Homeopathy. Dr. Black
has given us a most valuable arrangement of the drug in the
first part of the Hahnemann Materia Medica, where its
236
ARSENICUM.
*
symptomatology is revised and augmented, and illustrated
by clinical comments. Dr. Roth has criticised Hahnemann's
toxicological material, and has incorporated what he considers
trustworthy in it with all that has since appeared in a schema
of the drug which contains 1056 symptoms. The matter
from all these sources, with a more complete revision and
illumination of Hahnemann's cited symptoms, is embodied in
the article on Arsenic in Allen's Encyclopædia, where the list
has swelled to 2872. Dr. Berridge has furnished a series of
cases of poisoning by it as an appendix to the British Journal
for 1875 and onwards to the present time. But, next to
Hahnemann himself, the most eminent and fruitful worker in
the field of arsenical action has been Dr. Imbert-Gourbeyre,
professor in the medical school of Clermont-Ferrand. His
numerous writings on the subject-appearing during the last
twenty years in the Gazette Médicale de Paris, the Moniteur
des Hôpitaux, L'Art Médical, and other journals-I shall cite
as I come to the several points of which they treat.
In considering how I should best present this abundant
material to your notice, the history of Arsenic as a medicine
seems to suggest the most instructive way. We find it to have
been used of old, in China for ague, in India for chronic
cutaneous diseases; while at the present day it is chiefly
esteemed as a "nerve-tonic" in such disorders as neuralgia
and chorea. Now ague is a fever; chronic skin affections are
inflammations; and neuralgia and chorea are neuroses. It
has appeared best to me that I should discuss the action of
Arsenic in reference to these three types of disease, bringing
its pathogenetic effects before you in connection with its
curative virtues. I think that from this clinical point of view
we shall get a better idea of the great medicine before us than
if we attempted to draw a detailed sketch of its physiological
action, and then studied its therapeutic powers in correspond-
ing categories.
But, before we pass to such considerations, I must bring
before you certain general characters of the action of Arsenic
which belong to it more or less in every sphere of its activity,
and are of great importance as indications for its choice. I do
not say that their presence is indispensable, nor that, when it
obtains, it absolutely determines the prescription of the
remedy. But I do claim for them a prerogative rank among
the features which lead us to its use, and they may sometimes
weigh so heavily as alone to turn the scale in its favour. They
are seven in number.
* See Brit. Fourn. of Hom., xx.
ARSENICUM.
237
1. The first is periodicity. Arsenic is—as we shall see-one
of the few medicines capable of inducing a true recurrent
fever; and remissions, intermissions, and more or less regular
returns of the symptoms are noted by all observers of its
poisonous action, and are manifest in its provings. Periodic
recurrence is thus a true feature of its pathogenetic influence,
and experience has shown the same character to belong to its
therapeutic activity. It is not merely that such a phenomenon.
suggests the influence of malaria, and so guides to the drug as
one of the antidotes for that poison. It is very true that it
constitutes one element in the homoeopathicity of Arsenic to
malarious affections;* but even in the absence of all such
influence it both manifests itself, and cæteris paribus calls for
Arsenic. "In typical diseases of all kinds," wrote Hahne-
mann in 1796, "the type-exciting property of Arsenic in small
doses becomes valuable."
2. The second is adynamia. Christison long ago pointed
out that there were a set of cases of arsenical poisoning in
which there was little sign of irritation in any part of the
alimentary canal, but the patient was chiefly or solely affected
with excessive prostration of strength and frequent fainting,
death being seldom delayed beyond the fifth or sixth hour.
This effect of the drug is doubtless traceable in part to the
paralysing influence it has been found to exert upon the heart.
But it seems something more than this; and it characterises
(as Wurmb has shown) a great many of the symptoms ob-
served by the provers. It has become a well-established
indication for the remedy in practice, finding its analogue in
the intense prostration characteristic of certain diseases—as
influenza, diphtheria, &c.—which is in many cases quite out
of proportion to the substantive disorder which accompanies
it."Great exhaustion after the slightest exertion" is the
symptomatic way of describing it. We shall have numerous
instances of its practical value.
3. The third is malignity. This is a feature of disease more
easy to recognise than to describe. I do not mean by it so
much that fatal onward march of a malady which Dr. Frédault
denotes by the name, that "grave state in which there are no
* "Dr. A. T. Thomson states that the action of Arsenic is liable to
exacerbations and remissions, and sometimes even intermissions.
Thus we may suppose that there is a certain degree of analogy
between its operation and that of the malarious poison, by virtue of
which it may perhaps exert a corrective power over the working of the
latter in the blood" (Headland On the Action of Medicines in the
System, p. 224).
238
ARSENICUM.
gleams of true amendment, no crises which give a respite, no
signs of relief which encourage hope, and where there is an
utter lack of amenability to treatment."* I mean rather that con-
dition which may appear in any acute disease—as scarlatina or
diphtheria—and which leads us to name them "malignant,” a
condition especially shown by darkened colour of the blood
and foetor of its excretions and exudates, with corresponding
prostration and disorder of the nervous system. In all fevers,
exanthemata, and inflammations where this tendency to
putrescence and decomposition shows itself, Arsenic is one of
the first remedies of which we think and on which we depend.
4. The next is restlessness and anguish-a feature constantly
noted in the subjects of arsenical poisoning, and seldom absent
from any acute morbid condition, not purely local, to which it
is otherwise appropriate. It is something like that which I
have described as the characteristic of Aconite, but more
intense. I have advisedly used the term "anguish" to
designate it, rather than "anxietas " as with the other medicine.
Either, of course, is employed in its physical sense,-not in
that of the emotional disturbance which by analogy has been
similarly named; and there is a difference, slight but real,
between them. I can hardly put it into words, but you will
feel what is anguish in a patient's condition, and what is
anxietas.
5. The foregoing are characters belonging to the symptoms
of Arsenic generally. I have now to speak of certain charac-
teristics of its pains. The first of these is that they are most
frequently burning. This has been accounted for by the
circumstance that it is mucous membrane chiefly which is
affected by the drug, and that the pain of inflammation of this
tissue is always more or less of a burning kind, as that of
serous membrane is cutting. But such an explanation is quite
insufficient, for there are other pains indicating Arsenic-
notably its neuralgia—which have this same feature, but which
certainly do not belong to mucous membrane. Burning pain
as such, accordingly, is characteristic of Arsenic. There is one
caution, however, to be given, and that is that you do not class
under this heading such disagreeable sensations of heat as are
caused by acrid fluids, as the bile and the products of gastric
fermentation. Patients annoyed by the presence of these
irritants will complain of burning sensations, but you must
not therefore think of Arsenic for them.
K
6. Another feature of the arsenical pains is that they are worse
at rest, and therefore at night, and are increased by cold, being
L'Art Medical, Dec., 1876.
ARSENICUM.
239
of course, conversely, relieved by warmth, and diminishing
during exercise. Teste considers these characters of pains to
indicate that the drug to which they belong is of a depressing
kind, and believes that the action of all such medicines is
more marked on the left (as being the weaker) side of the body.
How this may be with Arsenic, I cannot say; but I am sure that
the aggravation of its pains-especially its neuralgia-during
the rest of night and by cold air impinging on the surface is
very distinctive of it.
7. The last characteristic of which I have to speak belongs
to the thirst of Arsenic. This is an early and marked symp-
tom of its action on the healthy body, and is always present
in febrile states to which it is suitable. But it has been added
that the Arsenic patient, unlike the one whose condition calls
for Aconite, "drinks little but often." This statement is
founded, pathogenetically, on observations obtained from
Stapf and Wahle in Hahnemann's proving of Arsenic. It is
also cited as from Richard; but in this author's brief narrative
of a case of poisoning to which reference is made I can find
no trace of it. Nor does it appear in any of the numerous
toxicological records on which Dr. Allen has drawn; and in
his Encyclopædia the next symptom but two after the "drinks
much, but little at a time" of Stapf and Wahle is-"thirst so
violent that he drank eleven jugs of water in half a day."
This is from a poisoning case. Therapeutically, I find that
the symptom in question has been used as an indica-
tion for Arsenic in fevers, and with good results; but
there is no evidence that its absence, or the presence of thirst
for large quantities, contra-indicates the remedy. Desire to
drink, but inability from the irritable state of the stomach to
take more than a small quantity at a time, is a frequent
symptom of gastritis, and so might truly call for Arsenic
when present; while in inflammations occurring elsewhere,
and in general fevers, the thirst may be as insatiable as
possible without forbidding its employment.
I have now gone through the leading general indications for
our medicine. Let me repeat my caveat that all such characters
are to be taken as suggestive, not as decisive, of the choice of
the remedy. Undoubtedly, the more of them that are present,
and the sharper their definition (so to speak), the keener will
be the action of the drug in removing the morbid state which
they characterise, and the more minute may be its dosage.
But there may be many a diseased condition in which they are
entirely absent, and to which Arsenic is yet thoroughly
homeopathic and curative. Never make such a misuse of
240
ARSENICUM.
them as that which we shall see in the case of cholera, where
the want of minute symptomatic similarity (among other
points, in that very "drinking little but often" whose small
value I have shown above) was made a ground* for denying
to Arsenic a place in the therapeutics of this disease, which it
so truly causes, and which it has so often arrested.
I. We now pass to the special actions of Arsenic; and
shall begin, as I said, by considering it as an anti-pyretic.
In this capacity it appears as a leading remedy for the types
of fever known as malarious, hectic, and typhous, and also for
cholera.
The use of Arsenic as a remedy for the intermittent and
other fevers arising from malaria is of very ancient date in China
and India. In Europe its employment was for a long time.
popular only, and it was not until the middle of the last
century that physicians (among whom our English Fowler
was prominent) took it up. Once again, however, as Stillé
says, "Arsenic fell into disuse, and was for a long time quite
neglected," until, in 1842, Boudin published a work which (in
the words of the same writer) "demonstrated its efficacy in
periodical fevers, and vigorously advocated its use, giving the
first impulse to those numerous researches into the action and
uses of the mineral which have since appeared."
Who was this Boudin, and how was he led to revive the for-
gotten employment of Arsenic in malarious fevers? The
answer supplies a curious and interesting chapter in medical
history. It is given by Dr. Chargé, of Marseilles, in a com-
munication made by him to the World's Convention of 1876.†
Boudin was, in 1840, in chief medical charge of the great mili-
tary hospital in that city. He one day lamented to Dr. Chargé,
with whom he was well acquainted, his want of success in the
intermittents of the soldiers returned from African service,
with whom at that time his wards were crowded. Our
colleague took him at his word, and begged him to try Arsenic
prepared according to the homoeopathic manner. On his con-
senting to do so, he took from his pocket-case a tube
of globules of Arsenicum 30, and presented it to his friend.
Boudin took a few patients just as they came, put upon their
tongues a few globules of the medicine, and they were all
cured. It is to be regretted that this striking result did not
lead him to study and adopt the method of Hahnemann in its
entirety; but we know the obstacles which have prevented
many a man similarly situated from adventuring on such
* See Monthly Hom. Review, ix., 120.
† See Bibliothèque Homeopathique, March, 1877.
ARSENICUM.
241
perilous investigations. However, he did follow up the special
therapeutic point now made. In his Traité des fièvres inter-
mittentes he writes-" Arsenious acid, suitably prepared, pre-
serves in the almost microscopic dose of a hundredth of a grain
all its medicinal energy, not only in the treatment of marsh
fevers, but also in that of a host of other maladies. Yet
more, I have often obtained with a single dose of a hundredth
of a grain of this drug the radical disappearance of fevers con-
tracted in Algeria or Senegal, and which had till then resisted.
the most varied treatment, including sulphate of quinine and
change of climate." And what was this "suitable prepara-
tion" whereby the virtues of the drug were so preserved or
rather developed? Dr. Chargé gives the " formule de Boudin.”
"Take a centigramme of arsenious acid; add by degrees, and
in small portions at a time, a gramme of pulverised sugar of
milk. Triturate in a glass mortar for a sufficiently long time
(at least ten minutes), and divide into twenty packets, of which
each represents a demi-milligramme of arsenious acid." He
calls this a hundredth of a grain; but, as the milligramme is
about of a grain, it is rather a hundred and thirtieth. But
it is obvious that the process is Hahnemann's, and hence the
activity of the drug. Dr. Chargé well shows that the larger
doses to which Boudin subsequently resorted are explained by
the imperfect preparation the drug underwent at the hands of
the ordinary chemists of Paris, where his later practice was
carried on. While at Marseilles, his Arsenic was supplied him
from a homœopathic pharmacy.
This by the way, to show that it was from the school of
Hahnemann that Boudin received the impulse which made.
him the reviver of the use of Arsenic in malarious fevers. But
let us now enquire what relation its physiological effects bear
to the febrile condition, as such, and to the various forms it
may assume.
Dr. Imbert-Gourbeyre has examined this point in an essay
"On the febrigenic power of Arsenic,"* and demonstrates that
fever is among the most constant and characteristic effects of
the poison. It is obvious, however, that in the great majority
of the observations he cites it was symptomatic of the gastro-
enteric irritation set up, rather than a primary effect. When
thus occurring, it is of the hectic type, often having marked
evening exacerbations; sometimes chill and heat, with thirst
and headache, recur periodically, in somewhat irregular rota-
tion. This is the condition set up in chronic arsenical poison-
ing, as seen (for instance) in the victims of the Aqua Toffana
* L'Art Médical, 1865; and Brit. Fourn. of Hom., xxiv., 72.
R
M
242
ARSENICUM.
of old. Hahnemann describes the cachexia thus induced in
his usual graphic manner. "It is" he says" a gradual sink- ·
ing of the powers of life, without any violent symptoms; a
nameless feeling of illness; failure of the strength; slight
feverishness; want of sleep; lividity of the countenance, and
an aversion to food and drink and all the other enjoyments of
life. Dropsy closes the scene, often with colliquative vomit-
ing and purging.
"*
But some of the evidence adduced by our author, and other
facts elsewhere obtainable, show that Arsenic can cause fever
without local irritation. Of this kind is the observation of Dr.
v. Grauvogl, who, after some days' use of the 15th attenuation,
experienced nothing but an insatiable thirst. From the 5th
potency he felt great languor and sleeplessness in addition to
the thirst; and it was not until, some weeks after, he descended
to the 3rd decimal, that symptoms of the stomach and bowels
showed themselves. Then Hahnemann remarked (1796)†—
"I have myself ascertained that Arsenic has a great tendency
to excite that spasm in the blood-vessels and shock in the
nervous system we call the febrile rigor. If it be given in a
pretty large dose (one sixth or one fifth of a grain) to an
adult, this rigor becomes very evident." It affects the vaso-
motor nerves as we have seen that Aconite does. But the
subsequent phenomena are very different in the two drugs.
With Aconite a brief febrile reaction of synochal type occurs,
and then all ends with perspiration. But from Arsenic we
have either a repetition of the chills at intervals, or a long-
lasting fever with typhoid symptoms. Of the former Hahne-
mann speaks :-"It possesses," he says (loc. cit.), "the power,
observed by me, of exciting a daily recurring, though always
weaker paroyxsm, even although its use be discontinued."
Thus it may set up an affection undistinguishable from ague,
of which instances have been recorded by Boudin, Delaharpe,
Imbert-Gourbeyre, Clarus, and Dudgeon.‡ Of the typhoid
condition often induced in protracted arsenical poisoning an
exquisite example is afforded by one of Orfila's cases. From
the eighteenth to the twenty-third day, it is said,
pearance resembled that of a patient labouring under typhus.”
By others, moreover (as Dr. Imbert-Gourbeyre shows), poison-
ing by Arsenic has been compared to the course of low fever;
and once it has been mistaken for it. Dr. Hausmann has
"his ap-
MRG
Quoted from his Arsenik-Vergiftung by Christison (Poisons,
3rd ed., p. 296).
+ Lesser Writings (tr. by Dudgeon), p. 336.
See (for the two last) Brit. Journ. of Hom., xi., 334, and xx., 204.
ARSENICUM.
243
also shown, in an essay on the subject in the Esterreich.
Zeitschrift (1845), that the intestinal lesions of typhoid have
often found their analogues in the autopsies of persons perish-
ing from the effects of Arsenic.
It is thus evident that (as Hahnemann first argued and
Boudin admits) Arsenic is homœopathic to the ague it un-
doubtedly cures; and that, upon the principle of similarity, it
ought to be useful in typhus and enteric fever. It is indeed so. My
own experience would lead me to lay it down as a canon that
what Aconite is to simple fever, that Arsenic is to its malignant
form. Whenever the well-known "typhoid " symptoms occur
-especially the dry tongue and the (often involuntary)
diarrhoea-whether in continued fevers, in the exanthemata,
as symptomatic of mortification, or as results of blood-poison-
ing, my advice is to put in your Arsenic, and use it freely and
persistently. I have seen many an apparently desperate case
cured by it. Dr. Imbert-Gourbeyre's paper will show that
this canon obtains general acceptance in the homoeopathic
school, and is not without confirmation elsewhere. Fleisch-
mann relied upon Arsenic almost exclusively in the treatment
of typhoid at his hospital.
The irritative fever of Arsenic suggests (as Hahnemann.
perceived and pointed out) its use in hectic conditions, such as
those which accompany tuberculosis and chronic mischief in
the lungs or intestines. We have always made much use of
it in the febrile marasmus of children (usually from mesenteric
disease) and in phthisis. Recently it has been much com-
mended in the latter disease, especially as diminishing the
hectic. In our own school Dr. Herbert Nankivell has recorded
much valuable experience with it, giving it usually in the
form of the iodide.* Dr. Ringer confirms the statement that it
reduces the temperature in tuberculosis; and states that
coincidently the symptoms are relieved, and even-in some
cases-apparent cure effected. Of a piece with this is von
Grauvogl's commendation of it in pyæmiat. As regards ague,
Arsenic has the highest repute as an anti-intermittent among
homœopathists, and in quite infinitesimal doses. Wurmb and
Caspar, from their experience in the Leopoldstadt Hospital at
Vienna, place it first among the remedies for chronic agues (it is
rarely indicated when they are recent). The special indications
for it they epitomise thus :-"one stage absent; heat burning;
rapid prostration; torpid weakness; dropsical swellings;
* Brit. Fourn. of Hom., xxx., 515; and Monthly Hom. Review, xvii.,
621; xxiii.
† Op. cit., i., 335.
244
ARSENICUM.
cachexia; abuse of quinine." But they add-"it will often
cure when other remedies selected with the greatest care
have failed." They were at this time using the 15th dilution
exclusively in their wards.* Bähr praises the same potency as
sovereign in malarial cachexia; but in recent cases prefers
the first three triturations. Of these, besides the ordinary
symptomatic indications of the drug, he says-" Arsenicum is
indicated the more specifically the cleaner the tongue remains,
the more rapidly the strength is exhausted by a single
paroxysm, and the sooner the characteristic sallow pallor
makes its appearance." To the German authors now cited I
may add the testimony of an American, whose residence in
the Mississippi valley gives him large experience in marsh-
fevers-Dr. Lucius Morse. "For the so-called dumb chills of
malarious climates," he writes,† "Arsenic is a foremost remedy.
In the outstart of acute attacks of intermittent fever, where
the paroxysms are distinctly divided into stages, I have found
it of little utility; but as an intercurrent remedy, in the treat-
ment of relapsing cases, I have found it to act admirably. It
also deserves attention as a prophylactic of diseases resulting
from malarious poisoning." Sensation of coldness of the body
is regarded by him as especially significant for its choice. He
gives the triturations from the second to the sixth decimal,
and, preparing these himself, follows faithfully Hahnemann's
injunction to triturate a good while, saying that the labour
expended has been well repaid.
Dr. H. Wood praises it in the fever known in America as
'typho-malarial."
((
Before leaving this part of our subject, I must speak of
the action of Arsenic in cholera. I think I shall carry most
pathologists with me at the present day, in maintaining (as I
have long ago done) that Asiatic cholera is essentially a
pernicious malarial fever, in which the poison exhausts its
influence in a single paroxysm. We have already seen Arsenic
causing the primary chill and the consecutive fever of this
malady; and we shall hereafter find the cramps, the vomiting
and purging, and the suppression of urine reproduced in its
pathogenesis.§ So complete is the resemblance that Dr. H. C.
* Brit. Fourn. of Hom., vols. xii. xiii.
† American Homeopathist, ii., 6.
‡ Brit. Fourn. of Hom., xxiv., 485.
"Dr. Blachez describes another form of arsenical poisoning, charac-
terised by choleraic symptoms of the intestinal canal, with suppression
of urine, cramps, and progressive coldness of body" (Ringer, 7th ed.,
p. 281).
ARSENICUM.
245
)
Wood can truly say that "arsenical poisoning has been mis-
taken for cholera, not only in life, but also after death, on the
post-mortem table." He is probably referring in these last
words to a case reported by Professor Virchow, in the forty-
seventh volume of his Archiv.* The very fungi described by
Klob and others as peculiar to cholera were present in the
rice-water fluid with which the intestines were filled; and the
condition of the mucous membranes was anatomically iden-
tical. The phenomena, moreover, which sometimes occur in
arsenical poisoning, where the patient dies in a few hours in
collapse, without symptoms of gastro-enteric irritation,—
sidération, as the French call it, have been compared by
many observers to the way in which cholera occasionally
invades the system.
It is true that this is not always so; and that the vomiting
and purging of arsenical poisoning usually depend on gastro-
enteritis, which is absent in cholera. Hence (as I have said)
the minute symptomatology of the disease does not altogether
correspond with that accepted as characteristic of the drug,
though the internal burning of which cholera patients so often
complain is a point in its favour. It was probably for this
reason that Hahnemann, on first hearing an account of cholera
when it invaded Europe in 1830, in naming the drugs most
likely from their homeopathicity to be its antidotes, specified
Camphor, Veratrum, and Cuprum, but omitted Arsenic.
Further knowledge of the disease has shown that the features.
in which there is a true similarity are those of most import-
ance; and Arsenic has accordingly been added to the three
Hahnemannian medicines by those who care more for real
lesions than for symptomatic minutiæ. With such it has
become the sheet-anchor in the most desperate cases. In the
epidemic of 1849, Dr. Russell at Edinburgh and Dr. Drysdale
at Liverpool concurred in giving to Arsenic the chief place in
the treatment of cholera, when the time for arresting it with
Camphor had gone by; and I believe this to be the general
experience of homoeopathists. I may add that with malarious
fevers Boudin classes, not only cholera, but also yellow fever
and plague, as being all "limnhæmic" affections; and accounts
Arsenic the great remedy for them all.
We have now completed our consideration of Arsenic an an
antipyretic. Before leaving the subject, let me say a few
words by way of comparison between it and Aconite in this
capacity. You will see at once that the contrast we observed
between the pathogenetic effects of the two drugs shows itself
* See Brit. Journ. of Hom., xxviii., 202.
246
ARSENICUM.
as plainly, and as of the same kind, in their therapeutic virtues.
Aconite is the remedy for acute and ephemeral fevers, Arsenic.
for those of some duration : the only point at which their
spheres intersect is (as I have said) in the treatment of
cholera. The fever of Aconite is neurotic: that of Arsenic
commences in the blood or the tissues, and affects the nervous
system secondarily. Aconite rapidly calms the violent but
superficial storms to which the circulation is subject: Arsenic
goes down with a slower but more penetrating movement into
the inmost recesses of the pyrexial process, and there cools its
ardour and steadies its agitation. They are both most
precious febrifuges; and we should be hard put to it to do
without either.
LECTURE XVI.
ARSENIC (continued).
At our last meeting we began the consideration of the great
medicine supplied us by the metal Arsenic. We dwelt upon
certain general characteristics of its action, both as a poison
and as a remedy; and then studied its virtues as an anti-
pyretic in connexion with its physiological effects in the same
sphere.
II. We come now to the place of Arsenic in the treatment
of inflammations. Here its general homœopathicity, at least,
is evident; for no more characteristically irritant poison is
known. It is only necessary on this score to enquire if the
similarity extend to the seat and kind of the inflammatory
action.
I. Let us first take the mucous membranes. To this tissue
Arsenic may fairly be called a specific irritant; as it affects it
in some measure wherever found, and however the poison is
introduced into the system. The kind of inflammation pro-
duced is not (as with Tartar emetic) muco-purulent, but the
membrane is dry, or exudes a thin ichorous discharge; and the
further progress of the mischief is towards ulceration rather
than suppuration. After this manner the alimentary canal is
affected throughout, but more especially the mouth, throat,
stomach, duodenum, and rectum. Of these the stomach may
be called the central seat of the action of the drug, which has
such affinity for it that Brodie found the gastritis more intense
when the poison was applied to a wound than when it was
swallowed; and yet, Boehm says, it is not eliminated by the
gastric mucous membrane. Throughout the canal the inflam-
mation is severe, and causes vomiting, diarrhoea, and dysentery ;
aphthæ in the mouth; ulceration of the stomach and intestine;
and even gangrene at the anus. I should note what Hahne-
mann says of the arsenical vomiting, that it is more frequently
a dry retching, with ineffectual efforts to vomit, than a true
emesis. On the respiratory tract the influence of Arsenic is
less virulent, save on the uppermost portion; but the whole
248
ARSENICUM.
extent is affected, as shown by post-mortem redness, and
cough and other symptoms of irritation during life. In the
frontal sinus the irritation is shown by the dull, tight frontal
headache so common in those exposed to its emanations.
The arsenical conjunctivitis, which is as well known as the mer-
curial stomatitis, belongs to this category; and there is also an
arsenical coryza-not merely in those living in rooms papered
with it (where it is constant, but might be a local effect merely),
but also (as Dr. Imbert-Gourbeyre has shown) from its internal
administration, even in infinitesimal doses. In
doses. In cases of
poisoning the conjunctivitis has been seen as purulent, and the
coryza to consist of a profuse ichorous discharge, going on to
ulceration. The genito-urinary mucous membrane is in-
flamed throughout, even—as in one case of Christison's-
inside the uterus and Fallopian tubes; in the penis, scrotum,
and vulva (as in the anus) gangrene not unfrequently takes
place. This last phenomenon is one of those specially studied
by Dr. Imbert-Gourbeyre.
*
These are the pathogenetic facts; and now let us turn to
those of therapeutics. If similia similibus were absurd; if the
presence of inflammation were, according to the old view, a
contra-indication for an irritant, Arsenic ought to be utterly
eschewed in gastritis and enteritis. Yet it is not so. Mr.
Hunt tells us that when his patients with cutaneous disease
had also chronic irritations of the alimentary canal, the
Arsenic he gave them rather benefited these than otherwise.
Dr. Thorowgood writes in the Practitioner to extol the medi-
cine in "irritative dyspepsia" (v., 21); and Dr. Ringer, sup-
porting this recommendation, adds the morning vomiting of
drunkards, chronic ulcer of the stomach, and several other
analogous affections, in all of which he says "it allays pain
and checks vomiting." These gentlemen have but borrowed
a remedy traditional in the homoeopathic school. There are
indeed few inflammatory diseases of the alimentary canal in
which Arsenic is not of great service, though in some it is
eclipsed by other remedies. Thus in the mouth and throat
Mercury, Nitric and Muriatic acids, Kali chloricum and
Belladonna supersede it on ordinary occasions. But in can-
crum oris,† in severe forms of aphthæ (especially such as
appear at the close of exhausting diseases), and generally in
malignant inflammations and phagedænic ulcerations (non-
syphilitic) of these parts, Arsenic has no rival. In gastritis,
* See Brit. Fourn. of Hom., xxiii., 77.
+ In an epidemic of this disease Dr. Arnold found it (in the 4th decimal
trituration) of the utmost service (see Brit. Journ. of Hom., xi., 149).
ARSENICUM.
249
acute and chronic, and in duodenitis, it is the chief remedy;
In chronic
and so in all dyspepsiæ resulting therefrom.
gastric irritability, with such retching as that I described just
now, it is often most efficacious. Dr. Guernsey praises it in
the condition described by Dr. Chambers as "the indigestion
of water." In ulcer of the stomach and intestines it might find
a place, but generally yields the palm to Kali bichromicum,
and also in the one to Uranium nitricum, and in the other to
Mercurius corrosivus; which last, moreover, is superior to it
in dysentery, save where the rectum is most affected and
where there is much prostration. As the purging caused by
it depends upon intestinal inflammation, it is scarcely homœo-
pathic to simple " functional " diarrhoea, however severe. But in
most cases of chronic diarrhoea, where there is generally some
disorganization, Arsenic is a glorious remedy; and in "English
cholera" it is esteemed by Dr. Black, of Chesterfield, a true
specific.
Arsenic holds an important place in the treatment of the
disorders of the upper portion of the respiratory mucous
membrane. Here, too, we have the support of Dr. Ringer,
who makes some interesting remarks on a variety of forms of
paroxysmal coryza, sometimes running into bronchitis, in
which he finds the medicine very useful. The sneezing and
wheezing of these affections ally them to hay-fever and
its asthma; though here-probably because of the local
presence of the specific irritant-remedies do not avail much.
Nevertheless, Arsenic has often gained some credit in its
treatment.* Dr. Ringer does not mention influenza. This,
like cholera, is an epidemic disease characterised by vaso-
motor disturbance, prostration, and copious flux. To the
typical form of this malady Arsenic precisely corresponds;
and in my hands has always proved rapidly curative of it,
unquestionably cutting short its progress. In sporadic
coryzas approaching this type it is no less valuable. Here,
too, I must speak of its use in ophthalmia. In simple chronic
conjunctivitis I myself place great reliance upon it;
and in strumous ophthalmia my experience coincides with
that of many others that it will often cure obstinate cases
where every other medicine has failed. Dr. Angell commends
it "in superficial and deep-seated ulcerations of the cornea,†
especially in scrofulous subjects; in catarrhal ophthalmia, with
* See Watson's Practice cf Physic (4th ed.), ii., 55, and Hahn.
Monthly, Aug., 1876.
It has been found to affect the cornea in frogs similarly to the skin,
-its influence upon which will come before us immediately.
250
ARSENICUM.
thin secretion and irritation of the edges of the lids; and in
ulceration of the tarsal edges, with thin secretion." Drs.
Allen and Norton make this same thinness of secretion a
prominent indication for Arsenic, adding excoriating quality
of the same, burning pains, and sense of dryness. In bron-
chitis it is rarely indicated, save when the constitutional
symptoms call for it, and there is much thin expectoration.
But Dr. Black and Dr. Bayes both think it should be used
oftener, especially in aged people. They are borne out here by
Hahnemann himself, who in a note to S. 584 of his patho-
genesis of Arsenic in the third edition of the second volume of
the Reine Arzneimittellehre, writes-"Of a similar suffocative
catarrh, becoming much worse every evening after lying down,
and bringing me nigh to death, I cured myself rapidly with
Arsenic, and that with a dose of marvellous minuteness. The
other symptoms of my illness were obviously those of the
remedy."
In inflammation of the urinary tract Arsenic is more than
rivalled by other medicines, as Cantharis and its analogues.
In affections of the generative organs its chief use has been
in chronic menorrhagia, where it is praised by Sir Charles
Locock and Mr. Hunt; and in endo-metritis. A thin, corro-
sive, burning leucorrhoea indicates it in uterine affections. It
will probably be found curative in noma pudendi, in cancer
scroti, and where the soft chancre runs into phagedæna or
sloughing.
2. The powerful irritant action of Arsenic upon the mucous
membranes makes it almost certain that it must exercise a
similar influence upon their external continuation, the skin.
That it does so, affirmed by Hahnemann,* is witnessed to also
by Hunt, Inman, Horatio Wood, and Christison; and Ringer
and Warburton Begbie concur in stating that its first effect on
skin disease is to make it redder and more inflamed, worse in
fact than before the treatment was begun. But upon this
point we have one of Dr. Imbert-Gourbeyre's most valuable
contributions. In a monograph de l'action de l'Arsenic sur la
peau (Baillière, 1872) he has demonstrated from numerous
facts, collected and observed, that Arsenic has the power of
causing almost every form of cutaneous disorder. He gives
instances of its production of pruritus, erythema, erysipelas,
urticaria; of papules, vesicles (including a true zona), pustules
and furuncles; of discolorations; and of falling of the hair
and nails. He does not mention squamæ in his list; but here
we have the testimony of Hunt and of Tilbury Fox, both of
Lesser Writings, p. 337.
ARSENICUM.
251
Dr.
whom speak of pityriasis as a frequent effect of its use.
Roberts gives a case of pityriasis rubra caused by it. Stillé
enumerates among the effects of arsenical wall-papers-" the
skin grows rough and scaly;" and says that its continued
medicinal use has in some few instances caused an eruption
of urticaria, pityriasis, or psoriasis upon the skin. In one
case," he writes," "of acute arsenical poisoning, and a fort-
night after the patient had apparently recovered from its
effects, the face, head, hands, and feet were swollen, and the
whole surface of the body was of a bright red colour. After
a few days the skin partially desquamated, and was tender to
the touch; and this was followed by an attack of psoriasis
which extended over the whole body. The hair of the head,
the eyebrows and eyelashes fell off, as did also the nails."
Of this last phenomenon he writes-" The continued use of
Arsenic has in some cases caused the hair to fall out over the
whole scalp, or in patches (alopecia areata);" and Naunyn,
in Ziemssen's Cyclopædia, enumerates among the symptoms
of chronic arsenical poisoning, "falling out of the hair, and
even of the nails, with or without the formation of ulcers at
the edges of the nails.”
Thus is convicted of unconscious homeopathicity one of
the most generally accepted of all the virtues of Arsenic, viz.,
its power over cutaneous disease. To assume, as is ordinarily
done, that it acts as a "nerve-tonic" in these disorders, is a
mere evasion. And here also the small dose accompanies the
law of similars. Mr. Hunt gives a case in which no more
than theth of a grain could be borne at a time; yet with
such minute doses he cured a chronic psoriasis guttata. He
recommends just enough to be given to keep the conjunctiva
slightly affected throughout the course-a relic, probably, of
the old mercurial practice; but Dr. Ringer finds it quite
unnecessary "to induce these toxic symptoms to ensure the
beneficial influence of the remedy."
At the present day the tendency among dermatologists
seems rather to depreciate the unvarying prescription of
Arsenic in skin disease which Mr. Hunt's success especially
brought so into vogue. But it is still highly reputed for
chronic pemphigus and the squamæ, and in general practice
seems to be used pretty universally when the skin is affected.
With us of the homoeopathic school, having many other
remedies for skin disease, it does not play so large a part or
undergo so indiscriminate an employment. But in chronic
cases of urticaria, eczema, pemphigus, lichen, prurigo, alopecia,
pityriasis, psoriasis and lepra we esteem it as highly as our
252
ARSENICUM.
brethren, and use it as the leading remedy. Where the con-
stitution is coincidently affected in the arsenical manner, quite
high dilutions of the drug may suffice.* The innocuousness,
and even necessity, of more substantial doses in most chronic
dermatites corresponds with what Hahnemann says:-" in
cases where, along with a local affection, the general health
seems good, we must proceed from the at first small doses to
larger ones."
Further evidence as to the poisonous action of Arsenic on
the skin has been supplied by the recent observations of Drs.
Ringer and Murrell regarding its action on frogs. Experi-
menting with the view of studying its paralysing action, they
noticed " a curious action of arsenious acid on the skin of
these batrachia." Soon (5-8 hours) after the hypodermic
injection they found that they "could strip off the cuticle with
the greatest readiness over every part of the body." No such
phenomena appeared in frogs otherwise killed, save when
Tartar emetic was used, and then " the cuticle became softened
and reduced to a jelly-like condition, too soft to be stripped
off, though it could be easily scraped off every part of the
body."
Dr. Emily Nunn, of Boston, U.S., undertook, in the Physio-
logical Laboratory of Cambridge, a microscopical examination
of the epidermis of frogs thus poisoned. Her conclusion with
regard to Arsenic is that "all the facts go to prove that the
changes are the result of the Arsenic acting directly on the
epidermic cells themselves," beginning with those lying
deepest. It is, she says, "obviously a specific effect," and
"not without interest in view of the remarkable therapeutic
value of Arsenic in skin diseases." Dr. Ringer also acknow-
ledges this connexion; and aptly points out that it is
diseases of the more superficial parts of the skin which are
most amenable to the influence of Arsenic. The action of
Antimony was, histologically, almost identical; but was more
rapid and violent, and accompanied with a marked softening
of the ultimate elements of the tissue.
3. Arsenic affects the serous hardly less powerfully than
the mucous membranes. The inflammations here caused by
it are of a sub-acute character, with speedy and copious serous
(less often purulent) effusion. The pleuræ are most frequently
affected; then the pericardium; less often the peritoneum
and arachnoid. The post-mortem evidence of this is to be
read in every work on toxicology. And here too, as with
Apis, the synovial membranes are affected similarly with
* See Brit. Fourn. of Hom., iv., 349.
ARSENICUM,
253
their serous analogues, though only during the convalescence
from acute arsenical poisoning.
Correspondingly, Arsenic is highly esteemed in the school of
Hahnemann in inflammations of the serous membranes,
whenever very copious serous effusion is present. No remedy
equals it here, especially when the pleura or pericardium is the
part affected. It thus resembles Apis, and, like that medicine,
is often very useful in chronic serous dropsies remaining after
inflammation. Some capital cases in point are related by Dr.
Yeldham in the third and fourth volumes of the Annals of
the British Homœopathic Society. It is in some repute in
the old school in the treatment of chronic articular rheumatism.
Besides these tissues, Arsenic has a potent influence upon
three important organs of the body; and this is mainly of
irritant nature, though not without other features. The organs
I refer to are the lungs, the heart, and the kidneys.
4. As regards the lungs, Arsenic first of all congests and
inflames them. This is evident from many symptoms during
life, both in poisonings and provings; while autopsies
frequently disclose great pulmonary engorgement and even
pneumonia. But there is a dyspnoea manifest in most of
these subjects which cannot always be thus accounted for;
and it has long ago led homoeopathists to use Arsenic largely
in the curative treatment of asthma. Dr. Black writes-
"There is no medicine which manifests so frequently and so
closely the symptoms of asthma; and in practice it proves an
admirable remedy." Dr. Russell, who devotes two of his
excellent Clinical Lectures to asthma, recommends it where
bronchitic asthma tends to become, or has become, chronic;
and furnishes several illustrative cases.
But I find it very
effective also in the more purely neurotic form of the malady,
especially in weakly persons, and where the attacks recur
periodically. This is another piece of homoeopathic practice
which has been appropriated by our brethren of the old school.
The therapeutists of the stamp of Anstie and Ringer seem to
rely much upon it: the latter praises it in the asthma of
emphysema. In pneumonia Arsenic has found little employ-
ment as yet.
5. The action of Arsenic on the heart has been fully studied
by the author I have so often cited, Dr. Imbert-Gourbeyre.
In his treatise de l'action de l' Arsenic sur le cœur (Baillière,
1874) he adduces copious evidence of the elective affinity of
the drug for this organ and of the profound changes it sets
up. Of functional disorders he specifies palpitation and
cardiac dyspnoea (to which he might have added præcordial
254
ARSENICUM.
pain and anxiety, often severe); and as lesions produced in
the heart he mentions endocarditis and hypertrophy. The
heart sometimes also shares in the fatty-granular degenera-
tion which occasionally results from arsenical poisoning.
This influence of Arsenic on the heart has been summed
up by Trousseau and Pidoux in saying that it abolishes its
contractility and often inflames its tissue. The feebleness of
heart thus induced is probably an essential part of the pros-
tration it causes, which is constantly accompanied with faint-
ings;* and we find in practice that the pulse grows stronger
under its influence. Its combination with lime (Calcarea
arsenica) is an excellent cardiac tonic. But the power of the
poison to inflame the endocardium has led us to use it freely
in chronic organic diseases of the organ. In these-especially
in dilatation and valvular mischief-the testimony to its value
is loud and unanimous. It relieves pain, palpitation, and
dyspnoea, besides having (as we shall see directly) a marked
influence over the anasarca always imminent in these cases.
Such use of Arsenic, long familiar to us homœopaths,
seems now finding its way into the opposite school, especially
among the French. That they employ the arseniate of anti-
mony probably makes little difference beyond reducing the
dose of the more potent element in the combination. But we
are indebted to our brethren for the demonstration of the
power of the drug over angina pectoris, to which nevertheless
it is quite homoeopathic, as no poison causes such severe
præcordial pain and anxiety. An accidental cure by Alex-
ander, in the last century, first called attention to it; and the
latest writer on the subject, Dr. Anstie, styles it "an invalu-
able remedy." He considers angina pectoris a cardiac neu-
ralgia; and I believe that it is when it is so that Arsenic will
do it so much good. But I have strong reason to think that it
is occasionally a muscular rather than a neurotic affection;
and here may come in other remedies, of which we have seen
one in Hydrocyanic acid, and shall see another in Cuprum.
6. On the kidneys Arsenic exerts a very potent influence.
In acute poisoning they share in the general irritation; so
that their secretion is diminished or suppressed, and, if any
urine is obtained, it is found to contain albumen. This pre-
sence of albumen is so constant a phenomenon that it has
been assigned as a diagnostic mark between arsenical poison-
* “The poisonous or hurtful effects that we have to look out for, when
arsenic has been prescribed, are a peculiar silvery whiteness of the
; and, if the medicine be continued, fainting is often
added" (Watson, op. cit., ii., 785).
ARSENICUM.
255
ing and antimonial. Of the more lasting renal effects of
Arsenic we have full information from the experiments of Dr.
Quaglio. He slowly poisoned six cats with the arsenite of
potash, during periods of from one to ten months, and pro-
duced in all more or less completely developed Bright's
disease. During life the urine was scanty, and contained
albumen, fat-globules, renal epithelium, fibrin-casts, and blood-
corpuscles; it was neutral in reaction, and the proportion of
solids was below the standard. The animals died comatose,
and after death their kidneys were found enlarged and
hyperæmic, and the epithelial cells charged with fat and
granules.
Correspondingly, while the ischuria of acute arsenical
poisoning forms one element of its homœopathicity to cholera,
its deeper effects have led to its use in Bright's disease. It
is apparently the large white kidney—the "tubal nephritis " of
Dr. Dickinson-to which it is a simile; and it is this form
which seems to have been present in the cases of cure by it on
record, which are numerous and brilliant.* Of the same
nature is the post-scarlatinal nephritis, in which it is, perhaps,
the favourite remedy in our school: it is certainly mine. It
must be mentioned that in four out of the six cats experi-
mented on by Dr. Quaglio there was found hypertrophy of
the left ventricle. Dr. Buchner maintains that the renal
mischief of Arsenic is always secondary to cardiac disease,
and that the drug is only suitable to morbus Brightii thus
arising. I cannot agree with him here, thinking both patho-
genetic and clinical evidence to be against the theory. But a
difficulty is created by the presence of hypertrophy of the
ventricle under such circumstances, as it was supposed to
belong only to granular degeneration. Dr. Dickinson now
finds, however, that it may occur in tubular nephritis also, at
any rate (as Baertels says) when secondary contraction has
set in. The relation of Arsenic to inflammations of the serous
membranes is an important element in its homœopathicity to
Bright's disease, acute and chronic; and indicates its employ-
ment, if not previously, at least when these occur.
It is in this place that we must speak of the power of
Arsenic over dropsy. Its tendency to cause œdematous
swellings, local or general, has been noticed by many ob-
servers, and among them by Fowler, whose name is indis-
solubly associated with the liquor potassæ arsenitis of the
Pharmacopoeia. Dr. Imbert-Gourbeyre has collected their
* See Lancet, Jan. 18, 1862; Black, p. 17, note ¹; and Brit. Journ.
of Hom., xii., 485; xiii., 556; xiv., 20; xvi., 219; xvii., 545, 573.
256
ARSENICUM.
testimony in a chapter on the subject in his l'action de
l' Arsenic sur la peau. One of the latest authors who has
mentioned the arsenical anasarca is Dr. Weir Mitchell, of
America.* In the cases which came under his notice he
examined the urine, and generally found evidence, though
slight, of renal disorder, either albuminuria or a few pale tube-
casts. Stillé's description of the dropsy of Arsenic points
plainly to its renal origin. "Under the influence of continued
small doses," he writes, "a characteristic puffiness of the face
arises, with œdema of the eyelids, which at first is most visible
in the morning, but is afterwards more permanent and exten-
sive, occupying the ankles, the limbs, and the abdomen with a
dropsical effusion." It may also lead to dropsy by its depres-
sing effect on the heart, and by the impoverishing influence
which we shall see it exerting upon the blood. Whether
from one or all of these causes, Arsenic is undoubtedly "hydro-
pigenic ;" and among homoeopathists it is always esteemed the
most potent "hydropifuge." Thus Bähr writes-" Arsenicum
is our most important diuretic. It is suitable in all forms of
dropsy, more particularly in dropsy depending upon heart
disease and oedema of the lungs. After giving Arsenicum,
a copious diuresis will sometimes set in with astonishing
rapidity, after which the dropsical swelling speedily disappears.
The result is most doubtful if we have only ascites to contend
against, and inasmuch as the medicine shows its good effects
in a few days already, after a few doses have been taken, it is
useless to continue it for a longer period, in the vain hope of
eliciting good effects from it by persisting in its use." He
recommends the low triturations; but the higher dilutions
have often been reported as doing great things, in cardiac
dropsy especially.†
III. I come now to the neurotic influence of Arsenic, and
the part played by it in the treatment of the neuroses.
It is universally recognised that Arsenic, like nitrate of
silver, affects the nervous centres after its irritant influence
has been more or less exhausted. The disorder induced
sometimes takes the form of tremors and twitches, sometimes
of epilepsy; more rarely of tetanus. But the most frequent
cffect is paralysis. Dr. Imbert-Gourbeyre has given us some
"Etudes sur la Paralysie Arsenicale" in the Gazette Médicale
de Paris for 1858, in which he cites thirty-one observations of
its occurrence. It is nearly always paraplegic; though a case
of arsenical hemiplegia is related, in which also the laryngo-
*New York Medical Journal, June, 1865.
+ See New York State Hom. Society's Transactions, iv., 337.
ARSENICUM.
257
scope detected paralysis of the vocal cord on the affected
side.*
The arms are involved nearly as often as the legs.
Cramps and contractions in the paralysed limbs are common;
but the most invariable concomitant is neuralgia. This
generally coexists with loss of sensibility, at least to every-
thing but cold, by which also the neuralgic pains are brought
on or aggravated. The paralysis is most complete in the
hands and feet, and spreads, if it do so, periphero-centrad.
There is a sense of great restlessness in the limbs when the
pains are present. The seat of the mischief seems to be the
spinal cord. In a case observed by Huss the spine was found
tender on pressure; and Wibmer says that in autopsies the
cord is always seen to be affected, especially with congestion
of the lumbar portion and cauda equina. Velpeau now
announces that he has succeeded in developing an acute myeli-
tis with it in a dog, and three undoubted cases of this inflamma-
tion in the human subject have been traced to its influence.†
Arsenic may thus occasionally find place in the treatment
of myelitis and of epilepsy; but we have as yet little ex-
perience of it in these diseases. On the other hand, it is the
prince of remedies in chorea and in neuralgia, to both of
which the above facts show it to be homeopathic. "In simple,
uncomplicated cases of chorea it is," Dr. Ringer says, " by far
the best remedy;" and Dr. Warburton Begbie says that in an
experience of nearly thirty years, and in a large number of
cases, he has never known it to fail. Neuralgia is a still more
important, because more frequent, disorder; and one cannot
speak too highly of Arsenic in its treatment. In this estimate
I have the concurrence of the late lamented Dr. Anstie, in his
brilliant treatise on the disease. But I cannot at all concur in
his view of the rationale of its action, which is that the drug
has "a happy combination of powers as a blood-tonic and
a special stimulant of the nervous system." The "blood-
tonic" properties he ascribes to it are only seen in discase, as in
malarial cachexia and the instance he cites in proof-of
anæmic children suffering from chorca after rheumatism. Its
influence in health is, as we shall see directly, of a very dif-
ferent kind. Its "special stimulation" of the nervous system
is hardly shown by sensory paralysis, which he himself says is
the chief chronic poisonous effect of Arsenic in this region;
nor would he at least argue that such an influence is anti-
pathic to nerve-pain, for he has demonstrated the consistency
and frequent coincidence of anesthesia with neuralgia. When
* Med. Times and Gazette, Jan. 11th, 1862.
† See L'Art Médical, xliii., 48.
S
258
ARSENICUM.
we consider, then, the undoubted production of neuralgic pains
by Arsenic, and the excellent results obtained from it with
the infinitesimal doses of homoeopathy, I submit that we are
shut up to the admission that its action is an instance of the
operation of the law of similars.
Our experience certainly is that it far excels all other drugs.
in the treatment of the idiopathic disorder. The arsenical
neuralgia is pure, i.e., neither inflammatory, toxæmic, nor
reflex. The pain is burning and agonising, accompanied with
great restlessness and anguish; it is often intermittent, with
tendency to periodic return; is generally made worse (even
though at first relieved) by the application of cold; is worse
at rest, and diminished during exercise; and usually affects (at
least in the first instance) the left side. Such a neuralgia you
often meet with as a consequence of malaria or influenza,-
still more frequently as a symptom of pure debility. If you
will read the cases published by Dr. Quin in the fourth
volume, and myself in the twenty-second and thirty-first
volumes of the British Journal of Homeopathy, you will
see evidence that Arsenic exerts a magical influence over
pure neuralgia, wherever occurring. Some of these were
prosopalgiæ, some gastralgiæ, one sciatica; and of the first
more than one were instances of the terrible "tic-douloureux,"
or "epileptiform neuralgia," usually reckoned so intractable,
but which Dr. Quin's skilful use of Arsenic entirely and
permanently removed.
Here also the comparison of Arsenic with Aconite ob-
viously suggests itself. In both there is the combination.
of anesthesia with neuralgia; but at this point the resem-
blance ceases. The neuralgia which Aconite induces is among
its acute effects: it corresponds accordingly to the idiopathic
affection when of recent origin and in fairly healthy subjects.
The arsenical neuralgia is always associated with paralysis,
and the drug becomes a remedy most appropriately in persons
advanced in life or of exhausted constitution, where degenera-
tive change may well be supposed to exist at the nerve-roots.
Experience has fully confirmed these indications for the two
drugs.
Before leaving the nervous system I must speak of the
mental and moral symptoms which characterise the sufferings
from Arsenic. These are so constant that I cannot but refer
them to a direct action upon the ideational and emotional
centres. As in the motor and sensory sphere, we have the
mingling of depression and irritation. As there the paralysis
is accompanied with cramps, and the anesthesia with
ARSENICUM.
259
neuralgia, so here there is melancholy, but also restlessness,
irritability, anxiety, and anguish. In some forms of melan-
cholia and hypochondriasis we may take advantage of this
action, as others have done with success.
1/2
S
In the three great groups which have now passed before us
-the fevers, the inflammations, and the neuroses-the part
of Arsenic, as a poison and as a remedy, is mainly played.
But there are other features of its action on which we must
dwell, before we quit its consideration.
1. I must speak of the profound influence which Arsenic
exerts upon the life of the blood. The researches of Schmidt,
Sturzwage, and Harley have made it evident that it acts as a
direct poison to the red corpuscles, either when formed or in
the course of production. In small doses the only result of
this influence of the drug is diminished metamorphosis of the
food and tissues, the excretion of carbonic acid and urea be-
coming notably less, and the change of the alimentary sugar
into glycogen being impeded. Hence the pseudo "good con-
dition of the Styrian arsenicophagi, and of the Vienna
horses, to whom the stable-keepers are accustomed to give
the drug with the view of making them sleek and fat. These
effects are reasonably traced to lowered functional power of
the red corpuscles as oxygen-carriers, and a consequent sub-
oxidation of the system,-the carbonaceous compounds, un-
consumed, depositing themselves in the form of fat. A
further degree of the same influence produces the "grayish
cachectic appearance," and "all kinds of anæmic troubles,"
which Naunyn includes among the chronic effects of Arsenic;
and, finally, the petechial effusions and hæmorrhages so often
seen the former of which have been studied by Dr. Imbert-
Gourbeyre. In poisoning by arseniuretted hydrogen the red
corpuscles suffer such rapid disintegration that abundant
hæmoglobinuria is noted.
>>
I may sum up this evidence in the words of Stillé.
"The
microscopical and chemical peculiarities of the blood under
the action of Arsenic are of great importance in relation to
the changes which the solids undergo, to the hæmorrhages
from the nose, the digestive canal, the urinary passages, to the
ecchymosis found in the lungs, pleura, pericardium, and
heart, and to the occurrence of dropsy during the use of this
medicine. The production of serous effusions as an ordinary
effect, and of chronic anæmia as the consequence of prolonged
exposure to arsenical influences, appear to furnish grounds for
* See Wurmb, §, 16; Hom. Times, vii., 2.
260
ARSENICUM.
believing that, in sufficient doses, Arsenic, like Mercury, tends
to disintegrate the blood-corpuscles, to diminish the propor-
tion of fibrin, and possibly, also, to attack still more directly
the vital principle upon which the normal qualities of the
blood depend." Since we have been able to count the blood-
corpuscles, this inference has been confirmed by actual inspec-
tion. "Drs. Cutler and Bradford, from their experiments
conducted according to Malassez' method, are led to con-
clude that Arsenic given in health causes a progressive
decrease of the number of the red and especially of the white
corpuscles" (Ringer).
It is now obvious in what fashion Arsenic is a "blood-
tonic." It is so upon the principle that likes are cured by
likes that it enriches the blood in disease because it im-
poverishes it in health. But the likeness must be complete if
the medicine is to be entirely appropriate and strikingly
curative. Arsenic is, as Dr. Bartholow says, "one of the most
valuable agents which we possess in the treatment of chlorosis
and anæmia,” but his only indication for its distinctive place
is that it is "especially adapted to those cases in which iron
does not agree or fails of effect." We, on the other hand,
should not think of giving Ferrum in those cases to which
Arsenic is suitable, and which we should recognise before-
hand. "Excessive prostration, considerable cedema, violent
and irregular palpitations, with marked appetite for acids
and brandy, and, above all, extreme anxiety "-such are
Dr. Jousset's indications for it in chlorosis, in which he
recognises it as one of our best remedies, especially where
menorrhagia is present rather than the opposite state. “A
high degree of debility, with excessive irritability, oedematous
paleness, cardiac phenomena even during rest and complete
gastro-ataxia" are Bähr's signs for its choice in this affection :
in which, he says, "it is remarkable how soon after the ad-
ministration of Arsenicum the normal appetite returns, and the
sickly complexion is replaced by a brighter hue." In anæmia
otherwise occurring, Arsenic is most suitable when the
poverty of blood has arisen from some miasmatic influence
or exhausting toxæmic disease. Such a condition is especially
seen in the malarial cachexia, where in both schools, and in
doses most wide apart in quantity, the drug is reckoned of
sovereign efficacy. Arsenic bids fair, moreover, to be our
great remedy in the malady now recognised as idiopathic, or
progressive pernicious, anæmia. The fever, the oedema and
the petechial effusion which characterise this form of the
disease all belong to our drug. Iron has been found quite
G
ARSENICUM.
261
ineffective in it; and a case has been published by an old-
school physician, Dr. Bramwell, in which Arsenic proved
completely curative.* More recently, our excellent colleague,
Dr. C. H. Blackley, of Manchester, has communicated† to the
British Homœopathic Society four cases which have come
under his notice, in which a cure of this disease was effected
by Arsenic, and in doses much smaller than those employed
by Dr. Bramwell.
2. I would further direct your attention to the ulceration of
the skin which is apt to follow upon acute, and to manifest
itself in chronic, arsenical poisoning, and whose tendency is
always to phagedæna and gangrene.
I need not quote
authorities on this point, but will use the fact as a peg on
which to hang the evidence I shall bring before you of the
remedial value of Arsenic in malignant ulcerations, including
cancer. It has some reputation in rodent ulcer. In lupus
exedens Mr. Hunt says that it is "not only our sheet-anchor
but absolutely a specific," warning us that it must be per-
severed with for a length of time-"half a life-time if neces-
sary." Of still greater importance is its use in carcinoma-
tous affections. Here again I may quote Mr. Hunt, as one
whose experience with this medicine is second to no man's.
"Arsenic is always useful and necessary in cancer. Although
I have rarely found a malignant tumour dissipated by Arsenic,
I have as rarely known the mineral fail to check its onward
course. It most assuredly exerts, when discreetly administered,
a certain amount of specific influence over this disease." I
think he might have spoken still more unreservedly, had he
used his Arsenic exclusively or especially for carcinomatous
ulceration. In the glandular tumours of this disease I prefer
Hydrastis, and in its fungoid and bleeding growths Phos-
phorus; but in epithelial cancer-as of the lip, face, and
tongue-Arsenic has unquestionably proved curative, and
that not seldom. Dr. Bartholow recognises its power here,
though doubting it as to other forms of cancer. Even in these,
however, Arsenic may do much to relieve the lancinating
* Med. Times and Gazette, Oct. 20, 1877.
+ See Annals, ix., 171.
キ ​"In its operation, Arsenic is the slowest by far of all medicines. It
never takes disease by storm, but gradually loosens its hold.
Month after month, and year after year, you watch for improvement under
its use, and find none, until at length you utterly despair of making any
impression; and perhaps the very next week you examine the patient,
and the crust has fallen off, the ulcer healed, and the disease of twenty
years has gone, never to return." (Brit. Med. Fourn., Jan., 4, 1862.)
262
ARSENICUM.
pains, and promote a better sanguification in the patients.
Dr. Walshe prefers the iodide of Arsenic to any other remedy
in this disease.
I
And now I must draw this long dissertation to a close.
would only ask you to note, in conclusion, the striking testi-
mony borne by the drug to the validity of the method of
Hahnemann. Because it is the greatest of poisons, it is the
greatest of remedies; and its poisonous and remedial effects
go hand in hand. Every morbid condition in which it has
gained repute it has been seen to cause; and, by working the
same method since, its therapeutic sphere has been widely
extended. To ague, cutaneous disease, chorea and angina
pectoris, we have added—among other diseases-typhoid and
hectic conditions, cholera, cancrum oris, gastritis, chronic
diarrhœa, scrofulous ophthalmia, asthma, chronic cardiac and
renal disease, and serous effusions and dropsies. Truly a
goodly list; and it might be yet extended. For myself I can
say this, that were I reduced to two medicines only out of the
whole Pharmacopoeia, the two I should choose would be
Aconite and Arsenic.
The action of Arsenic is so extensive, that it has points of
analogy with nearly every medicine in the Materia Medica.
Those which resemble it most closely are Mercurius corrosivus,
Kali bichromicum, and Iodine.
Like all polychrests, Arsenic must be given in various
dilutions to obtain its full efficacy. In cholera, typhoid con-
ditions, cancer, chronic menorrhagia and cutaneous diseases
we may use the first trituration of arsenious acid, or (which I
prefer) the liquor potassæ arsenitis, which contains gr. j of
arsenious acid in mcxx. The 3rd decimal trituration is a very
useful potency for chronic diarrhoea, and for chronic inflam-
mation of those tissues to which Arsenic is irritant. The 6th
dilution answers admirably for. influenza, coryza, acute serous
effusion, and other acute inflammations to which the drug is
homœopathic. The potencies from the 6th upward have
proved most serviceable in neuralgia, in chronic intermittents,
and in asthma.
A word as to compounds of Arsenic. The iodide-
Arsenicum iodatum-has been proved by Drs. Beebe and
Blakeley on their own persons, the 1st and 2nd decimal
triturations being used. No special effects were obtained.
Dr. Hale esteems it highly for catarrhs of any part with
peculiar and persistently irritating, corrosive character of all
discharges." He reports a cure of a malignant-looking
(C
ARSENICUM.
263
axillary induration by it, and a similar condition of the cervix
uteri, suggesting scirrhus, has more than once disappeared
under its use. The arseniate of soda-Natrum arsenicatum—
was very thoroughly proved in 1875 by the Alleghany County
Society. The results obtained may be read in the Hahne-
mannian Monthly for 1876 and 1878, and in Allen's Encyclo-
pædia. The effect of the drug on the mucous membrane of
the fauces and posterior nares was extremely marked; and I
have followed some of the provers themselves in using it, with
much satisfaction, in superficial inflammatory conditions of
these parts.
*
LECTURE XVII.
ARUM, ASAFOETIDA, ASARUM, ASCLEPIAS, ASTERIAS, AURUM,
BAPTISIA.
We have to consider to-day a few medicines of small im-
portance, along with two of higher rank in the shape of
Aurum and Baptisia.
The first in order is
Arum.
Under this head I include both the Arum maculatum-the
"lords and ladies" of our popular nomenclature-and the
Arum triphyllum, or Indian turnip, which is its American
analogue. Of the former we prepare a tincture from the fresh
root of the latter the best preparation seems to be a tritura-
tion of the expressed juice of the same part with sugar of
milk.
Arum maculatum was proved by Dr. Hering, and Arum
triphyllum by Dr. Lippe. Their results, with symptoms
observed in poisoning by the former species, are given in
Allen's Encyclopædia, and their clinical applications are de-
scribed by Dr. Hale in his New Remedies.
The one interesting point about Arum is the application
which has been made of its local effects on the mouth to a
corresponding condition when occurring in malignant scarla-
tina. The following description has been given of the
former :-" After chewing a young leaf-stalk for a few seconds,
a very intense, prickling, stinging pain was felt upon the tongue
and mucous membrane of the lips and throat, accompanied
with a flow of saliva, which seemed to relieve the pain a little
-the pains were as if a hundred little needles had been run
into the tongue and lips." This was from the Arum
maculatum, but Dr. Lippe has found some excellent results
from the Arum triphyllum when scarlatinal and other patients
ASAFOETIDA.
265
have shown great irritation of the buccal mucous membrane.
"The most indicative symptoms," he says, "are the very sore
feeling in the mouth, the redness of the tongue, the elevated
papillæ, the cracked lips and corners of the mouth." The nose
also may be sore, with or without much coryza. Dr. Guernsey
speaks of raw, bloody surfaces on these parts as characteristic
of Arum, with which there is much itching, so that children
will often pick at and bore into the places, though so doing
He further indi-
causes great pain, and makes them scream.
cates an acrid coryza as calling for it.
Dr. Lippe commends the drug also for clergyman's sore
throat. He gives the dilutions from the sixth upwards.
I have next to speak of
Asafoetida.
The drug known by this name is the dried juice of the root of
the Indian plant which yields it. From the Asafoetida of
commerce a tincture is prepared in the usual manner for
homœopathic use.
The chief proving of Asafoetida is that of Jörg, in which
twelve persons took part. Some additional experiments are
collated with his in Dr. Allen's article, which gives 585 symp-
toms to the drug.
Jörg's results are fairly summed up thus by Dr. Phillips.
"The administration of small doses causes alliaceous eructa-
tions; the digestion is impaired; there are burning sensa-
tions in the fauces; there is pain, fulness, and oppression of
the stomach; the abdomen becomes distended with flatus,
which, when discharged, is of a very fœtid and disagreeable
character; there is frequent inclination to evacuate the bowels,
and the discharge is thin and watery. The urine is not
augmented in quantity, but becomes acrid, and communicates
a sense of burning. The pulse is at the same time quickened
the head becomes more or less affected with flying pains,
often attended with much giddiness; and various nervous and
hysterical phenomena make their appearance. Like the pulse,
the respiration becomes quickened, and the secretion of the
bronchial membrane is promoted." Pereira adds that "the
urino-genital apparatus appeared to be specifically affected,
for in the males there was an increase of the venereal feelings,
with irritation about the glans penis, while in the females
the catamenial discharge appeared before its time, and uterine
266
ASAFOETIDA.
pain was experienced." Trinks mentions a case in which
(in large doses) it caused nymphomania.
Our main use of Asafoetida is as a remedy for hysterical
troubles. A symptom repeatedly observed by two of the
provers strikingly resembles the globus hystericus; and
hysterical cough, tympanites and asthma (it constricted the
chest in some) come within its range of influence. I confess
that I myself rarely use it, preferring the more agreeable
Moschus, whose action seems so very similar. It is only in
tympanitic distension of the abdomen that I find it preferable.
Dr. Ringer recommends it here, in doses, for children, of less
than a drop of the tincture. Dr. Guernsey, however, thinks
it quite the best remedy when hysterical symptoms manifest
themselves in the œsophagus, and Dr. Hoyne confirms this
experience. Quite another, and a very inexplicable action of
Asafoetida, is its influence upon diseases of bone. Dr. Hol-
combe writes, "I have twice verified the value of this remedy
in scrofulous caries of the bones. I used the 12th dilution.
It is singular that a remedy, whose principal applications are
to the most fugitive and sympathetic disturbances of the
nervous system, should extend its curative power to the most
deep-seated and chronic organic lesions." It is also highly
commended in acute periostitis. I give you these facts as they
stand. For myself, I have given Asafoetida very persistently
in several cases of chronic caries, without being able to discern
the slightest result from its use. I should say that it is from
the old school that its repute here originates. Stillé quotes
Neumann as speaking of its utility as "generally admitted."
Dr. Hoyne cites several instances of its beneficial use in
syphilitic disease. Asafoetida is also reputed of value when
the milk of nursing mothers is deficient.* In all these affec-
tions, hyper-sensitiveness is said by Dr. Guernsey to indicate
the drug.
*
The relations of Asafoetida as a nervine are with Ambra,
Moschus, and Valerian. Its influence upon bone (if a fact)
ranks it with the metals and metalloids Aurum, Fluoric acid,
Mercurius, Phosphorus, and Silica.
In hysteric disorders, the dose should probably be from the
2nd downwards. In diseases of bone Asafoetida is praised in
the dilutions from 12 to 30.
* Brit. Fourn. of Hom., ii., 417.
ASARUM EUROPÆUM.
267
I am entering a region unknown to you when I proceed to
speak of
Asarum Europæum,
or Asarabacca. A tincture is prepared from the entire plant.
Asarum was proved by Hahnemann and four others: the
pathogenesis, containing 270 symptoms, is in the third
volume of the Materia Medica Pura. There is a good article
upon it (the last published, I am sorry to say) in the New
Materia Medica.
That Asarum is a local irritant, of the Elaterium and
Veratrum type, to the mucous membranes generally, acting
as errhine, emetic, and purgative, is pretty well known; but
the fact has little bearing on practice. In Hahnemann's
provings we are most struck by, as general symptoms, exces-
sive sensibility and general chilliness without thirst: in
particular regions, depression of the cerebral functions with
heavy headache; weak sight and twitching of the eyelids;
still more striking dulness of hearing, as though a pellicle
were stretched over the meatus auditorius; passing of much
mucus from the bowels;* marked stitching in the lungs; a
great deal of myalgia in the back and lower extremities.
Asarum has hardly ever been used in disease: the above
symptoms may occasionally help you to its phenomenal appli-
cation. It is said to be suitable to chilly subjects; and to
remove darting pains after operations on the eyes. It has a
great reputation in Russia as a remedy for the effects of
excessive drinking.
I can say nothing as to the analogous medicines or the
dose of Asarum.
Of the plants known by the name of Asclepias we have in-
formation as to three, the A. incarnata, A. Syriaca, and A.
tuberosa. The first and second seem to have some uterine
influence, and the latter of these is a potent diuretic, in-
creasing the solid constituents as well as the fluid portion of
the urine. This we learn from Dr. Hale's New Remedies.
But the same author communicates facts about the
Asclepias tuberosa
which fairly give it a place among homoeopathic remedies. It
is used as a tincture or trituration made from the root.
* The symptom "scanty, yellow, mucous stool, in one string," has
been verified by three cases of cure by Dr. E. M. Hale (Brit. Journ.
of Hom., xxvi., 331).
268
ASCLEPIAS TUBEROSA.
The significant point about this plant is that it is popularly
known as "pleurisy root." Such terms usually have more or
less warrant from fact, and that it is so in the present case
appears from a proving instituted by Dr. Thomas Nichol, of
Montreal. Large doses caused only colic and purging; but
from the first decimal dilution he got decided pleuritic symp-
toms. Thus :-" throughout the evening the pains kept in-
creasing, making respiration painful, especially at the base of
the left lung, which is dull on percussion, while the cough is
dry and spasmodic." "The pain is very acute on the right
side, and seems to be seated in the pleura." The remedy
deserves a trial.
The next medicine I have to introduce you to is a novel
one. It is made from the star-fish,
Asterias rubens,
by bruising the dried fish in a mortar and triturating with
milk-sugar.
Our sole knowledge concerning Asterias is derived from the
proving and clinical cases furnished by the late Dr. Petroz.
They are translated from the first volume of the Journal de la
Société Gallicane in Metcalf's American Provings. Seven
persons took part in the experiments; but no information is
given as to the size or frequency of the doses they took.
Dr. Petroz makes the following remark:-" Experimenta-
tion on the healthy gives readily, and often in profusion,
symptoms indicating disturbance of function; but it never
goes on to alteration of tissue, rarely even to the earliest
indications thereof. We must therefore have recourse to
clinical experience. Its teaching is sure, when time has con-
firmed it." To no medicine does this statement apply better
than to Asterias rubens. The skin symptoms alone are well
marked; and these have led to its employment in chronic
ulceration, even when of a cancerous nature, with reported
success. Its action seems limited to the left side of the body.
It has also cured a case of cerebral congestion with obstinate
constipation in an old gentleman: I have myself found it of
great use in a similar case. Asterias had a reputation among
the ancients in epilepsy; and Petroz cites two cases in which
much benefit resulted from its use in infinitesimal doses. I
have little personal experience with this remedy.
Teste classes it (with Petroz' assent) in his group headed by
Sulphur, and including Bovista, Ethusa, and Cicuta.
AURUM.
269
The higher dilutions (12 to 24) were employed in all cases.
on record of relief or cure by Asterias.
We
e now come to a medicine which homoeopathy has done
much to rescue from unmerited neglect, and to restore to a
high place in therapeutics. I speak of gold. There is so little
difference between the action of the metal and its salts that I
shall speak of them generally as
Aurum.
We use the pure metal in the form of a trituration of the
finest gold leaf, which was that employed by Hahnemann in
his provings. The trichloride-A. muriaticum-is also used
in homœopathic practice: its solution is aqueous at first and
alcoholic afterwards.
The first proving of Aurum appears in the fourth volume of
the Reine Arzneimittellehre. It contains 137 symptoms ob-
served by Hahnemann himself; 198 from 7 fellow-observers;
and 3 from authors. There are also a few symptoms from A.
muriaticum and A. fulminans. Those of the metal itself were
obtained from one or two hundred grains of the first tritura-
tion; so that they have uncommon value. There is a second
pathogenesis in the Chronischen Krankheiten. It contains 82
fresh symptoms, of which 75 are Hahnemann's own. The
worth of these, according to the facts we have ascertained, is
more than problematical. Dr. Allen gives symptoms, both of
Aurum metallicum and of Aurum muriaticum, from additional
sources; and some provings of Aurum sulphuratum, and of
the chloride of gold and sodium. A valuable monograph on
the drug has recently been given us by Dr. Burnett,* which
contains a further proving on his own person.
Hahnemann's preface to Aurum is very interesting. He
tells us that the physicians of his time so unanimously pro-
claimed the inertness of metallic gold, that he was at first lcd
to use the muriate. Subsequently, however, he found that the
Arabian physicians had been in the habit of using the metal
itself in a fine powder; and had praised it as remedial in those
very affections for which he had found the muriate beneficial.
He then prepared a first trituration of gold-leaf in the usual
way, and proved it as described. From the symptoms pro-
duced he found that the drug was perfectly homœopathic to
the maladies for which the Arabians had given it; and,
* Gold as a remedy in disease. 1879.
270
AURUM.
guided by the same principle of similarity, he found it—in the
1st and 2nd triturations-curative in several other important
affections.
He could hardly have been aware, when (in 1818) he first
stated this in print, that in 1811 Chrestien had revived in Paris
the use of powdered gold. In his Observations sur un nouveau
remède dans le traitement des maladies vénériennes et lymphati-
ques he communicates a number of cases illustrative of its value
in syphilis, scrofula, and even in uterine scirrhus; and states that
the finely powdered leaf has the same effect as the oxide or the
muriate. Niel and Legrand have handed on the tradition, so
that a considerable body of information relative to the action
of gold has accumulated, and may be read in the account of it
given by Trousseau and Pidoux.
The anti-syphilitic virtues thus ascribed to gold, though
only a revival of its former repute (as Dr. Burnett has shown),
and though for a time very generally acknowledged, meet with
little recognition in the old school at the present day. The
drug is not mentioned by Wood, Ringer, or Stillé. But
among homœopathists it holds a high place in many of the
tertiary manifestations of the disease, especially the sarcocele,
the osseous affections, and the cachexia. It does so because
the provings have revealed an elective affinity on its part for
the organs involved. The bones are affected with burning
and boring pain, sometimes-especially in the face and feet-
accompanied by redness and swelling, sometimes—as in the
head-with nodes; and in one prover swelling and tenderness
of the right testicle came on for some hours daily. Dr.
Burnett also experienced its effect on these organs.
But the provings go farther than this. In the first place
they show a marked melancholia as produced by Aurum, and
this of a distinctly suicidal character. One of the experimenters
"imagined himself not fit for this world, and longed for
death: thinking of death gave him intense joy." Then they
show a strong action on the nose, which is inflamed without,
and blocked up with ulcers and crusts within; with putrid
smell when blowing it. Dr. Morse records an interesting
case in which a syphilitic patient, being overdosed with gold
by a quack, developed both sets of symptoms.* These two
actions have led to the chief uses of Aurum in the homœo-
pathic school. In suicidal melancholy Hahnemann himself
repeatedly extols its virtues; and Drs. Chapman, Bayes, and
Sharp speak in the same sense. Whether this affection is one
primarily seated in the brain is doubtful, from the other facts
* Hahn. Monthly, xii., 506.
AURUM.
271
about the action of Aurum. I am myself inclined to think it
a hypochondriasis having its seat either in the liver or in the
testes.*
Dr. Bayes states that the cases in which he has seen
Aurum curative have presented indications of congestion of
the head and liver, with fixed colour in the face, and a yellow-
ish tinge. Suicidal melancholia, moreover, is not an unfre-
quent accompaniment of testicular disease. The nasal action
of the metal has led to its successful use in chronic rhinitis, in
crusts of the nostrils, and above all in scrofulous and
syphilitic ozæna. Many testimonies to and illustrations of its
value in this complaint are on record.
Again, one of the affections specified by Hahnemann as
cured by him with gold was a mercurial caries of the nasal and
palatine bones. The French experience has shown that the
action of the metal is closely analogous to that of Mercury,
causing—as it does-its salivation (without much if any affec-
tion of the gums) and its erethistic fever with diuresis and
sweat. Thus Aurum has come to be reputed among us as a
remedy for chronic hydrargyrosis; in`which we have the sup-
port of Dietrich. It is an admirable medicine for those con-
stitutions broken down by the combined influence of syphilis
and Mercury which sometimes come before us for treatment.
I once gave to a poor fellow thus afflicted the first trituration
of gold. He came back to me in a week's time, looking quite
another man, and exclaimed-"Surely you have given me the
elixir of life!" Dr. Chapman has narrated a similar case
in the seventh volume of the British Journal of Homœo-
pathy (p. 396).
Once more. The action of Aurum on the nasal mucous mem-
brane has naturally suggested its use in affections of that offset
of it which we call the conjunctiva. Provings have not yet
manifested the influence of the drug here; but there are a
good many cases of chronic scrofulous ophthalmia on record in
* Dr. Burnett (p. 136) challenges this opinion of mine, which he is of
course quite in his rights in doing. But he is in error when he dis-
cusses it as if it were a "theory" about the seat of hypochondriasis. It
refers only to the form of this mental disorder to which Aurum is
homœopathic, which I judge-from the concomitants and the general
action of the drug-to be that connected with hepatic or .testicular
disorder rather than one purely cerebral. Dr. Burnett himself supplies
an excellent instance of its efficacy in the second of the two connexions
I have specified, when he recommends it for pining, low-spirited boys,
and says that, in these cases, if we examine the testes, we shall "find
them mere pendent shreds, just on the verge of atrophy." When
under Aurum they have brightened up and become like other boys—
"look again," he writes, " at the before-mentioned glands, and you will
find thein larger, firm, and well suspended."
272
AURUM.
which it has proved very effectual, even to restoring trans-
parency to the opaque cornea. It seems to have a special
action on this membrane, as Drs. Allen and Norton speak
highly of it for interstitial keratitis, and Mr. Clifton has lately
communicated a case of the syphilitic form of the disease, in
which its beneficial effects were unquestionable.
In these regions of action-in affections of the bones and
glands, and of the oculo-nasal mucous membrane, especially
when of syphilitic, mercurial, or scrofulous origin-Aurum
has made its mark among us. I may add to these that in the
Leopoldstadt Hospital at Vienna it was the favourite remedy
for periostitis; and cured one severe case of albuminuria, with
general and local dropsy. If I am right, too, in referring its
melancholia to the liver, it is but an action of the same kind
when we hear of it as occasionally curative in ascites from
hepatic disease-possibly cirrhosis; and in chronic icterus.
But I think that the future use of Aurum will extend beyond
this range. We have not yet utilised the rushes of blood to
head and chest it so markedly causes, though Dierbach has
recorded his experience of its value in disturbance of the
pulmonary circulation after hæmorrhages.* We have not yet
ascertained if it affects the female sexual system as it does the
male; though the salacity and erections it causes in the latter
are paralleled by the menorrhagia set up in the former. We
have not determined the precise nature of the dyspnoea caused
by it, or applied to practice its undoubted action upon the
heart. I think, too, that strumous and syphilitic keratitis are
not the only affections of the eye it can influence. When we
read of Herrmann-its most thorough prover-experiencing
"excessive tension in the eyes," now making sight indistinct, as
if a black crape were drawn before the eyes, now causing
hemiopia, in which only the lower half of objects is visible, and
now diplopia-I think that we may find some work for the
drug in the treatment of glaucoma. The horizontal hemiopia
of the drug has led Drs. Allen and Norton to its use in de-
tached retina, and with great advantage. Aurum seems to me
one of the medicines of the future.
The only writer in the English language who gives any
´independent account of Aurum is Dr. Bartholow; and he,
drawing partly from French and partly from homoeopathic
sources, has made out a list of its applications not unlike those
which I have now mentioned. He finds it-in fractional doses
* See also Burnett, p. 124-126.
† Dr. Burnett relates a case of rheumatic endocarditis, in which it
seemed very effective (p. 127).
BAPTISIA TINCTORIA.
273
·
of the chloride-useful in the granular and waxy forms of
Bright's kidney. He cites also the experience of Martini as to
its favourable action in chronic affections of the uterus and
ovaries. Dr. Tritscher, in our own school, has carried out this
treatment, and reports excellent results in indurations of the
uterus and ovarian tumours. He gives from one to six grains
of the first trituration of the chloride of gold and sodium.
The effects of Aurum take long to excite (10-15 days),
and they are slow to decline.
After Mercury, the most striking analogue of Aurum is
Platina, which is to the female sex what gold is to the male.
Its points of similarity and difference with Mercury, Arsenic,
Silica, and Phosphorus are well brought out by Dr. H.
Goullon in a paper on the drug translated from the Allg. Hom.
Zeitung in the twenty-second volume of the North American
Journal of Homœopathy.
Hahnemann's published experience with Aurum was gained
with the 1st and 2nd triturations; but subsequently he resorted
to the 12th and at last to the 30th. His disciples (including
Dr. Burnett) seem to have followed his earlier rather than his
later practice in this matter.
I would speak last of the
Baptisia tinctoria.
This is the "wild indigo" of North America. We make a
tincture of the bark of the root.
Short provings of Baptisia, made by seven persons, may be
found in the fifth and seventh volumes of the North American
Journal of Homœopathy. These, with further pathogenetic and
clinical facts, are collected by Dr. Hale in the article on the drug
in the second edition of his New Remedies, and by Dr. Allen
in his Encyclopædia, where the drug has 367 symptoms. There
are two monographs extant on the use of Baptisia in typhoid
fever,—one, published separately, by Dr. Bayes (1872); the
other, by myself, read as a paper before the British Homoeo-
pathic Congress of 1872, and printed in the Monthly Homœo-`
pathic Review of that year.
It is on this point that the interest of Baptisia is centred.
I have collected, in the paper referred to, fifty-three recorded
cases of continued fever, in all of which the effect of the medi-
cine was either to induce a speedy crisis, or materially to abate
and curtail the disease. In the discussion which followed its
T
274
BAPTISIA TINCTORIA.
reading at the Congress speaker after speaker rose up to confirm
from his own experience this estimate of its value; and there.
was not a dissentient voice. Two of those who spoke were
from the United States; and it was from thence that we first
heard of its virtues and reputation. Among the reports ex-
amined in the paper is one of the treatment of the "colonial
fever" of Melbourne; and Dr. Kitching has since given us his
experience of the corresponding disorder at the Cape, where
he has found Baptisia as potent as Dr. Madden found it in
Victoria.* So from four continents the fame of the medicine
comes borne to us; and we cannot but give it a full considera-
tion and trial.
*
The first question must be as to the nature of the continued
fever in which Baptisia has been found so effective. It is
described in the records under several names-" typhus,"
"typhoid," "continued," "gastric," "bilious." Is it never-
theless in all the one essential fever we know as typhoid
or "enteric ?" or do some of the cases come within other
categories?
(C
The four distinct forms of idiopathic fever which the labours
of Stewart, of Jenner, and of Henderson have defined, are so
universally recognised that I need not dwell upon them. The
only one which concerns us here is the so-called "febricula."
This is described as a primary fever-not catarrhal or sympa-
thetic-pretty closely resembling in symptoms the onset of the
other forms, but differenced in this, that it rapidly reaches its
maximum, and as rapidly subsides, within, at the most, five
days. It has no local complication or specific eruption. Now
it is quite possible that some of the sporadic cases where the
disease has broken up under Baptisia have been instances of
this disorder, and four out of the fifty-three cases I have collated
are perhaps invalidated on this account. But no such ex-
planation is admissible as regards the remainder of the single
cases in which it displayed curative powers, as all these were
of more prolonged duration; while in the epidemics reported
by two of the observers, it is noted that under old school
treatment the fever lasted two, three, or four weeks, and in
two cases under other homoeopathic remedies (Aconite and
Bryonia) for twelve days. That under Baptisia it terminated
not later than the fifth day is therefore no proof that it was
febricula.
>>
But is there yet another form of continued fever, resembling
typhoid rather than febricula in its duration and progress, yet
specifically distinct? and is it this disease in which the good
* See Monthly Hom. Review, xix., 207.
BAPTISIA TINCTORIA.
275
work of Baptisia has been done? This is a more difficult
question. Jenner, Trousseau and Murchison seem to answer
it in the negative: they think that all the varieties of fever
described by the old nosologists-gastric, bilious, mucous,
nervous, putrid, and so forth-fall under one or other of the
four types now recognised. But the Nomenclature of our
College of Physicians gives us a "common continued fever,"
as distinct from either typhus, typhoid, relapsing fever, or
febricula; and Dr. Aitken cites several testimonies, direct or
indirect, in favour of the existence of such a species. The
opinion of several of our own school who have expressed
themselves on the subject is of the same tenor. Thus-Dr.
Russell, in his Clinical Lectures, writes: "I mean by 'gastric
fever' a non-infectious continued fever, which has no regular
course; in which there is no eruption, and which is not
attended with diarrhoea or intestinal affection." Dr. Jousset
also maintains the existence of a "fièvre synoque," specifically
distinct from the "fièvre ephémère" and "fièvre typhoide"
which occur in France as in this country. I have hitherto
gone with the general current of doctrine in accepting the other
view, and maintaining that—excluding febricula-there is but
one endemic species of continued fever, and that the enteric.
I must now, however, acknowledge a change of view. Watch-
ing my own practice, and examining the records of that of
others, I have come to the conclusion that there is a true
"common continued fever," a veritable "synochus," which,
though it may run on from the " gastric" into the "typhoid
condition, never has the essential features or typical clinical
history of typhoid fever proper.
Our decision of this question has an important bearing on
the claims made for Baptisia. Typhoid is a disease of such
frequent occurrence and such ghastly mortality: it invades
such high quarters, and threatens, if it do not actually destroy,
such valuable lives; it has, even when not fatal, so lengthened
a process, so tedious a convalescence, such frequent sequela of
even direr import than itself, that any promising addition to our
power of controlling it cannot but be welcomed. But especi-
ally would this be so, if the promise held out were of more
than mitigation of severity only, more than sustainment of the
patient; if it were of actual abortion and breaking up of the
disease. If Baptisia proved to be the Aconite of this fever,
we should without controversy have gained a priceless
remedy.
""
I regret that I cannot stand to the claim on behalf of it to
this power which I have many times made during the last
276
BAPTISIA TINCTORIA.
sixteen years*. Were there no other endemic continued fever
but typhoid, my conclusions from practice would be unassail-
able, and instances where the disease seemed to elude the
abortive power of the medicine might be regarded as excep-
tional. But I am driven now to consider such cases as of the
true enteric type, and the rest as belonging to the common
continued fever " whose existence I have been led to admit.
I cannot, therefore, any longer maintain that Baptisia is
capable of breaking up a genuine typhoid, and must acknow-
ledge that those of my colleagues who have questioned its
power so to do have been wiser than I.
But has it therefore no influence on the progress of this
disease? Far from it: it plays a most important part in its
treatment. To ascertain the precise place occupied by it-its
relation to the stages of the disease and the sphere of other
medicines-let us first consider the experiments made to
ascertain its pathogenetic action.
These show the following symptoms:-
"(
After taking during the day (Feb. 5th) four drops of the
mother tincture, Dr. Douglass awoke in the night with a feel-
ing as if the room were insufferably hot and close, hindering
respiration. His pulse was about 90, full and soft. There
was most uncomfortable burning heat of the whole surface,
especially the face. The tongue was dry, and smarted and
felt sore as if burnt. The heat compelled him to move to a
cool part of the bed, and finally to rise and open a window,
and bathe his face and hands. With these symptoms there
was, he writes, a "peculiar feeling of the head, which is never
felt except during the presence of fever, a sort of excitement
of the brain, which is the preliminary to, or rather the begin-
ning of delirium, which with me never fails to occur if fever
continues and increases to any considerable intensity." He at
length got to sleep again, but awoke the next morning with
the same dry and burnt tongue.
-
The same symptoms recurred on the night of the 7th, after
four more drops of the tincture. The oppression of breathing
was still more marked, and felt quite congestive. Flushed face
and dulness continued during the next day. Each night while
awake he had painful intolerance of pressure as he lay, especi-
ally in the sacral region, obliging him at last to lie on his face.
On the 10th, after a dose of three drops taken in the after-
noon, the same symptoms rapidly supervened. It is added
that the head felt large, and the eyes were shining; the hands
also felt large, and were tremulous.
*See Brit. Journ. of Hom., xxi., 385.
BAPTISIA TINCTORIA.
277
-
He took no more medicine. The bowels had been consti-
pated throughout the proving till the 12th, when they resumed
their usual condition. He felt weak and tremulous, as if
recovering from an illness, and was not himself again till
the 15th.
The other provers had the same febrile symptoms, with hot
and high-coloured urine. Dr. Rowley records vomiting and
diarrhoea. Dr. Sapp, pain in the stomach, abdomen, and right
hypochondrium, passing down to the right iliac region; also
soreness in the region of the liver. Dr. Smith had diarrhoea,
followed by constipation and hæmorrhoids; and constipation
was present also in Dr. Hoyt.
Lastly, in a more ignoble prover, a cat poisoned by Dr.
Burt, the small and large intestines were found congested and
filled with bloody mucus.
From these symptoms two facts seem to stand forth with
unmistakable clearness.
Ist. Baptisia is capable of exciting true primary pyrexia in
the human subject. This is no slight thing, for there are very
few other drugs to which we can ascribe such power. And
this pyrexia, in the case of Baptisia, is exceedingly like that
of the early period of typhoid. The soft and full, yet quickened
pulse, the headache and tendency to delirium, the soreness all
over, and intolerance of pressure when lying, are marked
symptoms of this stage of the disease.
2nd. We have no evidence that Baptisia affects Peyer's
patches as they are affected in typhoid, nor even that it acts
upon them at all as Arsenic and Iodine, and perhaps Mercury
and turpentine do. But it is certain that it produces con-
gestion and catarrh of the intestinal mucous membrane, with
abdominal tenderness and diarrhoea. Now this again is the
condition present during the first week of typhoid.* The
Peyerian and solitary glands are, till the seventh day, involved
merely in the general hyperæmia, but the latter then subsides,
and they stand out alone.
We have, therefore, in Baptisia a medicine precisely homœo-
pathic to the first stage of typhoid fever, i.e., to the period
antecedent to the full development of the intestinal affection.
There is nothing, I think, to render it inconceivable that,
administered early and persistently in this period, though it
may not blight the growth of the disease, it may considerably
abate its energy. There are two opportunities then afforded
it for so doing. The dothien-entérite-as Bretonneau proposed
to call the infarction of the intestinal glands-does not begin
* See Aitken's Science and Practice of Medicine, i., 397-8.
278
BAPTISIA TINCTORIA.
till about the fifth or sixth day of the fever, to which it is (as
it were) secondary. Why should not its development be
materially hindered? Again, on the tenth day there is a
natural tendency to resolution in the local affection. "The
turgescence," writes Trousseau," of the aggregate and solitary
glands of Peyer, and of the mesenteric glands, begins to de-
crease, and goes on gradually subsiding up to the fourteenth
day, at which date the affected glands are still a little swollen,
but by the end of the third week resolution is complete, ex-
cepting that the mesenteric glands do not quite regain their
normal condition till a short time later." Why should not
Baptisia, by abating the whole force of the malady, favour this
tendency to resolution?
Of such an action as the latter, we have seen an analogous
instance in the case of Tartar emetic in smallpox. It does
not prevent the formation of the eruption; but it does
strenuously promote its resolution in the papular or vesicular
stage, so that the processes which end in pitting, and the
concomitant secondary fever, are averted. There is no reason
why Baptisia should not have a corresponding effect in
typhoid, which is not a more specific process, having a definite
clinical history, than variola. My own experience is that it
has such an influence, and that typhoid when treated with
it from the commencement rarely reaches any serious height
or runs an unduly protracted course. Some of the cases
recorded, moreover, seem to show that at no stage of the fever
is it without beneficial influence, and to lead to the inference
that, unless other remedies are better indicated, the patient
should always have the advantage of what it can do for him.
It might be alternated in the more advanced period of the
disease with the Arsenicum, the Mercurius, or the Terebin-
thina we should deem it right to give for the intestinal
affection, just as we sometimes alternate Aconite with the local
specific in fully developed inflammations.
Nor has the relegation of the abortive power of Baptisia to
common continued fever a merely negative significance. It is
of no little consequence to have a remedy which shall break
up this fever, on which typhoid symptoms are very apt to
supervene if it is only treated with ordinary medicines. You
have but to try it here to be satisfied of its surpassing value.
I have gone fully into this matter on account of its great
practical importance. For another statement of the question,
from the side of disease, I may refer you to the second
edition of my Manual of Therapeutics, in the articles on
typhoid and common continued fever. I hope that the facts
BAPTISIA TINCTORIA.
279
alleged may, induce some of those who hear me to test the
remedy in their own sphere of work, and to report the results.
It need not be given in infinitesimal quantities. Drop-doses
of the mother-tincture, or small portions of an infusion, were
administered in most of the published cases. Such doses,
moreover, will probably ensure a wider range for the medicine.
The tendency in America just now is to restrict its action in
continued fever to cases in which its minuter symptomatology
is reproduced-as soreness in lying, a sense of being all to
pieces, and so forth. Dr. Chargé adds softness of the pulse in
the first stage, and fœtidity later on Jahr gives despair
of cure and certainty of death. I do not doubt that in
cases so characterised its curative action may be markedly
exhibited. But it will be observed that those who write thus use
the higher dilutions exclusively. For more substantial doses
it seems only necessary that the patient shall be within the
first ten days of the fever, or at any rate shall not have passed
from the "gastric " into the "typhoid " condition (I use these
terms phenomenally), to ensure excellent effects from the
drug.
The action of Baptisia in continued fever, like that of Ailanthus
in malignant scarlatina, ought not to be allowed to stand
alone, but should lead to its application to similar pyrexial
states elsewhere encountered. The thirty-first volume of the
British Journal of Homoeopathy contains reports of epidemics
of relapsing fever and of smallpox, by Drs. Dyce Brown and
Eubulus Williams respectively. In the former malady it acted
at least as well as the Bryonia we generally give; but in the
latter it displayed really remarkable powers, enabling hæmorr-
hagic cases to recover, averting prostration, improving appetite,
obviating decomposition (as shown by the absence of the usual
offensive effluvia), and preventing pitting. Of 185 cases treated
with ordinary homoeopathic remedies, 19 died: of 72 treated
with Baptisia alone, none.
Dr. Bayes, saying truly that the most marked action of the
drug in fevers is to clean the tongue and enable food to be
taken, recommends it in analogous gastric conditions, with
much sinking at the stomach. I myself find much benefit
from it in the feverish colds of aged people, which often
assume a low type. I can, moreover, substantiate
from ex-
perience the high commendation given to it by Dr. Mitchell,
of Chicago, as a reducer of the hectic of phthisis.*
The nearest analogue to Baptisia is Gelsemium, which
takes its place in the "remittent fever" of childhood, now
* See United States Med. and Surg. Investigator, vi., 251-4.
280
BAPTISIA TINCTORIA.
maintained by most observers to be of the enteric type. It is
also allied, as an antipyretic, to Bryonia; and, more distantly,
to Acidum muriaticum and Rhus.
Of the dose I have already spoken.
LECTURE XVIII.
BARYTA-BELLADONN A.
I have to-day first of all to speak of the preparations of
Barium. Of these we have information as to four, the acetate,
the carbonate, the chloride, and the iodide. Let us take first
the most important, the carbonate—
Baryta carbonica.
It is of course prepared for our use by trituration.
Baryta carbonica makes its earliest appearance in the first
edition of the Chronic Diseases, where it has 286 symptoms.
In the second edition the list has increased to 794, eight others
contributing to it. Many of the additional symptoms, how-
ever, were obtained from the acetate. Dr. Allen judiciously
isolates those of the carbonate, and, adding some other obser-
vations, gives it a pathogenesis of 674 symptoms.
The main interest of Baryta carbonica in my eyes lies in its
influence on the tonsils. The muriate is, as we shall see, a
powerful remedy for glandular engorgements; and the carbo-
nate shares its virtues in an eminent degree when the glands
affected are the tonsillar. In chronic enlargements of these
organs there is general agreement as to this property of Baryta
carbonica; but it is not so well known as a remedy for acute
amygdalitis-for quinsy. Yet it is here, in my experience, the
most potent of medicines. It was from Dr. Ransford that I
first got the hint of its value; and he has recently given his
experience on the subject.* It was suggested to him, he says,
by Dr. Stens, of Bonn; and has since been of unfailing efficacy
in his hands. I can speak almost as unreservedly. It is im-
portant to distinguish the precise form of angina which calls
for Baryta. It is not the inflammation of the mucous mem-
brane, where Belladonna is so potent, or, if there be much
œdema, Apis; but it is when the parenchyma of the tonsils is
the seat of the mischief. It has rarely occurred to me to see
* Brit. Fourn. of Hom., xxxi., 737.
282
BARYTA CARBONICA.
suppuration follow when Baryta has been administered in good
time for this disorder.
It is probable (as Dr. Berridge points out) that Dr. Stens
took the idea of this piece of practice from s. 279 of Hahne-
mann's pathogenesis, which runs thus:-"After chilliness and
heat and bruised feeling in 'all the limbs, an inflammation of
the throat, with great swelling of the palate and tonsils, which
suppurate, and on account of which he cannot open the jaws,
speak, or swallow; with dark-brown urine and sleeplessness."
One would like to know under what circumstances this symp-
tom (which is said to have occurred 18 days after taking the
drug) was observed.
Baryta is also considered a valuable remedy for senility, so
far as this is premature and therefore morbid. It has some-
times removed, in old men (to whom it seems peculiarly adap-
ted), the after-consequences of apoplexy. Dr. Guernsey con-
siders it especially suitable to dwarfish subjects, of stunted
growth both in mind and in body; and thinks that its action
extends to the lymphatic and salivary glands in the neck.
The medium dilutions-as the 6th and 12th-of this medi-
cine are most in credit, but Dr. Carroll Dunham told me that
he had obtained the effects of Baryta in quinsy from the
200th.
Baryta acetica was, as I have said, the form in which the
metal was proved by several of Hahnemann's fellow-obser-
vers. Their symptoms-indicated by Hahnemann with a line
-have been separated from the rest by Dr. Allen; and, with
those of a recent case of poisoning, are 223 in number.
The poisoning case I have referred to, which was fatal, may
be read in the seventeenth volume of the Monthly Homeopathic
Review (p. 505). It revealed an activity on the part of the
salt hitherto unsuspected: the patient died in the full posses-
sion of his senses, but with absolute paralysis of all the
voluntary muscles. The observer, Dr. Lagarde, proceeded to
test its action upon himself. "After a lapse of three hours,
discomfort and general weakness with light-headedness set in.
In the upper extremities, and under the scalp and skin of the
face, formication was felt. After a second period of three
hours the weakness had perceptibly increased, and the left
arm could no longer be moved, although sensation was intact.
Dr. L. found it impossible to pull the bell or to leave the bed,
and eight hours after taking the dose the upper and lower
extremities were almost paralysed. The paralysis spread to
the abdomen, then to the chest and neck, and lastly to the
BELLADONNA.
283
sphincters. Coughing, spitting, and even the uttering of
polysyllables, became difficult; the respirations were laboured,
and the urine and fæces were evacuated involuntarily. The
pulse fell to 56.”
Such facts explain the repute of Baryta carbonica in para-
lytic affections, and suggest the acetate as a still more potent
form of administering the metal.
Baryta muriatica, the chloride of barium, was the prepara-
tion of the drug given of old in scrofulous disease. Its physio-
logical action is little known; but it has occasionally been
given with much benefit in disease of the mesenteric and other
glands in the homœopathic triturations, as you may read in
Dr. Goullon's treatise on Scrofula. Dr. Hammond, of New
York, employs it largely, in doses of a grain or two three times
a day, in sclerosis of the brain and cord, and professes to
obtain considerable amendment from it. One of our own
practitioners, Dr. Flint, of Scarborough, has recently obtained
with it striking remedial effects, almost amounting to a cure,
in a case of abdominal aneurism, which you may read in the
Monthly Homeopathic Review for June, 1879, and in the
Practitioner for July of the same year. He accounts for
its effect from the irritating influence on the arterial system
which Baryta salts are found, in experiments on animals, to
exert. I shall have more to say on this point when I come to
the action on aneurism of iodide of potassium.
On Baryta iodata, the iodide of barium, you may with
advantage read Dr. Hale's article in the fourth edition of hist
New Remedies. He considers it our best remedy in indurated
glandular enlargements, as of the tonsils, testes, and perhaps
the prostate. Dr. Liebold recommends it in strumous
ophthalmia, where the cervical glands are consentaneously
affected, and the patient is of stunted growth.*
We now begin the consideration of one of the most im-
portant remedies in homoeopathic practice-another apt
illustration, with Aconite and Arsenic, of the maxim magis
venenum, magis remedium-the Atropa
Belladonna.
We prepare a tincture from the entire fresh plant in the usual
manner.
* Trans. of Amer. Inst. of Hom. for 1874, p. 768.
284
BELLADONNA.
an
Hahnemann early devoted attention to the pathogenetic
effects of Belladonna, publishing in his Fragmenta de viribus
medicamentorum positivis (1805) a list of 99 symptoms ob-
served by himself, and 304 taken from records of poisoning
and overdosing. In the last edition of the first volume of the
Reine Arzneimittellehre (1830) the list has swollen to 1440, of
which 390 are his own, 585 from thirteen fellow-provers, and
475 from seventy-two authors. Since that time observations.
of the poisonous effects of the plant have multiplied; and fresh
provings of it, in small doses of the extract, have been made.
by the Vienna Provers' Society.* These I have myself
collated with Hahnemann's pathogenesis, after revising the
cited symptoms of the latter from their originals, in
arrangement of the drug for the Hahnemann Materia Medica
(part iii.). I have included many of the observed effects of
atropia, the alkaloid contained in Belladonna, to which most,
if not all, of its active properties are due. Among these are
some excellent provings conducted under the superintendence
of Dr. E. M. Hale, and recorded in the Transactions of the
Homœopathic Medical Society of the State of New York for
1868. The provers-four in number-took doses of from the
hundredth to the fifth of a grain. The results of recent
experimentation with atropia on animals, which has been very
extensive, are well summed up by Dr. Horatio Wood; and to
his article, to the chapter on Belladonna by Dr. John Harley
in his Old Vegetable Neurotics, to the Etude de la Belladonne of
Dr. Meuriot, and to the essay upon the drug in Hartmann's
Principal Homeopathic Remedies (translated by Dr. Okie), I
shall frequently refer in the course of my remarks. I should
say that Dr. Allen gives separate pathogeneses of atropia and
of Belladonna itself.
Belladonna is an excellent illustration of the fruitfulness of
the Hahnemannian as compared with the ordinary method of
studying medicines. The traditional plan has been to find out
by a few experiments in what class or classes a drug is to be
ranked-whether it is emetic, purgative, sudorific, narcotic,
and so forth; and then to use it in disease when it is thought
desirable to obtain such effects from it. But Hahnemann
taught that every drug must be studied as a separate indivi-
dual; that no general expression or classification can describe
its action; and that a complete register of the effects it
produces is indispensable for its use as a medicine. The
result of the former course of proceeding has been to class
Belladonna as a narcotic and sedative, and to use it in a few
* See Brii. Fourn. of Hom., vi.
BELLADONNA.
285
forms of pain and spasm. To these, previously to the
endosmose from homœopathy which has set in during the last
twelve years, the employment of the drug was restricted, save
for its old employment as a "resolvent," and when Trousseau
gave it empirically in constipation and acute rheumatism.
But the symptoms obtained from it by Hahnemann and those
who have followed him display its influence on well-nigh
every part of the organism; and suggest its application to a
great variety of morbid phenomena.
But now in applying, as well as in studying our medicines,
the method of Hahnemann is the only one largely available.
What use can be made of the information obtained except
upon the principle of similia similibus? What avails it to
know that Belladonna disorders perception, ideation, and
emotion in the hundred and more various ways I have exhi-
bited in my arrangement? There is no malady in which it
can be desirable to set up such disorder. But the rule, "let
likes be treated by likes," at once lays hold of the whole body
of morbid phenomena induced by a drug, and applies it to the
treatment of disease. Because Belladonna has this vast range
of poisonous action, therefore and just so far has it power to
cure. It thus sprang rapidly, in the hands of Hahnemann
and his disciples, into the first rank of polychrests. The
observations of Hartmann well exhibit its estimation and em-
ployment in the homoeopathic school. His catalogue of
disorders in which it has been found beneficial includes the
great majority of fevers, inflammations, congestions and
neuroses. It is probably more frequently prescribed in
homœopathic practice for acute disease than any other medi-
cine save Aconite.
Let us first consider the traditional knowledge and use of
the drug, and see how far it can be recommended as worthy
of imitation.
I. It had long been noted, as Pereira says, that Belladonna
relieved external pains rather than internal. Physiological
experimentation has now explained this, by showing that the
extremities of the sensory nerves are affected by it before
their trunks, which indeed require large doses to influence
them. Thus cutaneous anesthesia is most readily induced by
the local application of the drug; but it occasionally appears
after its ingestion. It was a prominent symptom in Dr. Hale's
provers; and the amaurosis which we shall see caused so
often by Belladonna is of a piece with it.
Belladonna is thus a strictly local anesthetic, acting as such
even when introduced into the general circulation. The only
286
BELLADONNA.
truly analogous morbid state, as a whole, to that induced by
it is the absence of sensibility which sometimes exists in
mental disorder. But the antipathic action of the drug may
here find a legitimate sphere of usefulness, and it may be em-
ployed—locally applied in ointment, liniment, and plaster—as
an anodyne for external pains. Perhaps we homoeopathists
do not avail ourselves sufficiently of such palliative aids,
which, with proper precautions, are as harmless as they are
comforting.
2. Belladonna affects the motor just as it does the sensory
nerves, ie., paralysing their extremities first, and then (if in
sufficient quantity) their trunks. Its action on the motor
centres is, as we shall see hereafter, somewhat different. But
this power of causing peripheral paralysis is turned to useful
account when the drug is employed locally as an anti-
spasmodic, as (for instance) in rigidity of the os uteri during
labour. Such a use of it is probably seen in its control over
the nocturnal enuresis of children. The bladder is one of the
few organs which it paralyses when taken internally; and to a
lesser degree of the same influence must generally, I think, be
referred its power in this malady, which implies excess of
irritability rather than want of power. The main proof of
this position is that large doses are required-ten or twenty
drops of the tincture; and homoeopathic records are signifi-
cantly silent on the practice.* I have never seen any benefit
from the doses we ordinarily use; and in this case we need
not fear the production of physiological effects from the
internal administration of the drug in substance, as children
below puberty are singularly insusceptible to its disturbing
influence.
G
3. Almost the same remarks may be made as to the action
of Belladonna on the sympathetic nerve-fibres, only that here
(with a not uncommon antagonism) it excites instead of
depressing. But here also it affects primarily the extremities
of the nerves; and its influence is only certainly manifest
when it is locally applied, the dilatation of the pupil being the
sole witness to it after internal administration. In this sphere,
too, we avail ourselves of the physiological action of the drug,
using it locally as a mydriatic. I shall return to this subject,
when I come to its action on the eye.
K
I
4. There is yet another power of Belladonna which may
* Dr. Claude records two cases of cure by it in the homœopathic
attenuations; but he admits that he has generally been disappointed
with it (L'Art Médical, xlviii., 345).
BELLADONNA.
287
often be usefully employed, but which as yet is difficult of
explanation; I mean the arrest of secretion it causes, notably
in the salivary glands and the skin. That this action is
exerted through the nerves is pretty certain, both from the
rapidity with which it is induced, and from the antagonism
displayed in regard to it by such pure neurotics as pilocarpin,
muscaria, and physostigma. But it can hardly be brought
about by vaso-motor excitation, as the dried surfaces are
congested rather than anæmic; nor will the depression of the
chorda tympani which is proved to exist account for its
action on the sudoriparous glands, which have not (as far as
we know) any such excitor nerves as have the salivary. But,
however caused, the arrest of secretion which Belladonna
brings about may not unfrequently be induced with benefit to
our patients. We have probably better ways of checking the
sweats of phthisis or other such fluxes, which require the internal
administration of the drug. But its local application in
hidrosis of the hands or feet, in salivation, and-above all-
to check the secretion of milk in sudden weaning or threat-
ened mastitis, is a practice often fraught with advantage.
I have willingly dwelt on these actions of Belladonna, as in
them we are on common ground with our brethren of the old
school, and in our frank acceptance of such practices lies one
of the hopes of a better understanding in the future. The
local and functional influence of the drug herein displayed
can be better utilised in the way of antipathic palliation than
in that of homoeopathic cure. But it would be a great error to
suppose that in such physiological effects and their applica-
tion on the antipathic principle we have the whole sphere of
the drug. When we look a little farther, we see behind these
phenomena of the periphery central disturbances of a very
different kind. While the retina is insensible to actual objects,
visual hallucinations throng about the subject of Belladonna's
influence. While the dilated pupil would indicate that the
brain was suffering from anæmia or effusion, its actual condi-
tion is that of active congestion and often furious excitement.
These phenomena-as also the dry throat, the scarlet skin,
and the conjunctival and vesical irritation which so often
appear-point to properties of another kind. Now, although
writers on Materia Medica treat of Belladonna as a pure nar-
cotic, a toxicologist like Christison does not hesitate to class it
among the narcotico-acrids, adducing several instances in
which inflammatory irritation-as of the throat and bladder-
has resulted from its ingestion. We have only to suppose
that it exerts this influence upon the cerebro-spinal centres
288
BELLADONNA.
also that it irritates nervous tissue besides disordering
nervous function; and the whole problem is solved. The
symptoms of tissue-irritation are seen at the centre, those of
functional excitation or depression at the periphery of the
nervous system; and hence the double set of phenomena
manifested.
Let us now consider, in this light, the disturbances set up
by Belladonna in the brain and cord; and the therapeutic
applications to which they have led under the guidance of the
law of similars. We may divide our matter according as the
phenomena are those of sensibilily, of motility, of the cerebral
functions proper, or of the brain as a material organ.
I. The sensory disturbance caused by our drug varies
according as the centre or the periphery is most affected. In
the latter case we have the anesthesia which has already come
before us; in the former we have such a condition as this,
reported by Hahnemann, and confirmed by Harley-"great
irritability and impressionableness of all the senses; he tastes
and smells everything more acutely; the sense of taste, of
sight, and of hearing is keener, and the mind is more easily
moved and the thoughts more active." Such hyperæsthesia is
always found to be an indication for Belladonna in homœo-
pathic practice. To this point the statements of Pereira are
singularly though unconsciously pertinent. "In the first
degree of its operation," he writes, "Belladonna diminishes
sensibility and irritability. This effect (called by some seda-
tive) is scarcely obvious in the healthy organism, but is well seen
in morbid states, when these properties are preternaturally
increased."
2. The central motor disorder caused by Belladonna is
quite analogous to its sensory disturbance, but is of more
varied character. Now we see twitchings, jerkings, and jacti-
tations like those of chorea, to which in one case of poisoning
they were compared by the reporter.* Now the symptoms
are tetaniform; the animals experimented upon, says Dr.
Fraser, appear as if suffering from strychnia.† Still more
frequently, in severe cases of poisoning, clonic convulsions of
epileptic type appear.‡ Again, there may simply be great
restlessness and bodily inquietude.§
All this is of a piece with the hyperæsthesia we have seen in
the sensory sphere, and, like that, indicates the homoeopathic
* See Hahn. Mat. Med., part iii., s. 22.
† Ibid. s. 28, 29.
‡ Ibid., s. 36-43.
§ Ibid., s. 44-47.
BELLADONNA.
289
use of the medicine. In chorea and tetanus we have scant
records of its employment. Dr. Hoyne relates an instance
of its favourable action in the latter disorder (1, 39); and Dr.
Croucher has lately communicated a case in which a Bella-
donna plaster along the spine seems to have been the curative
agent*. But in eclampsia, infantile and puerperal, it is largely
and successfully used among us; and in epilepsy itself has no
mean reputation. It probably acts here by modifying the
irritability of the medulla oblongata, to which Schroeder van
der Kolk has taught us to look as the centre of the epileptic
convulsion. By the same action it influences hydrophobia,
whose phenomena seem to depend on inflammatory irritation
of the medulla and its issuing nerves; and thus also it occa-
sionally benefits laryngismus, whooping-cough, and asthma.
If it is to do good in affections like these, the patients must (as
a rule) be young and impressionable subjects, of sanguine-
nervous temperament; and, in epilepsy, the malady should be
of recent origin. The use of the remedy on a large scale in
this last disease-as by Greding,† Grandi,‡ and Michéa§-where
all sorts of cases are taken together, has not yielded any great
percentage of cures. But Trousseau, after thirty years' ex-
perience, declared the Belladonna treatment of epilepsy the
least inefficacious he had known; and speaks of having
obtained a certain number of solid cures. Dr. Echeverria
finds it beneficial in epileptic vertigo. As to hydrophobia the
question is still more doubtful. But it is impossible to read
the mass of evidence collected by Bayle without concluding
that Belladonna must sometimes have cured, and has often
prevented, this dire disease, to which it is confessedly homœo-
pathic in the first degree. Youatt had no small confidence in
it as a prophylactic in dogs themselves.¶
So far the motor disturbance of Belladonna has been
obviously connected with its irritant influence on the nervous
centres. But now a glance at its pathogenesis will show a
good many symptoms of loss of power over the extremities;
and this not from exhaustion only, but occurring compara-
tively early in the poisoning. Sometimes, from atropia especi-
ally, the limbs are heavy and helpless: the condition is
compared by one observer to the first stage of the progressive
paralysis of the insane. More commonly, with Belladonna
* Brit. Fourn. of Hom., xxxiii, 266.
† Adv. Med. Pract., ed. Ludwig, vol. i.
Gaz. Méd. de Paris, 1854, p. 757.
§ Gaz. des Hôpitaux, 1861, p. 563-578.
Bibl. de Therap, ii., 502.
See Watson's Lectures, 4th ed., i., 629.
U
290
BELLADONNA.
itself, there is a loss of co-ordination, resembling that of
locomotor ataxy. I have pointed out in another place* that
the poison causes nearly all the apparently incongruous symp-
toms which characterise this singular disease. In the eye it
produces the injected conjunctiva; the dilated, sometimes
varying pupils; the ptosis; and the diplopia and amaurosis so
often observed in ataxy. It develops incontinence of urine
and tactile anæsthesia; and (according to Brown-Séquard)
depression of reflex excitability. Since, moreover, the patho-
logical basis of the phenomena of this disease is in the first
instance of inflammatory nature, it would be the truest homoeo-
pathy to give Belladonna as a remedy in its early stages. I
have had one well-characterised though incipient case, in which
a complete cure has been effected by the Ist decimal dilution
of the drug. And such an application of the remedy should
not stand alone. It has been ascertained that a morbid process
similar to that of locomotor ataxy, but occurring in other
tracts of the cord-a slow inflammation going on to induration
or softening-lies at the root of many other diseases. This
has been well shown by Dr. Jousset in respect of the muscular
tremblings of sclérose en plaques, of spinal paralysis, of general
paralysis of the insane, of the glosso-laryngeal paralysis of
Duchenne, of infantile palsy, and of progressive muscular
atrophy. I should myself be inclined to extend it also to
such affections as neuralgia, glaucoma, and exophthalmic
goitre, in all of which we shall find our Belladonna in repute.
It is of course in the incipience of these maladies—in their
stage of excitement--that the remedy is indicated. Trousseau
and Pidoux speak of Bretonneau as having obtained in several
cases of paraplegia a cure as unexpected as inexplicable by the
use of the drug.
3. We come now to the action of Belladonna in the mental
and moral sphere, which is one of the most potent it exerts.
Perception, ideation, and emotion are equally affected; and in
a manner similar to that which we have seen in the regions of
sensibility and movement. The drug excites and at the same
time perverts their function,-blunting their reaction to real
impressions while quickening in them a feverish automatic
activity, spurring them on in a rapid and disordered course
until they fail for exhaustion. Hallucinations (Stillé says
that the spectral illusions of Belladonna are all of a bright
gleaming character), delirium (often compared to delirium
tremens), insane talking and acting, melancholy and rage are
* On the Various Forms of Paralysis, 1869.
+ Translated from L'Art Médical in Brit. Fourn. of Hom., xxxiii., 577.
BELLADONNA.
291
the features of this part of the pathogenesis of Belladonna;
and are present in the same degree and variety in that of no
other drug save its congeners, Hyoscyamus and Stramoniura.
((
Correspondingly, Belladonna occupies in homœopathic
practice the first rank among the remedies for cerebral dis-
turbance. It is best indicated in the sthenic and congestive
delirium of the fevers and exanthemata; in mania-a-potu;
in furor transitorius; and in acute maniacal delirium, the
délire aigue of the French. A case of this last kind, related
by Dr. Maudsley, resulted from transfer of erysipelas from the
leg to the brain; and to this disease we shall hereafter see
Belladonna strikingly homoeopathic and curative. It should
also be serviceable in acute melancholia; and in the alterna-
tion of epilepsy with insanity. Hitherto, indeed, homœopathy
has had little opportunity of proving its powers in the treat-
ment of mental disease. But now that the New York State
Asylum has been erected for carrying out our method in the
care of the insane, we shall soon learn what we can do in this
direction, and how to do it. Dr. Butler tells me that Bella-
donna has been one of the medicines most largely and bene-
ficially used there; and Dr. Talcott, the present superintendent,
speaks warmly of it in acute mania.* In the ordinary practice,
Belladonna was of old time often employed with success
in mania and mental disorder generally. Trousseau and
Pidoux justify this use of the drug, naïvely remarking that
experience has proved that a multitude of maladies are cured
by therapeutic agents which seem to act in the same manner
as the cause of the disease they oppose."
4. Throughout these pictures of sensory, motor, and mental
disorder we continually have more or less evidence of the co-
existence of active determination of blood. The disturbance
set up is indeed, as I have argued, inflammatory in essence.
Still more marked is this feature when we come to the
symptoms of the head itself. The vertigo, intoxication and
headache so constantly occurring in the provers are all
hyperæmic in character; and in poisonings we have pheno-
mena of acute cerebral congestion, going on sometimes nearly
to phrenitis, more frequently to apoplexy. For the evidence
of this I must refer you to my arrangement of the drug in
the Hahnemann Materia Medica: I must here pass at once to
its therapeutical applications.
The vertigo of Belladonna is, as I have said, hyperæmic;
it is worse on movement and relieved in the open air. In
Dr. Harley's experiments its development seemed to coincide
* Homœopathic Times, vii., 1.
292
BELLADONNA.
with the rise of the pulse. Such congestive vertigo, when
occurring in subjects not too advanced in life, yields readily
to the drug. Of its headache I have been able to collect no
less than seventy-eight instances, including almost every
variety of the affection. Its most frequent seat is the fore-
head and the temples. Belladonna is, from these effects, and
from clinical experience, our chief remedy in headache. It is
suited both to the nervous or neuralgic form, and to the
congestive. Heavy, drooping eyelids, and blindness or flashes
of light before the eyes, point to it; also flushed face, hot
head, and sense of burning in the eyeballs. Secondary vomit-
ing does not contra-indicate it; but in true gastric headache it
is of no use.The Belladonna headache is always aggravated
by light, noise, and movement, and also by lying down; it is
easiest in a quiet sitting posture. Its essential characters,
indeed, are hyperæmia and hyperæsthesia.
It is but a step farther to say that in arterial congestion of
the brain, from almost any cause, Belladonna is an invaluable
remedy. The only instance in which it is outrivalled is the
cerebral hyperæmia of sun-stroke, where Glonoin takes its
place; though not necessarily to its exclusion. Nor does it
cease to be of avail when the congestion runs on to inflamma-
tion. I must agree with Bähr that its action does not
reach to meningitis, if the meninges he has in view are the
dura mater and arachnoid. Over the inflammatory results of
injury to the skull it has thus little power. But in ordinary
phrenitis or encephalitis, such as we meet with in the course
of reaction from concussion, and as the result of mental
excitement, intemperance, and such-like causes, Belladonna
is (with or without Aconite) the main remedy; that is, if the
patient is in the first stage of the disorder, and not in that of
effusion or collapse. It is no less valuable in apoplexy, as
long as cerebral hyperæmia is present, whether before or after
extravasation has occurred. Here, too, it is useful to check
the tendency to secondary inflammation.
Before leaving the sphere of the nervous system, I must
speak of the action of Belladonna in neuralgia. Its causation
of this phenomenon is doubtful,-only one symptom of the
kind being on record, in the fourth of Dr. Hale's provers.*
But Dr. Anstie has argued (mainly on the ground of the
numerous complications so often present in severe cases-as
spasms, paralyses, inflammations, disorders of nutrition, secre-
tion, and sensation) that true neuralgia is always of central
origin. The particular seat of it he thinks the posterior root
See Hahn. Mat. Med., part iii, s. 438.
BELLADONNA.
293
of the spinal nerve in which the pain is felt. In reviewing Dr.
Anstie's admirable treatise in the British Journal of Homœo-
pathy I have suggested that it is rather to the grey nucleus
we should look than to the issuing fibres. I have also pointed
out that the analogy of locomotor ataxy, whose pains Dr.
Anstie characterises as truly neuralgic, indicates that the
central mischief is primarily at least of an inflammatory nature.
If these things are so, we have no difficulty in understanding
how Belladonna cures neuralgia homœopathically, though it
has not time enough to set it up. The neuralgia which indi-
cates it is of comparatively recent origin, and occurs in young
or middle-aged persons. It is associated with marked sym-
ptoms of hyperæmia, and differs from that of Aconite-which
otherwise it so closely resembles-in having hyperæsthesia
present. It is usually situate in the trigeminus (especially the
right one), the drug having little influence over sciatica or
other neuralgiæ occurring below the head and neck. This is
also the experience of Trousseau.
Dr. Bayes says that a characteristic symptom here is
accession or aggravation of the paroxysm at about 5 P.M.;
while Dr. Guernsey notes of the pains that they come and go
with great celerity, and are made worse by the least jar. Dr.
Dunham considers the remedy not less indicated when the
pains, though suddenly disappearing, gradually increase to
their acme.
I have now concluded what I have to say of the action of
Belladonna upon the nervous centres. We have seen it
everywhere inducing excited but perverted functional activity,
increased manifestation of energy with diminution of real
power and effectiveness. Such are the hyperæsthesia in the
sensory sphere, the jactitation in the motor, and the delirium
in the ideational, which it confessedly developes. The pheno-
mena precisely correspond with the more active production
of cells of a low order-the "increased attraction of
nutrient fluid with "diminished selection "-displayed by the
non-nervous tissues when inflamed. I have accordingly
suggested that they imply inflammatory irritation of the
nervous substance on the part of the drug, and have supported
my view by pointing to the active hyperemia which is always
more or less manifestly present. This doctrine has indeed
long been tacitly accepted in the school of Hahnemann, as
shown by the universal recognition of the homœopathicity of
در
XXX., 367.
† I first did so—as a result of a study of the drug carried out with
Dr. Madden—in the Brit. Journ. of Hom. for 1862 (vol. xx).
294
BELLADONNA.
Belladonna to cerebral inflammation: I have only put it into
the language of modern pathology. We are glad to receive
for it the support of Dr. Harley. At the end of his analysis
of the effects of the drug he concludes that "the whole of the
phenomena may be attributed to excessive stimulation of the
nerve-centre. attended by increased oxidation;" and that
"hyperoxidation of nerve-tissue" is the essential action of the
poison. This is but the same thing in other words.
But observe the difference in practical results. Dr. Harley's
conclusions lead him to no therapeutic application of the
drug; while ours, by the way indicated by the rule similia
similibus, have made it the prime remedy for all disorders of
the nervous centres in which hyperæmia is associated with
hyperesthesia or pain, disordered co-ordination or clonic
convulsion, hallucination, excitement, or delirium. It is in
such conditions a remedy most highly prized by all who
practise homœopathically; and by none more so than those
among them who most habitually employ infinitesimal doses.
The remedy thus reflects confirmation and honour on the
method that created it, and adds another and no insignificant
leaf to Hahnemann's laurel crown.
LECTURE XIX.
BELLADONNA (continued).
At our last meeting we made a full study of the action of
Belladonna in the sphere of the nervous system, where we
meet with its most prominent effects and frequent uses. But
we have yet to see it operating as a potent agent in several
other regions. I shall speak of it to-day as it affects the
circulation and temperature, the mucous membranes and skin,
the eyes, the urinary organs, and the uterus; concluding with
some miscellaneous applications which it has received.
I. Belladonna, in not too excessive doses, increases the
action of the heart both in force and frequency. The latter
phenomenon seems due to paresis of the inhibitory fibres of
the vagi,-the drug acting (as we have seen it do elsewhere)
on the extremities of the nerves in the heart.* But were this
its only property, there would be no increase of the force of
the circulation; and for this we must invoke the stimulant
action on the sympathetic which we have already seen it
displaying, and which-if exerted-would make the heart's
beats stronger as well as more rapid. Thus also we account
for the fact that the arteries are contracted under its influence,
and the blood-pressure increased. Such arterial contraction
was long ago ascertained to follow its application to the frog's
web by Mr. Wharton Jones,† and the same thing has been
observed as a consequence of its internal administration by
Hughes Bennett‡ and by Harley. Many years ago, before
I knew anything of homoeopathy, I made an attempt to
account for its whole action on the body by means of this
influence;§ and, though the generalisation was unwarranted,
the fact remains established. Dr. Handfield Jones, it is true ||
-and also Dr. Dyce BrownT-has assumed an opposite
action on its part, on account of the hyperæmia manifested in
* A full account of the experimentation by which this action of atropia
is ascertained is given by Dr. Lauder Brunton, in his Experimental
Investigation of the action of Medicines, part i., p. 60.
† Brit. and For. Med. Review, xiv., 603.
Researches into the Antagonism of Medicines, 1875, p. 41.
§ See London Med. Review for 1860.
|| Functional Nervous Disorders, sub voce.
TMonthly Hom. Review, xv., 353.
296
BELLADONNA.
the head and on other surfaces by the subjects of its influence.
But it must be remembered that there are two ways in which
the circulation in any part may be increased, the one by
relaxation of its blood-vessels, the other by irritation of its
tissue. Opium, Amyl nitrite, and Glonoin, which primarily
dilate the arteries, may well be conceived to act in the first of
these two ways: Belladonna, which contracts them, can only
congest a part by irritating its substance, and so compelling a
larger afflux of blood. In this way-as we have seen in the
nervous system, and as we shall see in many other parts—I
account for the hyperæmia manifested under the influence of
our present drug.—Belladonna of course conforms to the law
of other stimuli, and in excessive quantities exhausts the sus-
ceptibility of, and so paralyses, the organs it naturally excites.
But such actions are, as I apprehend, beyond the sphere of
true pharmacodynamics, as available for therapeutic purposes.
The above phenomena, which I have expressed as obtained
by modern experimentation, have many prototypes in the
symptoms of poisoning and proving collected by Hahnemann.
Moreover, the febrile condition so repeatedly recorded by the
latter as resulting from the drug has now been demonstrated to
be a true pyrexia. "The similarity," writes Dr. Harley, "of the
general phenomena which attend the operation of Belladonna
and those which accompany pneumonia, enteritis, the develop-
ment of pus in any of the tissues and organs of the body, &c.,
arrests attention;" and again-" an infinitesimal quantity of
atropia—a mere atom-as soon as it enters the blood, origi-
nates an action which is closely allied to, if it be not identical
with, that which induces the circulatory and nervous pheno-
mena accompanying meningitis, enteric, or typhus fever."
Other experimenters also have found a considerable elevation
of temperature-from 1 to 4 degrees centigrade—under the
action of atropia. The fever induced differs considerably from
· that of Aconite and Arsenic. The chill is slight, and sweat-
ing is rare after the heat: the heat itself is very decided, the
surface feeling burning, but there is no great thirst, nor is
there either the prostration of Arsenic, or the restless,
uneasy, anxious condition especially characteristic of Aconite.
We of the homoeopathic school have long ago drawn from
such facts the inference that Belladonna has an important
place in the treatment of the primary fevers; and that where
pyrexia accompanies inflammation of parts which it specifically
irritates (as the brain or throat) it suffices to control both the
general and the local phenomena. It is interesting to
find Dr. Harley coming to the same conclusion. "It appears,"
BELLADONNA.
297
he writes, "that the stimulant action of Belladonna is con-
verted in great measure in febrile diseases into a tonic and
sedative influence." He gives it largely in the continued fever
to which he likens its action; and in the pyrexia symptomatic
of inflammations explains its modus operandi thus-" two
similar effects, the one arising from a local irritation and the
other from the presence of Belladonna, like spreading circles
on a smooth sheet of water, interfere with and neutralise each
other." He believes that "it has not yet attained to its legiti-
mate place as a therapeutic agent," and anticipates that “its
sphere of usefulness will be acknowledged before long to be
co-extensive with acute disease itself." If he would look into
homœopathic literature he would find that Belladonna had
attained this its "legitimate place among those whom
he stigmatises as "blindly led by an unscientific dogma" at
least fifty years ago; and that the analogy by which he
explains its action is a household word among them.
"}
The kind of fever to which Belladonna is specifically appli-
cable is that in which the excessive oxidation in which the
febrile process may be conceived to exist falls chiefly on the
nervous centres. The type to which it conforms is that which
our forefathers described as "typhus nervosus." The most
familiar example of the kind is the "brain fever" of over-excite-
ment; but a similar condition is often presented by the
toxæmic fevers. It is where there is too much blood-poisoning
for Aconite to act, but not enough to require Arsenic, and
where the disorder of the vegetative life for which Baptisia is
indicated is less prominent than that of the nervous centres,
that Belladonna finds its sphere. It is thus very frequently
our main antipyretic in the earlier stages of continued fever,
especially when presenting the form which used to be called
*
cerebral typhus." Turgor of the face, often with shining
eyes, is characteristic for it here. It also supplants Aconite in
puerperal fever, and in the more profoundly penetrating
exanthemata. In the initial fever of variola it has received
high commendation in both schools.* With scarlatina its
name is inseparably connected, from the virtues claimed for it
by Hahnemann as a (temporary) prophylactic against the
disease. His account of how he arrived at this estimate of it
is very interesting: you may read it at p. 466 of Dr. Dudgeon's
translation of his Lesser Writings. Much controversy has
raged on this subject, and very different results have been
obtained by different experimenters.† I think (as does Dr.
Stillé, no favourable judge) that the conclusion must be in
* See London Med. Record, Feb. 15, 1879.
(<
298
BELLADONNA.
favour of its pretensions; and that we do well in administering
it-according to the custom of most homoeopathists-when-
ever scarlatina breaks out in a household. The analogy of the
prophylaxis of ague by quinine makes strongly in its favour.
It was the homoeopathicity of Belladonna to scarlatina
which led Hahnemann to it; and, though some rash con-
troversialists have questioned the fact, it is generally admitted.
Not merely has the cutaneous irritation of the drug (which
sometimes ends in desquamation) been compared by many
observers to the scarlatinal eruption, but we have also in the
disorder the fever, the angina faucium, and the delirium also
induced by the drug. It thus naturally plays an important
part in our practice in the curative as well as the prophylactic
treatment of scarlatina. Hahnemann lays much stress on its
being the "smooth " scarlatina in which Belladonna is so potent
to prevent and cure: disappointment, he says, has commonly
proceeded from confounding this with the rothe Friesel, which
is a different malady. It is the smooth scarlatina which we
ordinarily see in this country.
II. Together with its pyrexia, Belladonna congests the
mucous and cutaneous surfaces throughout the body. "The
mucous membranes," writes Dr. Meuriot, "ten minutes after
the injection of atropia, are red, injected, and dry." This
seems to be the rationale of the well-known dry mouth of the
drug. It is not the mere result of diminished saliva, nor of
occluded arteries: "the blood-vessels of the part," says Dr.
Harley, "are congested, and the blood is arrested." After a
time, the dryness is relieved by a secretion of mucus, foul
and viscid; and therewith the pulse falls. In fever, as the
same author states, atropia will moisten the dry tongue,
moderating the circulation at the same time.
This condition of mucous membrane is probably induced
by the drug throughout the body: it explains many of the
symptoms it causes, and warrants the use of the medicine in
similar dry catarrhs wherever occurring. At some points,
however, the action runs on to actual phlegmonous inflamma-
tion. Besides the conjunctiva (of which I shall speak here-
after), this condition is best seen in the throat, which is one of
the cardinal centres of the action of Belladonna. Dryness,
dysphagia, constriction, soreness, painful deglutition, swelling
and burning, are the sensations experienced here by the
subjects of its influence; and the physical signs of inflamma-
tion are often evident. Correspondingly, for acute sore throat
Belladonna is as complete a specific as medicine can present.
It is specially indicated where there are much heat and pain
BELLADONNA.
299
on swallowing, bright redness of the affected parts, flushed
face, and headache. When the parenchyma of the tonsils is in-
volved-when we have true quinsy-I confess I prefer Baryta
carbonica. But Hahnemann himself extols Belladonna here;
and cites a case* where quinsy supervened during the treat-
ment of jaundice by Belladonna-whether post or propter can
hardly be decided. Elsewhere the signs of its tonsillar in-
fluence are not very prominent.
· III.
The skin is affected with Belladonna much as are
the mucous membranes; it becomes dry, red, and hot. Some-
times, especially in the face,t the action goes on to inflamma-
tion; and we have the condition which makes it as similar as
it is potent in the treatment of erysipelas. Every one who
has adopted this bit of homoeopathy from us-from Liston of
old down to Ringer to-day-speaks highly in its praise. Here,
as in the throat, it is the smooth, tense, bright-red surface
which calls for it; when much oedema exists, Apis is con-
sidered preferable, and when many vesicles form, Rhus-
though Dr. Yeldham would have us rely upon Belladonna in
every variety of the disease. Boils and carbuncles, which bear
so close a relation to erysipelas, may generally be helped-
the former often blighted-by our medicine.
IV. I come now to a very important and interesting sphere
of the action of Belladonna,-I mean the eye. The points
which here arise for physiological discussion would well-nigh
occupy a lecture of themselves: I must sternly confine myself
to a statement of the facts and to practical conclusions.
Belladonna displays in the visual apparatus nearly all the
actions of which we have seen it possessed. It anesthetises
the retina; it depresses the motor oculi, and excites the sym-
pathetic fibres which animate the iris; it frets the visual
centres to hallucinations, and inflames the conjunctiva. Let
us consider,-first its inflammatory effects; secondarily, its
influence upon the pupil; thirdly, the disorder of vision pro-
duced by it.
1. That Belladonna inflames the eye is very obvious. The
injection of the ocular membranes present during its action is
not merely symptomatic of cerebral hyperæmia, but is a direct
tissue irritation, which has often gone on to conjunctivitis.
Evidence of a similar condition in the sclerotica, iris, and even
retina, is not wanting in the pathogenesis of the drug; and
the same may be said of the lachrymal sac and canals.‡
* S. 507.-See Brit. Journ. of Hom., xxxi., 476.
† Hahn. Mat. Med., part iii., s. 424-7.
‡ Ibid, s. 449, 458, 472-3, 502, 508-9, 532-4, 538-44.
300
BELLADONNA.
·
Belladonna is, accordingly, a prime remedy in homoeopathic
practice for inflammatory affections of the eyes. It is in-
dicated in the severer forms of catarrhal ophthalmia, and in
strumous ophthalmia when of inflammatory type; also (say
Drs. Allen and Norton) in the acute exacerbations of chronic
disease, as granular ophthalmia. Sense of burning and dryness
in the eyes is characteristic of it here. I have seen it act
admirably in two cases of iritis of traumatic origin. Its use as
a mydriatic in iritis generally is well known and universally
adopted: I am not sure but that part of the good it does is
due to its specific operation. Dr. Anstie thinks that he has
seen incipient glaucoma checked by the subcutaneous injec-
tion of a minute dose of atropia in the neighbourhood of the
eye, whilst not uncommonly, in chronic glaucoma, its employ-
ment has been known to cause an inflammatory attack. The
fact that this peculiar affection is often a trigeminal neurosis,
of cerebral origin, and liable to complicate neuralgia of that
nerve, would also suggest the possible usefulness of Bella-
donna in it, as we have seen in the case of Aconite. Our
remedy is suitable to retinal hyperæmia,-especially (Drs.
Allen and Norton say) if a red conjunctival line is very
marked along the line of fissure of the lids; and even to
retinitis when acute and recent. A good cure with it of the
latter affection is recorded by a son of the Hartmann whose
monograph on the drug I have mentioned,* and another by
Dr. Norton. It has also cured optic neuritis.
2. The dilatation of the pupil so readily and uniformly
caused by Belladonna has long been a subject of great interest.
I have always been one of those who have maintained that
the phenomenon is due to excitation of the radiating fibres of
the iris through the sympathetic.† Dr. Harley has reinforced
our side, advancing against the opposite hypothesis of mere
paralysis of the third nerve the very different effects of Conium
(which undoubtedly causes such paralysis) and Belladonna
on the eye. Dr. H. Wood, after reviewing all recent experi-
mentation, concludes that here (as also in the heart and
intestines) both kinds of influence are at work-the cerebro-
spinal fibres being depressed and the sympathetic excited.
But the most important fact he brings forward is that the
whole action is a local one, even when the drug reaches the
eye through the general circulation. For thus is explained
that to which I have often called attention,-that the dilated
pupil of Belladonna is quite unconnected with its cerebral
* Brit. Journ. of Hom., xxxi., 182.
† See Ibid, xxii, 435.
BELLADONNA.
301
effects, which indeed, when occurring idiopathically, are asso-
ciated with contraction rather than expansion of the iridal
aperture. Dilated pupils, therefore, are at least no necessary
homœopathic indication for the use of Belladonna in cerebral
disorders; and often tell of a condition of exhaustion or
effusion to which the drug is quite unsuitable. Mere pheno-
menal homœopathy would demand their presence to make up
the totality of symptoms; but here, as in so many places,
physiology enables us to correct the impressions of our senses,
and to obtain similia which shall be real and not apparent
only. On the other hand, when Graves recommended the
administration of Belladonna in the head affections of fever,
when the pupils were contracted, although he thought himself
acting upon the old principle of antipathy, his remedy was
really homoeopathic to the morbid condition present.
I do not of course deny that a dilated pupil may be one of a
group of symptoms to which Belladonna is homœopathic and
curative. It is a part of the general influence of the drug on
the sympathetic (and perhaps musculo-motor) nervous system,
though not of that which it ordinarily exerts upon the brain-
substance. Thus Dr. Harley, when speaking of its action in
fever as just the opposite of that which it exerts in health,
says" it may happen, if we give a dose of atropia to a patient
with a pulse of 120 or higher, a dry and hard tongue, and
pupils measuring the ", that after ten, twenty, or thirty
minutes, when the action of the belladonna is fully developed,
the pulse will be decreased, the tongue be moist, and the pupils
contracted." So von Graefe has sometimes observed ephemeral
mydriasis as a premonitory symptom of insanity, especially of
ambitious monomania.
3. The impairment of vision caused by Belladonna is of two
kinds. That which is produced by its local application is far-
sightedness. It is hardly correct to call it either hyper-
metropia (as Dr. Harley does) or presbyopia (as it is generally
styled); for both these names connote substantive alterations
in the refracting media of the eye, while all that atropia pro-
duces is loss of power of accommodation for near objects.
That it effects this by paralysing the ciliary muscle, through
the nerves from the third which supply it, seems abundantly
proved; and I must abandon the view which, in agreement
with Dr. Harley, I formerly held as to the part played by the
iris in the process.
-
No therapeutic inference, upon the homeopathic principle,
is deducible from this action of the drug. But Pereira is mis-
taken in supposing that the impaired vision of Belladonna is
302
BELLADONNA.
"chiefly or entirely presbyopia." It has been noted when no
mydriasis has been present, and therefore presumably no
paralysis of the accommodation.* I must, therefore, explain
some at least of the blindness so often noted from its ingestion
by a direct anæsthetic influence exerted by it upon the retina,
analogous to that which it displays at other points of nerve-
termination. Whether its occasional curative power in
"amaurosis" is due to such an action I cannot say. Symp-
toms of hyperæmia, with photopsies and chromopsies (as red
sparks, flames, bright spots, lights, &c.), or chromatic ap-
pearances of bright objects, have generally been present in such
cases; and suggest, as they do in the pathogenesis of the drug
(where they frequently appear), congestion of the retina.
V. I have now to speak of the action of Belladonna on the
urinary organs. Passing out with the renal secretion, it excites
the circulation of the kidneys on its way; causing either
diuresis, or if the dose be large-congestion and stasis, with
diminution or even temporary suppression of urine. It seems
to be the primary or Malpighian circulation of the kidneys
which is influenced by Belladonna: there is no reason to
suppose that it has any direct action on the secreting cells of
the convoluted tubes. Belladonna, therefore, does not accom-
pany the scarlatinal poison the whole length of its course.
When tubal nephritis has been set up, it cannot neutralise the
mischief; though it may (like Terebinthina) do good by
unloading the Malpighian capillaries, and so setting free a
copious flow of urine to flush the ducts. But if renal
hyperæmia, whether from scarlatina or from cold, go no farther
than to produce defective secretion, hæmaturia, or even albu-
minuria, Belladonna may be all that is required. Dr. Harley
thinks highly of it in the last-named condition; and himself
points out that the quantity of albumen is liable to be increased
"unless the dose is a very small one." That is, he admits its
action to be homoeopathic.
K
Descending from the kidneys to the bladder, we find the
latter powerfully affected by Belladonna. The condition most
frequently set up is well illustrated in a case seen by Sir
William Jenner, where a Belladonna plaster had been placed
on a somewhat abraded surface of the body. Two hours after
the first appearance of the symptoms, "the patient was affected
with an extreme desire to micturate, though he could pass
only a few drops of perfectly colourless urine. From this time
till he lost consciousness, his desire to pass urine was constant:
* See Hahn. Mat. Med., part iii., s. 545-6.
† Ibid, s. 553-4.
BELLADONNA.
303
whenever he could retire, he did so, but succeeded in expelling
from the bladder, with considerable effort, only a few drops of
colourless fluid." I cannot agree with Dr. Harley that this
frequent and urgent micturition is "the result of repeated calls
to empty a distended and weakened bladder." It seems to me
a true strangury, by which phrase it is described by Christison
as occurring, with even bloody micturition, at the close of
poisoning cases.* No spasm, indeed, is present, and the
absence of pain forbids the supposition of inflammation; but
I think that irritation to no slight extent is set up. Böcker
states that the vesical mucus in the urine is increased by Bella-
donna. Correspondingly, for simple irritation of the bladder,
short of actual inflammation, I know of no medicine so valu-
able as Belladonna.
Of course in thus venturing to differ from Dr. Harley as to
the ordinary action of Belladonna on the bladder, I have no
thought of denying that in large doses it may paralyse this
organ, both in its detrusor and in its sphincter fibres. I have
already ascribed to such an action its power of breaking the
habit of nocturnal incontinence of urine in children.
6. I would finally speak of the action of Belladonna on the
uterus. Of this, from the physiological side, we have very
little evidence. Nearly all the symptoms (which are but
twenty out of a pathogenesis of 2680) given by Allen as be-
longing to the female sexual organs are from Houat or
Greding, either, though for different reasons, an impure source.
The residue enable us to affirm two things only. The first is,
that the drug is capable of producing a sensation of pressing
and urging towards the sexual organs, as if everything would
fall out there. The second is, that it tends to promote and
increase the menstrual flow. It is also said, in a quotation which
I am unable to verify, to have caused, in one case, "badly-
smelling metrorrhagia. It is, however, in high esteem as a
therapeutic agent in uterine congestions and inflammations.
Hartmann writes-" that Belladonna exercises a decided in-
fluence upon the uterus is proved by the essential aid it affords
>>
-
* See s. 2635 in Allen's Supplement.
† From the arrangement of the sexual symptoms in Hahnemann's
pathogenesis, it would seem that this symptom had been observed by
Stapf on his own person; and also by Hahnemann on a woman, under
dubious circumstances, indicated by its being bracketed. Dr. Allen
gives the latter under the head of " abdomen," and includes the former
in his symptoms of the female sexual organs.
Dr. Allen gives this symptom twice, ascribing it in the second
case to Gross, as contained in Hahnemann's pathogenesis. I can find
no such observation from him there.
304
BELLADONNA.
in that terrible disease, uterine cancer, and in not merely the
palliation, but the cure it effects in relaxation of the uterus,
or even the prolapsus which results from that disease. In
all of these affections, the sensitive urging and pressing down-
ward, as if all the deeper-seated viscera would protrude at the
genitals, exists, with which there is generally united a sensitive
pain in the sacrum, all of which symptoms characteristically
indicate Belladonna." He also recommends it for uterine
congestion, “manifested particularly by a violent burning,
stinging, fulness, tension and urging, deep in the abdomen
and the sexual organs generally, with which there is often
conjoined a dragging, lancinating sensation around the loins,
and heat in the region; also sensitive pressure and constrictive
pain in the small of the back, which causes the patient to
walk slowly and carefully." Dr. Matheson* speaks in the
warmest terms of the value of the drug in congestive and in-
flammatory conditions of the uterus. He gives the lowest
decimal attenuations; but Drs. Leadam and Guernsey, who
use the higher, seem no less appreciative of it. The former
speaks warmly of its power to relax rigidity of the os uteri
during labour; and the latter mentions hot discharges as indi-
cating it in both menstrual and lochial derangements.
W
Dr. Dunham, in his Lectures (I, 262), has some valuable
remarks on this subject. "No remedy," he says, "is more fre-
quently and successfully employed for affections of the genital
organs of women." He, with Hartmann, praises it in prolapsus,
when this is (as it were) active, rather than the passive relaxed
condition indicating Sepia and Stannum. The bearing down
is worse when the patient sits bent over, and when she walks,
but better when she sits erect or stands. I should call it a
kind of tenesmus of the cervix. He describes a form of
dysmenorrhoea connected with ovarian congestion, in which
he has found its repetition just before each menstrual epoch
for several months completely curative. He has also removed
with it offensive odour of both catamenia and lochia, being led
to it by the symptoms of Hahnemann's pathogenesis which I
have mentioned.
In the observations I have now made, the main action of
Belladonna, both as poison and as remedy, has been brought
before you. There are yet a few other applications of it, how-
ever, which must be noted before I leave it.
1. The first is its use in exophthalmic goitre. Dr. Kidd
*On Some of the Diseases of Women (1876), p. 40.
BELLADONNA.
305
long ago put on record a case cured by it,* and it has since
become a favourite remedy in the hands of many homœo-
pathists, as you may see from a discussion on the subject at
the British Homœopathic Society, reported in the thirty-third
volume of the British Journal. Dr. Jousset is one of those
who esteems it here. Its employment is now gaining ground
in the old school, as Dr. Ringer tells us-candidly admitting
at the same time that the practice was initiated among
homoeopathists.
2. Belladonna does not play such an important part in aural as
it does in ocular disorders; but its applicability to inflammation
of the middle ear, especially when brain symptoms coincide, is
obvious. Hartmann writes-"Although I am convinced, from
repeated experience, that Pulsatilla is almost specific in otitis
interna et externa, still cases do occur in which it is not suffi-
cient, but must give way to Belladonna. This occurs where
the internal inflammation is more vividly developed than the
external, or where the consensual cerebral symptoms are pro-
minent phenomena." This expresses the general experience
of homoeopathists.
G
3. We should hardly have known that Belladonna had any
action on the teeth and gums, had it not been for Hahne-
mann's provings. They, however, show it to be eminently
suitable to inflammation of the dental pulp. Whenever the
burning, throbbing and swelling indicative of this condition are
present in toothache, Belladonna should be given, especially
when the pain is worse at night. It will often, especially if
aided by Aconite, arrest an incipient gumboil. In this cate-
gory, too, I must speak of its great value in the dentition
troubles of children. It is when there is both the febrile con-
dition of Aconite and the nervous erethism of Chamomilla,
with marked cerebral excitement and tendency to convulsions,
that Belladonna exceeds either medicine as a remedy. The
higher dilutions generally answer best.
4. Belladonna plays but little part in the treatment of dis-
orders of the digestive organs, though it affects the whole
alimentary mucous membrane somewhat as it does the mouth
and throat. It has been recommended in peritonitis, in in-
flammatory ileus, and in colic when a spot is as if griped with
the nails, or when the transverse colon is felt through the
abdominal walls distended like a pad. A corresponding
action on the respiratory mucous membrane makes it very
useful in dry, irritating laryngeal coughs, worse in the evening
* Brit. Fourn. of Hom., xxv., 187.
† See cases by Mr. Harmar Smith, Brit. Journ. of Hom., xxv., 624.
X
306
BELLADONNA.
and early night; also in incipient laryngeal and bronchial
catarrhs, where congestive symptoms are marked. Dr. Dun-
ham's comparison between it and its cognate remedies here
should by all means be read (loc. cit., p. 267).
5. Lastly, there seems little doubt of the influence of Bella-
donna upon the lymphatic and mammary glands. It will often
subdue the beginnings of inflammation in the former,—best,
Dr. Jousset says, when given in the mother tincture. In
mastitis it is much praised when the mischief has got beyond
the point at which Bryonia checks it. "The breasts feel
heavy, and appear hard and red, the redness often running
in radii; flushed face and injected eyeballs; full, bounding
pulse; drowsiness; throbbing headache; sensitiveness to noise
and light," these are Dr. Guernsey's indications for it.
I have yet to say a few words about the celebrated alkaloid
of Belladonna,
Atropia. Being unable to discover the least difference in
kind between the poisonous effects of the drug and its pro-
duct, I have spoken of the two interchangeably. Dr. Allen,
however, has given a separate pathogenesis of atropia, con-
taining upwards of 500 symptoms. I too think that thera-
peutically we should keep them distinct. In all that I have
said hitherto about treatment, I have been speaking of the
administration of Belladonna. Whether atropia should ever
be used in its stead has been inquired into by the late Dr.
Caspar, of Vienna.* He treated more than a hundred cases,-
at first by giving atropia after Belladonna, though apparently
well indicated, had failed, and afterwards, as his knowledge
grew, by prescribing it in the first instance, following it up, if
ineffectual, by Belladonna. His main conclusion is that, as a
therapeutical agent, atropia occupies the purely neurotic sphere
of Belladonna, having no place in its tissue-irritations and
vascular excitements. He has cured with it idiopathic and
post-febrile headaches of long standing, hallucinations,
epilepsy (in three instances), irritable throat and larynx,
whooping-cough in the convulsive stage, and asthma. He
thinks that it has little or no action below the diaphragm.
But Dr. Kafka, after a proving of the sixtieth of a grain of the
sulphate of atropia upon himself, was led by the symptoms in-
duced to give it in chronic affections of the stomach attended
with much pain and vomiting, and with very satisfactory
results.† Dr. Bähr recommends it to relieve the pain of gastric
* See North Am. Journ. of Hom., vi., 457.
† Brit. Fourn. of Hom., xv., 238.
M
BELLADONNA.
307
ulcer; and in a case recently reported from America it seems
to have effected a complete cure.*
The second trituration has generally been that employed.
* Amer. Journ. of Hom. Mat. Med., Nov., 1872.
LECTURE XX.
BERBERIS, BISMUTH, BORAX, BOVISTA, BROMINE AND THE
J
BROMIDES.
I shall begin this lecture with a sketch of the action of the
barberry,
Berberis vulgaris.
We make a tincture from the small branches of the root, or
the bark of the larger roots.
An excellent proving of Berberis, made upon five persons,
mainly with infusions of the root, was published by Dr. Hesse
in the first volume of the Journal für Arzneimittellehre. Its
symptomatology is reproduced by Dr. Allen, who gives 1262
symptoms to the drug. A study of this pathogenesis, by Dr.
Edward Blake, may be read in the thirty-third volume of the
British Journal of Homeopathy.
From some remarks of Dr. Hering's in the sixth volume of
the American Homeopathic Review (p. 48), we learn that the
symptoms of Berberis have led to its successful use in several
affections of the biliary and urinary tracts. Mr. Clifton has
commended it to relieve pain in the passing of gall-stones,
and in hepatic congestion ;* while Dr. S. E. Newton, following
up a previous experience of Dr. Lippe's, praises it in the
sufferings attendant on the passage of urinary gravel.† These
actions are in perfect accordance with its pathogenesis, which
shows a marked influence on the two tracts now specified, with
alteration in their secretions. I am inclined to think that the
hepatic is the primary action; and that the urinary symptoms
are due to a change in the renal secretion secondary thereto,
setting up irritation of the mucous membrane along which it
passes. But, however this may be, whenever you meet with
pain, soreness, and burning in the biliary or urinary tracts
(especially when, in the latter case, there is much pain in the
Monthly Hom. Review, xii., 405.
† Brit. Journ. of Hom., xxxiii., 362.
BISMUTHUM.
309
hips), with tendency to gall-stone and gravel, you will do well
to think of Berberis.
Some attention has of late been directed to an alkaloid
found in Berberis, and present also in Hydrastis, Podophyllum,
and Calumba, which is called berberin. Experiments on ani-
mals prove it a very mild poison, such symptoms as it does
"Given to
produce being those of gastro-intestinal irritation.
fowls," writes Dr. Phillips, " in pills amounting to a quantum
of four to eight grains with each day's food, the drug produced
progressive loss of appetite, to the extent of causing marked
inanition." These effects may throw some light upon the
"stomachic" virtues ascribed to Calumba; but they do not
hint at the special virtues of Berberis. Berberin has also been
credited with anti-periodic properties, but recent trials have
resulted negatively.*
Berberis may be compared with Nux vomica and with
Capsicum.
The dilutions from six to eighteen were used in the cases
Dr. Hering reports; but the later experience I have mentioned
was gained with more substantial doses-Mr. Clifton getting
no good effects until he resorted to the mother-tincture.
Dr.
Blake's experience, and (I may add) my own, is to the same
effect.
My next medicine will be the familiar
Bismuthum.
Hahnemann called his preparation an oxide, and under this
name its symptoms appear in Allen's Encyclopædia. But I
think that if you read his directions for making it you will
agree with me that the resulting salt is identical with that
which chemists now style the subnitrate, and which is the.
bismuth of ordinary practice. This is the conclusion also of
the British Homoeopathic Pharmacopoeia, which directs the
officinal subnitrate to be used, and prepared of course by
trituration.
The primary proving of Bismuth is in the sixth volume of
the Reine Arzneimittellehre, where eleven symptoms are given
by Hahnemann, and ninety-seven by three others. Some
additional experiments with full doses are recorded by Wibmer,
and given in symptom-form by Allen under the head of Bis-
muthum subnitricum.
* See Brit. Fourn. of Hom., xxxi., 190. Practitioner, xi., 333.
310
BISMUTHUM.
Bismuth has long been known as a remedy for gastric pain
and vomiting. Hahnemann thinks that the symptoms ob-
tained from it show it to be homoeopathic enough to such
conditions; and Pereira speaks to the same effect when he
says that "in large doses it disorders the digestive organs,
causing pain, vomiting and purging." But recent experience
with it in chronic diarrhoea, such as that of phthisis and of
unhealthy children, has elicited the fact that it may be given
in enormous doses with nothing but benefit. The conclusion
has hence been reached that the irritant effects ascribed to it
of old were due to the Arsenic so often present in it, or to the
development of an irritant nitrate; and that in its pure state
it has no more active properties than chalk, and produces its
good effects by a local "sedative and desiccant" action on the
alimentary canal.
If this were so, Bismuth would lie outside the sphere of
homœopathy. But Drs. Chapman* and Bayes have each put
on record several cases in which, from the first to the third
trituration, it proved curative in gastralgia, and my own ex-
perience is of the same tenor; while Dr. Jousset finds it quite
effective, in similar forms, in the diarrhoea for which it is in
repute. Prepared by our processes, therefore, Bismuth is not
without dynamic action; and Dr. Horatio Wood shows that it
is not so insoluble as is commonly supposed. It would pro-
bably repay a more thorough proving, directed to ascertain
the precise form of gastralgia to which it corresponds. It
seems indicated when there is sympathetic "stomach-cough,"
which is worse when the stomach is empty.
Bismuth seems also to exert a marked action on the heart,
though this again may have been due to Arsenic. "Violent
beating of the heart" appears in Hahnemann's pathogenesis;†
a contracted pulse is several times noted by the provers; and
in the post-mortem examination of the only case of poisoning
on record the inner surface of both the ventricles was found
very red. Arsenic can produce such effects, as we have seen;
and we must not hastily use Bismuth in cardiac affections on
the strength of these observations.
Teste states that he has used the drug with brilliant results
in phlegmasia alba dolens.
Bismuth resembles, besides Arsenic, Argentum, Hydrocyanic
acid, and perhaps Zinc.
Hahnemann recommended the 2nd trituration to be used for
medicinal purposes; and in about that strength the drug has
* Brit. Fourn. of Hom., vii., 504.
† Dr. Allen (S. 61) has accidentally omitted the "violent" (starker.)
•
BORAX.
311
generally been given in homœopathic practice. Dr. Yeldham,
however, states that he has been compelled to give up all
attenuations, and resort to five-grain doses of the pure sub-
stance, with which he has “met with almost unfailing success
in that form of gastralgia to which females in particular are
liable.”*
I have again a well-known drug to bring before you in the
sodic biborate,
Borax.
It is prepared for homœopathic use by trituration, or solution
after 1*.
Hahnemann gave in the second edition of the Chronic
Diseases a pathogenesis of Borax, containing 460 symptoms;
nearly all of which are contributed by Dr. Schreter, and are
stated to have been observed by him on several persons.
These were evidently patients, and some of them infants, to
whom he was probably giving the medicine for thrush. Dr.
Allen adds reports from two other experimenters; but
their results are so meagre as only to afford twenty-one addi-
tional symptoms.
Borax is best known as a local remedy for thrush. What-
ever the rationale of its action, we cannot but continue to
employ a medication so simple and so effectual. Yet it is of
interest to inquire whether there is anything specific in the
practice, and anything which illustrates the homoeopathic
method. At first sight Hahnemann's pathogenesis would
seem to show that Borax can produce thrush. "Aphthæ in
the mouth," "an aphtha inside the cheek, which bleeds when
eating,”“ an aphtha on the tongue"-these symptoms from
Schreter should be proof positive of homoeopathicity. But
when we examine them closer, we find that they occurred
from four to five weeks after the administration of the drug.
Better evidence than this must therefore be given, ere we can
affirm the thrush-producing power of Borax. At the same
time there can be no doubt that small doses-say grains of
the first trituration, given internally, will cure the disease
nearly if not quite as rapidly as when local application is
employed; a fact which speaks strongly in favour of the
dynamic action of the medicine.
However this may be, the local use of Borax in aphthous
and also in pruriginous affections is of undoubted value. To
* Brit. Journ. of Hom., xxviii., 745, 757.
312
BOVISTA.
these its employment is at the present day well-nigh entirely
restricted. But in old times it was, as Pereira says, "regarded
as an agent exercising a specific influence over the uterus;
promoting menstruation, alleviating the pain which sometimes
attends this process, facilitating parturition, diminishing the
pain of accouchement, and favouring the expulsion of the
placenta and lochia." This use of the drug has been continued
in the homœopathic school. Schreter speaks of ready con-
ception having been observed in five women under its use;
and mentions one case where a woman who had been sterile
fourteen years on account of an acrid leucorrhoea, after other
remedies at last took Borax, whereupon she became pregnant,
and the leucorrhoea improved. Dr. Middleton, of Philadelphia,
reports a similar experience in several cases of dysmenorrhoea
with sterility. He gave a grain of the crude salt night and
morning.* Dr. E. M. Hale has put on record a case of mem-
branous dysmenorrhoea radically cured by it.† This piece of
practice, however, is not of homœopathic origin; for the phy-
sician who first recorded the successful use of the remedy was
Dr. Henry Bennet.
-
Dr. Guernsey lays much stress on "fear of downward
motion" as an indication for Borax. An adult, he says,
dreads going down stairs, or the downward movement of the
rocking-chairs so much used in his country; a child seems
ever in dread of falling, and if the nurse attempts to lower it
from her arms while asleep, it will cry out and throw its hands
up as from fear. This feeling is part of a general nervous sen-
sitiveness, especially to noise; but is peculiar to the present
drug.
Dr. Hale gave five-grain doses of the pure substance; and
neither for the uterus nor for the mouth does Borax seem to
need much dilution.
My next medicine is probably known to you by its poisonous
effects only. It is the "puff-ball," Lycoperdon
Bovista.
It is prepared by trituration.
Bovista was proved by Nenning and two others; 640
* See Hahn. Monthly, xi., 523.
† Brit. Journ. of Hom., xxix., 746. There is another in the tenth
volume of the Transactions of the N. Y. State Hom. Society (p. 279),
where the first attenuation was employed; and two in the New
England Medical Gazette for December, 1879.
BOVISTA.
313
symptoms from this source appear in Hartlaub and Trinks'
Arzneimittellehre. It was little used in practice until attention
was called to it by Petroz in the fourth volume of the Journal
de la Société Gallicane. The additional observations he com-
municates are combined with those of Hartlaub and Trinks by
Allen.
The puff-ball has been found by Dr. Benjamin Richardson
to be capable of producing anæsthesia in animals exposed to
the fumes of its combustion. This anesthesia is of the nature
of asphyxia, like that of nitrous oxide; it is not of the chloro-
form character. Petroz, finding a similar condition set up
from simple olfaction of the mother-tincture, was led to
administer it in a serious case of asphyxia. He does not
relate the circumstances, but says that the remedy was given
with great success. His experimenters, and those who took
part in the German proving, experienced great pain and
heaviness in the head. Their symptoms should be carefully
studied in Dr. Allen's arrangement, and may lead to valuable
results. Teste (who has a good article on the drug) says that
it is especially indicated by a sensation as if the head were
swelling up to a great size. He mentions in another place the
cure of a chronic leucorrhoea by Bovista, chosen mainly because
of the co-existence of this symptom; and Dr. Walter Wessel-
hæft has recorded a very interesting one of protracted metror-
hagia, in which, after the failure of all measures, medicinal
and mechanical, improvement set in immediately after the
administration of this remedy, to which he was led by the co-
existence of "severe neuralgic pains in the eyes and temples,
accompanied by a sense of enlargement and fulness of the
whole head."* Dr. Guernsey recommends it in leucorrhoea
like the white of an egg.
But the chief use of Bovista is in the cutaneous sphere.
The skin appears in the proving as much affected with itching
pimples; and Dr. Guernsey speaks of "tettery" persons as
special subjects of its beneficial use. It is said to be indicated
when the irritation is brought on by washing. Drs. Frédault
and Guerin-Ménéville commend it in the eczema of the back
of the hands known as bakers' and grocers' itch.
Bovista is classed by Teste with Sulphur, Asterias, and
Cicuta.
The medium dilutions have been those hitherto used; but
Dr. Wesselhoft gave the 3* trituration.
I now come to the piéce de résistance of this lecture, in the
*N. Engl. Med. Gazette, xi., 461.
314
BROMIUM.
shape of a discussion of the action of Bromine and its com-
pounds. And, first, of
Bromium
itself. An aqueous solution (alcoholic from the 3* upwards)
is directed by the Pharmacopoeia. But, as bromic acid soon
forms in such a preparation, it is recommended to keep the
Bromine pure, and dilute it with distilled water when required
for use.
In the second volume of the Neues Archiv Dr. Hering
published a pathogenesis of Bromine. The symptoms sup-
plied by himself and his fellow-provers were mainly obtained
from the 30th dilution; but some are taken from observers
who used material doses. The experiments of Höring,
Butzke, and Heiemdringer-which are of this character-are
given by Frank (i, 386), and should be consulted; as also
should be an Harveian prize essay on the subject by Dr.
Glover, published in the fifty-eighth volume of the Edinburgh
Medical and Surgical Journal. The symptoms from these and
other sources, as collected by Dr. Allen, amount to 821 in
all. Some additional memoirs on Bromine are mentioned
by Dr. Ozanam in the brochure to which I shall refer, and
may be consulted by those desiring further knowledge of the
drug.
The results of all these investigations are but scanty.
Bromine is unquestionably a powerful irritant; more so (Dr.
Glover says) when diluted than when pure. Hence it inflames
every mucous membrane with which it comes in contact.
Being very volatile, moreover, its exhalations ascend from the
stomach after it is swallowed; so that the coryza and saliva-
tion it provokes may not be more than local effects. Never-
theless, as, even when injected into the veins, it sets up
inflammation of the lungs and air-passages, we may fairly
credit it with a specific influence on the respiratory organs;
and these have been the main sphere of its homoeopathic use.
The rigors and prostration which accompanied its coryza in
one of Glover's dogs suggest it in influenza. Since in
Höring it caused difficult and painful inspiration, violent
stitches in the lungs, and cough in attempting to draw a long
breath, it ought to find a place in the treatment of pneumonia ;
in which indeed, and in phthisis, Dr. Hering praises it.
Dr. Kafka, also, esteems it highly in croupous pneumonia,
when Iodine (his chief remedy) fails. I often find it useful in
BROMIUM.
315
*
dry laryngo-tracheal coughs, with hoarseness, and pain and
burning behind the sternum. But its chief credit has been
gained in the treatment of membranous croup, of which there
are numerous instances on record in which it effected a cure.
As it usually came in to reinforce the ordinary remedies, the
cases in which it was employed were severe and advanced; so
that its potency is the more established. One of our latest
reports comes from Dr. Meyhoffer, who in a very able way
discusses the precise place of Bromine in the therapeutics of
this disease. He points to the prostration manifest in its
poisonous effects (which was also, I may say, noted by
Höring in his experiments on the human subject with
moderate doses); and decides that it is in extension of
diphtheria to the air-passages that it is indicated, while Iodine
-whose primary constitutional action is excitant—is better
suited to what is distinguished as true croup.
He does not,
however, admit an essentia, but only a phenomenal, difference
between the two diseases; and the whole tendency of medical
opinion is now in this direction.
Dr. Ozanam, of Paris, assuming this doctrine (which has
always been held by French pathologists), has published
several interesting observations on the use of Bromine in
croup and diphtheria, which are summed up in a short
treatise on the subject dated 1869.† He has ascertained that
an aqueous solution of Bromine, of the strength of one part
in a thousand, disintegrates a false membrane in an hour.
He then points to the elective action of the drug on the air-
passages, and also (as he thinks) on the throat; and to its
property, when inhaled by animals, of determining the forma-
tion of false membranes on these parts. He finally advances
its power-equal to that of Chlorine-of destroying conta-
gious germs; and concludes that on every ground it ought to
be a prime remedy for diphtheritic affections. He himself
has found it to be so. His first success was obtained in 1849,
and since then he has treated some 150 cases, with the loss of
only five, all of which were croupous. He gives every hour
one or two drops (in eau sucrée for children) of a freshly pre-
pared aqueous dilution of 3* strength, and adds inhalations of
a weak solution. Of late he has found a combination of
Bromine and Kali bromatum-bromure de potassium bromé—
* North Amer. Fourn. of Hom., x., 296. Philad. Journ. of
Hom., i.,529; ii., 74, 565. Brit. Journ. of Hom., xxiv., 625.
+ Mémoire sur les dissolvants et les désagrégeants des produits
pseudo-membraneux, et sur l'emploi du Brome dans les affections
pseudo-membraneuses (Baillière).
316
BROMIUM.
still more efficient, both chemically and clinically. Other
authors are cited by him as confirming his results; and I
should have mentioned that Dr. Meyhoffer speaks of having
treated twenty cases successfully with Bromine alone, where
diphtheritic exudation in the throat or larynx was accom-
panied by great prostration. M. Teste communicated to the
Paris Congress of 1878* a very favourable experience with
this medication, which he reckons "the most precious acquisi-
tion that the art of healing has made for a hundred years past."
He also uses the eau bromée, but in a one per cent. solution,
giving from one to three drops for a dose, every hour in
anginose diphtheria, every quarter of an hour in croupous. He
forbids the use of milk, which his observations lead him to
consider destructive of the action of the Bromine.
Dr. Oehme,† summing up the evidence as to the anti-
diphtheritic virtues of Bromine, concludes that it is mainly
from its chemical action that it proves useful; and M. Teste
agrees with him here. Himself in general an advocate of the
use of attenuated medicines, he finds that the present drug
cannot be so given with advantage. He thinks that it acts
by its great affinity for hydrogen, much as Chlorine does ;
and relates some curious observations as to the change which
eau bromée undergoes when exposed to the exhalations from
diphtheritic patients.
However it may be as regards diphtheria, the specific
action of Bromine on croup is unquestionable. In addition to
the reports of its value I have already mentioned, I may
mention that Dr. Kafka has contributed to the Allgemeine
homöopathische Zeitung for 1875 a severe case of mem-
branous croup in which inhalations of Bromine (1st and 2nd
decimal on cotton wool) had a most beneficial effect. Dr.
Guernsey's indication for it in croup and laryngeal diphtheria
is "rattling of mucus in the windpipe when coughing."
Besides its use in croup, Bromine has retained among
homœopathists the place it has lost in the old school as a
reducer of enlarged lymphatic glands. Dr. Goullon, in his
excellent treatise on scrofula, gives several instances of cure
of strumous glands by means of it. Dr. Guernsey recom-
mends it in idiopathic physometra.
Some curious sensations in the extremities are related by
Trousseau and Pidoux to have been caused by Bromine when
administered by Andral and Fournet to a number of sufferers
from arthritis. But as these phenomena are quite unique, and
* See its Transactions, p. 72.
† Therapeutics of Diphtheritis, sub voce.
/
BROMIUM .
317
were accompanied by great diminution of their pains, I think
they must have depended on the morbid state of the
patients, and cannot be used as homœopathic indications.
The chief analogue of Bromine is Iodine, as compared with
which, however, it has a very limited sphere.
In croup, Bromine has been usually given in about the 3rd
decimal dilution, in strumous glands in the 3rd centesimal.
Having spoken of Bromine itself, it becomes necessary to
enquire into its action when in combination with an alkali.
This at once gives it other features and a new range of action.
Let us speak of the bromide of potassium.
Kali bromatum.-The history of this substance is a curious
one. It was first used as an analogue of the iodide of the
same metal, and introduced into the Pharmacopoeia on the
strength of the virtues ascribed to it by Dr. Robert Williams
in chronic enlargements of the spleen. Its repute here soon.
waned, and it ceased to be officinal. In 1857 the late Sir
Charles Locock called attention to its power of checking
epileptic fits dependent upon irritations of the female sexual
organs. It was soon found that epilepsies from other causes
were amenable to its influence; and it rapidly acquired—at
least in this country, in France, and in America-an estima-
tion as an anti-epileptic far excelling all other remedies now
in use, and capable of doing more for the disease than had
ever been done or hoped for hitherto. "It has changed,"
Dr. Anstie quotes an eminent authority as saying, "the whole
prognostic significance of epileptic attacks."
"Like that of all other drugs," writes Sir Thomas Watson,
"its special virtue was discovered empirically, and could never
have been reasoned out." But, attention being once directed
to it, experimentation as to its physiological effects followed.
Conducted in the usual gross way, and on the lower animals
only, this seemed to prove Kali bromatum a pure sedative to
nervous tissue, and it was used accordingly in every kind of
irritation of brain, cord, and nerves. Disappointment naturally
followed, and the employment of the drug is now, by good
judges, restricted to true convulsions recurring paroxysmally,
excluding all habitual spasms. As Dr. Ringer says:-" al-
though convulsions may be excited by many causes, it is pro-
bable that the conditions of the nervous centres producing the
attack are in every instance identical; and it appears to be
these conditions which the bromide controls." At the same
time, more careful reading of the physiological effects showed
that it was the reflex function of the nervous centres-the
318
BROMIUM.
true spinal cord" of Marshall Hall-to which the bromide
so readily acted as a sedative: sensation and voluntary motion
were only affected by toxic quantities.
((
As checking convulsions, then, by deadening reflex excit-
ability, bromide of potassium has taken its place in general
therapeutics; and we of the school of Hahnemann have had
to consider what to do with it. Our power over convulsive
affections-especially over epilepsy-is not so great as to
make us independent of further aid; and the mere fact that
we have here to do with an antipathic action would not keep
us from Kali bromatum any more than from Amyl nitrite.
But palliation of paroxysms, as with the latter, is a very dif-
ferent thing from their suspension by the continued use of the
drug. Here the vices of antipathic medication become
manifest. It is allowed that epilepsy is seldom or never
cured by the bromide, so that the patient remains free
from it after ceasing to take the drug it is only kept in
check while he remains under its influence. For this purpose,
moreover, it is necessary to take large and frequent doses, so
that the blood be kept constantly charged with it, and the
nervous system never free from the sedation it causes. Even
then it is confessed that it oftentimes loses its power through
habituation of the tissue to its action,* and has to be suspended
for a time, at the risk of the paroxysms returning, so as to
start afresh on its work.
Before committing our patients to such a course of treat-
ment, it is necessary to enquire whether no harm results to
the organism at large from this constant saturation with a
medicinal agent-whether, in fact, the remedy is not worse
than the disease. The phenomena of "bromism" are now
well known. I will cite Dr. Bazire's description of them as
they appear in the nervous centres.†
"When given in large doses, such as thirty and forty grains two or
three times a day, it produces very striking symptoms in about ten or
fifteen days. The patient at first complains of a dull headache, be-
comes listless and apathetic, with an expressionless gaze and a lustre-
less eye. His intellect is clouded, his mind confused, and he is unable
to concentrate his thoughts. There is slowness of perception, and
questions have to be asked several times before their meaning is under-
stood and an answer can be obtained. If, when these symptoms
have begun to show themselves, the medicine be continued, hebetude
follows, with inability to think, and a kind of stupor resembling that of
the first stage of typhoid fever, together with drowsiness, somnolence,
* The last writer on the subject, Kunze, says—"The bromides only
retard the attack of epilepsy for at most half a year; after which it
comes on with renewed energy.' (See Practitioner, xxii., 222.)
""
+ See his translation of Trousseau's Clinical Lectures, vol. i.
BROMIUM.
319
and constant dropping off to sleep. The pupils are dilated, and con-
tract very sluggishly under the influence of a strong light; the sensi-
bility of the conjunctiva is so deadened that a finger may be passed
with impunity on the surface of the eyeball without producing winking.
Hearing loses its usual acuteness, and it is only by speaking in a very
loud voice that the patient can be aroused from his stupor.
"The sense of taste is probably impaired like those of hearing and of
sight. The tongue is moist and red at first, but after a few days it has
a tendency to drying and browning. There is anæsthesia of the velum
palati, the uvula and upper portion of the pharynx, so that these parts
may be tickled without producing nausea or involuntary movements of
deglutition. Swallowing itself, however, is unimpaired, and strangely
enough the appetite remains very good; the patient takes his food well,
and dozes off immediately after. Digestion seems to be easy, and the
bowels, although sluggish in their action, are not very confined. There
is intense thirst, and a craving for cold drinks. The anesthesia is not
confined to the mucous membranes only, for the sensibility of the skin
is diminished also, so that pinching and pricking are scarcely noticed
by the patient. From the beginning, the sexual aptitude fails; erec-
tions become rare and imperfect, and cease entirely after a few days.
"Simultaneously with the impairment of sensibility, disorders of
motility manifest themselves. Thus the patient is averse to taking
exercise, sits and lounges about; by degrees, his gait becomes altered,
he rolls and staggers like a drunken man, his limbs shake and bend
under him. After a time, he is obliged to keep to his bed, and when he
uses his hands, as in the act of carrying anything to his mouth, they
are seen to tremble, as if he were suffering from delirium tremens. The
respiration is calm and tranquil, with occasional sighing. The circu-
lation is considerably slackened; the pulse at the wrist is weak and
slow; the heart's beat lacking in energy, and its sounds distant and
feeble; in fact, in its effect on the heart, bromide of potassium seems to
resemble digitalis. If the drug be withheld, these symptoms gradually
diminish and pass off of themselves, but they leave behind them for
some time afterwards great feebleness, both physical and mental. The
anæsthesia of the fauces seems to be the last phenomenon to dis-
appear."
To these effects, sufficiently undesirable, must be added the
well-known acne of the drug, whose pustules sometimes be-
come boils, and end in large ulcers with conical scabs like
rupia. I may also cite Dr. Clarke's* description of the symp-
toms of a toxic dose, which, as he says, "are only an increase
or an exaggeration of those of a therapeutic one. "The
foetid breath becomes nauseous; oedema supervenes on con-
gestion of the uvula and fauces; the whispering voice sinks
into aphonia; sexual weakness degenerates into' impotence;
muscular weakness becomes complete paralysis; reflex,
general, and special sensibility disappears; the ears do not
hear, nor the eyes see, nor the tongue taste; the expression
of hebetude becomes first that of imbecility, and then that of
* Abstract of the Physiological and Therapeutical Action of Bro-
mide of Potassium, by Drs. E. H. Clarke and R. Amory. Boston, 1872.
320
BROMIUM.
idiocy; hallucinations of sight and sound, with or without
mania, precede general cerebral indifference, apathy, and
paralysis; the respiration, without the stertor of opium or
alcohol, is easy but slow; the temperature of the body is
lowered. As the bromism becomes more profound, the
patient lies quietly on his bed, unable to move, or feel, or
swallow, or speak, with dilated and uncontractile pupils, and
scarcely any change of the colour of the skin or face; the
extremities grow gradually colder and colder; the action of
the heart becomes feebler and slower, till it ceases altogether."
1
I confess that my own decision is against the bromidal
treatment of epileptic and other convulsions, save when from
their frequency they are threatening life or reason, and when
careful homœopathic medication has failed. I think, more-
over, that herein I am expressing the mind of most practi-
tioners of our school. It is quite possible, indeed, that some
true specific influence of an anti-epileptic kind may be ex-
erted by Bromine itself. This is suggested by the efficacy
ascribed by Dr. Hammond to the bromide of zinc, in quite
small doses, and by others to the bromide of arsenic in quan-
tities smaller still. I am speaking, however, of the usual
practice with the bromide of potassium. But we may here be
positively as well as negatively consistent with our principles,
and find in the phenomena of bromism indications for the
use of the drug according to the law of similars. This has al-
ready been done for us in several instances.
1. The acne of Kali bromatum was first noticed by Höring,
of whose experiments with Bromine I have already spoken.
It became in his case--as not unfrequently-a crop of boils.
It is common, but not constant-Dr. Clarke observing it in
two thirds of the cases treated by him with continuous doses;
and it is not, as Dr. Russell Reynolds says, determined by the
quantity of bromide that is taken. He has seen it follow a
few five-grain doses, and it has been absent in many cases
where thirty grains have been taken, three times daily, for
periods of six or even of twelve months. It sometimes results
in suppuration: sometimes the pustules die away without
going through this process. Its favourite seats are the face,
scalp, and back.
Here is a suitable starting-point for homoeopathic medica-
tion; and Dr. Drysdale states that he has more than once
cured such an acne with two- or three-grain doses of Kali
bromatum. But he had been anticipated in his statement by
a practitioner of the old school, Dr. Cholmeley. He states
that he has seen an obstinate, long-continued acne disappear
BROMIUM.
321
entirely while bromide of potassium was being taken for a
nervous disorder."
*
2. Kali bromatum has an unquestionable soporific effect,
and is in large use as a hypnotic, though opinions seem much
divided as to its certainty. It concerns us little in this
capacity; but we read with much interest the description of
the kind of sopor induced given by M. Laborde from obser-
vations made on himself. "It is," he says, "a state of heavy
somnolence; it is often suddenly interrupted, although there
are, properly speaking, no dreams, or no dreams that take a
definite shape; it is rather a nightmare, and an indefinite one.
Waking is accomplished with great difficulty." The indica-
tions for the drug in certain morbid conditions of sleep are
obvious; and we have the encouragement of Dr. Ringer, who
finds it very useful in the night-screaming and somnambulism
of children, and the nightmare of adults. We may remember,
too, the connection between too profound sleep and nocturnal
enuresis.
G
3. According to physiological experimenters, bromide of
potassium acts strongly on the vaso-motor nerves, constricting
(at least at first) the arterioles. They maintain that it is in
virtue of this power that it proves sedative to the nervous
centres generally. Dr. Russell Reynolds, however, takes just
the opposite view, considering that it acts upon the vaso-
motor system as a "sedative,” i.e., that it reduces such morbid
activity as would lead to the spasmodic narrowing of vessels,
and the consequent induction of irregularity in the supply of
blood. The principle similia similibus explains the apparent
contradiction. He commends it accordingly in disturbances
of this system elsewhere than in the head, and finds ten- or
even five-grain doses sufficient for their removal.
4. We shall probably find a place for Kali bromatum in some
functional paralytic conditions, as tabes dorsalis from sexual
excess, idiopathic aphasia, and simple dementia. Two local
paralyses are mentioned as having been cured by it-dys-
phagia of liquids in infants by Dr. Ringer (I have had the
same experience once myself), and incontinence of urine by
Dr. Warburton Begbie.‡ The latter has been caused by the
drug.
There are a good many other points of interest about bro-
mide of potassium; but I cannot do more than indicate them.
There is the question of the source of its efficacy, whether
* Med. Times and Gazette, Dec. 11th, 1869.
† See Practitioner, xii., 9.
‡ Ibid, xii., 98.
Y
322
BROMIUM.
this be from its bromine, as maintained by Dr. Richardson,
or from its potassium, as suggested by Professor Binz, or
whether (as Dr. R. Reynolds thinks) it is a tertium quid distinct
from either. Then there is its action on the sexual organs,
whose activity it seems-in large doses-to diminish even to
abolition this being due, according to some observers, to a
local action on the extremities of the excitor nerves, according
to others, to its depressing influence on the spinal cord. Dr.
Anstie thought much of it in insomnia, and even neuralgia,
from sexual worry; and it seems effective in nymphomania.
This, of course, belongs to its antipathic action; for I do not
think we can make capital out of the single observation of
Laborde in which sexual excitement seemed to follow upon its
But it is here, perhaps, that I must mention the action.
of the drug on ovarian cysts. A case of this kind is recorded
in the Edinburgh Medical Journal for 1868, in which, after a
single tapping, the continuous use of the bromide, in doses
of five, ten, and fifteen grains, effected a complete cure. In
the twenty-seventh volume of the British Journal of Homœo-
pathy Dr. Black records an equally satisfactory case, where
grain doses sufficed for the cure; and in the twenty-eighth
volume you may read one of my own. There is much
encouragement here for future trials. Other applications of
the drug may result in time from a consideration of the 444
pathogenetic effects of Kali bromatum recorded by Dr. Allen
under that heading.
use.
*
Of the other alkaline bromides, I may mention that that
of ammonium has been proved by Dr. Cushing, of Lynn, and
you will find his pathogenesis in Allen's first volume. Its
chief effect on him seems to have been the production of much
white, sticky mucus about the upper part of the digestive and
respiratory tracts. Dr. Hale praises it in the treatment of
chronic catarrh of the posterior nares. This writer has some
remarks on the dynamic action of other bromides, which you
will do well to read. The field is too little worked for me to
adventure upon it at present.
* In my case the cyst seems to have ruptured into the peritoneum.
Dr. Helmuth, in his System of Surgery (3rd ed. p. 106), relates a
curious case of cysto-sarcoma of the breast, of many years standing, in
which, under the influence of two-grain doses of the bromide, three
times daily, the larger cysts broke and discharged, and a number
of the smaller ones disappeared,
LECTURE XXI.
BRYONIA.
I shall devote this lecture to a medicine which, more than
any one which has yet come before us, therapeutics owe
entirely to Hahnemann. I speak of
Bryonia.
A tincture of the root of the Bryonia alba is the ordinary
homœopathic preparation; but the British Homœopathic
Pharmacopoeia allows the indigenous species-the Bryonia
dioica-to be substituted. Mr. Turner tells me that now and
then the tamus communis is brought to chemists by mistake
for the bryony root, and might be incautiously used by them.
Bryonia was early proved by Hahnemann: the pathogenesis
occurs in the second volume of the Reine Arzneimittellehre. It
consists (in the latest edition) of 781 symptoms, two thirds of
which are contributed by the master himself, and the rest by
six fellow-provers. It was also one of the medicines selected
for re-proving by the Austrian Society. Their results are
published in the third volume of the Oesterreichische Zeit-
chrift. Eighteen persons took part in the proving, two of
whom were females; and nearly all employed increasing doses
of the mother-tincture. The symptoms obtained are amalga-
mated with Hahnemann's by Dr. Allen, forming a total of
nearly two thousand; and the experiments on animals which
were made have been translated for the British Journal of
Homœopathy (vol. xxv). There are two interesting studies of
Bryonia which I may commend to your notice, the one by
Dr. Hirschel, in that part of his Pharmacodynamics which has
been translated by Dr. Hayle; the other by Dr. Dunham, in
his Lectures (1. 89). It forms also one of the first series of
"principal homoeopathic remedies" on which Hartmann has
made his Practical Observations.
I have said that therapeutics owe Bryonia to Hahnemann.
Before his time it was known only as a drastic emetic and
324
BRYONIA.
purgative, and very little used in practice. He proved it for
the volume of Materia Medica which he brought out in 1816;
and remarks there that "the symptoms it excites in the healthy
correspond to many affections of daily occurrence," and that
hence "its healing power must be of wide range." He had
already found it very useful in the fever which ravaged
Germany while the seat of war in 1813, as I shall tell you
hereafter; and he relates in the preface to this volume of the
Reine Arzneimittellehre a case of gastralgia with water-brash
cured by it in twenty-four hours, after the patient had been
laid by for three weeks. He gave here a single dose of a drop
of the pure juice, and at this time recommends the drug to be
somewhat thus administered in maladies of some standing
when the patient is fairly robust, but to be given in the 18th
dilution in acute disease with much constitutional excitement.
In a solution of about this strength he had employed it in the
fever of which I have spoken. He compares it to Rhus
(whose proving also first appeared at this time), giving as its
distinguishing features its mental symptoms (of which imme-
diately), and the aggravation of its pains by movement-those
of Rhus being worse at rest. This last characteristic has
proved of inestimable value in determining the selection of
Bryonia. He further suggests its probable usefulness in
certain abdominal spasms in the female sex, and (later) in
some kinds of constipation and of menorrhagia.
In consequence of all this, Bryonia soon came to be largely
used in homœopathic practice, and took that place among the
polychrests of our Pharmacopoeia which it has ever since re-
tained. Of its high estimation and wide sphere of usefulness
you cannot form a better idea than by reading Hartmann's
Observations; and I shall have to enlarge upon rather than
detract from his recommendations of the drug.
As Bryonia will be a new medicine to most of my hearers,
I must detail its pathogenetic effects with some minuteness.
Bryonia is a pure irritant. It has no neurotic or hæmatic
power; but sets up inflammation,-locally, wherever it is
applied, specifically, in the serous membranes and the chief
viscera they contain, some of the mucous membranes, and the
muscles.
I. No poison (not even Aconite or Arsenic) affects the
serous membranes so certainly and powerfully as Bryonia. If
you will read the autopsies of the animals poisoned at Vienna,
this fact will abundantly appear. In the first the pleura were
injected and full of serum, and the peritoneum and arachnoid
injected; in the second, third, and fifth the arachnoid only
BRYONIA.
325
was reddened; but in the sixth the pleura were as in the first,
and the pericardial vessels were injected. Correspondingly,
the provers have the characteristic pleuritic pains with fever;
and although the symptoms of the head, heart, and abdomen
are undecisive, they at least do not forbid the supposition of
an affection of their respective serous membranes. Moreover,
those close allies of the serous sacs-the synovial membranes,
which are more easily affected by drug action, give plain
indication of suffering from Bryony. The joints swell and
become tender, especially those of the fingers.
Since all the parenchymatous organs influenced by Bryonia
are enclosed in serous membrane, I used to try to account
for their symptoms by the primary action of the drug on the
investing tissue. I cannot, however, ask you to accept this
doctrine now. I must describe the effects on the viscera as
they exist, and leave their relation to the disorder of their
envelopes for further investigation.
I. It is curious, nevertheless, that as of all the serous mem-
branes the pleuræ are those most readily influenced by Bryonia,
so of all the viscera the lungs are those which suffer most
from its action. The short, quick, and oppressed breathing,
heat and pain in the chest, cough and bloody expectoration,
and fever, experienced by the provers, find their interpretation
in the phenomena presented by the poisoned animals. In
these, with similar symptoms during life, the lungs were always
of deeper colour and diminished crepitation, while in two the
lower lobes were hepatized.
2. Next to the lungs, the brain is the organ which shows
most signs of being affected by Bryonia. There is no perver-
sion of the sensorial functions, as with Belladonna; and the
determination of blood does not pass beyond the stage of
congestion. But up to this point it is very well marked; and
the provers get a hot and red face, with headache (generally
frontal), sense of weight and fulness, and vertigo. Epistaxis
also is frequent.
3. Of the two chief viscera enfolded by the peritoneum, the
liver is much more affected by Bryonia than the kidneys. It
causes tensive and burning pain in the hepatic region, which is
sometimes also sensitive to pressure. In one prover, the
skin over the whole body became yellowish. In the animals
the liver was always found gorged, and sometimes friable.-
In two animals the kidneys also were found congested; but I
think the scanty, hot, and high-coloured urine so often passed
by the Austrian provers a symptom of general fever rather
than of renal implication.
326
BRYONIA.
II. I now come to the action of Bryonia on the mucous
membranes. It is interesting to observe (in connection with
its relation to the rheumatic poison) how much less power-
fully it influences these than it does the serous and synovial
membranes. It is an acrid, and hence large doses cannot but
irritate the alimentary canal as they go down. Accordingly,
we have in the provers sore throat, vomiting, and diarrhoea
with colic and flatulence; and in the animals an aphthous
mouth, and ulcers in the stomach and intestines. But the
essential phenomena of Bryony in the gastro-intestinal sphere
do not seem to depend upon irritation of the mucous mem-
brane. They are,-water-brash (with this there is the charac-
teristic contractive pain at the lower end of the oesophagus),
bitter risings and vomitings, pressure on the stomach, feeling
of load as if a stone were there, and constipation. These
await their physiological expression; but they have received,
as we shall see, their full therapeutic application.
The respiratory mucous membrane is unquestionably affected
by Bryonia, though I doubt whether the irritation extends
lower than the first division of the bronchi. The symptoms
of the provers (pain, cough, &c.), whenever localised, are
referred to the trachea and its bifurcation; and these parts
only were found injected in the poisoned animals. The
pneumonia set up by Bryony was never associated with bron-
chitis, in this strikingly different from that of Tartar emetic
and Phosphorus. If Bryonia causes any nasal catarrh, it is
dry; and the cough also has little expectoration, and is con-
tinuous, irritating, and violent, often causing retching and
pains in the walls of the chest. Of late, our knowledge of the
action of Bryony on the air tubes has received a novel exten-
sion from an experiment of M. Curie's.* By administering
to a rabbit gradually increasing doses of Bryonia during eight
months till he came to 250 drops of the mother-tincture daily,
he developed in the animal a firm pseudo-membranous tube,
extending from the larynx to the third ramifications of the
bronchiæ. While this fact is of great interest, I do not think
it proves that the action of Bryonia on the air-passages is
either profound or extensive. Pseudo-membranous formation
on their surface is a pathological fact per se; and has no
necessary relation to the amount of affection of the subjacent
mucous membrane.
W
Upon the urinary mucous membrane I should have said
that Bryony had little or no action, but that several of the
provers experienced considerable vesical tenesmus, with a
* See Brit. Journ. of Hom., xix., 455.
BRYONIA.
327
feeling after micturition as though all the urine had not been
expelled.
III. In one of the animals poisoned with Bryony at Vienna,
where a very minute autopsy was made by a practised patho-
logist, it is noted that the substance of the heart and the
muscles of the neck were intensely red. Putting this together
with the soreness and pain on motion experienced by the
provers in so many parts of the body, even to the production
of pleurodynia and lumbago, I venture to set down our drug
as a specific irritant of muscular fibre. As we have no other
medicine with such an action, we must not lose even the hint
of it supplied by these facts.
Under these headings I have given you the main pathoge-
netic effects of Bryonia. I have only to add that in the
female provers the menstruation was premature and exces-
sive; and that in all febrile symptoms were frequent.
Let us now enquire what have been the clinical results of
these very extensive provings.
To Bryonia, as to all the great Hahnemannian medicines, a
special constitution and disposition has been assigned as that
to which it is most suitable. It is said to act best in persons
of firm and fleshy fibre, of dark hair and complexion, of
"bilious" tendency and choleric temperament, and where
much irritability and irascibility are present. You must not
lay too much stress on such indications; nevertheless, they
sometimes guide us to the true remedy. Still more cha-
racteristic are its pains, which are always of a shooting or
tearing kind.
I shall begin by characterising the relation of Bryonia to
fever. It is especially suitable to two great types, the rheu-
matic and the typhous.
I. After Aconite, Bryonia is incomparably the best remedy
for acute rheumatism. In its whole pathogenetic action it re-
minds one of the rheumatic poison. Its feeble affinity for
skin and mucous membrane, and its powerful influence over
serous and synovial membrane and muscular fibre, with its
fever and sour sweats, point unmistakeably to this disease.
Accordingly, most of us employ it throughout rheumatic fever,
generally in alternation with Aconite, unless the symptoms
call urgently for some other medicine. But we need a series
of comparative experiments which shall demonstrate what
part the Aconite and what the Bryonia takes in controlling
the disease. Bryonia appears equally suitable for articular
and for muscular rheumatism: it is least fitted for affection
of the fibrous tissues proper. It continues, of course, to be a
328
BRYONIA.
homoeopathic remedy when any of the serous membranes are
inflamed in the course of rheumatic fever; though it may
yield in importance to some other medicines. It is a capital
remedy (at any rate after Aconite) for rheumatism attacking
particular muscles, as those of the loins or neck, or the dia-
phragm; particularly when brought on by cold draughts. In
chronic rheumatism it is specially indicated when the pain is
increased by motion, i.e., when the affection is sub-inflam-
matory in character.
II. The great campaign of 1813 in Germany, which ended
at Leipsic, left-after the war had rolled away over the Rhine
-a woeful legacy behind it in the shape of an epidemic fever.
Of this malady Hahnemann gives a graphic account in a
paper which you will find in Dr. Dudgeon's translation of his
Lesser Writings (p. 712). Bryonia was the remedy he most
frequently employed, being indicated by shooting pain, worst
on movement,—Rhus and Hyocyamus also being given accord-
to the symptoms; and he treated 183 cases without a single
death. Bryonia has hence acquired among homoeopathists a
large reputation in the treatment of the essential fevers. The
head symptoms and the bilious disturbance of the drug fre-
quently find their antitypes here; and Hahnemann's patho-
genesis adds the dry mouth and tongue, and the nocturnal
delirium. One of his symptoms, indeed, if a pure patho-
genetic effect of the drug, would make it perfectly homoeo-
pathic to low fever:-" She sleeps the whole day, with dry,
great heat, without eating or drinking, with twitching in the
face; she has six involuntary passages, the stools being brown
and smelling badly." Hartmann characterises the fever of
Bryonia as one that often suggests Aconite, but wrongly; in
the old nomenclature, it is a synochus, not a synocha. The
patient, he adds, is often cold externally, though hot within.
Dr. Dunham attempts a detailed picture of the Bryonia fever.
"The headache," he writes, " is a splitting pain through the
temples, and at the same time, and more severely, in the
occiput. Oppression at the pit of the stomach, and tenderness
there; vomiting of food, mucus, and bile, stitches in the hypo-
chondria, and soreness and tension in the hypochondriac
region, along with dry cough and decided constipation, with-
out any desire for evacuation of the bowels, are present.
Together with these local symptoms, there are frequent short
chills, alternating or mixed up with heat of the body; a pulse
small and frequent, but somewhat hard. Add to the above,
a slimy and bitter taste, aversion to food, pains in the back
and limbs, much aggravated by touch and motion, together
BRYONIA.
329
with dulness of the sensorium and aversion to noises and to
mental exertion, and we have a picture of the form of fever
for which, whether remittent or intermittent, Bryonia is ap-
propriate." You will find its symptomatic indications in
typhoid very minutely detailed by Dr. Wolf in the eighth
volume of the British Journal of Homœopathy.
Nosologically, Bryonia is especially suitable for relapsing
fever. Dr. Kidd, who saw so much of this malady in Ireland
in 1847, considers Bryony the best medicine for it; and Dr.
Russell thinks that the fever treated by Hahnemann was of this
nature. Its place in typhus and typhoid is more difficult to
determine. There seems a general concurrence among the
older homœopathists as to its power of modifying favourably
the erethism of the first stage of "typhus abdominalis," our
enteric fever; and Trinks even claims for it the capability of
aborting the disease.† He commends it also for the rheumatic
pains and the bronchitis which occasionally complicate the
course of fever. It has long been the favourite remedy in this
country for "common continued fever "—the "gastric fever”
of popular nomenclature; but in my own hands Baptisia has
quite dethroned it here.
III. I will now speak of the power of Bryonia in affections.
of the serous membranes and of the viscera which they en-
close.
Dr. Trinks, than whom we have had no better practical
physician among us, thus characterises the place of Bryonia
in serous inflammations.‡
"From no small number of cases which I have carefully marked
down, the fact comes out that Bryonia is the sovereign remedy in all
inflammations of the serous membranes which have advanced to the
stage of serous effusion. This action of Bryonia extends all over the
serous membranes which cover the thorax and abdomen, and the organs
situated in these cavities, and which are so often attacked by inflam-
mation.
"As long as the local inflammatory condition had not reached this
stage, the fever being still of a sharp, well-pronounced synochal_cha-
racter, the Bryonia was of no use, but at this time Aconite and Bella-
donna were the specific medicines which arrested the inflammation
before it had been developed to the stage just specified. . But when on
the other hand the inflammation had advanced to the stage of serous
exudation, then in all cases Bryonia showed itself a medicine of quick
and certain operation, which not only removed the still-existing local
inflammation, but also with the least possible delay effected the absorp-
tion of the serous effusion which had already taken place.
"
'I find in my journal many cases of inflammation of the pleura, as
* Annals, iv., 181.
† Brit. Fourn. of Hom., xxix., 303.
‡ Ibid, viii., 482.
330
BRYONIA.
they occur very frequently in Dresden in the beginning and end of
winter, during the prevalence of strong east and north-east winds, in
persons disposed to tubercular phthisis; then two cases of inflammation
of the pericardium with serous exudation; and two very noteworthy
cases of inflammation of the peritoneum, with very copious effusion of
serum into the abdominal cavity."
These doctrines of Trinks' about the place of Bryonia in
inflammations of serous membranes have been confirmed by
all subsequent observers. Aconite should be given at first,
and continued (with aid from Sulphur) should the exudation
be plastic; but if serous effusion occur, its place must be
taken by Bryonia. It is especially in pleurisy that this treat-
ment has become accepted. You will find some good cases
illustrative of it by the late Dr. Beilby, of Glasgow, in the
tenth volume of the British Journal of Homœopathy. For
pericarditis you should read Dr. Russell's Clinical Lectures. I
myself greatly prefer in this disease Aconite or Colchicum. In
peritonitis from exposure to cold I have seen Bryonia act
exceedingly well after Aconite: there are two capital cases
in Trinks' paper. It is recommended also for the puerperal
form of this disease. Arachnitis is the only form of serous
inflammation in which Bryonia has not proved curative; but
since this malady, as occurring (where we most frequently
meet with it) in children, is generally tubercular, the failure of
any given medicine to cure it reflects no discredit on the
remedy. In non-tubercular cases in these subjects it would
probably repay the confidence which is generally placed in it;
and in the acute meningitis of adults it is of unquestioned
value.
Of the viscera enveloped by the serous membranes I shall
only speak here of the brain, as the lungs and liver will come
in under the head of the respiratory and digestive organs
respectively. I will just say, however, that Bryonia is fre-
quently indicated in inflammations of parenchymatous organs
on which it has no direct action, when it is their serous en-
velope which is affected. Such maladies are the diaphragmitis,
the lienitis and the ovaritis for which Hartmann commends
it. Returning to the brain,-Bryonia is of great value in
simple non-inflammatory congestion of this organ. Cases are
on record in which such a condition arising from suppressed
menstruation, from exposure to intense cold, and from sea-
sickness with long-lasting constipation, was promptly dissi-
pated by the medicine. It is also frequently useful in con-
gestive headaches, with feeling of bursting or splitting, which
are seated in the forehead, relieved by pressure, and much
BRYONIA.
331
increased by stooping, which causes a sensation as if the
brain would fall out. If as it often is-giddiness is present,
the patient feels as though he would pitch forwards. Another
kind of headache for which Bryonia is useful is a form of
hemicrania: the pain is generally on the right side, and is
accompanied by retching and bilious vomiting.
Before leaving the serous membranes, I must refer to their
synovial analogues; only to say, however, that Bryonia has
proved as useful in idiopathic synovitis-when caused by cold
or injury-as when the affection is the local manifestation of
rheumatism.
IV. I have now to speak of the power of Bryonia over
affections of the digestive organs. A form of gastralgia for
which it is suitable is again most excellently described by
Trinks. "The pressure on the stomach, a much more fre-
quent affection in the female than in the male, generally
caused by irregularity in diet, eating indigestible food, bread
not enough baked, coffee, brandy; or bad beer, finds for the
most part its radical cure in Bryonia. It comes on when the
stomach is empty as well as when it is full, but more fre-
quently immediately after it has been emptied of its contents:
the patients complain of a pressure at the pit of the stomach,
as if they felt a heavy annoying stone there; it lasts from two
to four hours, sometimes longer, and goes off with much
eructation. In worse cases, the so-called water-brash is an
accompaniment, or there is a great deal of acidity generated,
which shows itself by sour risings, heartburn, and vomiting of
a very sour and acrid mucus. In the severer degrees of this
pain of stomach, the epigastrium becomes extremely sensitive
to external touch and pressure, and the patient cannot bear
the clothes to be firmly put on." Teste notes of the Bryony
dyspepsia, that beer disagrees or gives no satisfaction to
thirst, and that water is absolutely required as a dissolvent.
As with Nux vomica and Lycopodium, gastric disorder
requiring Bryony is generally accompanied by constipation;
but whether for this malady occurring independently it is ever
better than the other more important medicines we have,
I cannot say. Hahnemann ranks it with Nux vomica and
Opium. Dr. Dunham considers that Bryonia is specially
adapted to torpor of the bowels, as distinguished from the
ineffectual urging of Nux vomica; and Dr. Guernsey indicates
dryness of the fæces, as if burnt, as calling for it.* Dr. Bayes
recommends it in the constipation of children, where the
fæces are so large and hard as to cause pain in passing. The
* See cases in Hoyne, i., 80, and Amer. Homeopathist, ii., 43.
332
BRYONIA.
diarrhoea of Bryonia also must not be forgotten as a possible
indication for its therapeutic use. I have heard of its doing
much in America for cholera infantum. Causation of diarr-
hoea by dry, hot weather is always regarded as indicating it.
In affections of the liver, Bryonia frequently comes into
play, often in association with Mercurius. It hardly reaches
to true hepatitis; but in congestive states of the organ, with
pain in the right shoulder, giddiness, and slight yellowness of
the skin and eyes, it is very useful. It is pre-eminently a
gastro-hepatic medicine, and constantly finds place when the
digestion is impaired in consequence of the imperfect action
of the liver.
V. We come now to the action of Bryonia in affections of the
respiratory organs, which from its pathogenesis should be
rather extensive. It is the best medicine-after Aconite-
for what is known as a cold on the chest," i.e., where a nasal
catarrh has run down the air-passages, as far as the first or even
second division of the bronchi. Heat, soreness, and pain.
behind the sternum, and an irritative shaking cough with scanty
expectoration, make up the Bryony picture. Or, in Trinks's
words, there is "dry, more or less severe cough, often rising
to the point of retching, which is excited and maintained by
a constant ' tickle' in the lower part of the trachea or under
the breast-bone, which is more severe by day than by night,
and forces up only a very small quantity of clear, sometimes
blood-streaked, expectoration; gives rise to pain of being
shaken in the abdomen, or in the chest and head, and makes
the patients often complain of an extremely annoying pressure
under the sternum, which confines the breathing. These
states occur frequently in elderly persons with stuffing of the
nose, running from the eyes, and derangement of the stomach,
at the beginning and end of winter. For this condition
Bryonia effects all that can be expected from a medicine, and
that very speedily." Another of our veterans, Dr. Schrön,
has some valuable remarks on the action of Bryony in the
respiratory sphere.* Among other things, he says, "In
chronic cough, which becomes very violent at the least
excitation of the lungs, as speaking, which is worst morning
and evening, and which is accompanied by very little expec-
toration, as we observe in individuals whose lungs have
suffered from previous inflammation and frequent attacks of
hæmoptysis, I have seen Bryonia administered with the best
effects. I had such a case in which the patient coughed for
whole nights together. Bryonia 6, given for some length of
* Brit. Fourn. of Hom., xvi., 439.
BRYONIA.
333
time, not only produced perfect night-rest, but favoured the
process of nourishment in such a manner, that the patient,
who was formerly quite emaciated, picked up flesh, and her
appetite improved." Dr. Dunham notes of the Bryonia cough
that the patient often presses on the sternum to support the
chest during the exertions he makes.
But besides conditions such as these, Bryonia has obtained
reputation in the treatment of the three great affections of
the respiratory organs, croup, bronchitis, and pneumonia.
1. For croup Bryonia had been recommended by M. Teste
(in alternation with Ipecacuanha) long before M. Curie ascer-
tained its power of developing false membranes. He speaks
very confidently of the certainty of this treatment. M. Curie
himself relies upon Bryonia in the treatment of croup and
laryngo-tracheal diphtheria. We have as yet no differential
diagnosis between it and Iodine, Bromine and Kali bichro-
micum as anti-croupous remedies.
2. In most of our text-books and domestic treatises,
Bryonia occupies the first place among the remedies for acute
bronchitis. I myself am quite unable to see its homœo-
pathicity to this disease, when the smaller bronchiæ are
involved; and I have never been able to trace any good
effect from it in practice. I said so much in a paper which I
read on bronchitis before the British Homœopathic Society;
and found that my colleagues generally had met with the
same disappointment in the use of the drug.* Bryonia,
therefore, must no longer stand at the head of the medicines
curative of this disease. Dr. Jousset, indeed, praises it in
capillary bronchitis; but he always gives Ipecacuanha in
alternation with it, and I should be inclined to ascribe most of
the benefit observed to the latter drug.
3. It is otherwise with pneumonia. From what has been
said, indeed, Bryony can obviously do no good in the broncho-
pneumonia so common in children and aged persons, where a
catarrh begins in the bronchial mucous membrane, and pro-
bably affects the air-cells rather in the way of oedema and
collapse than of actual inflammation. But to primary
"croupous" pneumonia Bryonia is perfectly homoeopathic, even
more so than the Phosphorus which in this country (at least)
usually plays the chief part in the treatment of the disease.
Its power of developing a false membrane in the air-tubes,
which makes nothing in its favour in bronchitis, is all-im-
portant here, where we have to deal-not with catarrh of
a mucous membrane (which is absent in the air-cells proper)—
* See Annals, v., 193.
334
BRYONIA.
but with fibrinous exudation. To convince yourself of its
power you have only to read Tessier's cases treated in the
Hôpital S. Marguerite, in which Bryonia was the chief
remedy employed.* Dr. Jousset continues to express un-
bounded confidence in it, giving it (like his master) in the
higher attenuations (12-24). I am myself in the habit of
administering it in the first decimal dilution; and think I can
claim for it, thus given, the power ascribed by Kafka to
Iodine and Bromine, but refused by Jousset to any medicine,
of aborting the disease. Pleural complication would of course
confirm the indications for it in any given case; and in
pleuro-pneumonia proper-if you ever encounter such an
affection in the human subject-you will find it specific. It
has been found curative of the epidemic pleuro-pneumonia of
animals.
There are yet a few residuary phenomena to be noted in
the action of Bryonia.
a. The first is the power which it exerts over the mammary
glands. Whenever, from the first coming in of the milk, from
catching cold while nursing, or from abrupt weaning, the
breast becomes swollen, tender, knotty, and painful, Bryonia
will almost certainly resolve the inflammation and prevent the
formation of abscess. Dr. Dunham advises it in milk fever.
b. Secondly, Bryonia is of such high popular repute in the
scleroderma of horned cattle-Haningkrankheit that it has
acquired the name of Haningwurzel. Dr. Mayrhofer proved
it on three oxen, and in each the primitive symptoms of the
disorder were developed--the skin becoming dry, creaky, and
adherent, and the hair bristly and knotty. It is thus suitable
in scleroderma neonatorum. It is occasionally praised by
homœopathists in dropsical conditions-as, for instance, in
the cedema of the legs which comes on in some pregnant
women without the intervention of renal mischief. It would
probably be suitable to the condition lately described as
skin-dropsy," where anasarca occurs independently of disease
of the heart or kidneys, and is supposed to depend upon in-
sufficient performance of their functions on the part of the
sudoriparous glands.—It is also possible that these effects of
the drug indicate a specific action as exerted by it on the
subcutaneous cellular tissue, and that it may prove useful
where inflammation and induration occur herein. Jahr con-
siders it the most effective medicine we have for absorbing or
promoting the rapid maturation of carbuncle.
<<
c. Bryonia has not much influence on the eye (at any rate
* Récherches cliniques sur le traitement de la Pneumonie, &c., 1850.
BRYONIA.
335
it is not much used in its diseases), though it would seem suit-
able enough to rheumatic ophthalmia. Drs. Allen and Norton.
say "It is rarely, if ever, indicated in diseases affecting the
external tissues of the eye, its great sphere of usefulness being
in diseases of the uveal tract." They commend it in iritis,
choroiditis (especially the so-called "serous" form), and ciliary
neuralgia, where the pains are of its shooting character, and
have its aggravation from motion. They add amelioration
from pressure as a characteristic condition for it here. Dr.
Vilas commends it in scleritis and episcleritis.
4. Several of Dr. Guernsey's indications for the drug I have
already mentioned. I may add-dry, parched lips and mouth;
thirst for large draughts of water; nausea and faintness on
sitting up; vomiting of food soon after taking it. It is com-
mended by some in vicarious menstruation, and is particularly
good, Dr. Guernsey says, when this takes the form of epistaxis.
I mentioned at the outset of these remarks the kind of
patient for whom Bryonia is suitable. I conclude by saying
that it is well indicated for morbid states brought on by that
very anger to which he is prone, and also to those resulting
from the dry east winds of our climate. This last point gives
it another feature of differentiation from Rhus, which rather
meets the consequences of damp.
From its extensive range Bryonia cannot but have many
analogues. In its relation to rheumatism, it compares with
Aconite, Rhus, and Colchicum; in fever it acts like Baptisia and
Eupatorium. It affects the serous membranes like Aconite,
Arsenic, and Mercurius corrosivus; the synovial membranes
like Pulsatilla; the alimentary canal like Nux vomica and
Lycopodium; the liver like Mercurius and Chelidonium; the
air-passages like Nux and Senega; the lungs like Phosphorus,
Chelidonium, and Tartar emetic.
The dose of Bryonia, like that of all the polychrests, varies
widely. As a rule it may be said that the lowest potencies
act best in rheumatism and dyspepsia, and the medium and
higher in respiratory affections. But even to this rule there
are exceptions; and in its other applications it is equally in
favour with those who use the high and with those who prefer
the low dilutions. That is, I believe, its action is qualita-
tive rather than quantitative.
LECTURE XXII.
CACTUS-CALCAREA.
Our first medicine to-day comes to us—as a medicine—from
Italy.
There are, I do not doubt, many excellent homoeopathists in
that country; but hitherto they have contributed little to our
literature or to our Materia Medica. Dr. Rubini, of Naples,
has come forward to redeem the credit of his countrymen in
this matter, and has given us a new and valuable medicine in
the night-blooming cereus,
Cactus grandiflorus.
A tincture is prepared from the young and tender branches
and the flowers.
Dr. Rubini, after observation of the physiological and
therapeutical effects of the Cactus for ten or twelve years,
published a pamphlet containing the results of his experience.
It was translated by Dr. Dudgeon for the British Journal of
Homœopathy, in whose twenty-second volume it may be found.
It contains numerous symptoms observed on the healthy (sub-
jects and doses not specified), and as many cured in the sick.
Some later provings, from four sources, are incorporated with
Dr. Rubini's results in Allen's Encyclopædia; and Dr. Hale,
in the article on the drug in the second edition of his New
Remedies, has collected all the clinical experience with it which
had appeared in print up to that time (1867).
From Dr. Rubini's proving it would appear that Cactus
has a very powerful action upon the heart and arteries,
closely resembling that of Aconite. General rigor, followed
by much heat and sweat, even recurring daily at the same
hour, and symptoms-as pain and hæmorrhage—of acute
congestion in the head and chest, attest its action on the
arterial system; while the heart gives evidence in pain,
CACTUS GRANDIFLORUS.
337
palpitation, oppressed breathing, and constriction about the
chest, of being unusually affected. The pulsation in the
scrobiculus cordis so characteristic of cardiac disorder is
markedly produced by Cactus. It causes also painful pressure
on the vertex; acid risings from the stomach, with sense of
weight there; severe twisting colic, with heat (external and
internal) of the abdomen; bilious diarrhoea, with pain before
the stools; inflammatory strangury, followed by copious urine
loaded with lithates; and painful menstruation. There is
great prostration; and the mental condition is one of profound
melancholy.
From such a pathogenesis as this brilliant results might be
anticipated. Dr. Rubini assigns to it a wide range of curative
power. The characteristic feature of the Cactus consists in
this, that while it developes its action specially in the heart
and its blood-vessels, dissipating their congestions, and
removing their irritations, it does not weaken the nervous
system like Aconite;" so he writes in the preface to his
proving. I must differ from him about Aconite weakening
the nervous system. It need never do so, if the dose be not
too large. But if Cactus acts in this manner, it may be a
formidable rival to Aconite, as it would obviously be used in
the same class of cases. It is said to have cured with striking
rapidity acute otitis, acute and even chronic bronchitis,
pleurisy, pneumonia, hæmoptysis, hæmatemesis, gastro-
enteritis, hepatitis, hæmaturia, and a quotidian ague.
These
experiences have yet to be confirmed. For my own part,
when I meet with these acute fevers, congestions, and hæmorr-
hages, I seem quite content with my tried and valued
Aconite, and am loth to experiment with any other medicine.
It is otherwise in affections of the heart, where Cactus appears
to exert a power beyond that of Aconite, and to fill a place
hitherto vacant. It seems beneficial in all over-actions of this
organ, from nervous palpitation to acute carditis. In the
distress arising from hypertrophy; in the severe sufferings
incident to valvular disease* (perhaps also in angina pec-
toris); and in chronic palpitation, it generally gives rapid
and lasting relief. The feeling as if the heart were grasped and
compressed as with an iron hand (probably spasm) is very
characteristic of Cactus in these cases, and is well-marked in
its pathogenesis. It would probably be beneficial, at least to
relieve pain, in internal aneurisms.
* See an excellently narrated case by Dr. O'Brien in the tenth volume
of the Monthly Hom. Review.-Dr. Meyhoffer's experience with Cactus
in cardiac affections, as related in his contribution to the Transactions
of the Paris Congress of 1878, is also worth consulting.
Ꮓ
338
CALCAREA.
Dr. Lippe states that he has frequently cured with Cactus
the pressive headache in the vertex so often met with as a
result of menorrhagia. I myself place much reliance on it in
the similar headache of the menopausia. Dr. Guernsey says
that the constrictive sensation-as of an iron hoop-caused by
Cactus in many parts of the body is an unerring indication
for it in practice. This statement has been confirmed by many
observers. Among them is Dr. Wallace McGeorge, whose
communication on the subject may be read in the eleventh
volume of the Hahnemannian Monthly (p. 507). He relates
an instance of vaginismus in which, led by this characteristic,
he prescribed Cactus with success. Dr. Farrington mentions
another of rheumatism of the diaphragm, where the same
constrictive sensation was prominent, and where the remedy
proved equally potent.
The great analogue of Cactus is obviously Aconite. Its
influence on the heart resembles that of Naja.
Dr. Rubini recommends the mother-tincture in acute in-
flammations and organic diseases of the heart. In its
nervous affections he states that the higher dilutions act well
The remainder of my lecture to-day will be occupied with
the subject of the action within the organism of the prepara-
tions of lime-
Calcarea.
Hahnemann has proved two of these-the acetate and the
carbonate; and some later work has been done with C. caustica,
fluorata, iodata, phosphorica, and sulphurica, and some know-
ledge attained of the virtues of C. arsenica and muriatica. I
shall speak of each of these separately, in its distinctive
characters. But, first of all, there is a good deal to be said
upon lime as such, without reference to the peculiarities of its
several salts.
Lime differs from all the substances which have hitherto
come before us as medicines, in that it is a normal con-
stituent of the animal body. It enters, as you know, into the
composition not only of the bones and teeth, but into that also
of muscle, nerve, and nearly every other solid and fluid por-
tion of the organism. It may hence be thought doubtful, at
the first blush, if such a substance can have pathogenetic
properties beyond those belonging to any local influence it
may exert. When absorbed into the blood, it must surely be
taken up by the tissues which it goes to constitute, and
CALCAREA.
339
welcomed instead of resented by them. It would seem, more-
over, to act in disease as a food rather than as a medicine; so
that its remedial use belongs to dietetics, and finds no place
in a course of Materia Medica.
I have no doubt that there is some measure of truth in such
arguments, especially on their therapeutic side. That, in
cases of deficiency of lime as of iron, these elements can be
given as food and so appropriated by the hungry tissues, I
have no doubt; and the practice which results from the con-
viction is daily supported by success. But this does not
warrant the inference that such substances can have no
operation as poisons and no use as medicines. Consider what
must happen if they are administered in excess-if more is
introduced than the tissues require for their health and
integrity. Elimination will doubtless dispose of some of the
superfluity. But the affinity of the substance for certain
parts of the organism will still be attracting it thither; and,
while its quality determines its destination, its quantity will
prevent its acting as a food and being wholly assimilated.
You cannot make perfect health more healthy; and if you
continue to ply a part with its natural stimuli and aliment
beyond the point of perfect health, you necessarily produce
disease.
Now it has been fully ascertained, and is well set forth by
Dr. von Grauvogl in his Text-Book of Homeopathy, that the
kind of disease produced is just that which ordinarily results
from deficiency of the substance in question. Thus the
habitual drinkers of chalybeate waters become anæmic. On
the other side, it is a fact—and upon the principle similia
similibus should be so that these elements of the tissues,
when given as medicines, promote the assimilation from the
food and blood of the very material of which they consist.
We shall see, when we come to Ferrum, that in this way
anæmia may be cured by doses of iron far too small to have
any nutritive value. Substances of this kind are called by
von Grauvogl "nutrition-remedies," as distinguished from
the "function-remedies," which are alien from the composition
of the body.
A Dr. Schussler has lately caused some sensation by pro-
posing to treat all diseases with such medicines as form part
of the organism, and so to limit our Materia Medica to a
dozen constituents. This proposition, indeed-commended to
us strangely enough by Dr. Constantine Hering-we cannot
for a moment entertain; but the importance of the remedies
in question is undoubted.
340
CALCAREA.
The question then arises—is lime one of them? To answer
it we must go, as with iron, to places where it is habitually
introduced in excess as a constituent of the food or drink of
the inhabitants. What do we find there? In the first
instance, bronchocele. An overwhelming mass of evidence has
now been collected in favour of the opinion that "the en-
demic prevalence of goitre is connected with the use of water
impregnated with calcareous salts." I quote Sir Thomas
Watson, who himself endorses this view. But what does
bronchocele mean? Is it a mere local, perhaps mechanical,
effect of the circulation of particles of lime through the
gland? Nay; for if we look a little farther-at the children
of goitrous parents, at those whose thyroids are enlarging
under unfavourable hygienic circumstances, we get a more
general condition; we have cretinism. Cretinism essentially
consists in defective growth; imperfect ossification of the
skull, with hydrocephalus and imbecility; and enlargement
of the mesenteric glands. Here we have the ultimate perni-
cious effects of the introduction of lime in excess into the
system; and they are obviously the same as those which
follow its deficiency. Dr. Beneke has well pointed out the
importance of phosphate of lime to cell-growth, as illustrated
by agriculture; and no cells can need it more than those which
are concerned in ossification. It only requires to be estab-
lished that lime dynamically cures what dynamically it causes;
and this, I think, is fully substantiated by experience. It is
apparent from the high repute which-as we shall see-the
carbonate enjoys in homoeopathic practice, when given for
those very conditions in doses of the utmost minuteness.
"Where we find," says Dr. Guernsey, "a large head, large
features, pale skin with a chalky look, and (in infants) open
fontanelles, we should think of Calcarea carbonica." It is
hardly less apparent in the excellent results which Dr. Ringer
reports from grain doses of the phosphate, of which he admits
that only a small proportion can be dissolved in the gastric
juices, and enter the blood.
I hold it established, therefore, that we have in lime a
medicine as well as a food; and that in the former capacity it
acts, like all its congeners, according to the principle similia
similibus. I pass, now, to consider the ascertained usefulness of
its several salts.
Calcarea acetica was proved, in a saturated solution of
oyster-shells in vinegar, by Hahnemann and four others: their
*See Brit. Fourn of Hom., xvii.
CALCAREA.
341
results, making 270 symptoms, appear in the fifth volume of
the Reine Arzneimittellehre. We count his solution our first
decimal potency, and make subsequent attenuations with
alcohol.
The pathogenesis of C. acetica deserves more study than
it has received, as it supplies almost our only certain know-
ledge of the finer actions of lime. The salt has been mainly
used in the bowel affections, acute and chronic, of children
to whose general diathesis lime is suitable. Dr. Clotar
Müller says that it was the rernedy in one of the only two
cases of migraine he ever succeeded in radically curing.
The symptoms indicating it were a feeling of great coldness
in the head and much gastric acidity.
It is usually given in the lowest attenuations.
Calcarea arsenica, the arsenite of lime, has not been proved,
but appears to possess the virtues of its constituent elements.
Dr. C. Hering commended it many years ago in epilepsy,*
and Dr. H. Nankivell has praised it in tabes mesenterica
and chronic pneumonic phthisis, with hæmoptysis,† while Dr.
Hilbers esteems it highly in dyspnoea from a feeble heart.
I can confirm the last-named indication.
Calcarea carbonica is the salt of lime which has found chief
use in homœopathic therapeutics. The form in which we
employ it is not chalk or marble, but the soft white substance
which is found between the external and internal hard layers
of the oyster-shell. This is triturated in the usual way. Its
pathogenesis appears in the first edition of the Chronic
Diseases, where 1090 symptoms are ascribed to it-all (as we
know) observed on patients taking it in the attenuations
from the 3rd to the 12th. In the second edition the list is
increased to 1631. Two hundred and seventy of the additional
symptoms are those of the acetate, which Hahnemann has
thought well to incorporate, marking them by a line-a sign
of distinction which Dr. Hempel's translation too often omits.
The remainder are from Hahnemann himself and from fresh.
fellow-observers, all of course experimenting with globules of
the 30th. Dr. Allen's arrangement of the drug contains some
additional symptoms obtained from an alcoholic solution of
the precipitated carbonate by Dr. Koch on himself and four
others.
Hahnemann, in choosing this animalised form of carbon-
•
* Brit. Fourn. of Hom., vii., 564.
+ Monthly Hom. Review, xvii., 631.
342
CALCAREA.
ate of lime for homeopathic purposes, was in harmony with
all tradition. From early times similar natural products have
been employed in medicine, such as "crabs' eyes," crabs' claws,
coral, egg-shells, and powdered human cranium; and have
acquired no small reputation. Modern therapeutists, suppos-
ing themselves wiser, have substituted a more purely
mineral form of the salt, but with the result of losing all but
its chemical and mechanical qualities. A practitioner of the
old school, who knows chalk only as a means of neutralising
acid in the stomach, or of plastering over the intestinal surface
to check diarrhoea, naturally ridicules us for counting it a
polychrest remedy. But he forgets that our Calcarea car-
bonica is something more than his "creta preparata," and
that it inherits an ancient and widespread renown. Stillé
follows Richter in thinking that an error has been made in
substituting mineral for animal preparations of lime, and says
that the latter are certainly better borne by the stomach.
Our fullest information on this subject, however, is given us by
Dr. Imbert Gourbeyre, in his "History of Calcareous Prepar-
ations," which has been translated from L'Art Médical in the
thirty-fourth volume of the British Journal of Homœopathy.
Of the symptoms of Hahnemann's pathogenesis I have
nothing to say. But, taking the phenomena of cretinism as
our best proving of lime, we have in the virtues of Calcarea
(so called among us par excellence) their truly homœopathic
application. It is in the large class of diseases due to derange-
ment of the secondary assimilation that it finds its curative
place. The three great forms of assimilative derangement are
rachitis, scrofula, and tuberculosis; and in all of these Calcarea
is a principal remedy.
(C
1. First, of rachitis. If a child cuts its teeth late, if it does
not walk so early as other children, if the fontanelles are late
in closing, the probability is that it is the subject of rickets :"
so writes the late Dr. Hillier, in his excellent Clinical Treatise
on Diseases of Children. Well, then, when rachitis thus mani-
fests itself, you will find Calcarea an invaluable aid in its treat-
ment. But when the diathesis is more pronounced, when its
phenomena reach beyond those of deficient supply of lime-
salts, you will have to look farther for your medicinal remedies.
I shall have more to say upon this subject when I come to
Silica, which I believe to be the most potent of anti-rachitics.
Let me notice here, however, that head sweats in the evening
are noted by Hahnemann as an especial indication for Cal-
carea, and have lately been mentioned by Jenner as patho-
gnomonic of rickets.
CALCAREA.
343
((
2. Regarding Calcarea in scrofula, I will begin by citing
our latest writer on the disease, Dr. H. Goullon, of Weimar.
Water," he says, "that contains the salts of lime in excess
is accused by some of producing scrofula. Thus it is said
that the inhabitants of Rheims owe the large number of
persons affected by scrofula among their population to this
circumstance. If this be so, does there exist a greater triumph
for Hahnemann's principle? Certainly the Hahnemannian
school, if it were without the salts of lime, would not wish
to treat scrofula. Calcarea carbonica performs wonders in
scrofulous ophthalmia; like Sulphur, it removes scrofulous
pot-bellies, if I may be allowed to use this expression; like
Phosphorus, it cures scrofulous diarrhoea." Dr. Goullon then
cites cases of tabes mesenterica; of strumous ophthalmia and
otorrhoea; and of disease of the joints and vertebræ in such
subjects, where Calcarea has proved curative. Dr. Gourbeyre
shews that scrofula was one of the chief maladies in whose
treatment the animalised forms of carbonate of lime gained
their ancient repute. My own experience with it is especially
in the treatment of mesenteric disease, in which-if not too
far advanced-it is an invaluable remedy. You will remember
the enlarged abdomen of cretinism. This brings us also to
bronchocele, of which Goullon writes: "The swelling of the
thyroid gland is so intimately connected with scrofula that
its former name-struma-has been applied to the diathesis."
He gives three cases of the disease cured by Calcarea. They
were all simple hypertrophies; but the power of the drug over
cystic growths-of which we shall speak presently—would
encourage its use in the cystic form also of goitre. Dr.
Gourbeyre relates the favourable experience of a French prac-
titioner (Chlyssiol) in this disease with powdered egg-shells,
and a case of his own, in which a large but soft goitre of many
years standing disappeared in seven months under Hahne-
mann's Calcarea carbonica in the fourth trituration.
3. I cannot speak with any certainty of the action of Calcarea
in tuberculosis. At the British Homœopathic Congress of 1873,
Drs. Gibbs Blake and Wynne Thomas brought forward some
evidence of its power over chronic maladies associated with
high temperature, some of these being certainly and others
presumably of a tuberculous nature.* But I have most confi-
dence in it here as a preventive. There is a peculiar form of
dyspepsia which often precedes the development of tubercu-
losis. Indicated more or less precisely by Drs. Tweedy Todd,
Clark, Bennett, and Ancell, it has been most fully characterised
Monthly Hom. Review, xvii., 683.
344
CALCAREA.
by Mr. Jonathan Hutchinson. Its special feature consists in
acid eructations after food: "everything the patient takes
'rises acid,' as he expresses it, but more particularly everything
containing fat, oil, or sugar." There is a special dislike to
fat present.* Now in this acid dyspepsia Calcarea proves
itself an excellent remedy. I know not whether the fact that
two of Hahnemann's provers of the acetate had constant sour
eructations has any bearing on the point, since they were
taking vinegar; but of the value of the carbonate, in the
minutest doses, there is not the least question. I have myself
cured with it a most obstinate case, in which the fount of acid
seemed inexhaustible, and even gouty symptoms were set up
in a patient the most unlikely to be attacked with such a
malady.
In all derangements of nutrition, whether rachitic or not,
when occurring (as they generally do) in children, Calcarea is
indicated where the profuse perspiration of the head which I
have mentioned is present.
The powers of our drug seem moreover to extend to the
new products which result from disorders of growth. It has
repeatedly been reported as causing the disappearance of
warts, polypi, and even benignant tumours of the encysted
kind. In this connexion it must not be forgotten as a pos-
sible aid against cancer. In the Lancet for 1868 Dr. Peter
Hood published two cases in which the daily administration
of small quantities of powdered oyster-shell effected a cure of
this dire disease. Mr. Spencer Wells, who authenticated his
observations, suggested that the rationale of the cure was that
the lime caused ossification of the blood-vessels of the diseased
part, and so starved it out. The process is one not easy of
conception; and a specific curative power is at least as
tenable a theory.
This is the great sphere of the action of Calcarea. But it
has other uses, which seem independent of its power over
assimilation. One of these is of a very curious kind; and, if
I had not repeatedly seen it (and also felt it) myself, and had
it vouched for by excellent observers like Drs. Dudgeon,
Drury, and Bayes, could hardly have credited it. It is its
power, when given in repeated doses of the 30th dilution, of
relieving the pain attending the passage of biliary (Dr. Bayes
says also of renal) calculi. It has for me quite superseded the
* Aitken Science and Practice of Medicine, 5th ed., ii., 206; to
whom I am indebted for these facts.
† See Goullon on Scrofula, art. Calcarea, and Brit. Journ. of Hom.,
xxvi., 31.
CALCAREA.
345
need of chloroform and even of the hot bath. Hahnemann,
moreover, insists much on the relation of Calcarea to the
menstrual function. "It is indispensable and curative," he
says, "when the catamenia appear a few days before the
period, especially when the flow of blood is considerable. But
if the catamenia appear at the regular period or a little later,
Calcarea is hardly ever useful, even if the catamenia should
be rather profuse." In these cases, says Dr. Guernsey (who
has a great penchant for out-of-the-way symptoms), the
patients often complain of a sensation as if cold, damp stock-
ings were on their feet: whenever they do, we may think of
Calcarea. Again, the medicine has a considerable reputation
in epilepsy* (Dr. Gourbeyre mentions the high ancient repute
of powdered human cranium in this malady) and in migraine,†
when these affections appear in the natural subjects of its
influence, i.e. (as I might have said from the first) in unhealthy
women and children, of leuco-phlegmatic temperament, and
with tendency to corpulence. In these subjects it will remove
many anomalous symptoms and local troubles, as headache
with sense of coldness, toothache (especially that of preg-
nancy) caused by the slightest cold, leucorrhoea, deficiency of
milk while nursing; and so forth. The sensitiveness to cold
mentioned in connexion with the toothache of Calcarea is
noted by Dr. Guernsey as characteristic of the general
morbid condition calling for it; "every current of cool air,'
he says, "seems to go through and through the patient."
Vertigo on ascending, I may add, is another of his "keynotes
for it.
* Brit. Fourn. of Hom., xxii., 246, 258.
† See Ibid, xxi., 282.
See N. York Medical Record, xvi., 83.
دو
Jahr says that, after failing in acute hydrocephalus with
the ordinary remedies, he took to treating the disease with
Calcarea 30, and with very different results. I have men-
tioned in my Therapeutics a favourable result obtained by
myself in this way. Still more decisive is its action in chronic
hydrocephalus, where its power as a nutrition remedy comes
into play. Perhaps C. phosphorica, as recommended by von
Grauvogl, may be still more effectual here.
I have quoted Dr. Goullon's commendation of it in strumous
ophthalmia. It is highly esteemed in the homoeopathic treat-
ment of this malady, especially when the cornea is involved.
Hitherto, we have supposed it to act here by modifying the
constitutional diathesis. Dr. Mc Dowell, of Baltimore, however,
has recently described‡ what he calls " oyster-shucker's
346
CALCAREA.
corneitis.' He is " disposed to attribute the disease to a
specific toxic element contained in the slime and dirt which
coats the oyster-shell;" but I think we may fairly prefer to
trace it to emanations from the shell itself.
))
The analogues of Calcarea carbonica are Baryta, Iodium,
Phosphorus, and Silica.
The higher dilutions, from the 12th to the 30th, are those
which appear to be most in favour, and which I myself use;
but the 3rd is undoubtedly efficacious. Calcarea seems
seldom or never employed by the exclusive adherents of
mother tinctures and crude drugs.
Calcarea caustica.-Lime in this form, in which we have it
in the ordinary lime-water, can have but slight pathogenetic
properties, as we give the latter freely, even to children, as an
antacid. But provings made with it by Koch, Keil, and
Liedbeck on thirteen persons give it in Dr. Allen's Encyclo-
pædia a list of 342 symptoms. These seem but trivial; and I
have no knowledge of their having received any application to
practice. Dr. Wyld speaks highly of it as a resolvent appli-
cation to boils and carbuncles.
Calcarea fluorata has been proved on three persons, in the
15th dilution, by Dr. J. B. Bell. It is one of Schussler's
"tissue remedies," introduced into the series because of its
presence in bone and the enamel of teeth. It seems several
times to have removed exostoses in the human subject, and
is recommended for the spavin of horses.
Calcarea iodata, the iodide of lime, has been proved by Dr.
W. S. Blakely and another in the crude substance and the
lower triturations; 47 symptoms of it are given by Allen.
These, too, are of no very definite character; though, as
with C. caustica, the head is the part most affected. Dr.
Meyhoffer thinks the iodide the best form of lime in the
chronic bronchitis of scrofulous children, when in a thin
subject (in the last point distinguished from the carbonate)
the cervical glands are much swollen, the cough rather dry,
and there is ground for suspicion of enlargement of the
bronchial glands. It is soluble in water, and with this the
lower attenuations are made; but Dr. Sherman says that in
this form it is readily decomposed, and that triturations are
preferable.
Calcarea phosphorica.--Dr. Hering has justly taken me to
CALCAREA.
347
1
task for having said, in the first edition of my Manual, that
this salt of lime had never been proved. He refers me to
some provings of the 1st and 2nd triturations made under
his superintendence, which I ought to have known of, as they
were in Jahr's New Manual. He speaks also of yet more
extensive provings still unpublished. Dr. Allen gives all that
are now extant. It has not been largely used in homœo-
pathic practice. Dr. von Grauvogl relies much upon it in
chronic hydrocephalus, both to cure the already existing
disease, and-by giving it to the mother during pregnancy-
to avert the tendency to its recurrence in future children. Dr.
Cooper* speaks highly of it for chronically-enlarged tonsils in
strumous subjects; and Dr. Verdi, of Washington, has much
confidence in it in phthisis.† Dr. Guernsey gives as a great
indication for it that every cold causes rheumatic pain in the
joints and in various parts of the body. It, too, is one of
Schussler's twelve remedies, and is given by him to promote
the nutrition of the tissues into whose composition it enters,
especially the blood corpuscles and the bones. Dr. Hering
long ago used it on the same principle to favour the union of
fractures and the closing of open fontanelles, and also to aid
in dentition. But the main use of phosphate of lime is as a food
in the same class of cases in which we use the carbonate as a
remedy, and perhaps in others. Dr. Dusart, of Paris, is a
well-known advocate of its use in this way, and his syrup of the
lacto-phosphate is a convenient form for its administration to
children. Dr. Ringer gives us the latest estimate of its
efficiency. He recommends it in most forms of mal-nutrition
and defective cell-growth; in anæmia from growing fast, rapid
child-bearing, prolonged suckling, or excessive menstruation;
in chronic discharges; in rachitis; and for the bad effects of
town life, including brain-fag. He gives one or two grains of
the salt three times a day. The homoeopathic uses have been
made with the lower triturations.
Calcarea muriatica (the chloride of calcium) has not been.
proved. I find it extremely useful in the moist porrigo
capitis of children, giving it in the first attenuation. Some use
it in solution as an abortive local application for boils; it is
said to ease the pain also. It has lately been recommended
in the old school as an anti-scrofulous medicine.§
* Monthly Hom. Review, xi.
† Brit. Fourn. of Hom., xxix., 749.
‡ Ibid, xix., 498.
§ Lancet, Aug. 28, 1877.
348
CALCAREA.
Calcarea sulphurica, the sulphate of lime, has been proved
(in the higher attenuations), as you will see from Allen; but
here too we owe any knowledge we possess of the drug to Dr.
Schussler. He says that it is present in connective tissue, and
acts chiefly on this part, being thus valuable in suppurations.
"It acts," he says, "with more intensity in most cases where
Hepar sulphuris, the sulphide of lime, has heretofore been
given." Quaglio and Kock support this statement; and "it
is willingly confirmed," says Dr. Hering, "by the one who in-
troduced the old Hepar in suppurations."
LECTURE XXIII.
CALENDULA, CAMPHOR, CANNABIS SATIVA AND INDICA,
CANTHARIS.
I begin to-day with the common garden marigold—
Calendula.
This plant owes its place in the Materia Medica of Homœo-
pathy to its power as a vulnerary. Dr. Allen gives a patho-
genesis of it obtained by two provers, but the symptoms are
few and insignificant, and it is rarely given internally. One
of our German practitioners, however, Dr. Thorer, becoming
acquainted with the virtues ascribed to the marigold by the
common people, endeavoured to ascertain by experiment its
exact place in the treatment of injuries. You will find his
paper translated in the fifth volume of the British Journal of
Homœopathy. His cases show that Calendula has a most
beneficial influence over wounds, especially incised wounds,
promoting union by first intention, or, where that is im-
possible, favourable cicatrisation with the least possible
amount of suppuration. From that time to this Calendula
has always been used in homoeopathic practice to promote
the healing process in wounds, ulcers, burns, and other
breaches of surface. You may read instructive comments on
its virtues by Dr. Yeldham in several papers in the British
Journal and the Annals. It was used on a large scale by our
American colleagues in the treatment of the injuries arising
in the course of their civil war; and it obtained (as you may
see, for instance, from Dr. Franklin's book on surgery) their
warmest commendations. No suppuration seems able to live
in its presence.
Of course there is nothing homoeopathic about Calendula,—
its working, that is, is no instance (so far as we know) of the
operation of the law of similars. Nevertheless, it is homœo-
pathists only—at least in England and America-who give their
patients the benefit of this precious vulnerary. You will find it
350
CAMPHOR.
invaluable in surgical, and also in gynecological, practice. Dr.
Ludlam, our foremost authority in the latter sphere, has just
made some remarks on its value herein, advising its use in all
solutions of continuity of the sexual passages, and even com-
mending its internal use in chronic endo-cervicitis and scrofu-
lous ulceration, with much purulent leucorrhoea.
I have now to speak to you of
Camphor,
-
of which we make an alcoholic solution. The proportion of
drug to vehicle in this mother-tincture has ranged in homœo-
pathic pharmacy from one eighth to one twelfth. The British
Homœopathic Pharmacopoeia makes it one tenth. The pre-
paration sold as "Rubini's Camphor" is a saturated solution,
as used by that physician in the treatment of cholera. Some
alarming accidents have lately occurred from persons employ-
ing this tincture with the freedom to which they have been
accustomed in the use of the ordinary preparation, which
can do no harm. There has been a very absurd and unfair
attempt to make capital out of these occurrences as against
homoeopathy. A few minutes thought and inquiry would
have shown that the only blame rested with the carelessness
which ignored an obvious and reasonable difference of
strength in the two solutions.
*
A proving of Camphor appears in the fourth volume of the
Reine Arzneimittellehre. It contains 105 symptoms from
Hahnemann himself, and 240 "observations of others," of
which 93 are from twenty-one authors, and the rest from four
fellow-provers. Camphor was also one of the medicines
proved by Professor Jörg: his results, obtained upon himself
and ten of his pupils, are given in Frank's Magazin (iv. 482),
and related by Hempel, who adds some further pathogenetic
records. Dr. Allen, combining these materials, gives 916
symptoms to the drug.
The action of Camphor on the organism has been a matter
of dispute from early times. The old physicians were divided
into two camps on the question whether it is a "hot" or a
"cold" remedy. Hahnemann recognises the variable cha-
racter of the facts before him, and suggests their explanation.
"The action," he says, "of this substance on the healthy body
is extremely problematic and difficult of definition, for this
reason, that the primary action of Camphor alternates so
* See Transactions of Clinical Society of London, vii., 28.
CAMPHOR.
351
suddenly, and is so easily confounded, with the reaction of the
vital principle." He explains farther on that he agrees with
those who consider chill and depression to be the first effects
of Camphor, and refer the symptoms of stimulation so often
observed to a secondary reaction. He is supported herein by
the weighty authority of Trousseau and Pidoux. After a full
survey of the evidence, they conclude that the essential action
of Camphor is "refrigerant and sedative," and describe its full
poisonous effects as those of collapse with chill. Stillé (who
has an exhaustive article upon the drug) takes the same view
as regards large doses-from thirty to sixty grains. But he
thinks, on the other hand, that all the evidence goes to show
that "the direct and primary action of small or medicinal
doses from one to fifteen grains-of Camphor is to stimulate
and excite the nervous and vascular systems, and through
them the whole organism." If he is right-and I myself
think that the facts bear him out-Camphor conforms to the
view of drug-action maintained by Dr. Sharp. It has an
opposite action on the healthy body in large and small doses
respectively; and its effects in cold and depressed conditions
of the system are due to the direct stimulant influence of the
moderate quantities in which it is administered. I have
already explained to you why I am unable to accept this law
as true of medicinal action in general; and I think that the
exceptional character of the dosage of Camphor shows that,
where it does apply, it leads to a mode of practice peculiar to
its operation, and different from that which obtains in
homœopathic treatment generally.
It was not many years before Hahnemann had an oppor-
tunity of giving his views about Camphor a practical applica-
tion, and thereby of making a most important contribution to
therapeutics. In 1831 Asiatic cholera for the first time.
invaded Europe. The few physicians then practising homœo-
pathically sought diligently for its similimum, that they
might be ready to encounter it. Several medicines were
suggested; but when Hahnemann spoke out from his retreat
at Coethen, he pronounced the one great remedy to be
Camphor. He described the well-known features of the first
stage of the invasion,-the sinking of strength, the coldness,
the anxietas; all these occurring before the vomiting,
purging, and cramps have set in. Here, Hahnemann said,
Camphor is a potent and certain remedy. It should be given
freely-by the mouth, by inhalation, by friction, by clyster;
and persevered with till the patient recovers. Nor, though
the second stage has supervened ere the treatment has
352
CAMPHOR.
begun, should Camphor be neglected. But here, unless im-
provement set in within a couple of hours, it is of no use to
persist, and recourse must be had to other remedies, of
which he specifies Cuprum and Veratrum.*
‡
Hahnemann had the gratification of hearing of the great
success which attended all who followed this advice of his,
and of numerous instances in which the family use of Camphor
had checked the earliest symptoms of the prevailing scourge.
In the epidemic of 1849, British physicians had an oppor-
tunity of testing the value of the remedy: and Dr. Drysdale
in Liverpool† and Dr. Russell in Edinburgh vied in their
praises of it. The latter, who has written a book on the
disease, says: "It is our firm belief that Camphor is an
almost infallible remedy for cholera, if given from the very
outset." In 1854, the same testimony was given to its value
in England; and from Italy still more striking evidence was
adduced as to what it can do. Dr. Rubini, of Naples-he
who has given us Cactus grandiflorus-states that during this
epidemic he treated, together with his colleagues, 592 cases
with Camphor alone without a single death. He gave it in
the spirit of Hahnemann's instructions-ad libitum doses of
a saturated tincture, and relied upon it to the exclusion of all
other medicines in every stage of the disease. You will find
a full account of his observations in the tenth volume of the
Monthly Homœopathic Review. Much exception has been
taken to his statement of results, as exaggerated; but I think
without just cause. Dr. Rubini is a physician of undoubted
experience and judgment, not to speak of trustworthiness;
and his published affirmations have never been contradicted.
He does not mean to say that all his cases were in collapse :
on the contrary, of a set of 200 treated in one institution, it is
expressly mentioned that collapse occurred in fifteen only.
What our colleague wishes us to understand is, that in an
epidemic of Asiatic cholera in which 377 cases came under
his own treatment, and 215 more under that of his fellow-
practitioners, they gave nothing but Camphor, and lost no
patient. There must have been the usual proportion of severe
cases among these; so that the results are most gratifying.
We have hitherto been jubilant about reducing the ordinary
50 per cent. mortality from cholera to one half; but 26 per
cent. of deaths is a melancholy rate after all. We are bound
* His paper may be read in Dudgeon's Lesser Writings of Hahne-
mann, p. 845.
† Brit. Fourn. of Hom., viii., 149.
1 On Epidemic Cholera, p. 211.
CAMPHOR.
353
to look in directions which promise something better still;
and Dr. Rubini's extension of Hahnemann's Camphor-treat-
ment deserves our most respectful attention. Mr. Proctor,
indeed, reports less favourably of it in the Liverpool epidemic
of 1866;* but further experimentation is required. In the
same epidemic Dr. Rubini treated 123 cases, and again his
mortality was nil.†
It is natural to inquire whether the report of the anti-
choleraic virtues of Camphor has spread beyond homoeopathic
regions, and whether any trial has been made of it. This
might well be, as in its case there are no posological preju-
dices to be overcome. I am only acquainted, however, with
one miserable instance of its use in the last epidemic, where
it was given to a few patients at the London Hospital. The
physician did not deign to follow our method of administra-
tion, viz., dropping it on sugar, but gave it suspended in
water. He thus nauseated his patients, and burnt their
throats; and consequently, instead of exhibiting it in a better
form, thought fit to abandon its use altogether. Both Ringer
and Wood, however, now recommend it; and the latter states
that it forms the chief ingredient in the popular cholera-
mixtures sold in America.
A similar action to the foregoing, though on a humbler
level, is the power which Camphor has of checking an in-
cipient "cold." Hahnemann, in the preface to his proving,
commends it in the influenza then first known as an epidemic;
and Dr. Ringer has lately extolled its virtues in the chronic
paroxysmal coryza from which some people suffer. In all
these nasal defluxions Camphor should be taken by olfaction
as well as internally. It is also of much repute in summer
diarrhoea. I think that Dr. Phillips well characterises the
condition which calls for it here as one of exhaustion with
irritability of the intestinal nerves resulting from high summer
heat; but Dr. Ringer finds it useful also in diarrhoea resulting
from cold.
A few words must be said on the symptoms of re-action
which sometimes occur after Camphor poisoning, where the
primary effects have been sedative. They are those of fever,
with much confusion and oppression of the brain, and even
disorder of its functions. The fever, as in a case recorded by
Dr. Hempel, may take on a typhoid form and be of some
duration. I cannot say whether these facts have any relation
* See Brit. Fourn. of Hom., xxv., 92.
+ See his Statistica dei colerici curati colla sola Canfora in Napoli
negli anni 1854, 1855, 1865. 3rd edizione, ampliata. Napoli, 1866.
2 A
354
CAMPHOR.
to the antifebrile and antiseptic powers ascribed to Camphor
by the physicians of the last century, or to its occasional
successful employment in mania. It was chiefly administered
in fever when an ataxic condition was present, and phenomena
of this kind are frequent in the Camphor re-action. But I do
think they are closely connected with another use made of it
in homœopathic practice, viz., to recover the patient from the
state into which he is thrown by the retrocession of measles
or scarlatina. There is here the same cerebral disturbance
and. oppression; and the patient, though hot within, is cold.
without. He has that characteristic of Camphor noted by
Dr. Guernsey, that, though cold to the touch, he will not
remain covered. I know the value of cold affusion in these
terrible cases; but it is at least jucundius, if not also tutius, to
effect what we want by the administration of Camphor.
The only marked local action of Camphor is on the genito-
urinary organs, which is all the more interesting, as it cannot
be detected as passing off by the urine. That it causes
strangury is undoubted, and is admitted both by Pereira and
by Ringer. The former is naturally astonished at a power of
diminishing irritation of the urinary organs being assigned to
Camphor. But that it has this power, whether the strangury
is idiopathic or the effect of Cantharides or other drugs, is
the testimony of all the old physicians. I have myself twice
seen patients in this agonising condition translated, as it were,
from hell to heaven in less than an hour by repeated small
doses of the drug. This action, therefore, is not antipathic, as
supposed by Stillé. As with Cantharis, the urinary irritation
of Camphor sometimes extends to the genitals, causing
priapism and such-like phenomena. But the ordinary and
permanent effect upon these organs (probably through the
nervous system) is of a depressing character.
"Camphora per
nares castrat odore mares" is quoted in all books on Materia
Medica; and Hahnemann cites an observation from Loss, in
which impotence thus produced lasted a considerable time. I
do not know whether much homœopathic use has been made
of this action of Camphor. Stillé mentions several striking
instances of its value as an antipathic palliative. Dr.
Hirsch has recommended it for irritable weakness of the
sexual organs, with nocturnal emissions. Dr. Norton mentions
a similar case.*
Besides these uses in disease, Camphor is reputed by Hahne-
mann an antidote to most vegetable and to some animal and
mineral poisons. Against the majority of these it probably
* In an article on the drug in Brit. Fourn. of Hom., ix., 407.
CANNABIS SATIVA.
355
has no true antidotal power, and it would hardly neutralise
their effects in poisonous quantities. But for the more delicate
disturbances produced by minute doses Camphor may be a capi-
tal remedy, by substituting a more potent impression than theirs
upon the nervous centres. This is probably what he meant.
Dr. Holcombe* thus sums up the action of Camphor: "It
is antidotal to almost all the drastic vegetable poisons-relieves
strangury-procures reaction from cold, congested conditions
-is the great anti-choleraic-and quiets nervous irritability
sometimes better than Coffea, Ignatia, or Hyoscyamus. This is
its whole clinical value-and a great one it is—in a nut-shell."
I must not leave Camphor without referring to Dr. Harley's
communication regarding it in the ninth volume of the Practi-
tioner. He finds that in medicinal doses-from five to thirty
grains-its effects are but slight, being chiefly those of sedation
of the motor and ideational centres of the cerebrum, with much
giddiness. These results are somewhat different from those
of other observers, and can only be provisionally accepted at
present. An epileptic fit has twice been observed as a result
of an overdose of our concentrated solution.
In its influence over the circulation Camphor resembles
Aconite, Arsenic, and Veratrum album. Its power of causing
strangury is like that of Cantharis and Terebinthina, less like
that of Belladonna.
The drug does not seem to bear attenuation. The primary
solution is that always in use.
I will now give you some account of the medicinal virtues
of hemp. Unlike the ordinary practice, we use not the Cannabis
Indica only, but that also which grows in colder climates. Let
me speak of the latter first-
Cannabis sativa.
Our tincture is prepared from the flowering tops and upper
leaflets.
A proving of hemp, by Hahnemann and eight others,
appears in the first volume of the Reine Arzneimittellehre. It
contains 330 symptoms, 47 of which, however, are from authors.
The severity of some of these is puzzling, when we consider
how mild a poison the plant is. But the mystery is explained
when we examine the originals of the two principal groups-
those of Morgagni and of Ramazzini. The former consists of
* United States Medical and Surgical Journal, vol i.
:
356
CANNABIS SATIVA.
cases of disease recorded in various parts of his De sedibus
et causis morborum, and mentioned as occurring in hemp-
dressers; but rarely traced or traceable to their occupation.
The latter are symptoms occurring in workers in hemp
and linseed-the connexion, as well as the nature of the
phenomena, showing that they are mere local effects of the
dust. These, therefore, must be eliininated from the patho-
genesis of the drug. But in their place we have five more
recent provings to put, all instituted with substantial doses,
which are duly incorporated with Hahnemann's by Dr. Allen.
There is an interesting study of the drug by the late Dr. Norton
in the ninth volume of the British Journal of Homœopathy.
It would appear, from Hahnemann's preface to his proving,
that Cannabis was in common use at his day as a remedy
for acute gonorrhoea. It was supposed to act as a "demulcent;
but he is well warranted in saying that its curative powers
depend upon the faculty it possesses of producing a similar
morbid condition in the urinary organs Its pathogenesis
shews excessive irritation of the mucous membrane of the
bladder and urethra, and of the prepuce. The latter is dark
red, hot, and inflamed; there is much burning in the urethra,
painful and difficult micturition, chordee, and mucous dis-
charge. It has been customary to add the observation of
Morgagni, in which the urine was so full of mucus and pus
that the catheter became clogged, and failed in its office.
This, however, is not to the point, as the case was one of
paraplegia from spinal disease, and the state of the bladder
(noted eight days before death) was only that incident to
such affections. But there is amply sufficient evidence besides
this to prove the homoeopathicity of Cannabis to urinary
inflammations; and it continues to be in the school of Hahne-
mann the favourite remedy for gonorrhoea after the most
urgent symptoms have been subdued by Aconite and (if
necessary) Cantharis. Even when the inflammation is not so
acute, I think we do well to commence the treatment with a
more vascular medicine, which in such a case had best be
Gelsemium.
"}
A good deal of use has been made of Cannabis in affections
of the eyes, owing to the symptoms in Hahnemann's patho-
genesis "the cornea becomes opaque; pellicle before the
eyes" and "cataract." For the first he himself vouches;
and though one would have liked to know under what circum-
stances it occurred, we cannot but accept it, and it is certain
that the medicine has some effect in removing corneal
opacities left behind after strumous ophthalmia. The symp-
CANNABIS INDICA.
357
tom "cataract" is referred to Neuhold. This author is re-
cording effects of the effluvia of hemp before drying, so that
his symptoms are valid enough. Nor is there any doubt that
his "suffusiones oculorum," which Hahnemann renders cataract,
may mean this. Celsus* uses the phrase in this sense; and
we cannot but remember Milton's
"So thick a drop serene hath quenched their orbs,
Or dim suffusion veiled;
""
though it is possible that by suffusion he means opacity of
the cornea as distinguished from the "gutta serena" of cataract.
At the same time, when we find the phrase occurring in a list
of the observed effects of hemp without special mention or
warrant, it becomes very unlikely that the author meant to
hazard in this manner so startling an assertion as that the
herb can cause cataract. We must wait for further informa-
tion on this head.
Hahnemann's pathogenesis credits Cannabis with a power
of causing inflammation of the lungs, with delirium and
vomiting of green bile. Some recommendations and applica-
tions of it in pneumonia have followed, but I think without
warrant. The observations in question are cited from Mor-
gagni; and he is evidently speaking of the irritating effect of
inhaling the hemp-dust on the workers in it.
In the fourth volume of the British Journal of Homœopathy
Dr. Quin has recorded an excellent case of hemicrania cured
by Cannabis. It was primarily coincident with the catamenia,
which were far too copious. I think I have seen the medicine
useful in menstrual headache.
The action of Cannabis on the urinary tract assimilates it
to Apis, Cantharis, Copaiba, and Terebinthina; that on the
eyes to Euphrasia.
There is a general agreement that for gonorrhoea the mother-
tincture of Cannabis is required, in frequent doses of from one
to ten drops; though Dr. Helmuth says that a tolerably large
experience leads him to prefer the 12th. In the other affections
mentioned the medium dilutions have been efficacious.
And now of the
Cannabis Indica.
The peculiar properties of this variety of hemp exist in a
resin which is developed in it by climatic influences. This,
* Seventh book, vii., 13, 14.
358
CANNABIS INDICA.
when presented separately, is the substance known as has-
chisch, bhang, gunjah, and churrus. A tincture is prepared
from it for ordinary practice by dissolving one part
in twenty of rectified spirit. One part of this tincture,
therefore, to four of alcohol will make our first centesimal
dilution.
Some provings of the Indian hemp, made upon seven
persons with the tincture and lower attenuations, were pub-
lished by the American Provers' Union in 1839. Since then.
scores of persons have tested its curious effects upon them-
selves; and the experiences of haschish-eating have been put
on record,-by one writer with a descriptive power and
gorgeousness of diction hardly inferior to that of the
"English Opium-eater." Of the results thus obtained Dr.
Allen has made an exhaustive collection; and 918 symptoms
of the drug, including the mental phenomena described at
full length, stand in his Encyclopædia.
To possess yourselves of the characters of the haschish in-
toxication, it is necessary that you should study it thus in
detail. No outline can adequately present it. It is a con-
dition of intense exaltation, in which all perceptions and
conceptions, all sensations and emotions, are exaggerated to
the utmost degree. Distances seem infinite and time endless;
pleasure is paradise itself, and any painful thought or feeling
plunges at once into the depths of misery. Hallucinations of
the senses are common; and the least suggestion will set going
a train of vivid mental illusions. All the time a dual con-
sciousness is present: the experimenter feels ever and anon
that he is distinct from the subject of the haschisch dream, and
can think rationally. The bodily sensations accompanying
these phenomena are not many. Headache, sense of dryness
of the mouth and throat, and anæsthesia of the surface, are
not uncommon. The headache is very commonly a sensation
as of the brain boiling over, and lifting the cranial arch like the
lid of a tea-kettle. The anesthesia may be preceded by
sensations over the body like those produced by slight electric
sparks. In the motor sphere there is experienced at times
the peculiar condition known as cataleptic. Dr. O'Shaugh-
nessy thus describes the effect of the resin on a native of
India: "At 8 p.m. we found him insensible, but breathing
with perfect regularity, his pulse and skin natural, and the
pupils freely contractile at the approach of light. Happen-
ing by chance to lift up the patient's right arm, the professional
reader will judge of my astonishment, when I found that it
remained in the posture in which I had placed it. It required
CANTHARIS.
359
but a very brief examination of the limbs to find that the
patient had by the influence of this narcotic been thrown into
that most strange and most extraordinary of all nervous con-
ditions, into that state which so few have seen, and the
existence of which so many still discredit,-the genuine
catalepsy of the nosologist."
Such application of Cannabis Indica to practice as has been
made has been in perfect homoeopathic rapport with these
effects. Dr. Handfield Jones naïvely describes it as "physio-
logically a nervous stimulant, and therapeutically a nervous
sedative." Dr. Ringer and others recommend it in headache,
the former esteeming it the most useful medicine we possess
for diminishing the frequency of the paroxysms of migraine.
It seems, he says, to act on the nervous centre whence they
spring. It is probable, however, that this effect is obtained by
inducing the physiological action of the drug, as croton-chloral
-which is a pure anæsthestic-produces similar results. It
should be remembered if we ever come across a case of cata-
lepsy. I myself had a patient in whom attacks, probably
hysterical at bottom, assumed a cataleptiform character, and
here Cannabis Indica proved rapidly curative. The exalta-
tion of ideas it causes reminds one of the first stage of the
general paralysis of the insane. It could not control the
meningeal inflammation said to be always present in these
patients; but it might benefit the excited nervous centres
while other remedies were striking at that essential element of
the malady. Its power of causing general anesthesia adds
another to the few remedies we have for this condition when
occurring idiopathically. Dr. Gray reports its successful use
in dissipating spectral illusions, without terror, occurring in
the course of fevers, &c. Indian hemp is found to be almost
entirely without effect in graminivorous animals. If Teste be
right, this indicates it as specially suitable in sthenic constitu-
tions and disorders.
-
The effects of Cannabis Indica on the brain may be advan-
tageously compared with those of Agaricus, Belladonna,
Camphor, Crocus, Hyoscyamus, Opium, and Stramonium. In its
power of causing catalepsy its only rival is the chloride of tin.
In the case mentioned I gave the second dilution.
I have last to speak of the Spanish fly,
Cantharis,
of which we make a tincture by percolation.
360
CANTHARIS.
There is a short pathogenesis of this substance in Hahne-
mann's Fragmenta de viribus medicamentorum positivis, consist-
ing of 30 symptoms observed by himself, and 75 from
nineteen authors. He did not, however, take the medicine
up again; and its full proving appears in the first volume
of Hartlaub and Trinks' Arzneimittellehre. It contains 952
symptoms, many of which are citations from records of poison-
ing and overdosing, and the rest obtained by five provers.
Dr. Allen adds experiments made by Giacomini on his pupils,
and observations from many other sources, making a total of
1651. Some very complete studies of the action of the
Spanish fly on animals have lately been made by Dr. Cantieri,
of Milan, and published in the Italian journal Lo Sperimentale
(xxxiv, 9, 10). I take the account of these from the abstracts
which have appeared in English periodicals.
The primary interest of Cantharis arises from its local use
as an epispastic. The theory of the "counter-irritation " thus
practised has been much discussed of late; and Drs. Anstie*
and James Ross† have revived the doctrine of Fletcher‡ on
the subject, and (as I think) have demonstrated afresh its
soundness. We have but to go here as elsewhere to patho-
genetics, and there we shall find the explanation and guidance
of our therapeutics. It appears, accordingly, that "blisters
applied to the thorax and abdomen of dogs and rabbits will
produce redness and absolute inflammation of the pleura and
peritoneum, in patches distinctly corresponding to the vesi-
cated surface of the skin." Hence blisters when used (as
they principally are) for chronic inflammations are homœo-
pathic agents, though acting by local absorption instead of
by elective affinity. We have not yet the same experimental
proof in the case of neuralgia, for which blisters are now
being so freely employed. But I have shown in other places§
that Dr. Anstie's whole theory and practice on this point is
homœopathic in everything but name, and implies that here
also an irritant is being sent to an already irritated part, and
needs to be diluted (by distance) to obviate aggravation.
But, although we thus claim for homœopathy whatever
benefit blisters may effect in the majority of cases in which
they are applied, we do not as a rule employ them. We have
* Practitioner, iv., 156.
+ On Counter-Irritation (Churchill).
Elements of General Pathology (1842), p. 484; see also Dr. Drys-
dale's exposition of Fletcher's doctrine in Brit. Journ. of Hom.,
xxvii., 494.
|| Inman, New Theory and Practice of Medicine, p. 322.
§ See Brit. Journ. of Hom., xxviii., 326; xxx,, 373.
CANTHARIS.
361
medicines which, given internally, seek out under the guidance
of elective affinity the part that may be inflamed or the nerve
that is aching, and there more pleasantly and at least as
effectually extinguish the fire. So far as this holds good,
blisters are put out of court. But it is a question whether
there are not gaps as yet unfilled by specific medication, where
judicious counter-irritation might supply what is missing.
Should we desire to test this question the excellent account of
the value of blistering given by Dr. Ringer will help us.
At
present we use Cantharis externally, not to produce blisters,
but to disperse them. In burns and scalds causing vesication,
in vesicular erysipelas, and in herpes zoster we have conditions
of the surface more or less resembling the local effects of
Cantharis; and in all these affections the external application
of the diluted tincture has been attended with great advantage.
In burns and scalds I have often seen the best effects from it.
I once had a case in which both legs had been severely burned
by Phosphorus. Carron oil had already been applied to one
before I arrived, and I did not think it well to interfere with
the dressings: the other, however, I treated with rags dipped
in a lotion made with Cantharides. The difference between
the subsequent history of the two limbs was most instructive.
That to which the Spanish fly had been applied got well with
little trouble in a week: the other suppurated, and it was two
months before it had regained its integrity.
When introduced into the system, Cantharis acts as an
irritant poison, developing in all parts which it reaches either
by local contact or by elective affinity the same "pellicular
phlegmasia" (as Trousseau and Pidoux call it) which it
causes on the skin. The inflammation it sets up in the tract
from the mouth to the stomach seems purely local, but the
intestines are somewhat irritated even when it is introduced
directly into the blood. Under these circumstances it
quickens (while weakening) the pulse, and raises the tempe-
rature, thus producing a true (though only symptomatic)
febrile condition; and it inflames, besides the genito-urinary
organs, the serous membranes throughout the body-perito-
neum, pleura, pericardium, and the cerebral and spinal arach-
noid. The first-named, however, the genito-urinary organs-
are the chief seat of its action. The slightest effects are
increased quantity of urine and still more increased frequency
of urination, with heat in passing it in the case of men, in
women smarting. In higher degrees of its action it inflames
the whole mucous tract from the kidneys to the urethra,
causing pain in the loins; scanty, high-coloured, bloody, and
362
CANTHARIS.
}
*
generally albuminous urine, often loaded with tube-casts and
sometimes with epithelial cells; and burning pain and tender-
ness in the hypogastrium, with severe strangury. The cha-
racteristic pellicle is sometimes found in the bladder, and has
been voided (say Trousseau and Pidoux) into the chamber-
pot. With all this there is fever and great restlessness. The
genital organs are similarly and considerably affected. With
the slighter degrees of urinary irritation there is moderate
erotic excitement; but in poisoning by the drug this some-
times becomes painfully excessive, and is accompanied by
priapism, inflammation (even to gangrene) of the external
parts, and of the uterus, sometimes causing abortion.
The nervous symptoms of Cantharis usually come on some
days at least after the ingestion of the poison. They consist
in delirium-which, with the local throat-symptoms, closely
resembles hydrophobia, convulsions, and ultimately coma.
They are possibly to some extent due to the meningeal irri-
tation which Cantharis can set up: Dr. Cantieri also found
softening of the nervous centres, especially in the cerebellum
and the lumbar cord. But they are chiefly, I think, secondary
to the renal mischief, i.e., they are uræmic.
It would seem that under favouring circumstances Cantharis
can specifically irritate the skin. Pereira mentions a case in
which the application of a blister to the pectoral region caused
the development of ecthymatous pustules not only there, but
all over the body. Occasional pimples, vesicles, and pustules
are mentioned in Dr. Allen's pathogenesis as occurring in the
provers, but the "psoriasis" and "eczema" which appear
there are hardly to be depended upon.
Correspondingly with these physiological effects, the main
homœopathic use of Cantharis is in inflammations of the
urinary organs. This is no novelty as regards their chronic
forms, for Groenvelt and Bartholin advocated the practice
more than a century ago. The former was sent to Newgate
for the offencef at the instance of the London College of
Physicians; but the practice has since had many upholders.
To use the drug, however, in acute cystitis and nephritis, and
in inflammatory strangury, was only possible upon the
determinate method and with the small doses of homoeopathy.
In such affections we count it the chief remedy. Its renal
symptoms show that it acts on the secreting tubes rather
than, as turpentine, on the Malpighian bodies. It is hence
inferior to that medicine in simple, congestive suppression of
See Brit. Journ. of Hom., xvii., 548.
+ Ibid., X., 557.
CANTHARIS.
363
*
urine or hæmaturia; but when desquamation predominates
over congestion, as in the acute Bright's disease of post-
scarlatinal dropsy, Cantharis takes the highest place. "There
can be no doubt," says Dr. Dickinson, "that the renal dis-
order produced by Cantharides is of the nature of tubal
nephritis." Its secondary head-symptoms are very significant
here. Dr. Ringer strongly recommends it in this malady in
minim doses of the tincture, after the first symptoms have
passed off; and says that the discrepancy respecting the effect
of Cantharides arises probably from the difference of the dose
administered by different observers. He also recommends it
in the same quantities in diurnal enuresis in women-the
condition for which Dr. Cooper has established the use of
Ferrum. Pereira mentions a case of a boy of fourteen who
had been subject to incontinence of urine from infancy. By
means of gradually increasing doses of the tincture of Can-
tharides he was entirely relieved of the incontinence by
day, but the nocturnal discharge continued. It would seem
likely that some at least of the influence exerted by Cantharis
on the functional power of the bladder comes from the spinal
cord. Dr. Samuel Jones, in an exhaustive lecture on the
drug reported to the American Observer for 1879, puts in
juxtaposition cases in which paraplegia with cystoplegia were
caused by it, and in which its administration temporarily
restored power to a bladder paralysed in a corresponding con-
nexion. The influence of Cantharis probably stops short of
the lower end of the urethra; and it is not thought much of
in gonorrhoea, save where the inflammation extends so high as
to cause irritability of the bladder. But in those cases of
spermatorrhoea described by Lallemand, which depend on the
spread of gonorrheal irritation through the ejaculatory ducts
along the spermatic passages, Cantharis is one of the most
homœopathic medicines; and Dr. Kidd speaks well of its
efficacy in their treatment.†
As to the other parts irritated by Cantharis, we must note
the great success obtained by Cazenave and others in the
treatment of cutaneous squamæ and vesiculæ by small doses
(m iij-v) of the tincture. We must also take into account
Dr. Jousset's estimate of the drug as the chief remedy for
pleurisy. As soon as effusion has taken place, he says in his
excellent Eléments de Médécine Pratique, we must resort to
Cantharis, in the third dilution, every two or three hours; if
necessary (though he says he has rarely found it so) descend-
* See Annals, viii., 550, for two illustrative cases, † Ibid, v., 131.
Trousseau and Pidoux; see also Brit. Fourn. of Hom., iii., 417.
+
364
CANTHARIS.
ing to the second, the first, or even the mother tincture. In
his hands it appears quite to take the place of Bryonia and
Apis; but he mentions one case in which the last-named
succeeded after it had failed. The original idea of using the
Spanish fly in this disease was Giacomini's, and was an infer-
ence of his from the value of blisters therein, which he (rightly)
conceived to act by the absorption of the Cantharis they
contained.
Lastly, we must consider Bretonneau's comparison between
the effects of Cantharis in animals and diphtheria. He
describes the concrete exudation lining the mucous mem-
branes, and the coldness and adynamia; to which Dr. Black,
commenting on the point,* aptly adds the albuminuria of the
two affections. This physician naturally suggests the trial
of the drug as a remedy for the disease. I have rarely used
it myself, and I believe that it has disappointed expectations.
Dr. Ludlam, however, in his Clinical Lectures on Diphtheria,
speaks highly of it for the prostration which often continues
after the acuteness of the mischief has subsided; and Dr.
Lawrence Newton communicates a similar experience.† The
symptoms of Giacomini's provers establish its complete
homœopathicity to this condition.
Dr. Guernsey says that it is often indicated (by the consen-
taneous urinary symptoms) in ovaritis. Dr. Jones lays much
stress on external coldness, even with shuddering, coinciding
with inward burning, as indicating it; and recommends it (in
the tincture) for chronic ulcers of the legs.
In its action on the urinary organs Cantharis finds its
nearest parallel in Terebinthina; but Arsenic, Mercurius
corrosivus, Scilla, Sabina, Kali bichromicum, Apis, Camphor,
Cannabis sativa and Copaiba coincide with it at some points
of the tract.
The dilutions from the third decimal upwards have been
those commonly used internally. For external application
the lotion should not be stronger than one part of the tincture
to forty of water.
* Brit. Fourn. of Hom., xvii.
+ Monthly Hom. Review, xiv., 411.
LECTURE XXIV.
CAPSICUM, CARBON SULPHURATUM, CARBO ANIMALIS AND
VEGETABILIS, CAULOPHYLLUM, CAUSTICUM, CEDRON.
My first medicine to-day is the Cayenne pepper,
Capsicum.
It is prepared by pulverising the ripe capsules of the Capsicum
annuum, together with the seed, and from these making a
tincture by percolation.
The pathogenesis of Capsicum is in the sixth volume of the
Reine Arzneimittellehre, and contains 275 symptoms from
Hahnemann, 65 from four fellow-workers, and four from
authors. Dr. Allen has added a few later observations.
Capsicum produces its well-known burning in the mouth,
throat, gullet, stomach, and intestines, along which it passes,
and in the urinary passages by which it is eliminated. The
condition set up is one of incipient inflammation, and is
identical with that produced by the rubefacient action of the
drug on the skin. Local application, moreover, is not always
necessary to induce the latter effect. Dr. Allen's patho-
genesis contains symptoms produced by repeated teaspoonfuls
of a solution of Capsicum taken for a slight cold; and among
these are a papulo-vesicular eruption all over the body, with
much itching and burning.
The common employment of Capsicum as a gargle in sore
throat is undoubtedly an instance of homoeopathic action. It
used to be limited to relaxed conditions of the mucous mem-
brane; but Drs. Ringer and Phillips concur to extend it to
the early stage of acute inflammation. The latter recom-
mends it in "throat-coughs," in which I have myself seen it
of great service. Dr. Bayes says that an indication for it in
coughs is when each paroxysm causes pain in the ear. Its
usefulness in atonic dyspepsia, especially that of drunkards, is
366
CAPSICUM.
well established; but belongs to it rather as a condiment.* It
has been found of service in nervous irritability of the parts it
inflames, as hiccough, and tenesmus of the bladder and rectum;
even in dysentery where the last symptom is prominent. A
sense of burning is of course another indication for it. It
should be useful in some irritations of the urinary tract: Dr.
Phillips speaks of having cured a chronic case of renal conges-
tion with it. I am not aware of its having been used in
cutaneous affections, save as a local application to chilblains.
Hahnemann, in his preface, refers to Bergius' recommen-
dation of the drug in intermittent fever. His own symptoms
present a very fair picture of the paroxysm of this disease.
He notes especially the chill, saying that he has seen it
gradually increasing for eleven hours after taking the medi-
cine, and then declining for twelve hours more. Capsicum
has always occupied a high place in the homoeopathic treat-
ment of ague: it is found especially useful when the sweat
coincides with the heat, instead of following it.
It seems probable that Capsicum is capable of a more pro-
found action than the sketch now given would suggest. Dr.
Houghton tells us that Dr. Allen directed his attention to one
of Hahnemann's symptoms-" a swelling on the bone behind
the ear, painful to the touch "-as suggesting its use in aural
inflammations, and that he has found it of the utmost service
in both chronic otorrhoea and acute median otitis, when the
mastoid cells are much involved. I have myself lately had a
case of the latter kind, in which I fully expected to have to
make a deep incision; but complete recovery, with good
hearing power, has ensued upon the steady employment of
Capsicum. Again, Dr. O. R. Wright communicates a case, in
which, during pleuro-pneumonia, all the signs of abscess of the
lung supervened, the cough becoming explosive, and the air
expelled therewith being intolerably fœtid, tainting the atmos-
phere of the room. Hahnemann's symptom, "the cough
expels an offensive breath from the lung," led to the adminis-
tration of Capsicum in a high dilution, and under this remedy
rapid and complete recovery ensued.† Our French brethren
praise it in hæmorrhoids, for which cayenne pepper is well
known as a popular prophylactic.
* Dr. Ringer writes:-"I can endorse Dr. Lyon's strong recom-
mendation of capsicum in dipsomania. Ten-minim doses of the tinc-
ture obviate the morning vomiting, remove the sinking at the pit of the
stomach, the intense craving for stimulants, and promote appetite and
digestion. It should be taken shortly before meals, or whenever de-
pression and craving for alcohol arises."
+ See N. York State Hom. Soc.'s Transactions, x., 123.
CARBON SULPHURATUM.
367
As an irritant of skin and mucous membrane Capsicum
most resembles Argentum nitricum, Croton, and Euphorbium.
Hahnemann recommends the 9th dilution, but nearer
approaches to the crude drug have generally given complete
satisfaction.
I have now to speak of the substance known since its dis-
covery as Liquor Lampadii and Alcohol Sulphuris, under
which latter name it stands in our Pharmacopoeia. It is a
bisulphide of carbon, CS2. Pereira calls it Carbonei bisul-
phuretum, and it appears in Hering's Materia Medica as
Carburetum sulphuris. I shall myself follow the analogy of
similar compounds in styling it (much as Dr. Allen does)
Carbon sulphuratum.
Provings of this substance have been made by Knaf in the
old school, and by Pemerl and Koch in the homœopathic
ranks-altogether on thirteen persons. Its use in the
manufacture of vulcanized india-rubber has led to many
observations of the effects of inhaling its vapour. These
have been collected by Delpech in the Union Médicale for
1855.* The materials thus specified, with others of like kind,
have been worked up by Dr. Hering into one of the mono-
graphs of his volume of Materia Medica, and by Dr. Allen, who
gives 750 symptoms to the drug.
Carbonic sulphide is a stimulant anæsthetic like ether, and
can be given for this purpose by inhalation. It has too many
inconveniences, however, to allow of its use in practice. If
long inhaled it causes local irritation, besides headache and
giddiness; and the workers in it become impotent. The
effect which most arrests my attention is the occurrence of
long-lasting ringing in the ears, with or without deafness.
This was experienced by one of those who took it internally;
but it is especially prominent in a record of the effects of
inhaling the vapour given by Mr. T. Wilson in the seventeenth
volume of the British Journal of Homeopathy. Neither
Hering nor Allen has used this observation. It has led, how-
ever, to the only homoeopathic application of the drug of
which I am aware, Mr. Wilson stating that he has cured a
case of tinnitus aurium of some standing with it in the first
dilution. It is a medicine which ought to have a wider
application.
* See an account of his observations by Dr. Jousset, in Brit. Fourn.
of Hom., xv.
368
CARBO.
I should have mentioned that our preparation is a solution
in alcohol, in which the drug is freely soluble.
I have now to speak of charcoal, animal and vegetable,
which we will designate generically as
Carbo.
↓
By all the writers on Materia Medica charcoal is regarded as
utterly inert, and Hahnemann is laughed at by Pereira for
filling thirty-five pages with the symptoms produced by the
millionth of a grain. The learned writer has omitted to
notice that this millionth of a grain was obtained by tritura-
tion, and that it is to this process that Hahnemann ascribes
the development of such extensive powers in a substance inert
in its crude state. This is a question of fact, and cannot be
decided à priori. The same answer is to be made to Dr.
Faivre, who, in l'Art Médical for 1869, relates some experi-
ments with finely pulverized charcoal with negative results.*
The division of the particles caused by his process is not to
be compared to that of the Hahnemannic trituration. A more
serious objection is raised by the results of the recent re-prov-
ing of Carbo vegetabilis by the American Institute. The first,
second and third centesimal triturations of this substance
were tested upon nearly fifty healthy subjects, without produ-
cing any effect whatever. Nine other persons did report
symptoms, which, arranged in schema form, number 327; but
six of these had previously observed their health without
taking any medicine at all, and under these circumstances had
noted sensations and phenomena amounting to half as many
again as those subsequently elicited by them. These results
in no way disprove the medicinal value of the drug, especially
when given (as it usually is) in the attenuations above the
third; but they render any pathogenetic effects ascribed to it
(in the triturations) extremely dubious.
We will take first in order
Carbo animalis.-Hahnemann directs this to be prepared
from ox-leather. Noack and Trinks recommend in preference
meat-beef, veal, or mutton-as the substance to be car-
bonized. It probably matters little. The potencies are, of
course, prepared by trituration.
A pathogenesis of Carbo animalis, made with the third
* Brit. Fourn. of Hom., xxviii., 232.
† See its Transactions for 1877, p. 181.
CARBO.
369
trituration, appears in the sixth volume of the Reine Arznei-
mittellehre. It consists of 188 symptoms from Hahnemann
himself and a Russian physician named Adam, with three
from Rust's Magazin. Hartlaub and Trinks subsequently
proved the drug, presumably in the same form; and gave
their results in the shape of 254 symptoms in the third volume
of their Arzneimittellehre. The final pathogenesis in the
second edition of the Chronic Diseases incorporates these two
series of symptoms. The remaining 283 of its 728 are from
Wahle.
That animal charcoal, even in its crude state, is inert, can
hardly be affirmed in the face of the observations cited by
Hahnemann from Rust's Magazin, to which Dr. Hempel, in
his article on the drug, adds some more of like tenor. Daily
doses of from four to twenty-four grains have not only dis-
ordered the stomach and bowels, but have caused the breaking
out of copper-coloured eruptions on the face, of acne, and of
boils; and have developed painful swellings and indurations
of the parotid and mammary glands. In these very glandular
enlargements, especially when of a scirrhous nature, Carbo
animalis has a repute of old which the homoeopathic school
has sustained,* extending it also to syphilitic glandular en-
gorgements, as bubo.† It is also considered by some as having
a dynamic controlling influence-distinct from its chemical
action—over low states of the system characterised by putres-
cence of the fluids and secretions. Noack and Trinks, who
praise it here, ascribe to it a deeper and more penetrating
action than has its vegetable brother. Dr. Drury commends
it, in a high dilution, against offensive lochia; and Dr. Allen
emphasises "offensive night-sweat" as a symptom repeatedly
verified.
Great lassitude, especially felt in the thighs, during and
after the menstrual period, appears to be Dr. Guernsey's chief
general indication for the remedy.
The action of Carbo animalis on the glands is somewhat
like that of Conium and Hydrastis.
With the exception mentioned, the lower attenuations have
generally been used.
Carbo vegetabilis is generally made from poplar, beech, or
birch wood; and raised to the third potency by trituration.
Vegetable charcoal was proved, Hahnemann tells us, with
doses of some grains of the third trituration. In the sixth
See Brit. Journ of Hom., xxxvi., 368.
† See Ibid, i., 300.
2 B
370
CARBO.
volume of his Reine Arzneimittellehre he gives 720 symptoms
so obtained by himself and three others, which, on the grounds
just stated, must be held of dubious validity. A later patho-
genesis in the second edition of the Chronic Diseases extends
the list to 1189; and, as no additional fellow provers are
mentioned, the new symptoms must be understood as ob-
served upon patients in the usual way. The symptoms
obtained by Dr. Wesselhoft are given by Allen in his sup-
plement.
Since the power of charcoal to check fermentation and to
absorb gases has been known, it has been largely used in
dyspepsia attended with acidity and flatulence. Dr. Madden,
moreover, from experiments upon his own person, has been
led to the conclusion that, swallowed in substance, finely-
powdered charcoal acts as a mechanical detergent of the
mucous membrane, dislodging any superfluous mucus it may
have formed, and so aiding digestion.* All these are extra-
medicinal effects of the drug, of which we may and do avail
ourselves in common with our brethren of the old school.
But, over and above them, we have dynamic uses of Carbo
vegetabilis which make it an important remedy. One of these
singularly coincides with its chemical action,-I mean its power
over flatulence, whether existing alone, or associated with
acidity and heart-burn. It is my own favourite remedy for
this condition; and I have seen the most distressing oppres-
sion and dyspnoea, recurring after every meal, removed by its
use.† Dr. Guernsey's indication, "the patient wants to be
fanned," belongs to this condition. I think it most suitable
for cases where the gas distends the stomach more than the
intestines, and where the tendency is rather to diarrhoea than
to constipation-in this last feature contrasted with Lycopo-
dium. Then there is an adynamia for which Carbo vegetabilis
is specific. It is non-febrile, therein contrasted with that of
Arsenic, and is attended by evidences (such as blueness and
coldness) of defective circulation and imperfect oxidation of
the blood. When such a condition exists in affections of the
aged, and in advanced stages of typhus after the temperature
has fallen, Carbo is an effectual rallier. But I cannot agree
with those who see a Carbo adynamia in the collapse of
cholera, and recommend it to be given therein.
* Brit. Journ. of Hom., xxvii., 64.
† Dr. Cooper prefers the C. animalis in flatulent dyspepsia; and
says that, given at night, it acts almost like an opiate in promoting
sleep, by removing the gastric condition which prevents it (Brit.
Journ., xxxvi., 227).
CAULOPHYLLUM.
371
There is, moreover, a good deal of evidence as to the power
of Carbo vegetabilis over affections of the respiratory organs.
Wurmb and Caspar esteemed it highly at the Leopoldstadt
Hospital in chronic hoarseness (to which it is markedly
homœopathic) and in emphysema. Bähr thinks it to be de-
pended upon in chronic neglected bronchitis, with emphysema,
and in the suppurative stage of pneumonia. Dr. Bayes says
that in chronic bronchitis of aged people, with profuse expec-
toration or profuse accumulation of mucus, with imperfect
power of expectoration, blue nails, and cold extremities, Carbo
In all these
vegetabilis from 6th to 30th is most useful.
affections of the respiratory organs a sense of weakness and
fatigue in the parts is very characteristic for Carbo.
Dr. Thayer, of Boston, speaks highly of it in epistaxis, and
Teste in soreness, itching, and burning of the female genitals
with sexual excitement-both of which affections are recor-
ded by Hahnemann (in the R. A. M. L.) as effects of the drug,
and are in the list given by him of curative indications for it.
Lycopodium, Veratrum album and Carbolic acid are the
medicines which may be most advantageously compared with
Carbo vegetabilis. Carbolic acid has in the gastric sphere the
same singular coincidence of chemical and dynamic action.
The sixth attenuation is that which I have almost always
used, though I have found the third trituration act capitally
in the dyspepsia of old people.
I have now to give an account of another of the many indi-
genous medicines with which our American brethren have of
late years enriched the Materia Medica, the
Caulophyllum
thalictroides, popularly called "blue cohosh" or "squaw root."
The former name hints at its similarity to Actæa racemosa
(black cohosh); the latter points to its main sphere of action.
We prepare a tincture from the root. Caulophyllin is also
much used.
There is a proving of Caulophyllin by the indefatigable Dr.
Burt in the second edition of Dr. Hale's New Remedies, to-
gether with all that is known regarding the drug. I do not
find anything fresh about it in the fourth edition.
The "squaw root," as may be supposed, acts chiefly on the
No woman having proved it, I am unable to state
what are its physiological effects upon the organ. Dr. Hale
uterus.
372
CAUSTICUM.
thinks that it is primarily excitant; and that it is homœo-
pathic to dysmenorrhoea, uterine cramps, spurious labour-
pains, abortion, and after-pains. It seems especially suitable
to affections of the motor nerves sympathetic with uterine
irritation (Actæa includes also reflex hyperesthesia). It has
been found useful in chorea, in spasms from suppression of
the menses, and in uterine paraplegia. Cases are also on
record in which it has strengthened labour-pains, where ergot
could not be given on account of the rigidity of the os uteri;
and in which flooding after abortion and long-continuing lochia
after parturition have been checked by its use. In "false
pains;" to avert threatened abortion; and to prevent prema-
ture labour, Caulophyllum is much recommended: also in
spasmodic dysmenorrhoea and after-pains, and as a preparatory
medicine for women who have difficult labours.*
It will pro-
bably continue to be given indiscriminately as a uterine
remedy, until a proving on a woman or the accumulation of
clinical experience enables its precise place to be fixed. I
have myself had little experience with it. The proving of Dr.
Burt reveals a marked power on the part of Caulophyllum of
causing acute rheumatoid affections of the small joints, espe-
cially those of the fingers. Putting this and its uterine action
together, it becomes probable that Caulophyllum will rank
with Actaea, Pulsatilla, and Sabina, as a remedy for that pecu-
liar form of chronic rheumatism described by Dr. Fuller as
secondary to uterine disorder. It has made some brilliant
cures of inflammatory rheumatism of the hands and fingers,
and is said by Dr. Ludlam to be more effectual in females
than in males thus affected.
I have already pointed out the close relations of Caulo-
phyllum with Actaa racemosa, Pulsatilla, and Sabina. It has
some points of analogy also with Secale.
The Caulophyllin, in the triturations from the first to the
sixth decimal, has been most frequently used.
I have next to speak of
Causticum,
and, before I go any farther, must endeavour to satisfy your
natural curiosity as to what the medicine so named may be.
* "Dr. Helmuth informs me," writes Dr. Hale, "that he has used
the Caulophyllin successfully for the removal of those discolorations of
the skin of the face common in women with menstrual irregularities or
uterine disease."
CAUSTICUM.
373
Its history is as follows:-In the Fragmenta de viribus
Hahnemann published thirty symptoms as obtained by him
from a substance he called "Acris tinctura." He stated that
it was an alcoholic solution of the principle to which quick-lime
and the alkalies owed their causticity. He obtained it by
digesting caustic potash in alcohol, and then saturating with
vinegar to neutralise the potash. As he found (from its
effects) a medicinal agent still present in the solution, he,
strangely enough, considered this to be the caustic principle
of the alkali. In the second volume of the second edition of
the Reine Arzneimittellehre (1824) we find a more extensive
pathogenesis of this preparation, now named "Aetzstoff-
Tinctur-Tinctura acris sine kali." 106 symptoms have been
observed from it by Hahnemann, and 201 from seven fellows;
and in a very long preface the chemical reality of the prin-
ciple of causticity is defended. In the third edition (1833)
the drug does not appear, for the reason that in the meanwhile
Hahnemann had seen reason to class it among his antipsorics.
Its pathogenesis had accordingly been transferred to the
Chronic Diseases, in the first edition of which (1830) it appears
with 1014 symptoms, including those which he had already
published. It is now called simply "Aetzstoff" or "Causti-
cum," and is directed to be prepared by adding to quick-lime
a solution of some previously fused bisulphate of potash, and
distilling. The product, he says, is hydrated causticum. In
the second edition of the Chronic Diseases are incorporated
some hundreds of symptoms communicated by Nenning to
Hartlaub and Trinks, making a total of 1505.
What, then, is the real chemical nature of this preparation
of Hahnemann's? Dr. Black has had it analysed, with the
result of finding it to be a weak solution of caustic potash of
varying strength. He recommends that the dilutions shall in
future be prepared from the liquor potassæ of the British
Pharmacopoeia. Twenty parts of this with eighty of distilled
water constitute, according to him, the first centesimal dilu-
tion of what we might now more correctly style Kali caus-
ticum. You will decide for yourselves whether to adopt Dr.
Black's suggestion, and will then look carefully to see if you
get the same effects from his preparation as are ascribed to
Hahnemann's. In the meantime, the British Homoeopathic
Pharmacopoeia does wisely, I think, in adhering to the latter.
It directs the attenuations to be made with rectified spirit.
Dr. Allen seems to agree with Dr. Black, for he incorporates
with Hahnemann's symptoms
CC some effects of caustic
potash."
374
CAUSTICUM.
The main sphere of the therapeutic action of Causticum has
consisted in paralytic affections and laryngo-tracheal catarrhs.
It was in facial paralysis that it first acquired reputation;
and as this affection, when local, readily admits of spontaneous
recovery, it is not easy to prove that any medicine has cured it.
But when so careful an observer as Bähr expresses no doubt
of the anti-paralytic virtues of the drug, we may wisely avail
ourselves of them; and now with the more confidence that we
have reason to believe that it is potash we are using. For
it has been well ascertained of late years that potash has a
poisonous action quite distinct from that of any alkali, and
that this is especially seen in the way it paralyses the spinal
cord and the heart.
What are the special paralytic conditions in which Caus-
ticum will prove efficacious has not been determined. I can
speak with most certainty of it in local paretic states, whenever
occurring. As regards the larynx we have the weighty testi-
mony of Dr. Meyhoffer. "The absence," he writes, "of
harmonious co-operation of the vocal cords is one of the most
permanent and persevering symptoms of deficient innervation
in laryngeal catarrh; persons recovering from this affection
cannot exert the vocal organ to the full compass of the voice,
nor use it in all its modulations, for at least two or three
weeks after every trace of capillary turgescence has subsided;
and any overstrained exercise of the vocal apparatus, or
oratorical display, at this period tends to perpetuate the
defect. This kind of diminished vitality is naturally of great
consequence to singers and public speakers: fortunately, a
specific remedy is at hand in what Hahnemann introduced
into medical practice as Hydrated Causticum (Kali causticum),
which often in a single dose removes this functional weakness
of the glottis, as well as that resulting from over-exertion."*
Of the same character is that which Dr. Guernsey notes of
the cough of Causticum, that the expectoration only comes up
far enough to be swallowed: there is no power to spit it out.
In the bladder we have a similar condition. It is especially
shown in that, when the patient coughs, there is involuntary
emission of urine during the paroxysm. This is a well-known
indication for Causticum. But it has also been useful when
such paresis of the sphincter exists without cough, as in the
enuresis of children and old persons; and I have found it
curative in a similar condition of the anus. In the eleventh
* Chronic Diseases of the Organs of Respiration, i., 56. See also
a case of aphonia, with facial paralysis, by Dr. Kafka in L'Art
Médical for June, 1875.
CAUSTICUM.
375
volume of the New England Medical Gazette (p. 491) a case is
reported in which it had a decisive curative effect in post-diph-
theritic paralysis of the fauces; and Drs. Allen and Norton
speak of it as the remedy par excellence for paralytic affec-
tions of the ocular muscles, especially if caused by exposure
to cold.
Independently, moreover, of associated paretic symptoms
(which may be absent), Causticum is a medicine of undoubted
power in laryngo-tracheal catarrh. Dr. Black's experience is
decisive here. He relates* cases of long-lasting catarrhal
aphonia, and of violent and fatiguing cough, in which its
administration effected speedy cure. It is especially indicated
in coughs by the co-existence of a sore sensation in a streak
down the trachea.
There is another property of the salts of potash which seems
to have found its homoeopathic application by means of Caus-
ticum. This is the increase of the urinary solids, first noticed
by Golding Bird with the acetate, and since confirmed by Dr.
Austin Flint with the nitrate, and by Rabuteau with the
chloride. The late Mr. Freeman has put on record some
cases where convalescence from typhoid fever was retarded by
the passing of large quantities of urine loaded with lithic
acid and lithates. The excessive tissue waste revealed by
this symptom was checked by Causticum, and the recovery
went rapidly on. In a similar case occurring in my own
practice, where after parturition this state of the urine was
associated with debility, low spirits, anorexia, copious sour
perspirations, and persistent aching of the mammæ, speedy
change for the better ensued upon the administration of this
remedy. It should be thought of for that rare form of
disease, azoturia.
For possible further application of Causticum I may refer
you to Hahnemann's list of morbid conditions in which it has
been useful; to a paper read upon it before the British
Homœopathic Society by Mr. Nankivell, with the discussion
following; to a study of it by Dr. Lohrbacher, now (1879) in
course of translation in the North American Journal of Homœo-
pathy; and to Teste's article on the medicine, in which he
lauds it in the treatment of smallpox. Some of the traditional
uses of caustic potash and the liquor potassæ are, more-
over, highly suggestive, especially Mr. Brandish's results from
his alkaline solution in scrofula. He, indeed, gave the potash
* Brit. Journ. of Hom., xxiv., 470.
+ Monthly Hom. Review, x., 288.
+ Annals, ii.
376
CEDRON.
in large doses; but Sundelin's experience, which was equally
favourable, was obtained by a preparation containing a drachm
of the alkali to an ounce of water, of which he gave two drops
twice a day, gradually increasing the dose. He "regarded
the usefulness of potash as most striking in scrofula affecting
persons of a soft but full muscular system, and a torpid phleg-
matic temperament." Drs. Allen and Norton find frequent
employment for it in scrofulous inflammations of the eyes.
They also ascribe to it some power over cataract.
"Several
cases" they say "have been arrested in their progress, and the
sight even improved, where, before its administration, they were
rapidly going on to complete blindness." Dr. Bayes says
that he has always found good results from Causticum in
constipation, when the evacuation is very solid, is expelled
with great difficulty and straining, and presents a shining
appearance, as if greased.
Gelsemium corresponds best to the paralytic symptoms of
Causticum; Bromine and Spongia to its laryngeal action.
Dr. Black's success was obtained with the first and second
decimal dilutions, and the anti-paralytic virtues of the drug
have generally been elicited from the potencies just above
these. In the higher attenuations, however, Causticum has
played a prominent part in the treatment of chronic disease,
as you may see from such a book as Jahr's Forty Years'
Practice. It is especially esteemed in old rheumatisms, and
is even praised by some in rheumatoid arthritis.
For my last subject to-day I have a drug which we
know as
Cedron.
It is the fruit of a South American tree of doubtful species;
but identifiable through its extensive native use. Dr. Hale
thinks there is no doubt of its being the Simaruba Cedron. A
trituration of the seeds is the best preparation, according to
Dr. Casanova; but the British Homœopathic Pharmacopoeia
directs a tincture to be prepared from the whole fruit.
Cedron has been proved by M. Teste on three persons in the
sixth dilution, and by Dr. Casanova on fourteen in the crude
substance and first three decimal triturations. The full report
of the former's experiments may be read in his Matiére
Médicale: the results of the latter are given by him, with
much clinical observation, in a series of papers published in
CEDRON.
377
the fifth and sixth volumes of the Monthly Homœopathic
Review. Dr. Allen adds symptoms from eight American
provers, all using the crude drug or mother tincture.
It appears that in Panama Čedron is considered a specific
for the bites of the venomous serpents of the country, and for
its endemic intermittents. Teste's three provers each experi-
enced a daily paroxysm closely simulating ague. The chills
came on towards evening; there was little or no sweat, but
much cerebral congestion. Several of Dr. Casanova's provers
had similar attacks, but there was no lack of perspiration with
them. Teste reports brilliant results from Cedron in the
intermittents of Martinique and Wallachia. A vial of the
sixth attenuation, given by him without label to a friend
visiting the island I have mentioned, attained quite a reputa-
tion as a secret remedy. Dr. Casanova's experiments,
pathogenetic and clinical, point in the same direction. He
considers Cedron a true anti-periodic, like Quinine and
Arsenic; and gives it in neuralgia and other disorders, as
well as in ague, when appearing in regularly recurring
paroxysms. The periodical (" almost clock-like," says Dr.
Jones) recurrence of the symptoms in his provers led him to
this practice. It checks, he reports, the tendency to mis-
carriage, when this repeats itself at the same epoch. He thinks
it infallible in the endemic intermittents of damp, warm, and
low marshy climates.
I am myself accustomed to use Cedron with success in
obscure cases of recurring chills and fever, such as those we
meet with in persons returned from tropical countries. I
have generally used the second dilution. Dr. Casanova says
that residents in hot climates are much more susceptible to
its action, pathogenetic and curative, than others differently
situated. Drs. Allen and Norton, guided by the severe shoot-
ing pain over the left eye experienced by one of the provers,
have been led to use the drug to relieve the supra-orbital pains
found in iritis, choroiditis, and other deep inflammations of the
eye; and have been frequently successful with it.
I should mention that the epithet I have cited as Dr.
Jones' is from a study of Cedron by him in the seventh volume
of the American Observer.
LECTURE XXV.
CHAMOMILLA, CHELIDONIUM, CHIMAPHILA, CHLORAL,
CHLORUM, CICUTA, CINA AND SANTONINE.
I
I begin to-day with a humble and familiar plant, which,
nevertheless, almost ranks with the polychrests of homoeo-
pathy,
Chamomilla.
By this we mean the common Matricaria Chamomilla, not the
Anthemis nobilis. At least, so Hahnemann meant; but, if
Stillé is right, the common wild camomile of England and
America is the Anthemis nobilis, while in Germany it is the
Matricaria Chamomilla. There is probably no essential dif-
ference between them.
Chamomilla early attracted Hahnemann's attention. A
pathogenesis of it appeared in the Fragmenta de viribus, con-
taining 272 symptoms observed by himself, and three from
authors. In the second edition of the third volume of the
Reine Arzneimittellehre, there are 189 additional symptoms of
his own, and 30 observed by Stapf in a girl of nineteen, after
drinking some large cupfuls of camomile tea. We have two
later provings of the drug, one by Dr. Hoppe of Basel, on
himself and two others, related in the thirteenth, fourteenth
and fifteenth volumes of the Vierteljahrschrift; the other by
the Vienna Provers' Union.* Dr. Allen, incorporating the
results thus obtained with a few others, gives us a pathoge-
nesis of 1,446 symptoms. For the therapeutic action of
Chamomilla, we have again the benefit of Hartmann's
Practical Observations (first series).
Chamomilla, at times largely used by physicians, had in
Hahnemann's day become practically a domestic remedy
only. It was chiefly used in pains and difficulties of the
uterus, from which action, it is said, its name Matricaria (from
Brit. Journ. of Hom., vi., 267, 270.
*
CHAMOMILLA.
379
matrix) is derived. His proving, and the applications which have
been made of it to practice, have given the drug a much wider
range of action. I fully agree with one of the Vienna provers
(Dr. Schneller) that Chamomilla affects the nervous system
primarily. Its pathogenetic effects are faint and obscure; but
its curative power is well defined. It is when the sensory and
excito-motor nerves are morbidly impressionable that Chamo-
milla is so valuable a medicine. Thus Hahnemann says—
"Chamomilla seems, in the smallest doses, greatly to moderate
excessive sensibility to pain and too great disturbance of the
mind induced by much suffering, whence also it meets many
of the troubles of coffee-drinkers and those who have been
dosed with narcotic palliatives. It is on the other hand less
beneficial to those who remain patient and composed during
their sufferings, an observation which I consider of the
utmost importance." It has even cured rheumatism and
neuralgia of the limbs where this great "nervousness was
present. Of its pains generally Hahnemann says-" It is
their peculiarity that they are worse at night, when they often
drive one to the border of distraction, not unfrequently ac-
companied with unquenchable thirst, and heat and redness of
the cheeks; also with hot sweat on the head and scalp. The
pains of Chamomilla generally seem utterly intolerable." And
again-"The paralytic sensation produced by Chamomilla in
any part is always accompanied by drawing or tearing pain,
and drawing and tearing pains rarely occur without the
paralytic or numb sensation in the part." Dr. Dunham adds
that the pains are made worse by warmth. “There must
always be intolerance of pain, aggravation at night, and
aggravation by warmth. This applies to the toothache, ear-
ache, facial and cervical neuralgia, and to the abdominal
colic, and distinguishes it from the symptoms of Colocynth,
which are diminished by warmth." The impressionability of
the excito-motor nerves which Chamomilla so powerfully
modifies shows itself in such clonic spasms as are apt to
occur in women and young children. In the former, it
effectually relieves the "false pains" and the cramps and
painful twitches of the legs, which harass the later months of
pregnancy; it is good also for spasmodic dysmenorrhoea, for
after-pains, and for metrorrhagia (whether in threatened mis-
carriage or otherwise) when there are forcing pains and the
blood is dark and clotted. The presence in such patients of
a spiteful, sudden, uncivil irascibility," of which they are
sometimes conscious, but say they cannot help it, is-accord-
ing to Dr. Guernsey and others a great indication for the
r
Mag
در
380
CHAMOMILLA.
remedy. In children it plays a most important part during
the process of dentition. It probably has some specific in-
fluence on the pulp of the teeth itself in the gums, for it often
gives great relief in ordinary inflammatory and rheumatic
face-ache. Hahnemann gives* the following description of
the symptoms which call for it :-"It is of service in those
toothaches that occur in fits, most violently at night, with
redness of the cheek, which during the fit seem to be quite
unbearable, that do not affect any one tooth in particular,
that in their slightest degree consist of formicating pecking
pains, when more severe cause a tearing pain, and in their
greatest severity occasion a shooting pain extending often
into the ear, that most frequently come on soon after eating
and drinking, are somewhat relieved by the application of a
finger that has been dipped in water, but are much increased
by drinking cold things, and that generally leave a swelling
of the cheek." But when in dentition the nervous system
becomes irritated, then for restlessness, fretfulness, and spasms
there is no medicine like Chamomilla. Dr. Guernsey's indi-
cation for it in teething infants, that the child refuses to be
soothed save when carried about, has often been verified.
Hartmann recommends it for the sympathetic cough occurring
at this time. Even the diarrhoea of teething will sometimes
yield to it; and when other remedies (as Mercurius) are
strongly indicated, Chamomilla in alternation-by quieting
the reflex irritation---will help them.
This application of Chamomilla to disturbance of the
vegetative organs, when induced by nervous causes, finds
another instance in its use in the effects of anger and active
vexation, when showing themselves in "bilious fever" and
jaundice, which was well known among the older homoeo-
pathists. Hahnemann himself wrote:-"The (sometimes
dangerous) disorder, resembling an acute bilious fever, which
is often brought on by violent angry vexation, with heat of
the face, insatiable thirst, bilious taste, tendency to vomit,
anxietas, restlessness, &c., has so much homoeopathic similarity
to the symptoms of Chamomilla that it can hardly fail to
remove the whole sickness speedily and specifically: one
drop of the juice diluted as before mentioned ”—that is, to
the twelfth degree-"cures as by magic." The occurrence of
jaundice from such causes is well known, and always suggests
Chamomilla. Dr. Hempel, however, maintains in his lectures
that "the primary action of Chamomilla seems to be upon the
functions of the biliary apparatus;" and some recent obser-
* Lesser Writings, p. 641.
CHAMOMILLA
381
vations of Dr. Sharp's favour its direct hepatic influence. He
found that, on a healthy person, the effect of the first
dilution, in drop doses, was to produce motions like those of
a baby: that is, as he thinks, to increase the secretion of
bile. On the other hand, five and ten drop doses of the
mother tincture made the motions scanty and dark in colour.
He further relates one case of jaundice, and two of diabetes
of hepatic origin, in which the action of Chamomilla was
everything that could be desired. Another suggestion of its
power of influencing the secretion of bile is supplied in a case
of over-dosing observed by Dr. Burnett, in which the symp-
toms were diarrhoea of white, putty-like stools, white-coated
tongue, and intense vertex headache, with a sensation of
pressure from within the cranium.* This was from the
Anthemis nobilis. Chamomilla, with Nux vomica, is Dr.
Jousset's principal remedy for what he calls
❝ictére
essentiel."
I can confirm from my own experience Hartmann's
recommendation of the remedy in flatulent colic, where the
flatus seems to collect in several spots in the abdomen, as if
incarcerated.
The analogues of Chamomilla as a nervine are Agaricus,
Belladonna, Coffea, Hyoscyamus, Ignatia, and Stramonium.
The facts about the dose of Chamomilla are very curious.
I have hitherto been in the habit of stating as the general
experience of homoeopathic practitioners-as it was certainly
my own-that the remedy begins at about the sixth potency
to manifest its great curative powers, and may often be given
with advantage as high as the 18th. I had in my mind
recorded expressions of opinion on the part of Drs. Madden,†
Bayes, Hempel,§ and Holcombe||-to say nothing of Hahne-
mann's own recommendation of the 12th as the best attenua-
tion. Dr. Black¶ has since cited some testimonies on the other
side; but these, when examined, show that it is not the lower
dilutions of the drug that give satisfaction, but the infusion,
the mother tincture, or at the highest the first decimal. The
only writer quoted by Dr. Black as using the 3rd decimal and
centesimal is Dr. Clotar Müller, and he says that "the curative
results were but seldom indubitable." The conclusion seems
Monthly Hom. Review, xxi., 408.
+ Brit. Fourn. of Hom., xxiii., 530.
+ Applied Homeopathy, sub voce Chamomilla.
& Mat. Med., sub voce.
|| United States Med. and Surg. Fourn., i., sub voce.
¶ Brit. Fourn. of Hom., xxix., 795.
382
CHELIDONIUM MAJUS.
to be that Chamomilla is one of those drugs whose crude and
infinitesimal actions are about identical; but that there is an
intermediate stage where dilution simply weakens. This is
my reading of the facts; but the question is a difficult one at
the best. It is, moreover, of Chamomilla as a nervine that
the attenuations have found such favour. Dr. Sharp seems
justified in saying that as an hepatic remedy the first dilution is
preferable; and in its colic I have found the mother tincture
most effectual.
I have now to bring before you a drug whose exhaustive
proving of late years should give it a prominent place among
our remedies. I refer to the greater celandine,
Chelidonium majus.
The tincture is prepared from the fresh plant in the usual
manner.
The proving to which I refer is by Dr. Buchmann of
Alvensleben. It appears in the seventieth volume of the
Allgemeine Homöopathische Zeitung, and is translated in the
twenty-third and two following volumes of the British Journal
of Homœopathy. Hahnemann had previously given a short
pathogenesis of the plant in the fourth volume of the Reine
Arzneimittellehre, consisting of 28 symptoms from himself, 122
from eight fellow-observers, and 6 from authors. Teste also
had contributed some provings on four persons with the sixth
dilution, and the Vienna Provers' Union had experimented
with the drug. All the results of the foregoing, and some
symptoms from other sources, are incorporated by Dr. Buch-
mann with his own-making 1456 in all*-in the "schema"
of the drug with which he concludes his record. I should
have said that his experimenters were eighteen in number;
and that nearly all took full doses of the mother tincture.†
Our knowledge of Chelidonium, which has been gradually
building, is perfected by what Dr. Buchmann has now so ably
done. Led by the doctrine of signatures, the Middle Age
physicians supposed that the bitter yellow juice of this plant,
* Dr. Allen, though drawing from no other sources, gives (I suppose
from difference of arrangement) 2428 symptoms to the drug.
""
† The fairness and impartiality of Dr. Phillips' book may be estimated
by his statement that "exact experiments are altogether lacking as to
the physiological action of the juice of Chelidonium.'
Yet he is ac-
quainted with Dr. Buchmann's work, as he cites him as a therapeutic
authority on the drug.
CHELIDONIUM MAJUS.
383
so nearly resembling bile, must be beneficial in disorders of
the liver. The disciples of Rademacher have shown that here
at least the signature has proved a true guide, by adducing
numerous cases of jaundice, gall-stones, and acute and chronic
hepatitis cured by the drug. Then comes Dr. Buchmann's
proving to show that this remedial power obeys the law of
similars. The action on the liver is very strongly marked in
his proving. Pain, both acute and dull, and tenderness of the
organ; pain in the right shoulder; stools either soft and
bright yellow, or whitish and costive; and deeply tinged
urine, appeared in nearly every prover. In three the skin
became yellow or dark; and in one regular jaundice was set
up. Correspondingly, Chelidonium bids fair to take high
rank in our school as an hepatic medicine. You will find a
number of cases illustrative of its value at the end of the
proving. Further experience, however, is required to enable
us to define its exact place here in relation to other hepatic
remedies, as Mercurius, Bryonia, Phosphorus, and Podo-
phyllum. Dr. Guernsey says that a pain at the lower angle
of the right scapula, running into the chest, is characteristic
of it. It has become my own stock-remedy for simple
jaundice.
G
Next, the experiments instituted by Teste led him to credit
Chelidonium with a specific affinity for the respiratory organs.
The two disorders to which he thought its symptoms specially
pointed were pertussis and pneumonia. Subsequent experi-
ence has confirmed his predictions of its value. In whooping
cough it has been found to act specially well after Corallium,
as indeed he recommends. And it really seems a most valu-
able accession to our remedies for pneumonia. It is especially
useful where the right lung is affected, and the liver in-
volved. Teste thinks it better than Bryonia in those cases
where the patient is of blond complexion and placid tempera-
ment. Dr. Ludlam praises it in the catarrhal pneumonia of
young children, where there is an excess of the pulmonary
secretion, with inability to raise or dislodge it. All this you
will find confirmed and made clear by Dr. Buchmann's experi-
ments and observations. He shows that in animals poisoned
by the drug the lungs are found generally engorged, some-
times hepatised. He developes in several of his provers all the
symptoms of an incipient pneumonia. And he contributes
from his own practice cases of the disease, in which the bene-
ficial action of the drug was most manifest. He corroborates
also its value in whooping-cough, and points to the spasmodic
cough induced by it as showing its homoeopathicity.
384
CHIMAPHILA.
Lastly, the new proving of Chelidonium reveals a hitherto
unknown influence exerted by it on the kidneys. Besides the
general symptoms of renal irritation, an examination of the
urine in one case showed the presence of tube-casts, of in-
creased uric acid, and diminished chloride of sodium. The
mischief in this case was so considerable that oedematous
swellings of the extremities occurred. We have as yet had
little or no experience with Chelidonium as a renal remedy.
Besides the facts embraced under the above headings, I
would note in the proving the severe pains in the knee-joints,
and the itching hæmorrhoids, developed in one prover (both
occasionally symptoms of hepatic disorder); the dark redness
so often appearing on the cheeks, hinting embarrassment of
the pulmonary circulation; the chills and fever; the inflamed
scrotum and eyelids; the itching of the skin, generally in
patches; and the periodical toothache. Dr. Buchmann also
points out a group of symptoms which show an action on the
diaphragm. He esteems it very highly in all external neu-
ralgia, and gives a good case of prosopalgia cured by it. In
the twentieth volume of the British Journal of Homœopathy
you will find some cases of supra-orbital neuralgia cured by
Chelidonium, in which also its curious affinity for the right
side of the body appears; and in the twenty-eighth volume
there is a case of my own, in which a migraine of this kind,
evidently hepatic in origin, was removed by it. You will also
do well to consult Mr. Clifton's graphic description of the
form of dyspepsia calling for it in the seventeenth volume of
the Monthly Homeopathic Review. I have only to add, that
cases are appended to Dr. Buchmann's proving which hint at
other fields of action for Chelidonium as yet unexplored.
You must not suppose, from Hahnemann's 66th symptom, that
gonorrhoea is one of these. It occurred in the case he cites
only as a re-appearance after suppression, while Chelidonium
was being taken for the swelled testicle which had resulted.
Bryonia and Phosphorus are the analogues of Chelidonium.
The dose for adults seems to range from the first to the
sixth decimal; from the sixth to the twelfth for infants.
I must now briefly mention one of the American indigenous
remedies, the " Pipsissiwa," winter-green, prince's pine, or
Chimaphila.
A tincture is prepared from the fresh leaves, bruised.
CHLORAL.
385
Chimaphila has not been proved: all our information
concerning it is derived from Dr. Hale's article in his New
Remedies.
There is one and one only point of interest about this
plant. It appears (besides being an active diuretic) to have a
specific influence upon the urinary passages, like that of the
Pareira brava and the Buchu, which ordinary practice knows
well, but which we have hardly hitherto used. Dr. Hale has
found it a valuable medicine in cases of dysuria with mucous
Dr.
sediment in the urine; and has cured gleet with it.
Holland relates a good case of chronic cystitis in which it
proved curative after many medicines had failed.*
Besides Pareira and Buchu, Chimaphila may be compared
with Cannabis sativa, Cantharis, Copaiba, Eupatorium purpu-
reum, and Uva ursi.
From one to five drops of the mother-tincture appear to be
the most suitable dose.
I have now to say something about the hydrate of
Chloral.
Into the use of this drug (obtained, as you know, by the
action of chlorine upon alcohol) as a hypnotic I do not pro-
pose to enter. You can learn it from the ordinary text-
books; and you must use your judgment as to its adoption.
Chloral is unquestionably the least harmful agent of the kind
we can employ, when we must employ them.
But our concern with the drug is to know whether we can
utilise any of its physiological action homoeopathically. Its
influence on the system appears to be that of a pure nervous
depressant. It acts very much as Opium does, only that it
affects the cerebrum so quickly, that the so-called primary
excitement of the latter, which I suppose to depend upon
vaso-motor paralysis, is slightly and rarely visible. Every
now and then, however, it does occur; and the flushing of the
surface is characterised by being accompanied with more or
less eruption, most frequently urticarious or erythematous,
but sometimes like that of measles or scarlatina, and always
associated with great itching. The conjunctivæ, also, are not
merely suffused, but hot, stiff, swelled, and tender (especially
on the lids), and there is sometimes lachrymation. Dr. Allen
gives a number of such phenomena in his pathogenesis of
Chloral, which contains 281 symptoms from various sources.
* Brit. Journ. of Hom., xxxii., 84.
>
2 C
386
CHLORUM.
Dr. Dyce Brown also has, in the fifteenth volume of the
Monthly Homoeopathic Review, related in detail many obser-
vations displaying its physiological effects; and, in the thirty-
second volume of the British Journal of Homeopathy, has
shown us how to turn them to good account, by giving a
series of cases of conjunctivitis, urticaria and pruritus in
which, in grain doses or less, it proved very efficacious in his
hands. In the former place he also calls attention to its dis-
turbing and depressing influence upon the heart, showing this
to be exerted through the nervous supply of the organ, and
to indicate the drug when from nervous causes its action is
disordered. The same thing may be said of its effects on the
respiration.
Several corroborations of Dr. Brown's experience with
Chloral in conjunctivitis and urticaria have been put on
record. Among them I may mention that of Dr. Hale, who
says that in two cases of conjunctivitis in his practice its
effect was simply magical, and of Dr. Burnett, who communi-
cates a case of nettlerash of four months' standing rapidly
cured by it.* It is my own favourite medicine for chronic
cases of this affection.
The drug has never been used above the first decimal
attenuation.
And now for a few words about chlorine itself, which
chemistry at the present day calls
Chlorum.
Dr. Allen gives a pathogenesis of this gas, embracing the
effects of its inhalation. The only one of these, however,
which appears noteworthy is that twice observed by Dr.
Carroll Dunham, viz: that while inspiration was easy enough,
at most accompanied by a crowing noise, expiration became
impossible, and asphyxic symptoms appeared. Now this, as
you are probably aware, is the condition present in the spas-
modic form of the disorder known as "laryngismus stridulus."
I say, the spasmodic form; for it not uncommonly comes
before us as a consequence of pressure on the recurrent nerves
by enlarged bronchial glands, and here the glottis is
paralysed, and inspiration-always wheezing-sometimes be-
comes excessively difficult. Dr. Dunham at once perceived
* Monthly Hom. Review, xxi,, 341. See also two cases by Mr.
Clifton in Ibid, p. 526.
CHLORUM.
387
its applicability to the first-named variety of the disease; and
both he and Dr. Searle have mentioned cases in which its
administration, in a weak aqueous solution, effected a cure.
Like its congeners, Iodine and Bromine, the combination
of Chlorine with an alkali developes new features in its action.
We know something of it as conjoined with lime and with
soda.
Calcarea chlorata-as I suppose we must call the old
"chlorinated lime," the "calx chlorata" of present nomen-
clature—is known to us only by Dr. Neidhard's strong re-
commendation of it in diphtheria.† He gives it in the form
of the "liquor calcis chloratæ," a drop or less for a dose.
Natrum chloratum must be our title for Labarraque's
solution-the "liquor soda chloratæ " of the British Pharma-
copoeia. It seems to be a complex preparation, containing the
hypochlorite of soda with its carbonate and chlorate, and
also hypochlorous acid. It has, however, been proved and
used as a unity; and this is all that we require to secure the
"single remedy" of homoeopathy. It has long been used in
ordinary practice as a disinfectant; but Dr. Cooper, employ-
ing it on one occasion for this purpose in a case of leucorr-
hoa, was struck by the remarkable improvement in the
patient's general uterine condition which ensued, and was led
to test its internal administration. He found it, thus given,
a most valuable remedy for congested and atonic states of
the uterus and its ligaments, with their accompanying pains
about the chest and hepatic disorders. Further experience
has led him to regard it as a potent medicine in chronic
catarrhal troubles of children, as in those of the middle ear;
and to have a general bracing influence upon the "flabby,
debilitated, hydrogenic constitutions" to which he considers
it best suited. You will find his original papers on the sub-
ject in the thirtieth and thirty-first volumes of the British
Journal of Homeopathy; and in the thirty-fifth volume he
has given a complete list of its observed effects, pathogenetic‡
and curative.
In uterine affections, Dr. Cooper gives the liquor sodæ
chlorate with little dilution. For children he finds it act
better in the (lower) attenuations.
* See Hom. the Science of Therapeutics, p. 493-501; Trans. of
N. Y. State Hom. Med. Society, ix., 256, 262.
† Diphtheria, its nature and homœopathic treatment, 1867.
Dr. Allen gives these in his supplement (vol. x.) under the heading
of Natrum hypochlorosum.
388
CICUTA VIROSA.
Of the three very similarly acting Umbelliferæ, we have
already discussed the thusa cynapium. The Enanthe
crocata is at present hardly used in our practice; but we have
some knowledge of the third, the long-leaved water hem-
lock, or
Cicuta virosa.
The tincture is made from the root.
Cicuta was proved by Hahnemann: the pathogenesis is in
the sixth volume of the Materia Medica Pura. It contains.
36 symptoms of his own, 168 from three fellow-provers, and
37 from authors-most of which were observed in eight
children poisoned by the plant, as related by Wepfer in his
treatise De Cicuta. The poisonous effects of the plant are
fully described by Hempel in his article.
From these cases of poisoning it appears that Cicuta causes
tetanus as manifestly as does Strychnia. But it has this
difference, that it affects the brain no less than the spinal
cord. The cerebral symptoms are various; but in their
intensest form they approximate to those of epilepsy, which
indeed in poisoning by Enanthe crocata is exactly simulated.
The proving adds little to the knowledge of Cicuta we thus
derive from toxicology, save that it shows its power of
causing local tonic spasms, as of the neck and jaw, and of
developing pustular inflammation on the face and hands.
Cicuta has not been much used in homœopathic practice,-
chiefly in epilepsy and pustular eruptions. Of the latter
Hahnemann says "I have cured chronic confluent impeti-
goes of the face, with burning pains, by means of one or two
doses of a small portion of a drop of the juice, letting three
or four weeks intervene ere I followed up the first (when
necessary) with the second." Dr. Conrad Wesselhoft has
recorded several cases showing its curative effects in eczema
of the chin in the male subject.* Teste calls attention to its
double action on the nervous system and the skin; and
suggests it as a remedy for cerebral and other nervous
affections resulting from repercussion of eruptions. It is good
for hiccough and belching when of a spasmodic character: I
have myself cured an obstinate and long-lasting affection of
this kind with it, and it has relieved such symptoms when
occurring in cholera.
Dr. Lilienthal has a paper on Cicuta in the Hahnemannian
* N. Eng. Med. Gazette, x., 505.
CINA.
389
Monthly for 1875, in which he directs attention to the great
hyperemia of brain and cord found in animals poisoned
by it, which die with convulsions, followed by paralysis. No
wonder, he says, that so many of our practitioners consider
Cicuta nearly a specific in (epidemic) meningitis cerebro-
spinalis. He is referring especially to the results obtained by
Dr. Baker, of Batavia, who reports sixty cases treated by this
remedy without a single death.*
The analogues of Cicuta are Aconite, Hydrocyanic acid, and
Strychnia.
It seems to have acted well in all dilutions.
I have last to speak of a medicine we call
Cina.
This is the "worm-seed" of commerce and domestic practice;
and is said to consist of the unexpanded flower-heads of one
or two eastern varieties of Artemisia. From it the now well-
known Santonine is obtained. We triturate the latter, and
make a tincture of the former.
The proving of Cina is in the first volume of the Reine
Arzneimittellehre. It contains 290 symptoms from Hahne-
mann and five others, and II from three authors.
Cina has derived its reputation and its popular names from
its activity as a vermifuge. That it does, especially in the
form of Santonine, kill and expel the round-worm and occa-
sionally the thread-worm, there can be no doubt. Hahnemann
refers to this use of it; and very justly, as it was given in doses
of from ten to sixty grains, warns against its danger. He
adds, moreover, that worms in healthy children cause little
inconvenience; while in the unhealthy they are a symptom of
the morbid condition, and will continually recur after expul-
sion until this is remedied. He says nothing about the
dynamic use of Cina in helminthiasis. But his experiments
and citations revealed the curious fact, that Cina produces on
the healthy body nearly, if not quite, all those symptoms
whose presence leads us to suspect the existence of worms.
There are the dilated pupils, with dimness of the sight and
twitching of the eyelids, the ravenous appetite, the pinchings
in the abdomen, the itching at the nose and anus, the frequent
micturition, the spasmodic cough with vomiting, the restless
sleep, the fever, and the twitchings in various parts of the body.
* N. Y. State Hom. Society's Transactions, x., 60.
390
CINA.
General convulsions also have frequently resulted from the
large doses of Cina or Santonine given as a vermifuge.
Homœopathic practitioners thus came to give this drug in
minute doses to children suffering from worm-affections.
They calculated that, on the principle similia similibus, it
might at least relieve the symptoms caused by the presence of
the parasites, though they themselves remained in situ. It
fully answered their expectations; and a curious result fol-
lowed. By some inexplicable influence these infinitesimal
quantities of Cina not only relieved worm-symptoms, but pro-
moted the death and expulsion of the worms themselves.
This occurred so often, that at length it became the recog-
nised homoeopathic practice to dispense with vermifuges, and
to rely upon dynamic remedies alone. The pathology of the
day was altogether favourable to this course, as it regarded
worms as a morbid product of the organism.
The results of such practice have been partly beneficent,
partly disastrous. It has saved thousands of children from
nauseating and poisonous worm-medicines, which for them
were quite needless, as Cina and similar remedies in minute
doses did all that was required. But, on the other hand, by
making treatment by the latter only a sort of orthodoxy in
homoeopathy, it has left hundreds of others unrelieved, when
a few grains of Santonine, or an injection of salt or quassia,
would have delivered them from their tormentors. With the
demonstration, now fully made, that worms are in all cases
introduced from without and act as foreign bodies, the
reasonableness of destroying them directly, where possible,
necessarily follows. This has been seen by most homœo-
pathists; and our later Domestic Guides have ceased to dis-
play the helpless inanity into which Hering's falls on the
subject.
Our wisdom, therefore, in the treatment of helminthiasis is
first of all to give the patient the possible benefit of the
dynamic action of medicines, that is, unless any other be dis-
tinctly indicated, of Cina. It seems beneficial in all varieties
of the malady, as Dr. Bayes says that he has repeatedly killed
tapeworm with it, as well as the lumbrici and ascarides for
which it is generally given; and it acts omni dosi, from the
twelfth dilution of Cina of this writer to the twentieth of a
grain of Santonine recommended by Dr. Dyce Brown. What
the former will sometimes do is illustrated by an excellent
case of Dr. Hamilton's in the thirteenth volume of the British
Journal of Homeopathy, where chorea depended on the pre-
sence of ascarides, and was cured by their expulsion by this
pada
CINA.
391
means. But, unless such measures speedily succeed, then-if
the symptoms are at all urgent-we are bound to resort to
the usual parasiticides, among which Santonine, especially
against the round worm, holds a prominent place.
This is the most important sphere of the action of Cina.
But Hahnemann, saying that it has more valuable properties
than those which make it a vermifuge, indicates it in whoop-
ing-cough (in which Dr. Jousset esteems it the principal
remedy), and in certain intermittents accompanied by vomiting
and canine hunger. Teste commends it in the flatulent colic,
without diarrhoea, of older children; and Dr. Bayes in the
gastralgia of empty stomachs. Dr. Martin Deschere, who has
recently given us a study of the drug,* justly says, that where
symptoms like those of helminthiasis present themselves, Cina
will cure, whether worms are present or not. Dr. Chepmell
has pointed out that such a condition often occurs in lingering
remittent fevers in children, and says that here Cina is quite
specific.
Of the dose of Cina I have already spoken; and I am
unable to mention any true analogue to it.
I must now dwell somewhat
upon
Santonine, whose properties, though involved in those of
Cina, are much more marked when it is administered separ-
ately. One of these is enuresis. As Dr. Ringer writes-
"Santonine, if given frequently, is very apt to occasion a great
difficulty in holding the water, and thus it is not uncommon
for children, if they take much of this medicine, to wet the
bed, and to be obliged to pass the water very frequently, or
even to be unable to hold it during the day." He character-
istically adds: "this remedy is sometimes able to stay the
nocturnal incontinence of urine of children." I had suggested
that it did so when, as often happens, worms were the cause of
it; but in his later editions Dr. Ringer says that this is no
necessary element in the cases.
-
A more important and interesting action of Santonine is
that which it exerts upon the eyes. The xanthopsia caused
by it has long been noticed, and has of late years been fully
studied by Dr. Edmund Rose.† He finds the derangement of
vision produced by it to be, in the first degree, "colour-blind-
ness;" in the second degree, "colour-confusion," which he
considers to be the condition known as Daltonism; and, in
full intoxication, hallucinations. His inquiry into the causa-
* North Amer. Fourn. of Hom., xxvi., 115.
† See Brit. Fourn. of Hom., xxvii., 214.
392
CINA.
tion of these phenomena leads him entirely to reject the theory
—of which there is no proof-that the xanthopsia is due to a
staining of the media of the eye. He sets it down rather,
connecting it with the other phenomena, as a result of con-
gestion of the retina, which the opthalmoscope demonstrates
to be present.
The colour-confusion and hallucinations he
traces to a corresponding influence on the optic nerves and
the visual centres respectively. The latter he connects with
the hallucinations of other senses, the (evidently cerebral)
vomiting, and the spasms of the cranial nerves, as showing
that the drug acts directly on the brain.
Such investigations seemed at first sight to have rather a
scientific than a practical interest. But Dr. Dyce Brown,
whom we always find quick at seeing the therapeutic infer-
ences to be drawn from physiological observations, has done
this good work for Santonine. In conjunction with an oculist
friend, Dr. Ogston, he put the drug to the test as a remedy
for several of the deeper-seated affections of the eye. The
results, which were published in the British and Foreign
Medico-Chirurgical Review for 1871, are very striking.* Of
the forty-two cases treated thirty-one were cured or improved;
and these included choroiditis, retinitis, atrophy of the optic
disc, pure amblyopia, and retinal anesthesia. The ultimate
influence of Santonine on the brain was manifest, for cerebral
amblyopia and paralysis of the motor oculi were greatly bene-
fited, and concomitant headaches removed.
In one case,
moreover, of undoubted double cataract vision was greatly
improved after some months' use of the Santonine; and with
reference to this Dr. Brown tells us that in some experiments
of Dr. Ogston's "it several times happened, especially when
young kittens were employed, that within a few minutes after
the animal was killed, a dense cataract developed itself in the
lenses of both eyes. Within half an hour these parts became
quite opaque, the opacity remaining very marked after the
removal of the lens from the eye.' "It seldom," he says,
"occurred to any extent in the eyes of adult animals, nor has
it ever been observed to occur during life." Nevertheless,
unless cataracts are of spontaneous origin in recently defunct
kittens, the tendency of Santonine to produce them is un-
doubted; and that is enough for homoeopathy.
>>
Į
-
I am not aware whether any further testing of the power of
Santonine in eye disease has been carried out. But Dr. H.
Wood reminds us that in 1862 MM. Guérin and Martin had
recommended it in amaurosis, especially in that following
* See also Brit. Journ. of Hom., xxix., 445.
CINA.
393
1
*
acute choroiditis and iritis.* Apropos of this, it is worth men-
tioning that Stillé cites a case in which a child of six
months took five grains of it, instead of three which had been
ordered. It became amaurotic, and did not recover its sight
for two months. I myself rely on it with much confidence in
that hyperesthetic and hyperæmic condition of the organs
which comes on from continuous fine work, as in seamstresses.
The action of Santonine on the eyes is comparable with
that of Atropia and of Digitalis.
In Dr. Ogston's cases a grain of the drug was given every
night. But Dr. Brown's first patient, whose improvement in
sight while taking Santonine for worms first drew his atten-
tion to the subject, had doses of the twentieth of a grain only.
It must be remembered that two grains have proved fatal to
a child.
* I had referred to the record of their experience in the second
edition of this Manual.
LECTURE XXVI.
CINCHONA.
We will address ourselves to-day to the consideration of
the famous Peruvian bark and its no less famous alkaloid,
quinine. I have had some doubts as to the designation I
should use for the bark itself. Cinchona is the scientific
name of the botanical genus, and perpetuates the memory of
its introducer into Europe: by this term it has always been
known in England. But if you look into the continental
medical Latin of the last two centuries you will find it called,
if not "cortex Peruvianus," then "china-china." This is
said to represent its native appellation, "china" meaning
bark, and the reduplication implying that it is bark of barks.
By this name it has passed into the nomenclature of other
countries: it is still "china-china" in Italy, it is "quinquina"
in France, and "china" or "chinarinde" in Germany. Under
this last title it stands in the Materia Medica Pura; and as
China it is known in the school of Hahnemann throughout
the world. I cannot refrain from using the familiar term when
speaking of the special homœopathic uses of the drug; though
for historical and general purposes I shall best-lecturing as I
do in England and for Englishmen-call it
Cinchona.
The homœopathic tincture is directed to be prepared from the
yellow bark, which was that mainly used in the provings. It
is richer in quinine than the other varieties.
Hahnemann has bestowed great attention on Cinchona.
Its first pathogenesis appears in the Fragmenta de viribus,
where it is credited with 122 symptoms of his own, and 99
from authors. In the last edition of the third volume of the
Reine Arneimittellehre Hahnemann's own symptoms have
increased to 427, and he has pressed no less than 21 provers
into his service, obtaining from them 575 symptoms. There
CINCHONA.
395
are also given 141 observations from authors, 35 in number.
You may well be surprised at hearing that so many ill-effects
have been ascribed by medical writers to a substance of by no
means virulent nature; and an examination of the originals
justifies the hesitation to accept them. A good many are the
obvious mechanical effects of the large quantities of powdered
bark in those days introduced into the stomach; and are
often so represented by their reporters, and stated to have
disappeared after an emetic. These are quite inadmissible
as pathogenetic effects of the drug; and I think that the
mass of those that remain are no less so, for another reason.
The opponents of the use of bark in intermittents, and also
those who maintained that it should not be given without the
previous use of evacuants, alleged many instances of harm
resulting from its administration. To all these phenomena
(including asthma, jaundice, and dropsy), whether aggrava-
tions of the paroxysms, their transformation into other shapes,
or results of their suppression, Hahnemann has freely helped
himself to complete the Cinchona-pathogenesis. Influenced
by his then theory of homoeopathic cure, he considered all
these to be symptoms of the Cinchona-disease, by the induc-
tion of which in a mild form even cases suitable for it were
cured. The objection to such a doctrine is that no Cinchona-
disease of the kind has ever been induced upon other than
aguish subjects. So that the phenomena are at the utmost'
effects of the compound influence of the drug and the disease;
and are more probably due to the latter alone, the bark
acting only as a disturbing influence of no specific kind. I
would therefore recommend you to expunge from the patho-
genesis of Cinchona all the symptoms which Hahnemann has
cited from authors, save the few I shall mention. For the
study of the symptoms of his fellow-provers I can recommend
you a paper by Dr. Langheinz, "On the relation of Peruvian
bark to Intermittent Fever," which is translated from the
Vierteljahrschrift in the twenty-fourth volume of the British
Journal of Homœopathy. He arranges some of them accord-
ing to the time of their occurrence after the ingestion of the
drug, and so reconstructs a fair picture of the effects as they
followed one upon another. He also relates the proving of
Cinchona by seven of Jörg's pupils, and some other experi-
ments with it.
Hahnemann found Cinchona in use for two great purposes,
—as a tonic, and as a remedy for intermittent fevers. He
proved it to discover on what principle it so acted. That it
caused a febrile paroxysm was the Newton's apple which
396
CINCHONA.
led him to formulate similia similibus as the law of specific
therapeutics. Of this I will presently speak at length. But
he also found that it produced in the healthy a peculiar kind
of debility; and that its "tonic" properties in disease, when
analysed, were demonstrably applicable to weakness of this
very sort. When used with precision, under the guidance of
the homoeopathic rule, he stated that Cinchona would do all
its strengthening work in infinitesimal doses, as high even as
the twelfth dilution. The special kind of debility for which
it is suitable he indicates as that which results from ex-
hausting discharges or other loss of fluids. There is here
emptiness of the blood-vessels and much loss of energy, but
therewith considerable erethism of the nervous and even of
the circulatory system. In this condition, where the weak-
ness is itself the disease, Cinchona is curative, because
homoeopathic to it. Hahnemann reprobates in a forcible
manner the pernicious practice, prevalent in his day, of giving
bark for every kind of weakness, and where the disease which
caused the weakness was still present. He acutely pointed
out that the best results which were obtained from it were
seen in the convalescence from acute disease, and were just
correlative to the super-added debility caused by the depleting
treatment then pursued. For all this you should read the
preface to his proving, which is a master-piece of observation
and reasoning.
This thought of Hahnemann's was as original as it was
brilliant and fruitful. It was a pure induction from his
provings. The only attempt made at precisionising the tonic
properties of bark in former times was the doctrine that it
acted best in a relaxed state of the solids. Here its large pro-
portion of tannin may have come into play. But Hahnemann's
doctrine was far more definite, and at once fixed its genuine
and certain range of action. It will not cure anæmic debility
like Ferrum, or nervous debility like Phosphoric acid. But
in that occasioned by loss of blood; by diarrhoea, diuresis, or
excessive sweating; by over-lactation; and by too great and
rapid expenditure of semen, it is a most effectual remedy.
Nor does it fail us when a discharge is a morbid
one ab
initio, as in excessive suppuration. "In all these cases," says
Hahnemann, “the other symptoms of the patient generally
correspond to those of China." In one particular especially
they do so, viz., in their tendency to pass into a hectic condi-
tion. We have here the succession of chill, heat, and sweat
which we shall see to be characteristic of the drug, and which
gives it its place in the treatment of ague. It cannot be too
CINCHONA.
397
strongly impressed on the mind that China is the great anti-
hectic. It is to this febrile condition what Aconite is to the
synochal and Arsenic to the typhoid form. But whether with
hectic or without, remember that weakness from drain on the
system is the sphere of the tonic action of Cinchona; and
within it you will find it manifesting some of the most beau-
tiful curative powers known to the art of medicine. They are
seen alike in the most acute and the most chronic forms of
debility so induced. Thus, in the prostration, even to syncope,
which follows upon puerperal hæmorrhages, Dr. Guernsey
relies upon it with undoubting confidence; and that in the
minute doses he habitually employs. (Failure of vision and
ringing in the ears are of course indications of this condition ;
but I hardly think that Dr. Guernsey is warranted in pointing
to the well-known tinnitus of quinine as proving the homœo-
pathicity of China to the last-named symptom. It is gene-
rally, in quinic intoxication, associated with symptoms of
cerebral hyperæmia; whereas here we have present a pre-
cisely reverse state of things.) The virtues of the remedy
extend, moreover, to other effects of the same cause-to head-
aches and various pains and neuroses, to hydræmia, and even
to dropsy.
For want of such a defining thought, bark and its alkaloid,
hitherto indiscriminately used as tonics, seem now falling out
of favour. All recent physiological experimentation, more-
over, has gone against the notion that the drug exerts any
primarily roborant action on the system. Quinine was found
by Briquet (as we shall see) to lessen the force of the heart's
action and diminish the arterial pressure, and also to im-
poverish the blood. The latter action has been studied more
fully by Binz, with the result of proving quinine to be the most
potent of protoplasm-poisons, so that even in minute doses it
kills the white corpuscles. While such facts indispose the
practitioners of traditional medicine to use Cinchona as a
tonic, they support its credit in the school of Hahnemann.
They show also, as Dr. Drysdale has pointed out,* how just
was Hahnemann's discernment of the precise kind of debility
to which bark is homoeopathic. To check the formation of
the blood by killing its white corpuscles is to produce a
similar effect on the system to that occasioned by actual loss
of the vital fluid.
We enter upon a larger and more difficult question when
we come to the action of Cinchona as a remedy for intermit-
tents. Is it anti-periodic, whatever be the origin of the
* Brit. Fourn. of Hom., xxvii., 283.
398
CINCHONA.
malady so recurring; or is it anti-malarial, whatever be the
form assumed by the disorders so caused? What is the
measure and extent of its efficacy, and what the dose and
time of its administration? Lastly, what is the rationale of
its action? These are some of the points presenting them-
selves for discussion.
And, first, as to the facts. There can be no doubt of the
specific power of bark over ague. It was the one bright spot
in the medicine of Hahnemann's day, which led him to
believe that if he could find the rule of its action he would
have the clue to a better therapeutics. It is still cited-as
by Dr. Latham-as the cardinal instance of the “cure” as
distinguished from the "treatment" of disease.* And it has
been shown that "the disappearance of ague, as a cause of
mortality in this country, exactly coincides with the introduc-
tion of Cinchona bark into general use;" so that while
between the years 1653 and 1660 there died in England
of ague 10,466 persons, in the corresponding septenary
period from 1733 to 1740 the deaths from this cause were
only 31.†
And now, how is this curative power of Cinchona and its
alkaloids to be characterised? If it is anti-periodic, it will
manifest itself more or less in all affections of periodic recur-
rence: if it is anti-malarial, it will hold good to some extent
in all results (at any rate, all recent results) of malarial poison-
ing. The action will spread laterally along whichever plane it
occupies in ague itself. Well; the testimony to the general
anti-periodic virtues of Cinchona is somewhat conflicting.
Hahnemann says that "almost all typical diseases may be
suppressed by powerful doses of China;" and, though in his
Materia Medica he condemns the practice as pernicious, it
appears from some papers included in Dr. Dudgeon's collec-
tion of his Lesser Writings to have been formerly his own, and
fairly successful. Pereira speaks of it as "beneficial" and
"serviceable" in many cases where "a paroxysm (of pain,
spasm, inflammation, hæmorrhage, or fever) returns at stated
intervals;" but he does not use such qualified language of its
power over ague. Trousseau and Pidoux will not allow that
it is an anti-periodic. If periodicity, they say, belongs to an
affection which has not malaria for its cause, bark often fails
to influence it. Of our latest writers, Horatio Wood states
that quinine has no less power over non-malarial than over
malarial periodic affections, so far as checking their recurrence
* British Medical Journal, Aug. 17, 1861.
† Russell, Clinical Lectures, p. 355.
CINCHONA.
399
((
is concerned; but that the benefit is often temporary only.
Ringer speaks less distinctly on the subject. He commends
it in periodic, but also in non-periodic neuralgia; and writes-
'Quinia appears to be useful in some, but quite useless in
other cases of intermittent hæmaturia." Phillips is decided on
the other side. "It is a stereotyped remark in medical works,"
he writes, "that the more exactly a nervous (or indeed any
other) disease conforms to a regular type of periodic exacerba-
tions, the more surely will quinine prove useful. As a general
proposition this is untrue. It is only when the neuralgia is
due to actual malaria that the rule holds; and in the case of
recurrent inflammation, or of hectic, there must be either
malaria or else septic poisoning at work, or else we shall find
this maxim fail us." It is evident from his whole work that
our late colleague speaks from a survey of others' experience,
and not merely from the brief space of his own in this field;
otherwise his statements of fact could not be allowed much
weight. He makes a good point, however, when he points to
the inefficacy of quinine in migraine, however strictly periodic
its recurrence.
On the other hand, the testimony to its efficacy in malarial
poisoning, whatever form it may assume, is loud and uniform.
To begin with, it is an almost certain prophylactic.* Its use
renders possible the penetration into certain regions which
would otherwise be deadly to the traveller. Then it is
no less effectual whatever be the type of the malarial fever,
whether intermittent, remittent, or continued. Dr. Maclean
shows that by far the best treatment for the incessant vomit-
ing and distressing pain in the head which occur in bad re-
mittents is to give quinine freely. Again, when malaria mani-
fests itself in quite different ways, as in dysentery on the one
side, in neuralgia or even epilepsy on the other, quinine is the
one and most effective remedy.
I think, then, we may conclude that Cinchona cures ague
by its specific antidotal influence against the malarial poison.
But what kind of antidote is it? Does it act after the manner
of a chemical neutraliser? or does it set up in the parts.
affected an action incompatible with that of the poison, and is
this action of a similar or an opposite kind? The former
alternative has of late been widely advocated. Since the
researches of Binz and others have shown how potent a poison
quinine is to all protoplasm, the hypothesis has been framed
that malaria consists of an abundance of low organisms, and
that bark antidotes it by destroying these. I think that
* See Stillé, op. cit., i., 514; Ringer, 7th ed., p. 559.
400
CINCHONA.
several considerations concur to render such a theory unten-
able. One is that the dose of quinine which suffices to cure
an intermittent is often far too small to affect the vitality of
the supposed microzymes. I will not bring forward homoeo-
pathic experience, but will content myself with referring to
the treatment of ague by subcutaneous injection of the drug.
It is found that by this method doses of two grains each, re-
peated every fourteen or twenty days, are generally sufficient
to check the paroxysms and prevent relapse: the maximum
quantity required in the worst cases was from six to ten
grains, and the maximum frequency of injection every day or
two.*
Still better results have been obtained; but I give
these as easily credible. On the other side, Dr. Buchanan
Baxter has ascertained† that the vitality of microzymes is sus-
pended only, not annihilated, by quinine in such proportions
as the animal body can bear in its blood. But the crucial
test is afforded here, as previously, by the extension of the
plane of action. Quinine is not the only protoplasm poison.
Strychnia and mercuric chloride have the same property in less
degree; yet they have little or no power over intermittents.
So also bark is not the only febrifuge; but the other sub-
stances which resemble it in this power exercise no common
destroying agency over infusoria. Some have it, as Dr.
Baxter has ascertained with regard to beeberine and picric
acid, and as is now generally recognised in respect of willow-
bark and its derivatives; but no one would think of ascribing
it to black pepper, chamomile, and cobweb, whose repute
against intermittents is nevertheless considerable.
I cannot therefore assent to the hypothesis that bark cures
ague by destroying in the blood the microzymes which cause
it. My conclusion accordingly must be that it antidotes
malaria by setting up, in the parts that are or would be affec-
ted by it, an action incompatible with its own. In this I am
supported by the high authority of Bretonneau, of Trousseau
and Pidoux, and of the elder Wood. "I know," the latter
writes, "no better explanation of the anti-periodic property
than that which supposes it to depend upon the powerful in-
fluence exercised by the remedy upon the nervous centres,
through which probably the paroxysms are produced. Every
consideration in connection with the peculiarities of regular
intermittent diseases leads to the conclusion, that the parox-
ysms are produced by an influence acting through the cerebral
centres, without which the result would not take place. Now,
* Lond. Med. Record, ii., 333.
↑ Practitioner, xi., 342.
CINCHONA.
401
if these centres can be preoccupied by a strong impression
from some other source, they may be rendered insensible to
the morbid influence, and the paroxysm, therefore, set aside.
Quinia is characterised by its disposition to act energetically
upon certain nervous centres, which are probably the same as
those through which the cause of the disease operates. Quinia,
therefore, interrupts the succession of the paroxysms; and, as
they are sustained, probably, in part at least, either by habit,
or by some chain of morbid action passing insensibly from one
paroxysm to the succeeding, the interruption is either per-
manent, or continues until the original cause may reassume,
in some mysterious way, its original activity, and produce a
relapse in the now unguarded system."
We are thus prepared for the question whether bark is ho-
mœopathic to ague, whether this prerogative instance of
specific therapeutics conforms to the principle similia similibus.
This question is sometimes put thus-Can the drug cause, has
it ever caused, an intermittent fever? But even though we
had to answer in the negative, the homoeopathicity of the
remedy would not be disproved. It is rare that drugs can
excite concrete diseases; and it is quite unnecessary for the
practical carrying out of the rule "let likes be treated by
likes" that they should do so. For this, and for the demon-
stration of similarity in a remedy, it is sufficient that it is seen
working in the same direction as the disease;—that it affects
the same parts, and-so far as its action goes-in a similar
manner.
Now of such homoeopathicity of bark to ague we have
abundant evidence. I will not dwell on mere assertions,
though several of these might be cited from out of the ranks
of the old school to corroborate that of Hahnemann.* But
from the elaborate discussion of the question carried on by
Dr. Langheinz, and also by Dr. Rogers in his tractate entitled.
The Present State of Therapeutics, I will cull two or three
actual observations bearing on the point.
The first is a case of tertian fever in a child, which was
treated by grain doses of quinine every two hours during the
interval. After the third dose there appeared a rigor, followed
by heat and sweat; the whole attack lasting forty-five minutes.
The same thing happened after each succeeding dose; and
one of the attacks was witnessed by the reporting physician,
who describes it. It was a typical ague on a small scale, with
thirst during the heat. The tertian paroxysm recurred once
* See the testimonies of Auber and Goedorf in Langheinz' article, and
of Wei enweber and Götz in Monthly Hcm. Review., x., 760.
↓
2 D
402
CINCHONA.
#
at the expected time, but in less force; and then came no
more. The bark fever also, after growing slighter and slighter,
disappeared; and the patient became and continued well.
But it may be said that this was not a pure experiment, as the
patient was already suffering from ague; and if I were en-
deavouring to prove that Cinchona can cause intermittent
fever in the healthy, the objection would be valid. When,
however, my object rather is to ascertain the direction in
which it acts, the modus operandi of its curative working, then
such an observation is most illuminative. It shows the drug
at every dose exciting a miniature paroxysm of the disease,
until the susceptibility of the system for both bark and malaria
was exhausted. It suggests that a similar process, though
without such outward manifestations, is going on in all cases
where a single full dose is administered-as recommended by
Briquet and most therapeutists-some score or more of hours
before the expected paroxysm. It tells the same story as
that which we shall hereafter meet with when we speak of
Thuja; when we shall see this medicine, given continuously
to a sufferer from warts, excite two crops of new ones, whose
dying away is followed in a short time by the disappearance
of the old enemies.
But we have further testimony. In Dr. Langheinz' paper
you may read a case in which a patient convalescing from
typhoid, and taking half-grain doses of quinine, had what the
reporter calls "a well marked fit of ague" after each dose.
The medicine was omitted for ten days; but on its being pre-
scribed again, in the form of decoction of bark, the same.
phenomena followed. Three other cases are cited by this
writer in which quinine given to patients affected with other
diseases caused in them a single or (as in one of them) a
double paroxysm of fever, i.e., of the typical sequence of chill,
heat, and sweat. If you will have experiments on the healthy,
you will find some there from Wittman, in which the same
phenomenon appeared; or I may refer you to Hahnemann's
provings of Cinchona and Noack's (of which I shall presently
speak) of quinine, in which it was of no unfrequent occurrence.
If you wish for such experiments on a larger scale, I may
refer you to the report-cited by the same writer-of the
health of the workmen in the quinine manufactory at Frank-
fort-on-Maine. From this it appears that most of those who
are much exposed to the dust of the bark sooner or later get
an attack of fever, consisting of one violent paroxysm of chill
and heat; after which they seem to become insusceptible.
I will sum up in the words of Trousseau and Pidoux.
}
CINCHONA.
403
Daily observation, says M. Bretonneau, proves that Cin-
chona given in a strong dose determines, in a great number
of subjects, a very marked febrile movement. The charac-
ters of this fever, and the epoch at which it manifests itself,
vary in different individuals. Most frequently tinnitus aurium,
deafness, and a sort of intoxication precede the invasion of
this fever; a light rigor then is added, a dry heat accom-
panied by headache succeeds the first symptoms, subsides
gradually, and ends in moisture. Far from yielding to new
and stronger doses of the drug, the fever caused by the ab-
sorption of the active principle of Cinchona does not fail to
be exasperated." I am sorry to say that these authors do
violence to history and truth by claiming this discovery for
Bretonneau, instead of acknowledging it as Hahnemann's.
<<
Now it is no answer to such facts as these to point to the
exceptional nature of their occurrence, to bring forward the
number of patients, workmen, and even experimenters in
whom Cinchona and quinine have produced no such symp-
toms. You will remember how Dr. Drysdale has shown that
there are two classes of drug effects, which he names absolute
and contingent; the one resulting in almost every subject of
the drug's influence, as the mydriasis of Belladonna, the other
requiring for its development a special susceptibility on the
part of the prover, and, like disease itself, not to be produced
at will. It is symptoms of this contingent order which most
closely resemble the phenomena of idiopathic disease, and
avail best for the working out of the rule similia similibus.
Of such kind is the fever of bark. I think that the evidence
I have adduced is quite sufficient to show that the aguish
paroxysm may be and has been induced by the drug; and
this is enough to outweigh hundreds of instances in which it
has failed so to act. It is enough, moreover—since there are
no opposite facts on record which suggest that it is antipathic
-to justify the conclusion that it is homœopathic to the
disease it cures ;* in further support of which we have the
fact noted by several observers, that the first paroxysm oc-
curring after quinine is begun is apt to be more violent than
its predecessors. This invariably occurs when a full dose is
given immediately before a paroxysm.
This question is of so much importance to the argument for
and against homoeopathy as a therapeutic method, that I
have gone into it at greater length than I should otherwise
The absence of subsequent periodical recurrence of the fever induced
by bark is of no importance to the question. The deficiency can be
supplied in treatment by the repetition of the dose.
404
CINCHONA.
have been justified in doing. But its determination has also
a practical bearing on the use of the remedy. If it cures
ague by destroying microzymes, it must be given in large and
frequently repeated doses, so as to saturate the blood up to
their perishing point. If it acts by giving the nervous system
a substitutive shock, as Dr. Wood seems to suggest, it is best
administered in single full doses to cinchonism shortly before
each expected paroxysm. But if "substitutive " here, as else-
where, means "homoeopathic,"* then no such violent mea-
sures are required; and we need only proportion our doses to
the severity of the disease, giving them with moderate fre-
quency during the interval. And again, if Cinchona cures in
virtue of its homoeopathicity, it will cure most effectually when
most homœopathic, and less so as the type of the fever
departs from that which it causes; till at length we shall come
into a region where it will not cure at all, even though it may,
if given in sufficiently large doses, suppress the paroxysms.
Now these corollaries just express the experience of ho-
mœopathists in the treatment of intermittent fever. Hahne-
mann says, in his preface to Cinchona, that, when all the
symptoms correspond, a single small dose of bark given
directly after the attack, previous to the elements of a new
paroxysm having accumulated in the system, will cure the
ague then and there. He does not here specify what these
corresponding symptoms must be. But from some of his
notes to the proving we may gather them to be-thirst just
before and after the hot stage; commencement of the parox-
ysm with some accessory symptoms, as palpitation, anxiety,
nausea, great thirst, canine hunger, pressing pain in the hypo-
gastrium, or headache; distension of the external veins; and
rush of blood to the head. Dr. Bayes, who saw much of
ague
in Cambridge, cured the majority of his cases with the third
and higher dilutions. He states that "in intermittent fever
the symptoms which most strongly indicate China are where
the chills, the hot stage, and the perspirations are generally
evenly and well marked, and there is a distinct intermission
of comparative health. There is a loud rumbling in the head,
sense of constriction from ear to ear over the vertex, great
sensibility to currents of air, sinking at the epigastrium, a
feeling of emptiness without hunger, or of hunger easily ap-
peased, contractive pain under the lower left ribs, sometimes a
sense of fluttering, mental depression with irritability." Dr.
Chargé emphasises the absence of thirst during the actual
chill and heat, saying that its presence in either is a positive
* See p. 221.
I
CINCHONA.
405
counter-indication for the drug; he also notes the abundance,
though slow development, of the sweat (which occurs mostly
at night), and the frequency of gastro-hepatic disturbance
during the intervals. I am speaking here, of course, of China
itself; the minute indications for quinine as a distinctive
remedy I shall specify hereafter.
I have entered into these minutia because it is by attending
to them that the most brilliant cures are made, and with the
smallest and least frequent doses. But I am bound to say
that I think the good to be done by attempting such precise
practice is far outweighed by the disadvantages it entails.
In the pursuit of the exact similimum through an intermin-
able list of not always trustworthy symptoms time is lost and
disappointment incurred. Bark is passed by because the cor-
respondence is not exact; whereas it is sufficiently close to
enable it to cure quite satisfactorily, even if the doses must be
a little larger and the repetitions rather more frequent than
would otherwise be necessary. The result is that Dr. Rogers
is able to make a point against homoeopathy, that its treat-
ment of ague is, by the statements and confessions of its own
adherents, not so successful as that of the old school; and this
simply through its neglect of quinine. It ought not to be
possible to substantiate such a charge, as I must confess Dr.
Rogers to have done; and I must again advocate, as I have
often done before, the treatment of all recent and simple
agues with quinine alone. When these display the regular
series of chill, heat, and sweat, unmarked by any special
phenomena, the remedy is pretty well infallible. The objec-
tion that it merely "suppresses the paroxysms," and does not
really cure the disease, has no weight here; for in such recent
cases the paroxysm is the disease, and in its repeated recur-
rence lies all secondary evil which may occur. Nor can any
harm be done, even in case of failure, while moderate dosage
is practised; and here, as quinine cures rapidly if at all, little
time need be lost before resorting to other means.
S
I am glad to be supported in this position by one of the
veteran homœopathists of the United States (now just lost to
us), Dr. Jeanes. In a paper recently read before the Phila-
delphia Medical Society on "Intermittent Fever,"* he main-
tained that the power of Cinchona and its alkaloid to check
the progress of ague is a great boon to humanity, and one of
which we should not hesitate to avail ourselves, even though
we have to use massive doses for the purpose. On the other
side I fully concur in all that has been said, by Dr. Hirschf
See Brit. Fourn. of Hom., xxxii., 723. + Ibid, xxv., 406.
W
406
CINCHONA.
and others, on the evil of forcing a suspension of the parox-
ysms by needlessly large doses-using, as Dr. Drysdale puts
it, a surplus of physiological action, instead of suffering the
whole of this to be absorbed into the therapeutic operation.
Such practice is especially to be reprobated in cases of long
standing, where cachexia is established. Here the more
minute and specialised homoeopathic treatment has time to be
carried out, and repays the trouble; and in this bark is rarely
indicated for chronic intermittents.
I have now said enough upon the two great actions of
Cinchona, its tonic and its febrifuge properties. But, over
and above all this, Cinchona does good service to us in several
ways, most of which Hahnemann himself has pointed out.
It appears from the pathogenetic symptoms, he says, that
it will cure only a small number of diseases. He first specifies
the kind of ague in which it is febrifuge and of weakness
where it is tonic, as we have already seen. And then he
goes on-
I. "The primary effect of China is to open the bowels;
hence it will cure certain kinds of diarrhoea, provided the other
symptoms correspond."
This is a curious effect of a substance containing so much
tannin, yet it occurred repeatedly, both in Hahnemann's and
in Jörg's experiments, and has been observed also in the
workers in bark at the Paris manufactories. I have re-
peatedly verified it in practice, both in acute and chronic
diarrhoea. The latter must be of a passive and painless
character to call for it; when enteritic or ulcerative it requires
Arsenic and remedies of that kind. But in acute summer
diarrhoea-not that of autumn, which is more profuse and
bilious-severe griping pain is nearly always present; and the
first effect of the China is to relieve this, after which the flux
itself ceases. China is also one of the remedies for lienteria,
-diarrhoea with undigested food having been noted from it by
both Hahnemann and Herrmann.
2. "The too ready and frequent morbid excitement of the
sexual organs, resulting in an involuntary emission of semen,
and caused even by slight abdominal irritations, is permanently
relieved by China."
Sexual excitement was noticed by several of Jörg's provers
and by Hahnemann himself: Dr. Phillips says that all the
alkaloids of Cinchona will cause it. The condition Hahne-
mann describes is just that left behind by a too frequent
repetition of such excitement, especially of an abnorma.
kind.
CINCHONA.
407
3. "Pain which is excited by merely moving the affected
parts, and which gradually rises to the most fearful height,
has frequently been cured by a single drop of the twelfth ·
dilution of China, even when the attack had returned fre-
quently." In another place he notes of the pains of China,
that they are "increased by motion, and especially by touch-
ing the affected parts; and also characterised by this, that
the pain, though it may have disappeared for the moment,
may be excited again by simply touching the parts, when it
frequently becomes horrid and intolerable.”
Neuralgic and rheumatic pains, having these features, may
be controlled by China; they are said to be of drawing, tear-
ing, or even jerking character.
Hahnemann indicates China also in certain forms of
jaundice, in humid gangrene of the outer parts, and in suppu-
ration of the lungs. And lastly he lays down that "bark
will scarcely ever be useful except where the nightly rest of
the patient is disturbed similarly to the disturbance which
characterises China;" of which disturbance he says: "China
is characterised by restless night-sleep, with dreams causing
anxiety and starting; when waking from these dreams one
finds it difficult to come to one's senses, or the anxiety con-
tinues." It is the best remedy when such disorder of sleep is
readily brought on by drinking tea. It is, indeed, to the
general effects of excess in this beverage what Nux vomica is
to the corresponding evils of much coffee-drinking.
I have cited these remarks of Hahnemann's at length, as
he has evidently studied China very closely. Its patho-
genesis abounds with references from one symptom to another,
which only appear elsewhere under Ignatia and Pulsatilla.
There is little to add to his enumeration of the curative
powers of the drug. I may mention its value, however, in
that relaxed state of the ligaments of the joints which makes
them (especially the ankles) ache after any exertion. I may
say, moreover, that it seems to excite the ovario-uterine
functions so as to convert the existing catamenia into a
hæmorrhage-the blood coming away in black lumps. It is
thus homoeopathic to a form of menorrhagia itself, as well as
to the debility which it occasions. Dr. Guernsey considers it
to be a "keynote " for the drug when the symptoms are aggra-
vated every other day. He also lays much stress on distension
of the abdomen as characteristic of it: "the. abdomen feels
full and tight, as if stuffed-eructations afford no relief."
similar feeling is experienced elsewhere, even in the limbs, so
that the garters, as well as the clothes about the waist, must
A
408
CINCHONA.
A
be loosened. Dr. Thayer, of Boston—an old and experienced
practitioner-esteems China very highly in gall-stones. Since
1854, he says (writing in 1874), he has "not failed in a single
instance to cure, permanently and radically, every patient with
gall-stone colic who has taken the remedy" in his manner;
and he has treated many from all parts of the United States.
He gives the 6th dilution, at increasing intervals, till only one
dose a month is taken. Sometimes, he says, the first effect
seems to be an increase in the frequency of the attacks, till
(as he supposes) the gall-bladder is emptied; but then they
subside and cease.
*
As an anti-malarious agent, Cinchona compares with
Arsenic and Cedron; as a tonic, with Ferrum.
For dose, Hahnemann recommends the 12th dilution. I
confess, however, that save for nervous conditions I have
never found it necessary to go above the Ist; and for the
hectic of suppuration the mother-tincture seems to act
best.
* See Brit. Journ. of Hom., xxxiii., 345.
LECTURE XXVII.
CINCHONA ALKALOIDS, CISTUS, CLEMATIS, COCA, COCCULUS,
COCCUS CACTI, COFFEA.
In connexion with Cinchona it is necessary to speak of two
at least of its alkaloids. The first is the well-known quinia,
which homoeopathic nomenclature follows that of Germany
in calling
Chininum, but which is better known by its popular name
of quinine. It is, as you know, commonly used in the form
of a sulphate, of which triturations or an alcoholic solution
may be made.
Quinine has, since its discovery in 1820, gradually taken
the place of the powdered bark as a remedy for ague. It has,
moreover, manifested such decided physiological properties
of its own, that it has been thought worthy of a special
proving, which it has received at the hands of Dr. Alphonse
Noack, of Lyons. Five persons took part in it; and its re-
cord is contained in the second volume of the Journal für
Arzneimittellehre.* Dr. Allen gives its results, together with
those of numerous other experimenters (among whom I may
especially mention our colleague, Dr. J. C. Morgan, of Phila-
delphia), making a total symptom-list of 1076. Much infor-
mation, moreover, as to the physiological action of quinine
is contained in M. Briquet's Traité therapeutique du Quin-
quina et ses préparations (1853); and Binz's recent publication,
Ueber das Chinin und seine Wirkung (1877), gives the latest
researches on its action. I may also refer you to a useful
collection of facts relative to its pathogenetic effects made by
Dr. Ch. de Moor, and appearing month by month, since its
commencement, in L'Homeopathie Militante.
So far as the pathogenetic properties of quinine have re-
lation to its use in intermittent fever, they have already come
before us. But experiment reveals other actions exerted by
it, which have to be considered and utilised; while its ex-
tensive use as a medicine makes it necessary that we should
form a precise apprehension of what can be wisely and well
done with it.
* See also vol. i. of the Révue de la Mat. Méd. Spécifique.
-
410
CHININUM.
I. Let us first consider the group of phenomena entitled
"cinchonism," and readily induced by full doses of quinine.
Their seat is the head, with the eyes and ears. There is deaf-
ness, with tinnitus-the latter preceding and being more
considerable than the former, and taking the form of buzzing,
singing, roaring, or hissing; there is disturbed visual function,
even to blindness; and in the brain itself we have head-
ache, with fulness, weight, and tension, vertigo, and sometimes
epistaxis. When the headache is localised, the forehead and
temples are its seat. Accompanying these phenomena are
evident signs of congestion, as flushing of the face and redness
of the eyes and ears. One of Noack's provers describes his
headache as intense towards evening, when the arteries of the
head began to beat with violence, as if the skull was about
to burst. His face was burning; there were noises in the ears
and sparks before the eyes. Dr. Hammond has lately ex-
amined precisely into this matter, In a man who had taken
ten grains the retina and tympanum were found sharing in
the hyperæmia of the outward parts; and in a cinchonised
rabbit the same condition was seen in the brain, when a hole
was made in the cranium.* In animals, and even in the
human subject, meningitis may follow, with delirium and con-
vulsions; and with or without this complication collapse and
coma succeed the stage of excitement when the dose has been
large.
Such effects as these are in the ordinary mode of treatment
simply an unpleasant, but to some extent necessary, evidence
that the system is thoroughly affected by the drug. For
homœopathy they are direct therapeutic indications. They
should give us a valuable medicine for some forms of head-
ache, and for congestive disorders of sight and hearing. We
have yet to learn what is the pathological (or even the full
symptomatic) condition of those eyes and ears, which are re-
ported as having been rendered permanently amaurotic or
deaf by the drug. In chronic congestive headaches it is a
favourite remedy in my own hands.
2. Next, the survey of Noack's provings-in which full doses
were taken-shows several pretty uniform effects of the drug.
One of these was tenderness and pain in the vertebræ, especi-
ally in the dorsal region; another was the pain and tension at
*It is fair to say that opposite results were obtained by Vicol and
Mossop, who after five and ten grain doses found the disk and retina
very anæmic. Here, however, no disturbance of vision was present,
and the phenomena may have depended upon depressed general cir-
culation.
CHININUM.
4II
the stomach which Trousseau and Pidoux also note. The
most constant phenomenon was a highly lateritious state of
the urine, which, on cooling, deposited numerous orange
coloured crystals consisting of urate and purpurate of ammonia,
with phosphates.
It is not easy to give these effects of the drug any physio-
logical expression. But they must be borne in mind as in-
dications for it in ague or other disorders to which it is found
adapted. The state of the urine mentioned led me once to
give it with striking success, though no stronger than the
3rd dilution, in a case of daily occurring supra-orbital neu-
ralgia, as I have related in the twenty-sixth volume of the
British Journal of Homeopathy.
3. M. Briquet, besides investigating fully the phenomena
of cinchonism, ascertained by exact experiment the influence
of quinine on the circulation. He found that while small and
rare doses seemed to increase the force and frequency of the
heart's action, the more intense and sustained effect of the
drug was enfeeblement of the circulation, with diminished
arterial pressure and lowered temperature. In this he has
been supported by subsequent observers. He concluded that
quinine could not have any of the tonic properties of Cinchona,
but should rather be used as a “hyposthenisant” in febrile and
inflammatory states. His conclusions have been carried out
by his native confrères, especially in the treatment of acute
rheumatism. That there is something specific about it here
may be inferred from the fact that Dr. Jousset reports it very
efficacious in the small doses of the school of Hahnemann;
and that Sydenham is rightly cited by Hahnemann as stating
that the continued use of bark sets up a sort of "scorbutic
rheumatism," shifting in situation, and alternating with in-
ternal pains. It was in such rheumatic conditions that
Cinchona in substance was so esteemed by the older physi-
cians, and Stillé thinks that it is more effective than its
alkaloid.
4. The ideas of those who use quinine as a tonic, supposing
such to be its primary influence on the system, have sustained
a still graver shock from the experiments of Binz, to which I
have already referred. Briquet had found that quinine,
while it increases the fibrin, diminishes the number of the red
corpuscles of the blood. Binz has further ascertained that in
virtue of its power as a protoplasm-poison it paralyses and
kills the white corpuscles, so that they never become red: it
also lessens the ozonising property of the blood. As a tonic,
therefore, it is under a cloud; but, on the other hand, German
412
CHININUM.
and English practitioners are now following suit with the
French, and, taught by Cohnheim the important part played
by the white corpuscles in inflammation, are giving quinine in
large doses to restrain their activity. Cinchonism, however, is
not found a desirable addition to the patient's sufferings; so
as alcohol is found to hinder its development, it is given
simultaneously. Thus the unhappy subject of inflammatory
fever, to whom Aconite and cold water would be the greatest
of boons, is now to be dosed with quinine and brandy. I
frankly say that for myself in such a case I should prefer the
lancet. I am not objecting to using quinine in such disorders
as pyæmia and leucocythæmia; and in the former of these
it seems to have proved strikingly efficacious. The quantity
given need not be very considerable, as Binz finds that one
part in four thousand, or even less, will effect the purpose.
5. Another indiscriminate and, I think, unwarranted use of
quinine seems to be receiving its death-blow; I mean its
prescription for every kind of neuralgia. Dr. Anstie coincides
with foreign observers in rejecting it in all but malarious
neuralgia, making a doubtful exception in the case of the
supra-orbital form when otherwise caused. It was this nerve
which was affected in the case of my own which I have cited:
it is probable that more extensive provings would show that
the drug has an elective affinity for it. It appeared, indeed,
to have such affinity in Dr. Morgan's proving, who, though
experiencing some amount of neuralgiform pain everywhere,
felt it far more frequently and acutely in the supra-orbital
region. Dr. Ringer thinks that, therapeutically, this nerve is
the special seat of the influence of quinine.
6. The power of quinine to arrest the paroxysms of per-
nicious malarial fever, otherwise almost certainly fatal, has
been turned to good account by our French homoeopathic
colleagues in a similar condition which occasionally com-
plicates any form of acute disease. It has best been studied by
Dr. Frédault, under the name of " ataxy," in L'Art Médical for
1876-7. He describes it thus :-"There may present itself not
so much a serious condition, permanent and established, as in
simple gravity; not so much a serious condition approaching
to malignity by an increasing tendency to aggravation even
till death; but one characterised by disorders in its progress,
and especially by relapses and amendments, remissions, and
then again aggravations,—the phenomena having features
which remind one of the perniciosity of marsh fevers, not indeed
having their regularity and defined characters, yet resembling
them though at a distance, and denoting a special gravity."
g
CISTUS CANADENSIS.
413
When this condition-whose three signs are gravity with
incoordination of symptoms, temporary seizures resembling
those of pernicious ague, and threatenings of a fatal issue—
supervenes in the progress of any acute disorder, he thinks
that it is best met by the administration of a gramme of
quinine, either at once, or in dosi refracta. He relates several
cases illustrative of his remarks; and points to attacks of cold-
ness of the extremities, especially of the hands and the nose,
as very significant of this condition. Drs. Jousset and Cretin
fully agree with him; and the occasional administration of
quinine in this way seems to play no unfrequent part in the
practice of our Parisian confrères. I am a little jealous lest it
should be adopted too frequently, to the neglect of more purely
homœopathic treatment; but I cannot doubt that it is a valu-
able piece of practice, and one which may at times render us
serviceable aid. I have seen such phenomena occurring in
acute disease, and know well their peril.
The only other alkaloid of bark which I shall mention is
cinchonia-
Cinchoninum.-This has received a good deal of experimen-
tation on the human subject in the old school, so that Dr.
Allen can give a pathogenesis of 288 symptoms taken from
fourteen observers. The most significant point is that noted
by Bouchardat, that it is less liable than quinia to produce
tinnitus and visual disorders, but that in smaller doses and
more frequently it occasions a peculiar and pretty severe
tensive pain in the forehead. In doses of twelve or fifteen
grains, he says, it is much more apt than quinia to cause
præcordial pain, and faintness even to syncope.
I pass now to some medicines of lesser note, beginning by
giving you a short account of the rock-rose, or
Cistus Canadensis.
The tincture is prepared from the whole plant.
The Cistus has been proved, mainly in the tincture and
Ist dilution, under the superintendence of Dr. Hering. His
pathogenesis, with the medical history of the plant, is given
entire by Dr. Hale in the second edition of his New Remedies.
It was the great popular reputation of the rock-rose in
scrofula which led to its being proved. The symptoms (which
we have only in schema-form) shadow forth, faintly indeed,
the manifestations of the diathesis in the eyes, ears, nose, and
414
CLEMATIS.
lymphatic glands; and in such affections (especially in
glandular enlargements) it has been used successfully by
homœopathic physicians. Dr. Bradshaw has cured white
swelling of the knee-joint with it,* in which, and in the cor-
responding disease of the hip, it is in considerable old school
repute. I am myself most impressed with its effects upon the
throat. The sense of dryness there is more marked in the
pathogenesis of Cistus than in that of any other medicine I
know, except perhaps Belladonna. The following symptom,
too, looks very like shingles. "Below the right shoulder-
blade, extending round to the front of the body, was a very
much inflamed spot about the size of the palm of the hand,
painfully sore to the touch; soon after pimples began to
appear on this spot in a large group; they caused violent burn-
ing. Later, a pain went from this belt-like spot to the left
hip, and into the groin; the pain was like rheumatism, motion
increased it."
Cistus is said to require a magnesian soil; and Dr. Hering
suggests that it may be related to that mineral as (for similar
reasons) Belladonna is to lime and Pulsatilla to iron.
The ist dilution has been used successfully in scrofula.
If the next name on my list were as valuable a medicine as
its sister is a beautiful flower, it would be precious indeed.
Clematis
is prepared from the leaves and stems of the Clematis crecta.
A pathogenesis of Clematis, obtained by seven persons
with substantial doses, was published by Stapf in his Archiv
(vol. vii). Hahnemann subsequently included the drug among
those of the second edition of his Chronic Diseases, but only
added to Stapf's symptoms six from Stoerck, of which more
anon. It was next taken up by the Austrian Society, where
twenty-one persons proved it, nearly all using the mother
tincture. The symptoms from all these sources, with a few
others, are given by Dr. Allen, whose total amounts to 821.
I shall best bring the results of this extensive experimenta-
tion before you by connecting them with the therapeutic uses
of the drug. Hahnemann says in his preface that "it will be
found curative in a number of affections which have their
origin in the abuse of Mercury and are complicated with
* Monthly Hom. Review, xiii., 38.
}
CLEMATIS.
415
psora, in foul eruptions of the head and general surface, in
several urinary troubles, in stricture of the urethra, and various
kinds of very troublesome inflammation of the eyes." He
goes on to state that Stapf has found it helpful in orchitis
and indurated swellings of the testes following mismanaged
gonorrhoea; and then refers to Stoerck's previous experiences
with the drug.
This well-known physician published, in 1769, a tract en-
titled Libellus, quo demonstratur, herbam veteribus dictam
Flammulam Jovis posse tutó et magna cum utilitate exhiberi
ægrotantibus. His cases are given in the fourth volume of
Frank's Magazin; and include ulcers and excrescences,
secondary syphilis, "scabies humida," arthritis, and head-
ache. The drug appears to act much like Dulcamara and
Sarsaparilla in such affections, setting up diuresis and dia-
phoresis, increasing the circulation on the surface, and favour-
ing the return of suppressed discharges; so changing chronic
morbid conditions for the better. Full doses of course are
required for such actions.
As regards orchitis, Dr. Desterne has criticised unfavour-
ably the published experience with Clematis ;* but such a case
as that recorded by Dr. Ransford in the twenty-fifth volume
of the British Journal of Homœopathy appears exempt from
his objections, and bears out the credit of the remedy. There
seems no doubt of its pathogenetic action upon these organs :
the swelling and painful sensitiveness noted by Stapf's provers
being reproduced in several of those of the Austrian Society.
Its efficacy in urethral stricture is equally warranted by its
effects in the healthy, and has received several testimonies in
its favour besides that of Hahnemann. Hirschf praises it in
the spasmodic form, and Franklint in the inflammatory variety.
I have myself seen it act with rapid curative power in symp-
toms of commencing stricture supervening upon chronic gleet.
It is only, of course, in such conditions that internal medication
can be expected to do anything: you would not look for help
from it in organic strictures of long standing. As to eruptions,
the provers experienced several, of vesicular and even pustular
kind; and Hempel gives one case and Hirsch another of
eczema impetiginodes cured by it. Hahnemann's last recom-
mendation speaks of several kinds of inflammation of the
eyes as curable by it. Much burning and redness were de-
veloped in the provers; in one the pupils were contracted;
* See Hempel, sub voce.
† Brit. Fourn. of Hom., xxv., 612.
‡ Science and Art of Surgery, i., 428.
416
COCA.
and in three the vision was indistinct, as if objects were seen
through a gauze or fog. Hirsch recommends Clematis in
"chronic inflammatory states of the borders of the eyelids,
with soreness and swelling of the meibomian glands, such as we
find in young scrofulous subjects." But the affection of the
eyes in which Clematis has done yeoman's service is iritis.
Drs. Allen and Norton do not seem to speak from personal ex-
perience of it here, but they mention the high praise it has
received from many, among whom was my own teacher, Dr.
Madden. They consider it indicated where great sensitive-
ness to cold is present, as is Mercury, to which they reckon it
an analogue in point of its action in iritis. I myself have
every confidence in it in both the rheumatic and the syphilitic
forms of this disease.
All this evidence makes it probable that we have not yet
sounded to the depths the virtues of Clematis, or assigned it
its definite sphere of action. I know of no medicine pre-
senting much analogy with it; nor has its use been extensive
enough to enable us to fix its most suitable dose.
I have now to bring before you the Peruvian shrub known
as the Erythroxylon
Coca.
The leaves are the officinal portion; a tincture may be made.
from them when fresh, or triturations when dried.
Coca has been proved by twenty-four persons in all (mostly
homœopathists), besides the observations made by travellers
of its effects on the natives. A full collection of all this in-
formation has been made by Dr. C. Hering, and published by
him in his Materia Medica.
Coca is one of those substances of which we shall soon
encounter a cardinal instance in coffee-substances which
'cheer, but not inebriate," stimulating the nervous centres
without engorging their substance and disordering their func-
tions like alcohol, opium, and haschisch. It has been used from
time immemorial by the natives of South America as we usc
tea and tobacco. Taken in excess, it causes mental excite-
ment, palpitation, sleeplessness or vivid dreaming, sparks or
flames before the eyes, and ringing in the ears, with increased
susceptibility of the senses. It has in a marked degree the
property belonging to this class of substances ("aliments
d'épargne") of diminishing tissue-waste; so that, while under
((
COCCULUS INDICUS.
417
its influence, there is little need of food, the bowels are costive,
and the urine is deficient in solid matter. By acting thus, and
by diminishing the sense of fatigue, it proves invaluable to
the travellers in its native regions, who chew the leaves as
they go on. It has a further virtue, common to it with
Arsenic, of obviating the distress experienced in climbing
heights, and breathing
“the difficult air of the keen mountain-top."
This power of the plant is witnessed to by all observers.
*
Coca has found little use as yet in practice. Dr. Hering
recommends its employment in troubles coming on with a low
state of the barometer; and the analogy of Arsenic would
suggest its trial in asthma. Dr. Clotar Müller, who was one
of the first to prove and discuss Coca, says that he has found
it useful to palliate over-action in cardiac disease. It may
occasionally replace Coffea in insomnia from nervous excite-
ment.
And now, of
Cocculus Indicus.
This is unknown as a medicine save in homœopathic practice,
where it is employed in the form of a tincture prepared from
the seeds.
Cocculus was proved by Hahnemann among his earliest
medicines; a pathogenesis of it appears in the Fragmenta de
viribus, containing 156 symptoms from himself, and 6 from
three authors. In the third edition of the first volume of the
Reine Arzneimittellehre the number has swelled to 557, of
which more than half are Hahnemann's, the remainder being
contributed by eight fellow-observers.
Hahnemann says in his preface that Cocculus had never
been employed as a remedial agent previous to the provings
instituted by him with it on the healthy. He commends it in
some lentescent nervous fevers; in abdominal and other
spasms, with depression of spirits, especially in women; and
in not a few paralytic affections and moral disturbances.
The experience of his disciples has verified especially the
second of these recommendations, and has established it as a
true anti-paralytic; while it has, with the aid of physiological
experimentation, both defined and extended its sphere of
action.
* See Brit. Journ. of Hom., XV.
2 E
418
COCCULUS INDICUS.
Cocculus is well-known as a poison for fishes, and as an
agent used for the adulteration of beer. In both cases the
intoxication it produces is manifest rather in the motor than
in the ideational centres; and to the same effect is the testi-
mony of those who have experienced its effects in their own
persons. Hahnemann has related in Hufeland's Journal a
case of poisoning by it, which may be read in English in Dr.
Dudgeon's collection of his Lesser Writings (p. 377). Cold-
ness; paralytic stiffness of the limbs, with drawing pains in
their bones and in the back; and sullen irritability, with
anxiety, were the prominent symptoms. The patient said
that his brain felt as if constricted by a ligature. He wished
to sleep, but a frightful sensation, as of a hideous dream, came
over him directly he closed his eyes, and made him start up
again. He had great repugnance to food and drink. This
last is a frequent symptom of Cocculus, and is very character-
istic of it.*~ The experiments which have lately been made
on animals with the alkaloid contained in Cocculus, picro-
toxine, show that convulsions, both tonic and clonic, are a
special characteristic of its action. The latter present many
of those singular features which have been observed as results
of injury to the crura cerebri, as semi-circular and backward
movements, and rolling over on the axis of the body. With
these there is great slowness of pulse and respiration, indi-
cating disturbance at the origin of the vagi.
Cocculus thus appears to influence the motor nervous tract
throughout the cranio-spinal axis. To such action is refer-
able, I think, the whole range of its curative influence. It is
of great service in certain kinds of vomiting. These, when
analysed, appear to be of cerebral rather than gastric origin.
They are such as occur in sea-sickness, and in some persons
from riding in a carriage or any similar motion; they have
another instance in the vomiting of migraine and of cerebral
tumours. In the latter Cocculus yields to Apomorphia, but
in the former it has no rival. Such sickness is usually accom-
panied with vertigo; and for this trouble, when thus asso-
ciated or appearing independently, Cocculus is a principal
remedy. You will recollect the constant association of vertigo
with those movements of gyration of which I have spoken as
caused by Cocculus: it is, Dr. Ferrier says, their subjective
side. The abdominal spasms in which it is, as Hahnemann
alleges, so frequently serviceable are not mere colic; they
appear always to spring from the nervous centres either
directly or by reflex irritation. They are generally accom-
* See Meyhoffer, op. cit., i., 111.
www
COCCULUS INDICUS.
419
panied by flatulence, which is not the product of fermentation,
but seemingly generated by the intestinal walls. It is most
troublesome at night, so that it wakes the patient, or prevents
his sleeping. Such flatulent spasms are most frequently seen
in the female sex, and especially when its characteristic
functions are being performed, as during menstruation and
pregnancy. "Menstrual colic" is an example, and here
Cocculus is renowned: Dr. Edward Blake esteems it also
our best remedy for pure dysmenorrhoea. It is also useful
in other nervous affections occurring at these times, as in
menstrual headache. The following case of Dr. Black's shows
what it can do here, and illustrates also the nausea and vertigo
characteristic of the drug :
"Miss H-, æt. 35, of a full plethoric habit, has suffered from her
present headaches for now fifteen years; they came on shortly after the
catamenia appeared, and have ever since regularly occurred at that
period. Violent headache-described as a dull pain affecting the whole
head; the patient has a difficulty in describing it minutely; is unable
to lie for a moment on the back of the head; is forced to lie on the
side; unable to bear the least light; any noise excites nausea and
vomiting. During the headache she feels as if suffering from sea-sick-
ness, and, on sitting up, the objects around seem to move up and
down. The headache lasts from thirty-six to forty-eight hours, and
comes on the third or fourth day of the catamenial period.
The
catamenia are abundant, but unattended by local pain. General health
good.
“March 16th.–Cocc. 18, m. et n.
،،
April 4th.-The headache has occurred at the usual time but not
so severe as usual, for she was able to move about, and was not con-
fined to bed, as she always was before. A dose of the 6th dilution was
given from every half-hour to every six hours during the third and fourth
days of her period with great advantage. Cont. Cocc.
"20th.-Rept. Cocc. 18, as on March 16th.
Add
<<
May 1st. Has had a very slight headache at the usual period,
which was again much relieved by frequently repeated doses of Cocc.
18; she was now ordered Bell. 6, alternately with Cocc. 18, m. et n.
This was the last prescription; for one headache occurring after that
she took the Cocc. Since October, 1844, to July, 1846, she has con-
tinued free from those headaches.
“Remarks.—The principal indication in this case for the selection
of Cocculus was the marked tendency to nausea resembling sea-sickness,
as if the stomach heaved up and down. So great was this idiosyncrasy
that she told me that travelling in a carriage made her feel ill, and that
sickness has often been brought on by looking at a vessel pitching up.
""
The use of Cocculus in convulsive and paralytic affections
is yet in its infancy. It is said to have removed hemiplegia
following apoplexy; and Trinks has recorded an excellent
case of post-diphtheritic paralysis in which it was the curative
420
COCCUS CACTI.
agent.* It might prove useful (perhaps in the form of picro-
toxine) in some of the rarer forms of chorea, in which peculiar
and definite involuntary movements—like those it produces—
constitute the disorder. Dr. Phillips' recommendation of it
in hysterical paralysis seems well in accordance with its
general action; and from its pathogenesis it should be useful
in paralytic weakness of the cervical muscles.
A French physician, M. Felix Planat, has just published a
treatise entitled Récherches physiologiques et thérapeutiques sur
la picrotoxine. He states that he has, by the administration
of this alkaloid, brought on convulsions, with foam at the
mouth, in a rabbit, a kitten, and other animals of lower or-
ganization; and that, giving it persistently in epilepsy (in
the form of a strong tincture of Cocculus), on the principle
similia similibus curantur, he has obtained several undoubted
cures. The French Academy has awarded this writer a prize.
upon the Barbier foundation. I have recently had a case of
epilepsy, in which repeated drawing of the head to the right
side with temporary unconsciousness occurred. Cocculus has
completely removed this feature of the case, though the actual
fits have not been influenced by it.
The only medicine with which I can compare Cocculus is
Chamomilla, and this solely in regard of its abdominal symp-
toms.
The medium dilutions (as in Dr. Black's case) have been
those mainly used, Hahnemann himself recommending the
twelfth. But Dr. Phillips says he has got excellent results in
cerebral vomiting, flatulent distension and spasms, and men-
strual colic-for none of which uses, however, does he credit
the school in which he learnt them--with doses of one to three
drops of a strong tincture.
We have next to consider the place and action of cochineal,
Coccus cacti.
This must not be confounded, as is sometimes done, with the
Coccinella septempunctata, the lady-bird. The dried insect,
powdered, is treated with alcohol for a tincture, or (better)
triturated with milk-sugar.
Cochineal has been proved by the members of the Austrian
Society in their wonted exhaustive manner. The experiments
* See Brit. Fourn. of Hom., xix., 312.
† London Medical Record, May 26, 1875.
COFFEA.
421
-in which twenty-eight persons took part-are related in
detail in the fourth volume of the Esterreichische Zeitschrift;
and the schema of the symptoms may be found translated in
Metcalf's Homeopathic Provings, and by Dr. Allen, who adds
symptoms from two other provers. Hempel's article, also,
should be consulted.
I
The Austrian proving makes it evident that the virtues
popularly ascribed to cochineal in whooping-cough spring
from its homœopathic relation to the disease. Few of the
provers escaped a cough; and with Dr. Wurmb it was "so
violent that it caused vomiting, and the expectoration of a
great quantity of thick, viscous, and albuminous mucus."
am not aware, however, that the medicine has been much used
by homoeopathists against this disease, save in France, where
Dr. Guérin-Méneville says that it is in daily employment.
Jousset considers frequent micturition of pale clear urine, with
tenesmus, an indication for it here. I myself gave it once, in
the 1st decimal trituration, in a case where a father whose
house was full of whooping-cough contracted just such a cough
as that Dr. Wurmb describes. The curative effect was very
marked. Again, this proving amply accounts for the reputa-
tion of cochineal in the school of Rademacher as a “kidney
remedy." The urinary symptoms are numerous, and of a
high grade of intensity. Nephritic colic and vesical and
urethral tenesmus are plainly pictured therein; and you may
read in Hempel cases where affections of this kind and also
acute renal dropsies have been cured by cochineal. I have
little doubt but that the study of this beautiful proving will
lead to a more extensive use of the medicine, especially in
sore throat with great dryness (like Belladonna and Lachesis,
which last was taken by one of the provers to relieve the
symptom, and with immediate effect), in inflammation of the
labia (like Apis), and in laryngeal irritation and hoarseness.
Cochineal has hitherto proved curative chiefly in tolerably
material doses; but, as the proving was mainly made with the
dilutions, we ought to get more out of these than we hitherto
have done. In whooping-cough, Jousset gives it from the 6th
to the 30th.
We now come to one of those substances which stand on
the boundary line between food and medicine,
Coffea.
We use the raw, not the roasted bean, preparing it either as a
422
COFFEA.
tincture or by trituration. Hahnemann's caution in this res-
pect is justified by the discovery that methylamine is developed
in coffee by roasting.
A full proving of Coffea-by five persons, one of whom was
Hahnemann-is recorded by Stapf in his Beiträge; and con-
tains 246 symptoms.
Stapf well characterises the primary effect of coffee as "a
pathological excitation of all the organic functions. When
coffee acts moderately upon the healthy organism" (he says)
"the irritability of the organs of sense is morbidly increased,
the visual power becomes more acute, the hearing more sensi-
tive, the taste is finer, the sensorium is more vivid (hence
increased susceptibility to pain), the mobility of the muscles
is increased, the sexual desire is more excited, even the
nervous activity of the digestive and secretive organs is in-
creased; hence a morbid sensation of excessive hunger,
increased desire and facility for alvine evacuations and for the
emissions of urine. To what an extent the nervous and
animal activity of the organism is increased by coffee appears
from the sleeplessness which it excites in various shades and
degrees, from the peculiar pathological excitation of the mind
and soul, and from the febrile warmth which it causes to a
considerable extent." This primary effect of coffee is made
use of in many ways, as you well know,--to arrest the parox-
ysm of ague and of asthma, to relieve headache, and to
antidote the depressing effects of vegetable poisons, such as
Opium. But it also points to several conditions in which
the drug may become homœopathically curative, as when
pain is felt excessively (in labour, for instance), in nervous
excitement, and especially in sleeplessness. For this last it
has a high repute in the school of Hahnemann; and my own
experience with it makes me surprised to find Dr. Ker saying
that he has never known it to do any good.* Possibly he
used it in too low dilution. I find it particularly useful when
the patient cannot get to sleep because of ideas perpetually
forcing themselves upon his mind. Dr. Bayes says that the
insomnia cured by Coffea is that which is owing to excessive
agitation of mind or body.
There are two forms of neuralgia in which Coffea has often
proved beneficial. One of these is toothache. We are in-
debted to Dr. E. M. Hale for establishing as the characteristic
for it here (besides restlessness and great complaining) that
the pain is entirely relieved for a time by holding cold water
* Monthly Hom. Review, xviii., 744.
}
COFFEA.
423
He has lately
in the mouth, returning as this grows warm."
communicated a case in which strong coffee drunk to keep off
sleep produced a toothache having this very feature.† The
other Coffea neuralgia is a variety of migraine, which the
excessive use of the beverage is so apt to occasion. Hahne-
mann, who wrote an essay on the injurious effects of this
practice, so common in Germany in his time, thus describes
the migraine it causes :-" It comes on in the morning shortly
after waking, and increases little by little. The pain becomes
intolerable, and sometimes burning; the integuments of the
head are very sensitive, and hurt when touched ever so slightly.
Body and mind seem excessively sensitive. The patients
look exhausted; they retire to lonely and dark places, and
close their eyes in order to avoid the light of day; they remain
seated in an arm-chair, or stretched upon a bed. The least
noise or motion excites the pain. They avoid talking or
being talked to, or hearing others talk. The body is colder
than usual, although no chills are experienced; the hands and
feet especially are very cold. They loathe all food and drink.
on account of a continual sickness at the stomach. If the
attack is very violent, a vomiting of mucus takes place, which,
however, does not diminish the headache. There are no
alvine discharges. The pain scarcely ever ceases before even-
ing. The attacks come on irregularly, and without premoni-
tory symptoms."
I have given this description, because of late the alkaloid of
Coffea-caffeine-has come into use, generally by hypodermic
injection, as a remedy for migraine. This caffeine contains.
the toxic principles of coffee in a very concentrated form. In
doses of from two to ten grains, it causes (according to Leh-
mann) violent excitement of the vascular and nervous systems
-palpitations of the heart, extraordinary frequency, irregu-
larity, and often intermission of the pulse, oppression of the
chest, pains in the head, confusion of the senses, singing in
the ears, scintillations before the eyes, sleeplessness, erections,
and delirium. These phenomena seem to be the result of
direct excitation of the heart and nervous centres, which latter
(in animals) goes on to tetanus. The cardiac condition in-
duced by it is described by Dr. Phillips as one of irritability,
in which the slightest excitement is sufficient to bring on
violent palpitations.
K
This keener action of the alkaloid should be utilised in
practice according to the law of similars. That it can be we
* Brit. Journ. of Hom., xxiii., 492.
† Ibid, xxxii., 546.
424
COFFEA.
have the testimony of Dr. Anstie. His experience led him
to hope that caffeine might prove a very valuable remedy,
both in neuralgia and in alcoholic insomnia. And when a
correspondent asked how an agent mainly employed for rous-
ing the nervous system (as in opium-poisoning) can be effec-
tively used as a calmer of pain and nervous irritation, his
reply was just that which ours would have been-that "the
dosage is wholly different in the two cases." Dr. Meyhoffer
has made much use of the cardiac action of the drug.
"Coffea," he says, "is to the nerves of the heart what Cactus
is to its muscle." In nervous palpitation, with abundant
secretion of urine, he gives the 3rd or 6th dilution with
rapid effect. In asystolia he finds caffeine, in doses of one or
two centigrammes, to exert a most beneficial effect, very like
that of Digitalis, but more completely ameliorative when
sleeplessness is part of the patient's distress.
I have only to add that Dr. Bayes describes the hemicrania
in which Coffea is useful as a kind of clavus; and mentions a
case in which spasmodic stricture of the rectum was remarkably
controlled by the medicine.
Coffea admits of close and profitable comparison with
Chamomilla and Ignatia, and (less so) with Coca.
The attenuations from the third upwards have generally
been used. Dr. Bayes finds the twelfth most effectual; and
with this my own experience coincides.
*
Comptes rendus du Congrés International d'homœopathie, 1878,
p. 69.
LECTURE XXVIII.
COLCHICUM, COLLINSONIA, COLOCYNTH, CONIUM, COPAIBA.
Our first medicine to-day is the meadow-saffron,
Colchicum.
We prepare the tincture from the fresh common bulb, by ex-
pressing the juice, and treating the residue with alcohol.
*
Colchicum has twice been proved in the school of Hahne-
mann, first by Stapf (Archiv, vol. vi.), and later by Reil
(Vierteljahrschrift, vol. viii).* The two pathogeneses, with
numerous observations from other sources, are combined by
Dr. Allen, giving a collection of nearly 1,200 symptoms.
In poisoning by Colchicum, the gastro-enteric symptoms
are very prominent. These are of specific nature, as they
appear with hardly less severity when the poison is directly
introduced into the circulation. They have two forms, or
perhaps stages. In the first, there are constant and profuse
serous evacuations, with collapse, blueness and coldness, hoarse
voice, and cramps-the whole forming a vivid picture of
Asiatic cholera. In the second the symptoms are those of
gastro-enteritis, with especial dysenteric phenomena-the
passing of shreddy mucus from the bowel being a constant
feature. In both forms muscular weakness is very marked;
and there is often deathly nausea.
Next to the stomach and intestines, Colchicum acts most
powerfully on the kidneys. It is supposed to be diuretic;
but I apprehend that the notion has arisen from observation
of its action in disease. In a short proving of it which I
made twenty years ago upon my own person the quantity of
urine was very notably decreased; and Stoerck found the same
thing. Suppression often occurs in cases of poisoning, and
is probably due to intense congestion of the Malpighian
bodies, which lesion has been caused by the poison in dogs.
* See Brit. Fourn. of Hom., xix.
† Libellus de Rad. Colch. Autumn, 1759.
426
COLCHICUM.
A more important question concerns its influence upon the
elimination of the urinary solids. Some statements have
been made to the effect that it increases the proportion of
these, and especially of the urea and uric acid. Dr. Garrod*
has analysed these statements, and made some careful experi-
ments himself, with the conclusion that "there is no evidence
that Colchicum produces any of its effects upon the system
by causing the kidneys to eliminate an increased quantity of
uric acid; in fact, when the drug is continued for any
lengthened time, it appears to exert a contrary effect." He
also says "We cannot assert that Colchicum has any in-
fluence upon the excretion of urea, or the other solid ingre-
dients of the urine.”
A case of poisoning by Colchicum is reported in the London
Medical Gazette for 1838-9 in which the symptoms assumed
another character. There was intense gnawing, dragging pain
in all the joints of the extremities, beginning in the hands and
feet with numbness and pricking, with profuse acid sweating,
and stiffness and pain in the occiput and nape of the neck.
Such rheumatoid phenomena occurred in Stoerck's experi-
ment on himself, and are very marked in Dr. Reil's proving.
Here, however, they seemed seated in the muscles rather than
the joints; and Teste's statement was borne out, that the neck
is especially influenced by the drug. Several provers had
decided pleurodynia.
There are three other statements to be made about the
physiological action of Colchicum. The first is, that cows
which eat it become affected with distressing and sometimes
fatal tympanitic distension. The second, that it appears
directly to slow the heart's action. The third, that in one
case of poisoning by it the pleura were found inflamed.
We pass now to therapeutics. The gastro-enteric action of
Colchicum has hardly yet been utilised in homoeopathic prac-
tice. Its botanical congener, Veratrum album, has pre-
occupied any place it might have found in the treatment of
cholera. I should suggest its substitution, however, in some
cases, should great nausea be present, and should the cramps
attack especially the soles of the feet. Stillé mentions its
being recommended for cholera (to which he recognizes its
homoeopathicity) by a Mr. Cotter, who states that he used it
successfully in eight cases. I once effected a rapid cure of an
obstinate acute diarrhoea with Colchicum, guided to this medi-
cine by the deathly nausea and prostration which were present.
It ought to find an occasional place in the treatment of dysen-
* Nature and Treatment of Gout, 2nd ed., 1863,
COLCHICUM.
427
tery and sub-acute proctitis, with much passing of mucus;
and might be useful in relieving tympanites, as indeed in
veterinary practice it has proved to be. Borborygmi are very
marked in its diarrhoea; and the symptom, "He has ap-
petite for forty different things, but as soon as he sees them,
or, still more, smells them, he shudders from nausea, and can-
not eat anything," has been frequently verified clinically.
But the main interest of Colchicum lies in its relation to gout
and rheumatism. Its power of relieving the gouty paroxysm
was renowned of old; and, since its revival in later times, has
become firmly established and universally recognised. It is
confessedly, moreover, of a "specific" nature. It is not an
indirect result of evacuations caused by the drug, for it occurs
just as surely when these are absent. It is not an ordinary
"anodyne" effect, for Colchicum has no such property. Nor
does the medicine act as an "antiphlogistic," for it subdues
the pain before the heat and swelling begin to subside, and
some time before the temperature falls; it, is moreover, in-
operative in other than gouty inflammations. The term
specific" is accordingly used to denote its action; and
pathogenesy shows that here, as elsewhere, "specific" means
homœopathic. The anti-arthritic power of Colchicum would
hardly, indeed, have been arrived at by the rule similia simi-
libus; but, being empirically discovered, no other formula
seems so well to express the relation of its curative to its phy-
siological effects. So far as it influences healthy joints it is
to cause inflammation and pain in them, and not any con-
dition opposite to that which obtains in the gouty state.
If this be the rationale of its influence, Colchicum acts
directly upon the affected joints in acute gout, and may have
no power over the morbid diathesis. Pereira writes-"That
Colchicum alleviates a paroxysm of gout I have before men-
tioned; but that alleviation is palliative, not curative. It has
no tendency to prevent a speedy recurrence of the attack;
nay, according to Sir Charles Scudamore, it renders the dis-
position to the disease much stronger in the system." Ringer
says that a full dose may remove the pain in an hour, but
Wood adds that by such practice the mischief is often trans-
ferred to the internal organs. It was supposed at one time
that it might be of permanent benefit by increasing the elimi-
nation of uric acid by the kidneys; but Dr. Garrod's investi-
gations seem to have barred this claim. It must thus be
concluded that, in the ordinary dosage, Colchicum acts locally
only upon gout; and, like quinine with ague, may by excess
of action suppress it injuriously. It is a question whether
((
428
COLCHICUM.
homœopathy can make a better use of it. There must be
something in the physiological action of the drug which
makes it so effective specially against gouty pain and inflam-
mation-something qualitative, as Drysdale expresses it,* in
its relation to the disease. Whether the suggestion of Dr.
Garrod's results is worth anything-whether Colchicum
diminishes the renal elimination of uric acid, and is thus
homœopathic and curative to gout at its possible fountain-
head, remains to be investigated. However this may be, it
is certain that in the various gouty neuralgiæ and inflam-
mations Colchicum is more effective than any other medicine.
Herein we agree with the late Sir H. Holland, who says that
whether the gouty inflammation developes itself in the foot, the
bronchi, the eyes, or the head, the specific virtues of the
remedy are equally apparent. Several of these affections-
especially the pleurodynia, the angina, and the ophthalmia-
are figured pretty plainly in its pathogenesis; and quite small
doses are often sufficient to cure them. Dr. Dunham lays
stress on the tendency of Colchicum to make the returns of
gout more asthenic; and, connecting this with the muscular
weakness it causes, thinks it most perfectly homoeopathic when
gout presents the asthenic form in coming before us for treat-
ment. The old-school writers of course present this as a
counter-indication for the drug.
•
It makes for the purely local action of Colchicum in gout,
that rheumatism-so similar to it in its arthritis, but so unlike
it essentially-should be also under the control of the medi-
cine. But it further strengthens the doctrine of qualitative
relation, that rheumatic joints are not nearly so much influ-
enced by it as gouty, and are most helped when the inflam-
mation is, as there, purely synovial. It is, as its provings
indicate, in muscular rheumatism-especially torticollis-that
it shows itself most effectual. But in two published cases-one
of Dr. Kidd's and one of Dr. Laurie'st-it displayed such
remarkable power of controlling rheumatic pericarditis, that it
ought to be more frequently used in the treatment of this
affection. We have seen that it has inflamed the pleuræ.
Teste says that the rheumatic pains to which it corresponds
are generally tearing. In warm weather they are principally
felt at the surface of the body; as the air grows cooler they
seem to penetrate the deeper tissues and the bones. Dr.
Dunham says that they are worse at night.
A statement of the last-named author's I must cite without
comment, for what it is worth. "I would draw attention,"
† Ibid, v., 314, and xiii., 198.
* Brit. Journ. of Hom., xxvi., 313.
COLLINSONIA CANADENSIS.
429
he writes, "to the fact that, in many cases of poisoning by
Colchicum, cataracts have formed before death in the eyes
of the sufferers. Professor Hoppe reports that with it he
greatly benefited, though he failed to cure, three cases of soft
cataract."
This is all I have to say about the therapeutic power of
Colchicum. But I know of few drugs which seem to promise
more extensive applications in the future.
Actæa racemosa, Arnica, Bryonia and Veratrum album seem
to be its closest analogues.
The question of dose is a large one. Five drops of the
mother-tincture every few hours seem to give speedy relief,
without baneful consequences, in ordinary gout; but Dr.
Dunham says that in the atonic forms to which he thinks it
specially suitable, the 15th dilution is quite strong enough.
There seems nothing gained by diluting the drug for its other
applications.
Another valuable contribution to our Materia Medica from
the indigenous plants of the American continent is the
Collinsonia Canadensis.
The tincture should be prepared from the root.
In the second edition of Dr. Hale's New Remedies may be
found a short proving of Collinsonia, together with all that is
known about the drug.
From this proving, and from the considerable clinical ex-
perience now accumulated, we are able to define pretty clearly
the sphere of action of Collinsonia. It affects the whole
gastro-intestinal canal, but especially the rectum. The pre-
sence of flatulence, spasm, and colic in the parts above con-
firms the indications for the remedy drawn from the condition
of the rectum itself; but these last alone are decisive. From
Dr. Burt's proving it appears that Collinsonia in small doses
causes constipation, with straining and dull pain in the anus
after stool. Here is shadowed forth the most important
action of the drug. It is in constipation and hæmorrhoids from
congestive inertia of the lower bowel that Collinsonia proves
such a precious remedy. We frequently meet with such a
condition in the middle and latter months of pregnancy; and
here I have the greatest confidence in the drug. But it is also
a most effective remedy for piles in general, when connected
with constipation, and may be resorted to with advantage
430
COLLINSONIA CANADENSIS.
whenever Æsculus fails. Nor, though acting primarily on the
rectum, does it confine its curative influence to that one only
of the pelvic viscera. In many uterine affections connected
with constipation it is of great value. Cases are collected by
Dr. Hale in which dysmenorrhoea, pruritus, and even pro-
lapsus uteri have under such circumstances yielded to its use.
One of the cases of pruritus was a woman in the eighth month
of pregnancy; so that Collinsonia should be remembered when
we meet with that distressing form of the affection. In larger
doses, it irritates the rectum so much as to set up diarrhœa,
soon running on into dysentery: there are severe colicky pains
in the hypogastric region before and after the stools, and much
tenesmus. It has not been used to any extent in complaints
of this kind; but in proctitis and rectal dysentery it should
rival Aloes.
The rectum is thus the main field of action of Collinsonia;
but you will see from Dr. Hale's article that it is gaining con-
siderable reputation as a cardiac remedy. Time will show its
real place and value here, whether it is merely in the sym-
pathetic cardiac disturbance of hæmorrhoidal subjects that it
is effective, or whether it acts more directly on the organ.
Dr. Ludlam has lately borne a testimony to the virtues
of Collinsonia, which, from the high estimate we all entertain
of his judgment, is worth citing here. “We have often,”
he says, “used this remedy in hospital and private practice.
It seems specially adapted to women, and to those women
who have hæmorrhoids either during, or as a sequel to, preg-
nancy and parturition, or in complication with obstinate con-
stipation or chronic inflammation with slight displacement of
the womb. For the first of these cases, where the trouble
dates from gestation or from labour, or from both, and the
condition has become chronic, there is no remedy to compare
with it for efficacy. We have cured a dozen cases of this kind
that have been sent to us by physicians from as many states,
with the collinsonia in the 3rd dilution. And the college class
can bear witness to its remarkable efficacy in many such
cases in our clinic at the Hahnemann Hospital. When the
hæmorrhoids are associated with constipation, and with a
mild form of retroflexion or retroversion, and especially with
prolapse of the uterus, it will often relieve the whole difficulty.”
I have already hinted that Aloes is a close analogue of
Collinsonia. So also are Esculus and Podophyllum, and-
more remotely-Hydrastis, Nux vomica, and Sulphur.
I have nearly always used the 2nd dilution; but others
seem to have done as well with the 3rd, and others with
COLOCYNTH.
431
more material doses. Herein also Collinsonia resembles
Esculus.
I now go on to speak of
Colocynth,
a drug which is a crucial instance of the fruitful results
attainable by the Hahnemannian process of "proving" on the
healthy body. Here is a substance which traditional medi-
cine knows simply as a purgative. The modern experimen-
tation on animals has done nothing for it: as a purgative
and nothing else it still stands in the works of Ringer, Wood,
and even Phillips. But a few physicians in Vienna agreed to
test its effects on their own bodies; and lo! a range of action
is revealed which at once puts it in a high place among
specific remedies.
The dry pulp of the fruit is either triturated, or treated with
alcohol to make a tincture.
There is a pathogenesis of Colocynth in the sixth volume of
the Reine Arzneimittellehre. It contains 26 symptoms from
Hahnemann himself, 195 from six fellow-observers, and 29
from authors. In the Chronic Diseases a second pathogenesis
appears, but has only swollen to 283 symptoms in all, the
additional ones being mainly Hahnemann's, i.e., observed on
patients. But our knowledge of the drug has been immensely
increased, and, indeed, pretty well perfected, by an exhaustive
proving conducted with it by the Austrian Society. Dr.
Watzke's account of the experiments-in which seventeen
persons, including two women, took part—is translated from
the first volume of the Esterreichische Zeitschrift in Metcalf's
Homœopathic Provings. It contains also an analysis of
Hahnemann's pathogenesis, and a complete account of all
that is known of the drug, both as poison and as medicine.
This monograph is indispensable for the study of Colocynth;
and so also is a commentary upon it by Dr. Pope, which you
will find in the twelfth volume of the Monthly Homœopathic
Review.
Traditional medicine, as I have said, knows Colocynth only
as a purgative. It is aware, however, that this action is
specific, and not merely local, being induced by its external
application as well as by its introduction into the stomach.
It seems most probable that thus, at least, it purges the lower
bowel only, as the rectum is the only part of the alimentary
COLOCYNTH.
432
tract found inflamed when a poisonous dose is injected into a
vein. As under such circumstances there is no manifest
irritation of the stomach, the vomiting which has been
observed as a consequence of its external application would
appear to result from an influence upon the (gastric) nerves.
Still more certain evidence of such an influence is the severe
colic which always accompanies the purgative action of
Colocynth, and which is more marked with it than with any
other cathartic. The pain is generally about the umbilicus,
is of a twisting and burning character, increased by food, and
relieved by the accompanying diarrhoeic evacuations. Tenes-
mus also is a constant feature of the Colocynth diarrhoea. In
one case of poisoning by it the intestines were glued together
by recent lymph, showing its power to inflame the peri-
toneum.
The colic and diarrhoea so characteristic of Colocynth were
experienced by all the provers. But in most of them other
symptoms appeared, showing the power of the drug to act
upon the nervous trunks on the surface as vigorously as upon
the abdominal plexuses. The trigeminus is not uncommonly
affected, causing toothache and hemicrania. But the nerves
about the hip-joint suffer most severely, the pain darting
sometimes down the anterior crural and sometimes down the
sciatic trunks, even to the foot. The spermatic and ovarian
nerves are also affected-the only two provers of the female
sex complaining of deep stitches as from a needle in the
ovaries; and one of the male provers experienced pain and
swelling of the testicle and spermatic cord.
The therapeutical virtues of Colocynth are a true reflection
of the pathogenetic powers now described as belonging to it.
It is occasionally but rarely indicated in dysentery. It is
homoeopathic to this disease when the morbid process is
confined to the rectum, the evacuations consisting chiefly of
blood; or when severe colic is present. So also it may now
and then be of service in peritonitis:* Dr. Ludlam recom-
mends it especially when that portion of the membrane which
envelopes the ovaries is affected. I may remind you that this
trouble is often spoken of as "ovarian neuralgia." In both
these inflammations, however, I prefer Mercurius corrosivus as
a rule. The grand sphere of Colocynth lies among the
neuroses, especially where pain is the most prominent feature.
In Dr. Watzke's article you will find collected a number of
cases in which neuralgia of the fifth nerve, of the solar and
* Dr. Watzke's case, in vol. xxv. of the Brit. Fourn., p. 561, looks
like commencing peritonitis nipped in the bud by Colocynth.
COLOCYNTH.
433
other abdominal plexuses, and of the lumbar and femoral
nerves, have been cured in a brilliant manner by this medicine.
It is in colic and sciatica that its greatest triumphs have been
achieved. I have myself found it curative only in recent
cases of the latter disease, greatly preferring Arsenic and Rhus
in those of longer standing. But for colic I rarely require
any other remedy, save in those cases for which Plumbum is
the obvious simillimum. Dr. Bähr thinks it is "rheumatic
colic" for which Colocynth is suitable, and Plumbum for
neuralgic. He describes a similar condition in the stomach,
for which also he recommends this remedy. Both "are met
with in the transition seasons when the air is cold, but the
sun is still powerful enough to heat the blood; they likewise
occur in summer, in consequence of sudden changes in the
weather." In the colic most characteristic of Colocynth, the
patient doubles himself up to relieve the pain, which he de-
scribes as very sharp. Dr. Carroll Dunham* mentions a case
in which Colocynth, given because of the presence of its
characteristic symptoms in the abdomen and about the hip,
seemed to cause the permanent disappearance of an enlarged
ovary; and Dr. Ludlam recommends it, under the same cir-
cumstances, in ovarian neuralgia. In one of the provers it
removed neuralgic pain and swelling of the right testicle and
spermatic cord-the result, as he believes, of his previous
provings of Natrum muriaticum; and it has been found of
service in the violent pains in the eye ball which precede the
development of glaucoma.
I would add what Dr. Pope says of the Colocynth neuralgia
in general. "It appears to me to be that of the rheumatic
or gouty-rheumatic diathesis. The character of the pain, the
fact that the joints are all prominently affected, that in the
extremities motion so generally increases the suffering, that
aggravation of it is so readily induced by cold and damp, all
seem to indicate a dyscrasia of this nature." I may say in
corroboration of this that Wurmb, who was subject to articular
rheumatism and diarrhoea on the slightest chill, entirely lost
this tendency after proving Colocynth.
The medicine which seems to me most closely allied to
Colocynth is Bryonia. It has some points of analogy, more-
over, with Arsenicum, Chamomilla, Chelidonium, Cocculus,
Gambogia, and Nux vomica; Dr. Pope says also with
Staphisagria.
It seems generally agreed that Colocynth must be somewhat
diluted to obtain good effects from it in neuralgia. Even
*Hom. the Science of Therapeutics, p. 485.
2 F
434
CONIUM.
Dr. Kidd advises the 3rd decimal here, and I myself prefer
the 6th. But in colic he speaks of getting from the mother-
tincture the same results for which Hahnemann recommends
the 24th and 30th dilutions. I have myself always seen
aggravation, where diarrhoea or dysentery co-existed, from any
approach to this strength.
We have next to study the action of hemlock,
Conium.
Our tincture is, and always has been, made from the expressed
juice of the whole plant. It is thus equivalent to the "succus "
of the British Pharmacopoeia, which Dr. Harley has demon-
strated to be the only really active preparation of hemlock.
Conium is one of the medicines of the Reine Arzneimit-
tellehre. Its pathogenesis appears in the fourth volume, and
contains 89 symptoms from Hahnemann, 131 from 3 fellow-
observers, and 155 from 30 authors. A later pathogenesis in
the first edition of the Chronic Diseases adds observations by
two others and by Hahnemann himself, swelling the list to
700: and in the second edition Hahnemann supplies 212
more, which must have been observed upon sick persons while
taking the 30th dilution. These new symptoms I have as
usual to discard; and I must do the same with nearly all
those cited by Hahnemann from authors. They are, with
hardly an exception, observations on patients taking Conium
for cancer and other serious diseases: they profess to result
from preparations and doses of the drug which later investi-
gation has shown to be inert; and they are but seldom put
forth by the writers themselves as medicinal effects. It is
Hahnemann who, unable to credit Stoerck's statement of the
innocuousness of this renowned poison, chooses to set down to
its action all phenomena appearing in the patients while
taking it. Symptoms most obviously the result of the disease,
or of an occasional cause-the cough of pulmonary cancer, the
enteritis and death of a severe chill, the serous apoplexy of
an octogenarian-are all set down as pathogenetic effects of
Conium. Dr. Harley has now shown that Stoerck was quite
right, and that hemlock as he gave it is incapable of pro-
ducing its physiological effects. Unless, then, the cited symp-
toms of Hahnemann's list are read in Allen, where they have
been revised, you will do well to refrain from using them as
instances of the action of our drug upon the healthy.
CONIUM.
435
There has been so much confusion between Conium and the
other umbelliferæ, and the extracts in which it has been given
have been such bad preparations, that save Hahnemann's
earlier provings with the juice-nothing was certainly known
of the real action of Conium till some thirty years ago. One
description of poisoning by it, however, stood on immortal
record. I make no apology for gracing this lecture with the
passage from the Phado of Plato which contains it.
<<
Socrates, having walked about, when he said that his legs
were growing heavy, lay down on his back; for the man so
directed him. And at the same time he who gave him the
poison, taking hold of him, after a short interval examined
his feet and legs; and then having pressed his foot hard, he
asked if he felt. He said that he did not. After this
he pressed his thighs; and thus going higher, he showed us
that he was growing cold and stiff. Then Socrates touched
himself, and said that when the poison reached his heart he
should then depart. But now the parts around the lower
belly were almost cold; when uncovering himself, for he had
been covered over, he said (and they were his last words)
'Crito, we owe a cock to Æsculapius; pay it therefore, and
do not neglect it.' 'It shall be done,' said Crito, 'but con-
sider whether you have anything else to say.' To this ques-
tion he gave no reply; but shortly after he gave a convulsive
movement, and the man covered him, and his eyes were fixed;
and Crito, perceiving it, closed his mouth and eyes.”
If we needed any further demonstration that the Kovov
with which the Athenians poisoned their criminals was our
Conium maculatum, we should have it in the elaborate argu-
ment-philological, botanical, and physiological-which Dr.
Imbert-Gourbeyre has given us in the pages of L'Art
Médical.* But evidence of convincing force was afforded by
the case of poisoning recorded by Dr. Hughes Bennett in his
Clinical Lectures, which revived the interest in Conium in
recent times. The identity of the phenomena he described
with those recorded by Plato was obvious: both were speaking
of a poison which caused paralysis from below upwards,
killing at last by gradual asphyxia. Dr. Christison began at
once to experiment with it on animals, and got the same
results. "In various experiments," he writes, "with a very
strong extract prepared from the green seeds with absolute
alcohol, the only effects I could remark were palsy, first of the
voluntary muscles, next of the chest, lastly of the diaphragm,
-asphyxia, in short, from paralysis, without insensibility, and
* Transl. in Brit. Fourn. of Hom., xxxiii.
436
CONIUM.
with slight occasional twitches only of the limbs." Similar
conclusions have been reached by more recent experimenters,
who have mostly used the alkaloid of hemlock, conia. But
the most satisfactory observations with the drug are those of
Dr. John Harley, who has followed (though without acknow-
ledgment) the Hahnemannian method of proving on the human
subject. It appears from the facts recorded in his Old Vege-
table Neurotics that the main and only action of full doses of
hemlock is upon the motor centres, which are-as it were—
put to sleep. If the experimenter continues to use his legs
the effect will most probably be earlier felt in these parts,
after the manner seen in Socrates. If he remain in a state of
comparative rest, the effects will be first declared in the eyes.
There is here enfeebled power of accommodation of vision, with
giddiness accompanying every fresh adjustment of focus;
then ptosis, subjective or objective; from fuller doses, a dull
lazy or fixed expressionless stare, and some dilatation of the
pupils; more rarely diplopia. These phenomena imply para-
lysis of the third, fourth, and sixth cranial nerves. They
come on, together with those of the legs, within an hour after
the ingestion of the dose, and sometimes pretty suddenly: in
another three hours they are gone. Consciousness is un-
affected, and sensation slightly and rarely. No other effect on
the system was observed.
It is a moot question whether Conium produces these
results by affecting the intra-cranial motor centres, or by
directly paralysing the peripheral extremities of the nerves.
All agree that the cord is not involved, as it is only by
poisonous doses that reflex function is affected. But on the
former question Dr. Harley is on one side, and the Conti-
nental experimenters on the other. It is probably a matter
of physiological interest only, so far as homœopathic appli-
cations of the facts are concerned. For, even were its action
primarily central, there is no general paralysis originating in
the brain or cord which is merely functional, as that of Conium
from its brevity must be. It might, however, be useful in local
paretic conditions, especially of the ocular muscles. Given
antipathically, and in doses large enough to produce its
physiological effects, it has been reported useful by Dr.
Harley in many forms of motor irritability, as chorea, paraly-
sis agitans, infantile convulsions, and local spasms and cramps;
but the observations of others have hardly confirmed his
results.
So far of the neurotic action of hemlock, which is all that
is recognised by modern medicine. But we are now con-
CONIUM.
437
fronted with the fact that the plant was re-introduced into
practice by Störck as a remedy for various profound derange-
ments of the vegetative life, and that in this capacity it con-
tinues in high favour in the school of Hahnemann. (Its action
on the nervous system was indeed hardly perceived by the
older homoeopathists. Caspar, in his lectures at Vienna in
1851, spoke of it as slight, mainly secondary, and displaying
itself chiefly in spasms!) It is the fashion nowadays to reject
all experience gained before the rigid experimentation of later
times set in; but it is a very unwise fashion. Trousseau and
Pidoux set a much better example; and profess to have veri-
fied to some extent the statements of Störck and his imitators.
Such experiments as those of Harley, valuable as they are in
themselves, prove no negative. They say nothing as to what
the long-continued use of small doses of the drug might do,
either pathogenetically or curatively. Hahnemann was led,
from his provings of this kind, to conclude that Conium tended
to engorge the glands, and recommended it in practice for
such engorgements, especially when the result of mechanical
injury. The experience of the old physicians went to prove it
useful also when cancer or scrofula attacked these organs;
and this too has been taken up in the school of Hahnemann.
Again, that wasting of the mammæ and testicles has not
uncommonly occurred (according to the same authorities) from
its use suggests the glands of the reproductive system as
especially under its influence, and warrants its use in ovarian
affections also. Thus, in one way and another, an extensive
homœopathic employment of Conium has grown up, as you
may see from reading Noack and Trinks' recommendations
of it, or the catalogue of its curative applications given by
Dr. Carroll Dunham in an article upon it in his Homeopathy
the Science of Therapeutics (p. 443). I may sum it up in the
following propositions :
1. Conium is especially useful in the organic affections of
lymphatic individuals, and among these to children and old
women.
2. It is of frequent service in hypochondriasis starting from
the sexual organs, as in that of uterine disease, and that which
occurs (in either sex) in connexion with enforced abstinence
from sexual intercourse. Its characteristic mental symptoms
are depression, timidity, taciturnity, aversion to society, and, at
the same time, a dread of being alone.
3. It is a genuine anti-scrofulous medicine, reducing swollen
glands, especially when very hard, and especially removing
the photophobia of strumous ophthalmia. This last property
438
CONIUM.
is a very curious one, as it has never caused photophobia in
the healthy; and yet it removes it (and with it much of the
co-existing malady) in strumous ophthalmia in doses far too
minute for any primary physiological action to be exerted.
4. It had a great repute of old in "scirrhus." This term
was often applied to all tumours hard enough to merit the
name. Caspar commends it in the forming stages of fibrous
tumour of the uterus, and two cases are mentioned treated by
it in the Leopoldstadt Hospital at Vienna, the tumour in one
disappearing, in the other becoming greatly diminished in
size. But homœopathy preserves to some extent the Störckian
tradition of its efficacy in true malignant scirrhus. There ap-
pears no doubt of its having checked, if not cured, cancers
of the breast, lip, and stomach in the small doses we employ.
5. It is very beneficial in indurations of glands or other soft
parts caused by injuries, including in this category traumatic
cataract.
6. It has a specific action on the female breast, dissipating
its engorgements and tumours, and relieving its pains. Dr.
Imbert-Gourbeyre cites some observations showing its homoeo-
pathicity to the latter, though its action on the former is pre-
sumably antipathic.
7. It has hardly less influence on the ovaries, and on their
homologues in the male-the testes. It is often beneficial in
scanty menstruation and unready conception in the one sex,
and in deficient virility in the other, resulting from passive
engorgements of these organs; and also in feeble but erethistic
conditions of the male genitals.
8. It is of great value in a certain form of cough. Dr.
Hirschel describes this as "periodical, dry, excited by itching,
grating, tickling in the throat and behind the sternum; it
comes in short bouts, and is especially evoked by lying down,
talking and laughing." It is worse in the evening and at night.
These are the main uses of Conium among us; but every
man's published experience adds to it. I may refer you to
that of Dr. Bayes, who has much faith in it in hepatic and
uterine derangements, with acrid secretions; and to that of
Teste, who thinks it a prime remedy in all chronic inflamma-
tions of parenchymatous organs. Dr. Guernsey gives as "key-
notes " for it-intermission of the urine during its flow; vertigo
on turning from side to side in the recumbent posture; and
swelling, pain, and hardness of the breasts (which at other
times may be lax) at each menstrual period. This is a field
which needs careful survey and fresh work. I believe that if
the original experiments of Hahnemann and his disciples
COPAIBA.
439
were disengaged from their questionable surroundings, and
the outline filled in by some patient proving on the healthy
carried on for a length of time, we might have a valuable
pathogenesis for future applications.
In its action on the motor nervous system Conium resembles,
phenomenally at least, Curare, Kali bromatum, and especially
Gelsemium: in the vegetative sphere its analogues are Iodine,
Hydrastis, and Baryta.
The homoeopathic uses of which I have spoken have been
obtained mainly with the medium and higher dilutions.
The medicine last on our list is
Copaiba.
Our tincture is a solution of this oleo-resin in absolute
alcohol.
A short pathogenesis of Copaiba appeared in the Fragmenta
de viribus, containing 12 symptoms from Hahnemann and
8 from authors. He did not again take up the medicine; and
the pathogenesis in Allen consists of these symptoms and
others observed as results of excessive medicinal doses, with
those of a proving made by Teste on himself and seven or
eight others with the 6th dilution.
The interest of Copaiba centres in its action on the urinary
mucous membrane. It is generally acknowledged that it acts
here as an irritant-the influence being strongest in the
urethra, and becoming weaker as it ascends towards the
kidney. Even on the latter, however, it acts as sometimes a
potent diuretic, sometimes a provocant of hæmaturia or
ischuria; and Bartholow says that he has reason to believe
that desquamative nephritis and fibroid kidney have resulted
from its free administration for a lengthened period. But the
urethral influence is most marked. Sometimes the irritation
travels along the seminal tracts, and the testicle swells and is
tender. Even rheumatism, according to Pereira, has been
ascribed to the use of the balsam. But without building upon
this last statement, enough has been said to show the perfect
homœopathicity of Copaiba to gonorrhoea, in the treatment of
which disease it has so high a reputation. This it enjoys in
the homoeopathic school also, as you may see by reading Dr.
Yeldham's excellent treatise on Venereal Diseases. He pro-
fesses to agree with Ricord that its local effect is indispensable
for cure to be wrought by it; but departs from this position in
440
COPAIBA.
recommending it also in the gonorrhoea of women, for which,
and for some forms of leucorrhoea, it is of undoubted value.
The truth is that Copaiba affects more or less all the mucous
membranes, as well as their external continuation, the skin.
An eruption—now measle-like, now urticarioid, now erythe-
matous-often accompanies the action of the drug; and not
only is the digestive tube disordered, which might be from
local action, but also the respiratory passages. Ricord has
found it produce "irritation in the larynx and bronchi; dry-
ness also in the larynx, huskiness in the chest, and dry and
painful cough, in connection with which there is expectoration
of a semi-purulent, greenish, and nauseously-smelling mucus
(Phillips).
Thus the ancient repute of the drug-as well sketched by
Teste-in bronchial affections is substantiated and explained.
Stillé believes its value equalled by that of no other medicine
in chronic bronchitis without fever. But, after all, it is as a
remedy for urinary catarrhs that it must be chiefly used. I
have found it specially valuable in irritation of the urethra
and neck of the bladder occurring in old women. The
cutaneous action of the drug has hardly been utilised
among us; but Dr. Guérin-Méneville mentions that on one
occasion, when giving it to a lady in the 6th dilution for
some urinary troubles, it caused the disappearance of an
acne which had long and obstinately disfigured her face.
Bartholow thinks that the eruption of Copaiba is only
secondary to gastro-intestinal disturbance; but Allen cites an
observation of Hardy's, in which a sort of pemphigus was
developed under its use, and this can scarcely be so explained.
Moreover, it has been given with some advantage in the old
school for psoriasis, and it is said that when it disagrees with
the stomach, or purges, it does not benefit the disease, its
good effect on which is generally marked by the development
of its own specific eruption on the skin. Even if Dr.
Bartholow should be correct, it would only make Copaiba a
better remedy for that form of urticaria which is owing to
the ingestion of some offending article of diet. Dr. Dessau,
an old-school physician of New York, in communicating to his
colleagues some illustrations of "the value of small and fre-
quently-repeated doses," mentions a very severe case following
the eating of lobster-salad, which, after lasting three days and
three nights, untouched by ordinary treatment, disappeared in
twenty-four hours under the use of Copaiba. He speaks also
of having had "most gratifying results" from it in chronic
urticaria occurring in children. He confesses to having been
V
"}
COPAIBA.
441
led to the remedy by the principle similia similibus, and gives
it in drop doses.*
Cannabis sativa, Cantharis and Terebinthina are the nearest
analogues to Copaiba.
There seems nothing gained by raising the drug above the
Ist dilution; and in gonorrhoea Dr. Yeldham recommends.
from ten to twenty drops of the first decimal for a dose.
* See New York Medical Record, July 28, 1877.
LECTURE XXIX.
CORALLIUM, CROCUS, CROTON, CUNDURANGO, CUPRUM,
CURARE, CYCLAMEN, DIOSCOREA.
I have but a few words to say of the first name on my list
to-day-
Corallium rubrum.
It is prepared by trituration.
There is a short pathogenesis of coral, taken from the third
volume of the Archiv, in Allen; it was obtained from four
persons, using the 3rd trituration. Our only therapeutic
knowledge about it is derived from Teste. "In the provings,"
he writes, "which I made with this drug on my own person,
some years ago, I elicited a few exceedingly characteristic
symptoms, which induced me to prescribe it, sometimes with
striking success, for nervous cough, asthma Millari, and
endemic whooping-cough." In his Treatise on Diseases of
Children, M. Teste places Corallium first among the remedies
for laryngismus stridulus and the spasmodic stage of pertussis,
and says that a patient, to whom he had given the medicine
for a chronic convulsive cough, said to him, "It is like water
thrown upon fire." I have myself once or twice given
Corallium in whooping-cough with very satisfactory results.
On February 1st, 1867, I was asked to see the daughter of the
Rev. S. E.-. In the previous November she had had a very
troublesome cough, which resisted all the treatment of the
ordinary kind directed against it. Change of air was at last
prescribed; and immediately on arriving at Norwood the
cough ceased. She returned home at Christmas time; but
the cough gradually reappeared, and had now assumed its
former intensity. I found her firing minute-guns of short
barking cough. This, I was told, went on all day; and for
half-an-hour or so towards evening increased to a violent
spasmodic paroxysm. In other respects the health was fair.
CROCUS SATIVUS.
443
She was nearly 13, and had not yet menstruated. The larynx
and trachea were not tender, and the cough gave no pain. I
ascertained on inquiry that she was of nervous temperament,
and had more than once manifested hysterical symptoms. I
gave her a drop of Corallium 30 three times a day. On the
5th I saw the patient again. The cough had steadily
diminished since beginning the medicine. There had been
no paroxysm for two evenings, and I heard not a single bark
during my visit. By the 9th the cough had quite disap-
peared; and it did not return. Since this time Corallium has
become quite a favourite medicine with me for hysterical and
other spasmodic coughs; and I am rarely disappointed
by it.
The provings in the Archiv developed much coryza and
epistaxis, and even ulceration within the nostril. Balanitis
also was set up. The last symptom has led to the recom-
mendation of the drug in soft chancre; but I am not aware
that any evidence of its efficacy has been adduced.
We have analogous medicines in Nitric acid, Atropia,
Drosera, Hyoscyamus, and Nux vomica.
For dose M. Teste recommends for children the 30th
potency, which led me to choose it in the case I have just
related. I have since found the 12th to answer every purpose.
I come now to a medicine which Homœopathy has revived
out of long neglect and disuse, the saffron,
Crocus sativus.
We prepare by percolation a tincture from the saffron of
commerce.
There is a very fair proving of Crocus in Stapf's Beiträge.
It was conducted on several persons, and with the mother-
tincture. The articles of Hempel and Teste also should be
consulted.
The ancient reputation of Crocus as an emmenagogue,
though ignored by modern therapeutists, has been confirmed
by our provings. We of course use the drug medicinally for
precisely the opposite purpose, viz., to restrain menorrhagia.
It is specially recommended where the menstrual blood is
blackish and clotted, or (Dr. Guernsey says) of pitchy con-
sistence. I have cured with Crocus many a case of menorr-
hagia so characterised, giving this drug during the period,
and China in the intervals. In this, and indeed in other
444
CROTON TIGLIUM.
affections, the coexistence of a feeling as if something alive
were moving about in the abdomen is said to be a special
indication for Crocus. Its relation to such a symptom, which
appears also in its pathogenesis, would make it suitable in
cases of imaginary pregnancy, for which indeed Teste recom-
mends it. Crocus has some power of affecting the brain,
causing determination of blood thereto, with epistaxis (the
blood having the same pitchy character as that before noted),
and exciting in some persons immoderate fits of laughter. It
might be useful in hysteria, or even in recent insanity, in which
this symptom was prominent. I am myself most struck, in
reading the pathogenesis of Crocus, with the eye-symptoms.
It ought to be very useful in that form of weak vision in which
the patient feels as if there were a gauze before the eyes, and
tries to wink or wipe it away. It is, Drs. Allen and Norton
say, asthenopia; and they have found Crocus of marked
benefit in it.
The analogues of Crocus are Belladonna, Platina, Sabina,
and (most complete of all) Ruta.
I have always given the 2nd dilution; and should prefer
descending to ascending the scale.
Alphabetically, my next medicine would be the poison of
the rattle-snake, Crotalus. But I think it more convenient to
discuss this under the head of the serpent-poisons in general,
which I propose to do when I come to the chief of them,
Lachesis. I will, therefore, proceed to give you some account
of the homœopathic uses of
Croton Tiglium.
The expressed oil may be triturated with milk-sugar, or
dissolved in alcohol; but the officinal preparation is a tinc-
ture of the seeds.
A very full pathogenesis of Croton, taken from sixty-three
different sources-a good many of which are provings, is
given by Dr. Allen. It contains 815 symptoms.
Croton is another of those drugs whose use well illustrates
the difference between Old Medicine and Homœopathy. It is
found to have drastic and rubefacient properties. Hence,
says Old Medicine, we will use it to purge and to counter-
irritate whenever we think such processes likely to be bene-
ficial. Nay, replies Homœopathy: Croton will rather be a
remedy for certain forms of diarrhoea and of cutaneous in-
CUNDURANGO.
445
flammation, resembling those which it causes. And this we
have indeed found it to be.
The purgation produced by Croton is specific, and seems
not the result of inflammatory irritation, but rather of such a
transudation of the watery part of the blood as is caused by
Elaterium and Veratrum album, and obtains in Asiatic cholera.
The accompanying symptoms in severe cases, indeed, are
strikingly choleraic in character; and Croton might fairly take
rank among the remedies for choleraic diarrhea, for which indeed
Dr. Jousset recommends it. Dr. Guernsey considers a sudden
and forcible expulsion of the stool a leading indication for its
choice the liquid evacuation, he says, is poured as from a
hydrant. It has not, however, been so much used in this
sphere as in that of cutaneous disease. Teste was the first to
call attention to the specific nature of its action on the
skin,* and to recommend it as a cutaneous remedy. Later,
Dr. Bähr has followed in the same track: you will find his
observations translated in the sixteenth volume of the British
Journal of Homœopathy. It is agreed that eczema is the special
form of exanthem developed by Croton, and that the face and
the external genitals are its favourite habitats. It is precisely
in such eczematous rashes that both Teste and Bähr have
found it curative; and I can add my mite of confirmation to
their statements. The rapid and permanent manner in which
Croton often relieves the itching attendant upon eczema is
one of the prettiest things in medicine.
Dr. Guernsey says that Croton will remove the pain
shooting through from the nipple to the shoulder of which
nursing women sometimes complain.
The analogues of Croton as a drastic are Elaterium, Vera-
trum, and Colchicum; as a cutaneous irritant it ranks with
Rhus, Apis, and Mezereum.
The attenuations from the 3rd decimal to the 6th cen-
tesimal have been successfully used.
I have now to speak of the drug known as
Cundurango.
This a South American shrub, the bark of whose stem is used,
in tincture or trituration. It has been proved by Dr. Burnett
* "Dr. Tilbury Fox states that Croton oil sometimes produces a
symmetrical erythema of the face, lasting for a few days, where no
direct application of the drug could have occurred" (Ringer, p. 281).
Z
446
CUNDURANGO.
→
in this country, and Drs. Dinsmore and Dikeman in America;
so that Allen's Encyclopædia can give a pathogenesis of it,
containing seventy-five symptoms.
Cundurango has been introduced as a remedy for cancer.
You will find its history in various places in the volumes
of the British Journal of Homœopathy from the thirtieth to
the thirty-fourth. Dr. Clotar Müller was the first of the
homoeopathic school to test it. He found it powerless in
scirrhous indurations; but over malignant ulcerations, to all
appearance carcinomatous, it exerted in his hands an un-
doubted curative influence. The same experience is reported
by Dr. Obolinski, of Cracow. Professor Friedreich, of Berlin,
next followed with a case which his experienced diagnosis
declared to be unquestionable cancer of the stomach, and
which Cundurango cured in three months.* Dr. Fischer, from
our ranks, communicates another instance of cure of what
seemed the same disease. Lastly, Professor Nussbaum has
has been able to say :†-" We have seen good results in
cancer from Cundurango. Friedreich reports several perfect
cures; and I have seen good effects, though no cure, from its
internal use. I applied locally only compresses moistened
with a solution of sugar of lead, and still the internal use of
Cundurango produced extraordinary and lasting amelio-
ration."
In the view of these encouraging results, we disciples of
Hahnemann naturally inquire what is the pathogenetic action
of the substance. Dr. Burnett‡ made a full proving of the
infusion. It congested his Schneiderian membrane, the effect
extending into the frontal sinus; caused pimples, pustules, and
blotches on the skin; and especially affected the lips, making
them red, and giving rise to painful cracks in the corners of
the mouth. This last trouble it caused also in two patients
who were taking it for other affections; and Dr. Burnett re-
ports several cures by the drug of the same condition when
occurring idiopathically, both in the mouth and at the anus.
Mr. Proctor suggested to him the similarity between its effects
and those of syphilis; and it seems that it was an accidental
cure of constitutional syphilis by the herb which first led to
its use in Ecuador, and that it is as an anti-syphilitic that it
there enjoys most repute. Dr. Dikeman§ took several five-
* See North American Journ. of Hom., May, 1874; and Ziems-
sen's Cyclopædia, vii., 252.
+ See Ibid, August, 1875.
1 See Brit. Fourn. of Hom., xxxiii., 400.
$ New England Medical Gazette, x., 486.
CUPRUM.
447
drop doses of the mother tincture, and found it act as a
diuretic, causing also much cardialgia, and itching with
brownish tint of the skin. Dr. Dinsmore experienced a
curious” derangement of the sight of the right eye, lasting
some time, and appearing to depend upon congestion of the
retina.
No inference seems deducible from such facts as to the re-
lation of the drug to cancer, and its use must be, for the
present, regarded as empirical only. I can but suggest its
comparison with Hydrastis, and mention that Friedreich gave
it in tablespoonfuls of a decoction made with half an ounce
of the bark to a pound of water. Dr. Müller used the Ist
decimal dilution or mother tincture.
I have now to speak of a more important remedy, in the
shape of
Cuprum,
by which I mean the salts of copper in general as well as the
pure metal; for there seems no difference in their action,
and they were used indiscriminately by Hahnemann in his
provings and citations from authors. We triturate the metal,
and make solutions of its salts.
A short pathogenesis of Cuprum, in the form of the sul-
phate, appeared in the Fragmenta de viribus. The acetate
was then proved by Hahnemann and four others, and the
results published in Stapf's Archiv. These and the foregoing
finally appeared under the heading "Cuprum " in the third
volume of the Chronic Diseases, with additional symptoms
from Hahnemann himself, obtained doubtless from patients.
with the 30th potency of the triturated metal. If these
last could be eliminated, we should have in the rest a very
fair pathogenesis of Cuprum; the more so, as 154 of the 387
symptoms are from authors, nearly all being observations of
poisoning with the various salts. A collection of cases of
poisoning has been recently given us by Dr. Berridge, in the
appendix to the British Journal of Homœopathy; and these,
with the symptoms of the Chronic Diseases and a few others,
have been arranged by Hering in his Materia Medica. Dr.
* Dr. Gutteridge, in a recent summary of experience with cancer,
says—“ Cundurango relieves pain traceable to cancer; for example,
patients sometimes complain that any movement of the thumb and fin-
gers on the affected side gives pain, and Cundurango relieves this. I
have found it of no further service" (Annals, viii., 172).
448
CUPRUM.
Allen divides his pathogenesis of the drug into three portions,
headed Cuprum, C. aceticum, and C. sulphuricum respectively;
but, with some inconsistency, gives to the first the symptoms
recorded in the Archiv as produced by the acetate.
The poisonous action of copper, like that of most metals, is
exerted primarily upon the alimentary canal, and secondarily,
after absorption, upon the nervous centres. In these two
spheres of action I propose to consider it.
I. The gastro-enteric symptoms induced by copper are
those of acute inflammation, with severe colic and tympanites.
That they are specific, and not local only, would appear from
the sixth case of Dr. Berridge's collection, where they oc-
curred in a lady who was in the habit of using vaginal
injections from a brass syringe which proved to be coated
internally with verdigris. They also appear in workers with
copper. Their abdominal trouble is described by M. Blandet
as "a form of enteritis of which the chief symptom is a colic,
with remissions. The workman bends himself double to re-
lieve it; the belly is tender on pressure; there is headache
and inclination to vomit; diarrhoea or constipation; the
vomit consists of bilious fluid; fever is present, and frequently
lassitude."* The copper colic is thus different from that of
lead, which is non-inflammatory.
Little or no use has been made of these effects of the
metal in the school of Hahnemann; for the employment of
the drug in cholera rests upon other grounds. We must go
to the ordinary practice to find an instance of the homoeopathic
use of Cuprum here; and it at once meets us in the case of
chronic diarrhoea with or without ulceration, for which the
sulphate is in high repute. One of the latest writers on
Materia Medica in the school, Dr. Bartholow, speaks highly
of the sulphate in many acute and chronic inflammatory
states of the stomach and intestines; and shows his sense of
the kind of practice he is following by always advising
minute doses from th to end of a grain. Dr. Wood
speaks of its action as "stimulant and astringent;" but in
the face of toxicology this seems a mere evasion of the ob-
vious inference from the facts. Vomiting and diarrhoea, to
indicate Cuprum, should be spasmodic and painful.
II. The neurotic influence of copper is very decided.
"The effects," writes Pereira, "produced by the long-con-
tinued use of small doses of the preparations of copper are
said to be various affections of the nervous system, such as
cramps and paralysis." Then he writes-"If the cupreous
* See Berridge, Obs. 37.
CUPRUM.
449
preparations be used in very small doses, they sometimes give
relief in certain diseases, principally of the nervous system,
without obviously disordering the functions; in other words, in
these instances the only apparent effect is the modification
observed in the morbid condition." This is pretty good homœo-
pathy, as far as it goes; but we must individualise rather
more closely.
I. The cramps mentioned by Pereira are especially charac-
teristic of the action of Cuprum. We have seen an instance
of them in its colic; and you have only to read a few cases of
poisoning by it to observe how readily they are induced else-
where under its influence. They may be local or general,
clonic or tonic; they may be a simple trembling, or may go
on to violent convulsions. Sometimes they occur in the air-
tubes, as observed by Dr. Maissonneuve,* causing very in-
tense dyspnoea with laryngeal and bronchial spasm.
Hence has arisen the first great homœopathic use of
Cuprum, viz., to relieve cramp or spasm, and check convul-
sions. Its applications of this kind are very numerous. In
cramps of the calves Dr. Jousset (giving it in the 12th di-
lution) has never known it to fail; and Dr. Guernsey com-
mends it in violent after-pains. In spasmodic affections of
the respiratory organs it takes a high place. In prolonged
laryngismus it may be given with great relief;† though it is
doubtful whether it can check the recurrence of the com-
plaint in children, where deeper causes are usually at work.
In whooping-cough it has been much praised by Drs. Neid-
hard‡ and Drummond;§ and Bähr says that by giving it as
soon as the spasmodic stage sets in he has succeeded so well
that he has scarcely ever been obliged to resort to any other
treatment. it is especially indicated here when the cough is so
violent as almost to suffocate the patient, who remains stiff
and motionless after it, or threatens to go off into convulsions.
When these actually occur, Dr. Jousset esteems it highly. In
pure nervous asthma Dr. Russell says|| that there is no medi-
cine on which we may rely more confidently to relieve the
paroxysms: he says nothing, however, about checking their
recurrence. Passing now to the heart, we find Dr. Bayes
commending it highly in angina pectoris, and ascribing the
suggestion to Dr. Holland. The experience of these practical
* See Berridge, Obs. 96.
† See Brit. Journ. of Hom., xxiii., 675.
‡ Ibid, xii., 437.
§ Ibid, xxxi., 411.
Clinical Lectures.
2 G
450
CUPRUM.
physicians should be borne in mind; I have more than once
followed its guidance with advantage. Then we have the use
of copper, common to both schools, in chorea and epilepsy.
It is difficult to assign it its exact place in the treatment of
either affection; but in epilepsy Dr. Bayes suggests that it is
indicated by extreme violence of the convulsions. He thinks
it (as also do Bähr and Jousset) one of our best medicines in this
disease, and cites several cases in point. Many others are
given by Dr. Baertl, in a collection of cures of epilepsy which
is translated in the twenty-second volume of the British Journal
of Homœopathy. In chorea Cuprum is very effective in giving
the final steadying to the muscles, after medicines like Actæa,
Agaricus, or Stramonium have quieted their excessive agita-
It has often been noted as characteristic of Cuprum in
convulsive disorders that they begin with cramps in the ex-
tremities, especially in the fingers and toes. This would
suggest the drug as a remedy in the "carpo-pedal spasms" of
childhood-in a case of which lately seen by myself it proved
speedily curative. Restlessness between the paroxysms is re-
garded by Dr. Guernsey as indicative of Cuprum in such
affections.
It is, lastly, that feature in Asiatic cholera which has given
it the name "spasmodic," which also gives Cuprum a place
among its remedies. The alvine evacuations of cholera are
altogether different from those produced by copper; yet the
true correspondence of disease and drug was perceived by
Hahnemann, and his discernment has been thoroughly war-
ranted subsequently. In his original directions for the treat-
ment of cholera* he put forth Cuprum as the specific remedy
for the "second stage of clonic spasmodic character" if-as
too often happened-Camphor failed to relieve. He stated
that it was to be preferred even to Veratrum here; and recom-
mended it also as a prophylactic. There is now abundant
evidence of its efficacy in this last capacity, both among the
workers in the metal and in those who have worn a plate of
it next the body during the prevalence of the epidemic. Drs.
Russell and Drysdale both had occasion to speak well of it in
the epidemic of 1849 in this country, the former com-
mending it for the cramps, the latter also for the vomiting.
In 1866 Mr. Proctor, who treated a number of fully developed
cases with great success (he lost 14 only out of 98), writes†
p
“For the cramps it was unquestionably the best remedy, and
I may say for the vomiting also. In the stage of collapse I
* Lesser Writings, p. 847.
† Brit. Journ., xxv., 94.
CUPRUM.
45I
gradually found myself trusting mainly to Cuprum, and the
impression is very strong on my mind that in collapse it is the
most reliable of our remedies. It appears to go deeper into
the organism and to fasten upon the disease with a firmer and
more tenacious grip. Certainly it accomplishes much by
keeping the stomach quiet, and thus enabling us to introduce
and retain what other medicine, or stimulant, or nourishment,
we may desire."
2. The paralysis of Cuprum resembles that of Plumbum
more closely than does its colic. It is one affecting the hands.
alone, or at most the arms. Here is a description of it in a
copper-worker :-" Right forearm in constant pronation, hand
bent at right angle to arm, thumbs drawn into palm, fingers
flexed; motion of elbow remains good, but in the hand, and
especially in the joints of the fingers, extension is impossible,
and flexion only partial; upper extremities much emaciated,
right more than the left; right hand nothing but skin and
bone." At one time I should have been unable to point to
any application of such facts; but if you will compare this
picture with that given by Dr. Hammond in his Diseases of
the Nervous System of "amyotrophic lateral spinal sclerosis," I
think you will be struck with the coincidence. Cuprum may
well have the same relation to "amyotrophy"—that is, the
same morbid influence on the trophic centres-as Plumbum :
the great emaciation so often noted in chronic poisoning by it
involving the muscles.
3. A more important part of the neurotic action of Cuprum
is its powerful influence upon the brain. Almost every form
of cerebral disorder has been induced by its poisonous action;
at the same time autopsy shows no sign of organic mischief.
The inferences deducible herefrom were well drawn out and set
forth by Dr. George Schmid, of Vienna: you will find his paper
on the subject translated in the first volume of the British
Journal of Homœopathy. He was led especially to recommend
the use of copper-in the form of the acetate—in the cerebral
symptoms which result from the retrocession of any of the
acute exanthemata, or from difficult dentition in children,
when the condition is scarcely active enough to require Bella-
donna. These suggestions have been confirmed by the expe-
rience of most homeopathists; and the use of Cuprum in
such conditions may be considered established. Its last
illustrator is Dr. Drummond, of Manchester, who in a paper
published in the thirty-first volume of the British Journal
relates cases of retrocession of eczema, measles, and scarlatina
in which Cuprum aceticum was employed with most grati-
452
CUPRUM.
fying results. He speaks, also, of great benefit from its use
in cerebro-spinal meningitis; and in some recent experiments
on animals related in the thirty-second volume of the same
journal great hyperæmia of the meninges of brain and spine
was noted.
The experiments just mentioned were made in view of an
extensive proving of copper and its salts, lately set on foot
by the Central Homœopathic Society of Germany, which pro-
mises greatly to enlarge our knowledge of the action of the
drug. In two rabbits to whom the drug was administered
by subcutaneous injection the urine became scanty and albu-
minous, and the kidneys were found after death with their
tubes full of shed and degenerated ephithelium. The left
ventricle of the heart was much hypertrophied and the liver
granular. This is very suggestive, and connects Cuprum with
Arsenic. It has been found of service in the uræmic cramps
and convulsions of granular degeneration of the kidneys.
Further indications for its use may be derived from the ex-
perience of the school of Rademacher, with whom it is one of
the great systemic remedies. Dr. Heinigke states that Rade-
macher considered it indicated when there was premature
exhaustion of strength in illness; and that it rapidly showed
when it was doing good by the sense of being better which
the patient experienced. Another sign of the same meaning
was that the urine became clearer and more plentiful when it
was otherwise. A long series of cases of diseases benefited by
it, related by Dr. Kissel, a prominent member of the school, is
translated in the eighteenth volume of the British Journal. I
should add that the jaundice which so often appears in
copper-poisoning has not yet been accounted for or utilised in
practice; and that its effect on the skin deserves further
notice. Patches of "lepra " have been observed as a result of
the continued ingestion both of the acetate and of the metal;
so that the drug may prove curative in the squamous forms
of cutaneous disease. Hahnemann recommends it in old
ulcerations.
The chief analogues of Cuprum are its fellow-metals,
Arsenicum and Plumbum. It has points of resemblance,
moreover, to Nux vomica and Secale.
The higher potencies of metallic copper, the lowest of the
acetate, have been most frequently given with success.
My next medicine is one of almost purely physiological
interest, but which homeopathy has lately begun to employ
CURARE.
453
in practice. It is the Indian arrow-poison, variously called
wourali, woorara, or (as we have it)
Curare.
It is prepared for our use by solution in alcohol.
Our knowledge of the poisonous action of Curare is well
put together by Dr. Carfrae in the fourth volume of the
Annals. Cases illustrating its curative power have been given
us by Mr. Freeman in the ninth volume of the Monthly
Homœopathic Review.
The poisonous effects of Curare are very well ascertained.
It seems to act purely and simply upon the motor portion
of the nervous system, paralysing it, and doing so from
the periphery towards the centre. It has very naturally been
tried in tetanus; but without success. If, however, the cure
of hydrophobia recently obtained by it be repeated in sub-
sequent trials, its antipathic action will have achieved a real
triumph. We on the other hand have as naturally endeavoured
to put it to use in the treatment of paralysis. Mr. Freeman's
observations are the only records of its use which we have
at present. He specifies his cases as-I. Paralysis of the
parts supplied by the motor cranial nerves, pains being
absent. 2. Lateral paralysis after apoplexy. 3. Paralysis
from mechanical injury. 4. The class of cases known as
nervous debility. 5. The debility of aged persons. 6.
Debility after exhausting illness. Of the two cases cited
under the first heading, one is briefly described as general
motor paralysis," and the action of the drug is dubious.
The other seems an instance of temporary loss of motor power
from repeated attacks of “apoplectiform congestion," which,
according to Trousseau, is epilepsy. There was double facial
and right lateral paralysis; swallowing and articulation also
were affected. Curare immediately restored the power of
swallowing and the other symptoms steadily subsided,
whether post or propter hoc I cannot say. The cases of the
second and third sections do not impress me with the power
of the drug. Far more satisfactory is its action in the semi-
paralysis called nervous debility, and in that which results
from over-suckling, or from exhausting illnesses. On the
whole, it is in these last-named conditions that we may expect
most benefit from Curare, as its action reaches only to func-
tional changes.
CC
:
I would add that Claude Bernard states that Curare para-
454
CYCLAMEN EUROPÆUM.
lyses the vaso-motor as well as the musculo-motor nerves.
The fact may bear fruit one day in our therapeutics.
A paper on Curare was presented to the World's Conven-
tion at Philadelphia, by Dr. Pitet, of Paris, containing some
additional observations upon its therapeutic powers. It has
not yet been printed; but from my recollection of it I may
state that he reported it of striking service in relieving some
forms of paralytic dyspnoea. I hope that by the time I next
lecture on the drug the Transactions of the Convention, con-
taining this paper, will have been published.*
The dilutions from 3 to 12 were used in Mr. Freeman's
cases.
Causticum, Conium and Physostigma are analogues of
Curare; and also Gelsemium.
The next medicine on my list is the common sowbread,
Cyclamen Europæum.
The tincture is prepared from the fresh root.
The original proving is in the fifth volume of the Reine
Arzneimittellehre, where there are 5 symptoms from Hahne-
mann himself, and 197 from four fellow-observers. The
medicine has since been re-proved in Germany, in the mother-
tincture and lowest dilutions,-30 persons taking part in the
experiments. You may read their results-originally pub-
lished in the Zeitschrift of the Austrian Society-in Allen's
Encyclopædia, where 753 symptoms are recorded.
Cyclamen was in ancient repute as an emmenagogue, and
was accounted so potent an abortifacient that Gerarde, in his
Herball, cautions pregnant women against walking over it in
gardens. Our provings give evidence of the former property,
and show the menstrual flow induced to be black, clotted, and
even membranous, with violent labour-pains. Its most re-
markable action otherwise is on the head and eyes, where it
causes headache, with great dizziness, and flickering or obscura-
tion of sight. Some remarks upon its sphere of influence, and
cases illustrating its therapeutic virtues, by Dr. Eidherr, of
Vienna, may be read in the tenth volume of the North
American Journal of Homœopathy. He relates several instances
in which such symptoms of the head and eyes co-existed with
menstrual derangements, and in which Cyclamen proved a
most valuable remedy. Dr. Dunham, moreover, mentions
* Still, alas! (Feb., 1880) unpublished.
DIOSCOREA VILLOSA.
455
that these phenomena had led him to its use in similar cases
before the Austrian provings had shown its action on the
female sexual system; and Dr. Merryman relates a good
case of climacteric vertigo and mental confusion cured
by it.*
I think, however, that the use of Cyclamen should not be
confined to such purely sympathetic derangements of the head
and eyes. I should suggest its trial in that form of migraine
which begins with flickering before the eye of the side affected;
and Drs. Allen and Norton consider it as ranking among our
most important remedial agents for convergent strabismus.
The resemblance to Pulsatilla is most obvious; also to
Ruta and Crocus.
In Dr. Eidherr's cases the 15th decimal attenuation was
that employed.
My next medicine in regular course would be Digitalis; but
as I cannot begin this important remedy just as the hour is
up, I will occupy our remaining time to-day with its nearest
successor in alphabetical order. This is the wild yam root—
Dioscorea villosa.
A tincture (triturations would be better) is prepared from the
root; but the special virtues of the drug appear to reside in
the resinoid, Dioscorein, triturations of which are accordingly
in most frequent use.
Our knowledge of this drug, first derived from Dr. Hale's
New Remedies, has been greatly increased by Dr. Cushing, of
Lynn, U.S., who has published a monograph upon it. To the
four provings supplied by the former writer he has added some
extensive experimentation on his own person, both with sub-
stantial and with attenuated doses.
Dioscorea is a medicine for one disease-a form of colic.
This has hitherto been described by the American
"Eclectics," to whom we owe the drug-as " bilious," meaning
thereby not the passage of gall-stones, but abdominal pain
accompanied by vomiting of bile. Subsequent experience
has shown that this last symptom is non-essential; and also
that the drug is homœopathic to the malady, and cures excel-
lently well in the small doses we affect. Those who have
proved it concur in reporting severe pain about the umbilical
region as the most marked of their symptoms: it is from this
* United States Medical Investigator, iv., 576.
1
456
DIOSCOREA VILLOSA.
Dr.
point that the colic demanding the medicine starts.
Helmuth, from clinical experience, considers that the colic
requiring Dioscorea is more continuous than that to which
Colocynth is suited: it is also described as "a constant pain,
aggravated at regular intervals by paroxysms of intense.
suffering." One of the best descriptions we have of its sphere
of action is that given by Mr. Clifton.* It is in "flatulent
spasms," whether affecting the stomach or bowels, that he
finds it especially useful. There is frequent expulsion of
wind, but little relief therefrom. While the patient has a
tendency to bend double, and feels as if pressure would relieve
him, as a matter of fact it rather aggravates, and most solace
is obtained by stretching the body out." In these circum-
stances of amelioration and aggravation the drug is most dis-
tinguished from Colocynth.
From one to three grains of the first trituration of Dioscorein
form the usual dose, but Mr. Clifton gives drop doses of the
mother tincture of the root.
* See Monthly Hom. Review, xxi., 473.
I
LECTURE XXX.
DIGITALIS, DROSERA.
We begin to-day with a medicine of great interest and
importance, the purple foxglove,
Digitalis.
The tincture of the British Homœopathic Pharmacopoeia is
made from the leaves. This is of consequence, as they are
the only part of the plant which contains digitaline, and
alcohol dissolves it freely.
Digitalis was proved by Hahnemann, with the expressed
juice of the leaves, for the Fragmenta de viribus, where its
pathogenesis contains 23 symptoms from himself, and 33
from ten authors. In the fourth volume of the Materia Medica
Pura his own symptoms have increased to 73, and there are
224 from ten fellow-provers; while he has gone to thirty-seven
authors, and obtained from them 131 observations. These
were mostly made upon patients taking the drug, but are not
often vitiated on that account. The Chronic Diseases (in its
latest form) gives us another pathogenesis, containing 702
symptoms. The additional 300 are furnished by three new
observers, and by the experiments of Jörg and eight of his
pupils, who proved the drug in small doses-one to three
grains of the powdered leaves. I should say that in the
Materia Medica Pura Hahnemann directs the seeds to be
used, in the Chronic Diseases the whole plant. The essay by
Dr. Bähr, which obtained the prize of the Central Homœo-
pathic Society of Germany in 1858,* adds several experiments
of his own, and the drug has also been proved by Lembke,-
both these latter observers using digitaline as well as the
mother plant. The result of all these provings, with copious
records of the effects of poisonings and over-dosings, is given
us by Dr. Allen in his Encyclopædia.
* Digitalis purpurea, Leipzig, 1859.
458
DIGITALIS.
Upon the facts as known in the time of each have been
based two studies of the drug, one by Dr. Black in the fourth
(1846), and another by Dr. Madden and myself in the twenty-
first volume (1863) of the British Journal of Homœopathy.
But even since the later date the literature of the medicine
has immensely increased. It has been largely experimented
with on animals both at home and abroad, and its effects and
modus operandi have excited continual discussion. Its thera-
peutic applications, moreover, first made to scrofula, and then
to phthisis, have received a wide extension in the sphere of
cardiac disease and other disorders of the circulation. It
therefore fills a large space in the treatises of Wood, Ringer,
and Phillips, and has been made the subjeet of special mono-
graphs by Brunton,* Reith,† and Fothergill. To the con-
clusions arrived at in our study of the drug I still in the main
adhere; but the whole subject needs fresh exposition as it
has received renewed consideration.
I would first call your attention to the emetic effects of
Digitalis. The drug is not used medicinally to excite vomit-
ing, as its other workings are undesirable. But its emetic
properties are undoubted, active, and specific. It sets up the
condition of nausea-with its depression, salivation, sweating,
and other phenomena-as powerfully as does Antimony; and
its vomiting is severe, and, when once excited, often lasts for
days. When once excited, I say; for it frequently does not
come on for many hours after the ingestion of the drug.
We have already studied the nausea and emesis produced
by drug-action when speaking of Tartar emetic. We have
seen that it is brought about by an influence on the nervous
centres at the base of the brain and in the medulla oblongata.
We have also seen in the case of that drug a power to retard
to a large extent the action of the heart and lungs, and have
found such power explicable by a similar central impression,
in this case transmitted by the pneumogastrics. Now the
effect of Digitalis which most struck the older observers was
its slow pulse. They found the rate reduced from its norm or
higher to about 40, as Hahnemann shows by numerous cita-
tions. To the same effect is the testimony of all recent obser-
vation and experiment. Some indeed speak of a primary
acceleration, and many more of the same thing occurring
secondarily; but nearly all agree that retardation is the
characteristic and long-lasting effect of the drug. Analogy
* On Digitalis. Lond., 1868.
† On the actions and uses of Digitalis, Edinb. Med. Journ., 1868.
‡ Digitalis: its mode of action, and its use.
Lond., 1871.
DIGITALIS.
459
would suggest that with Digitalis, as with Tartar emetic, the
slow pulse is an effect of stimulation of the vagi; and the
balance of experiment is decidedly in favour of the hypothesis.
The primary acceleration, noticed by several as an effect of
small doses, is readily thus accounted for, as a very weak
galvanic stimulation of the pneumogastrics is found to quicken
the heart's action. It may be, however, a result of the un-
opposed influence of the ganglionic excitation of which I shall
presently speak. In the former case the pulse would be
weaker, in the latter stronger; and both characters have been
noticed in it by different experimenters.
C
But now another fact encounters us. The retarded heart-
beat of excitation of the vagi is always accompanied by
diminution of arterial pressure, whereas this last is notably
increased under the influence of Digitalis. We have thus to
suppose a similar action exerted by it upon the arteries them-
selves, through the medium of the vaso-motor nerves. Such
an action is acknowledged by all observers; and, with hardly
an exception, is affirmed to be central rather than peripheral.
That is, it is effected by an influence exerted by the drug on
that uppermost vaso-motor centre which physiological research
has discovered at the base of the brain, hard by the corpora
quadrigemina.* By this influence the whole arterial system
is thrown into a state of tension; the vessels themselves are
contracted; and the heart is stimulated to beat forcibly, and
would beat fast if the inhibitory power of the vagi would
permit. Thus it comes about that the slow pulse of Digitalis
is often a strong one.
These are the pritnary phenomena of the action of Digi-
talis. It is seen to have just such a limited neurotic influ-
ence as that which belongs to Tartar emetic (and also to
Lobelia and Tabacum); an influence upon the group of
centres at the base of the brain which preside over nausea and
vomiting and control the circulation. It may either excite
the first of these alone; or, if this be avoided, it stimulates the
whole nervous system-inhibitory and motor-of the circula-
tion, holding heart and arteries in a firm grip. This increase
of tension by excitation of the vaso-motor centre is peculiar to
it among its cognate drugs.
But it is admitted by all observers that, after a time when
moderate doses, at once if large doses are given, an opposite
condition manifests itself. The pulse quickens, and becomes
* An interesting account of the process by which this centre has been
discovered is given by Dr. Moreau in the Révue Homeopathique
Belge for January and February, 1875.
460
DIGITALIS.
weak, irregular, and intermittent; the arterial pressure, as
measured by the hæmadynamometer, falls. The heart's
action is still for a time forcible, but it is tumultuous. The
general symptoms are those of depressed circulation, with
lowered temperature: there is syncope, and-if the dose be
large enough-death. It is the custom to speak of such
phenomena as those of reaction, from exhaustion of the
over-stimulated nerves. But I think that it is impossible to
explain them all upon such an hypothesis. No nervous ex-
haustion can stop the heart's action, as long as the organ itself
is healthy; and after death thus induced the ventricles are
found contracted and not dilated. These are insurmountable
difficulties in the way of adopting it. Some recoil there doubt-
less is after over-stimulation; but not to such an extent as
that seen in the collapse of Digitalis-poisoning. I believe
that we must look for an explanation of this to an action of
the drug upon the heart itself. That it has such an action
seems proved by the researches of Claude Bernard, which
have been strangely lost sight of in the recent discussions
about Digitalis. It is, according to him,* one of the poisons
which act directly upon the muscular tissue, paralysing and
killing it. It affects that portion of muscular tissue which
constitutes the heart earlier than any other, so that in cold-
blooded animals like frogs the heart's action may cease four
hours before general death ensues: there is (as has been said) a
dead heart in a living body. Rigor mortis sets in exceedingly
early; and on opening the thorax immediately after death the
heart is found contracted, rigid, motionless, and totally empty.
A further examination discloses remarkable chemical and
electrical changes in the heart and other muscles. The
muscular juice is acid instead of alkaline; and the external
surface is electrically negative to the cut surface, instead of
(as, normally) positive.
I am glad to find these views, in maintaining which, as I
have done since 1863, I imagined I stood alone, supported
by Dr. Stillé. "It is evident," he says, "that the in-
creased power of the heart under the influence of Digitalis
is not identical with that which it acquires from the use
of diffusible stimuli or hæmatic tonics, but, on the other
hand, may co-exist with an impaired muscular energy."
By them, as it seems to me—and recent experimentation is
in accordance with them-all the phenomena before us are
elucidated. While Digitalis stimulates the nervous supply of
* See Med. Times and Gazette, Sept. 29, 1860. Dybkowsky and
Pelikan have been led (according to Stillé) to the same conclusion.
DIGITALIS.
46I
the circulation, it kills its muscular apparatus. The latter
action is slower than the former, and is for a time masked by
it. But that, while pneumogastrics and sympathetic are acting
upon the heart, slowing and at the same time urging its beat,
it is nevertheless losing its inherent vigour, is shown by a
remarkable fact. It is often noted by the older observers that
though the pulse under the influence of the drug was slow
while the patient retained the recumbent posture, it became
enormously quickened-often to double its rate and more-
when he stood up. This could only be from enfeeblement of
the muscular walls of the heart, which endeavoured by in-
creased rapidity of action to answer the additional call made
upon it. Thus rightly was the fact explained.* The same
account must, I think, be given of the irregularity of pulse so
characteristic of the drug's action. The rhythm of the heart's
alternate contractions and expansions is a property of its
tissue. It cannot be altered by any modification of its nervous
supply it fails only as the muscular substance itself loses its
integrity. As Dr. Fothergill says,-" Irregularity of rhythm
is not due to disordered innervation, but to obvious debility."
Lastly, the symptoms and post-mortem appearances which
show the heart dying in systole instead of diastole, which are
thought to prove the drug a cardiac stimulant to the last,
receive their explanation. The heart poisoned by Digitalis is
contracted and not dilated; but the contraction is the rigor
mortis. The immediate cause of this phenomenon has been
shown to be the change of the muscular juice from alkaline to
acid; and this very change is involved in the destructive
action of the drug upon the integrity of the muscular
tissue.
It will be well, while these facts are before us, to speak of
the therapeutic virtues of Digitalis in the sphere of the circu-
lation. Its power of slowing the heart's action was early
made use of in the treatment of phthisis, where rapidity of
circulation is so obvious and exhausting; and subsequently
by the Rasorists in Italy, and again of late years in Germany,
it has been largely employed in the treatment of fevers and
inflammations. In the former it certainly retarded the pulse,
but rarely checked the progress of the disease: in the latter
it effectually reduces the temperature, but does nothing to
abate-if it does not actually increase-the mortality. It is
S
* Of the same character is that which von Boeck (Ziemssen's Cyclo-
pædia, xvii., 710) remarks, that even in the stage of recovery from the
effects of the poison, very slight causes suffice to bring on cardiac
paralysis.
462
DIGITALIS.
abandoned in phthisis; and will inevitably share the same
fate in fever. Such primary actions of drugs are rarely avail-
able for true curative purposes. The only really valuable
application of this property of Digitalis seems to be in cases
where the orifices of the heart are narrowed, and the frequency
of its contractions prevents it from returning to a functionally
normal state, and keeps up the disturbance of the circulation.
It was in this cardiac condition that Digitalis was most fre-
quently used of old; and the physicians of the first half of
the present century speak in high terms of the benefit ob-
tained by the temporary retardation of the heart's action
induced by the drug.
But it had early been noted by several-and notably by
Pereira and Sir Henry Holland-that, though it seemed
strange, a weak heart would grow strong and an intermittent
pulse become regular under the action of the foxglove. Such
experiences accumulated; and, when physiological experiments
began to be made, it was thought that the facts were well
accounted for, and that Digitalis was after all a stimulant and
not a depressant of the heart. A rush was made in the oppo-
site direction, and Dr. Handfield Jones gave utterance to the
general impression when he proclaimed the drug "our cardiac
tonic kar' oxhy, specially to be resorted to in cases of
asthenia and peril from failing circulation." That such
effects can be produced by utilising the sympathetic channel
of the neurotic stimulation induced by Digitalis is, I think,
undoubted It is surely this which is brought into play
in such cases of collapse as that recorded by Dr. Fothergill.
The patient-after a labour with twins-was apparently in
articulo mortis: the limbs were cold, the body in a state of
deathly clammy sweat, the face livid, no pulse could be felt at
the wrists, and a mere fluttering was heard when the ear was
placed over the region of the heart. Brandy and ether had
been given without any good effect; and, as dissolution was
every moment expected, it was decided to try Digitalis.
Half-a-drachm of the tincture was given every hour; after
four doses reaction set in, and after three more recovery was
complete. Digitalis acts here on the hollow muscle of the
heart as it does on that of the uterus, stimulating it to con-
tract; and through the same ganglionic nerves. By a similar
process mainly it is, as I shall argue presently, that it promotes
the action of the kidneys and drains the water-logged tissues
in cardiac dropsy. But, if Digitalis acts upon the heart only
through its nerves, it is difficult to see how it can exercise
more than a temporary stimulant influence upon it. A drug
DIGITALIS.
463
can surely give strength to a tissue only by acting directly
upon the tissue itself, or upon the blood which nourishes it.
The theory is seen by many to be fallacious; and Brunton
gives warning that a fragile heart may easily rupture under
stimulation, while Reith asserts that sudden death is no
uncommon result of the practice, accounting for this by the
anæmia of the organ caused by the contraction of the coronary
arterioles. Ringer finally argues that the "tonic " theory fails
to explain the benefit wrought by the drug in cardiac disease,
and asserts that in simple debility of the heart it is useless
and even hurtful.
While these variations have been going on in the ranks of
the old school, Homœopathy has been pursuing with Digitalis,
as with other medicines, the even tenor of her way. I know
not how it has been with my colleagues, as there has been
little published on the subject: but for myself Digitalis has
always been a valued remedy in weakness of the heart. I
have regarded it as a cardiac tonic in disease because it is a
cardiac debilitant in health; and have used it accordingly.
Simple enfeeblement of the muscular walls of the heart has
seemed to me a very common condition. Vertigo, tendency
to syncope, breathlessness on exertion, and palpitation—some
or all of these are its symptoms; and it finds in Digitalis
a potent and rarely failing remedy.* Again, the slow pulse of
the drug, seized upon by Hahnemann's penetration as the
characteristic feature of its action, has often led to its suc-
cessful use in cases where it was present.
The use of Digitalis in organic disease of the heart is a
larger subject. The old view of its operation led to its being
given in hypertrophy and over-action of the organ: now it is
prescribed for dilatation and debility-and in both one and
the other with good effects. From what I have said you will
infer that I regard the benefit wrought in the former class of
cases to be due to its primary action in slowing the heart
through the vagi; while in the second class there may be a
combination of primary sympathetic stimulation, which would
account for any speedy results manifested, and homœopathic
strengthening of the enfeebled muscular tissue. Upon these
principles I should judge the virtues now ascribed to it as a
remedy. Dr. Ringer has furnished a most elaborate and
practical survey of all the facts; and comes to the conclusion
* The hypothesis of direct action upon the substance of the heart
thus implied is supported by what Trousseau and Pidoux note, that
Digitalis is less useful in functional (that is, nervous) than in organic
disease of the organ.
464
DIGITALIS.
that Digitalis is useful in proportion as the symptoms depend
upon irregularity of the heart's action. As such irregularity
prevails throughout the action of the drug, Digitalis would
seem homœopathic to it whenever present. So also as regards
the conditions which Dr. Phillips postulates for it, viz., a
general venous hyperæmia-Dr. Ringer meaning the same
thing when he says that it is in heart disease with lividity and
jugular fulness, not in that with waxy pallor, that it is avail-
able. Here again the modus operandi of the drug, and there-
fore the manner of its administration, must depend upon.
whether we have only enfeebled or also obstructed circulation
to deal with.
This brings us to the action of fox-glove in cardiac dropsy.
It is confessedly by no direct diuretic operation that it bene-
fits here, as its effects of this kind under other circumstances
are very uncertain. It only certainly increases the flow of
urine when dropsy is present, and that from imperfect action
of the heart. By removing the weakness or irregularity of
the organ on which the oedema of the limbs depends it allows
of the re-absorption of the effused serum into the relieved
veins; and then the kidneys take on the work of pouring the
fluid out from the body. This is Dr. Ringer's explanation;
and it seems to me in perfect accordance with the observed
facts,—especially in these points, that Digitalis is most effec-
tive in dropsies occurring in relaxed and debilitated subjects,
and that its diuresis coincides with increase of arterial tension.
"The same kidneys," writes Bartels, “which for months had
secreted small quantities of dark albuminous urine of high
specific gravity, as long as the tension in the general arterial
system remained far below normal, and the cyanotic colour of
the patient demonstrated the serious over-repletion of his
veins, secrete ample quantities of urine free from albumen,
clear, and of normal specific gravity, so soon as, in conse-
quence of some spontaneous process of cure, or by interposi-
tion of medical skill, the distribution of the blood is once more
cqualised, the natural blood-pressure being restored to the
arterial system, and the abnormal increase of tension in the
veins being subdued."
But here once more we have to consider what is the cause
of the deficient arterial tension,-whether it is due simply to en-
feeblement of the cardiac muscle, or to embarrassment of its
(otherwise normal) action through alteration of the valves. In
the former case Digitalis would be truly homoeopathic; and,
given in our usual doses, may prove permanently curative. But
the evidence goes to show that the latter alternative more fre-
DIGITALIS.
465
quently obtains; and here we can only increase the lacking
tension by stimulating the vaso-motor nerves, which act
directly upon the arteries as well as on the heart itself. We
can do this with Digitalis, but it must be by inducing its
primary physiological action, for which purpose larger doses
are required.*
*
I have dwelt thus fully upon the principal sphere of the
action of the drug, as it was necessary to clear it from mis-
apprehensions, and to ascertain the exact modus operandi of
the benefit it affords. Beyond this sphere Digitalis is hardly
used in ordinary practice. Its occasional success in hæmorr-
hages seems to belong to it, as it is supposed to check them
by contracting the arterioles, as Secale does. But patho-
genetic experiment reveals a much wider range of influence
on the part of the drug; and homoeopathic therapeutics have
done much to utilise the same for the benefit of suffering
humanity. I will try to indicate the salient points.
I. The influence of Digitalis upon the brain is evidenced
by various cerebral symptoms, and by consentaneous subjec-
tive disorders of the sight and hearing. Headache, chiefly
frontal, heavy and throbbing in character, has often been ob-
served: the drug, when pushed in experiment, has threatened
to set up meningitis, and in poisoning by it delirium and
mania are not uncommonly observed. There is buzzing in
the ears; and the sight is affected in a remarkable manner.
The colouring of objects is altered; they appear blue,
yellow, or green, or all faces seem of a corpse-like whiteness.
Motes float before the sight, which on covering and pressing
the eyes appear as sparks; then flashes and balls of fire are
seen, and objects appear brilliant, with a fiery halo round
them. Last, amaurosis sets in; which has been known to last
for a month after omitting the drug. With these disorders of
vision there is at first pressure in the eyeballs; later, throb-
bing pain and sense of fulness and enlargement.
The clue to all these phenomena (which remind one of those
of quinine) seems afforded by the highly injected state of the
cerebral meninges which was found in the only post-mortem
examination of Digitalis-poisoning Christison was able to
discover. The visual symptoms, like those of Santonine,
suggest congestion of the retina and incipient glaucoma. For
these the drug has not been, to my knowledge, used thera-
peutically; but Hahnemann says that "hardness of hearing,
with hissing as of boiling water, has been frequently cured by
P
* Dr. Kidd, in his Laws of Therapeutics, has some very instructive
cases illustrating this practice.
2 II
466
DIGITALIS.
Digitalis, when the other symptoms corresponded likewise to
that drug." The head-symptoms have led to its use in acute
hydrocephalus, for which it already comes to us with high
repute, Pereira accounting it "a most valuable agent in the
arachnitis of children." He, and Bähr with him, thinks this
a part of a general specific influence it exerts upon inflam-
mation of serous membranes: the latter considers it appli-
cable not only to the serous pleurisy for which Wurmb and
Fleischmann commend it, but to all forms of the disease, and ex-
tols its virtues in pericarditis with much serous effusion. As
regards hydrocephalus, there are two instances of its suc-
cessful use in the seventh and twelfth volumes of the British
Journal of Homœopathy, which are encouraging to further trial
of the drug in this fatal disease.
2. Of the mucous membranes, the stomach and descending
colon are specifically inflamed by Digitalis. It causes ash-
coloured stools; but not, I think, from any influence on the
liver. Dr. Inman has shown that the fæces do not become
brown until they reach the colon, and that the green stools of
infants assume their peculiar colour at this point also. It
would appear, therefore, that the secretion from the follicles
of the colon has an important influence on the colour of the
fæces; and through these I conceive that Digitalis whitens
the stools, for it causes no other element of jaundice or sign
of hepatic disorder. Now it is no uncommon thing to be
consulted about children whose liver is said to be locked up,
because they are passing white chalky stools. There is no
jaundice; and I do not believe that the liver is here in fault
at all, but that the secretion of the colon is deranged.
Digitalis is a capital remedy for this condition, as pointed
out by Drs. Chapman and Black.* I must tell you, however,
that true jaundice is said to have been occasionally cured
by it.
3. Although in cardiac dropsy Digitalis is only secondarily
diuretic, yet I must agree with Dr. Brunton that it has a
direct irritant action on the kidneys. In Jörg's provers, and
in Bähr, decided diuresis was set up, and in acute poisoning
by the drug suppression is often present. It diminishes the
urinary solids, and this not merely relatively but absolutely.
It is thus decidedly homoeopathic to the granular degeneration
of the kidneys in which Christison praises it so highly. Dr.
Clifford Allbutt writes accordingly :-" In granular kidney the
one drug which of all others seems least appropriate, but
which is, on the other hand, most beneficial, both temporarily
* Brit. Journ. of Hom., iv., 279.
DIGITALIS.
467
and permanently, is Digitalis." He is thinking especially of
the high arterial tension common to drug and disease.
Dr. Dickinson esteems it the best medicine in the acute
Bright's disease which follows scarlatina.
4. Considerable influence is exerted by Digitalis on the
male sexual organs. In Jörg's provings these were uniformly
excited,—one prover having to leave off after three days on
account of the extent to which the irritation proceeded. Bähr
found similar effects. The fact that other observers have
found it to exert an anti-aphrodisiac effect must not be allowed
to prejudice these undoubted facts. It is possible that the
large doses taken by them exerted the contracting influence
of the drug upon the arteries, and thus rendered erectile pro-
cesses and the venereal nisus impossible, while smaller quan-
tities may excite the nervous centres of the function. It is
certain that it is not only from the old school, and in the mode
of administration recognised there, that we hear of the medi-
cine being given to diminish venereal excitement, and in
spermatorrhoea. Dr. Bähr has the highest opinion of its value
in the last-named malady, and in nocturnal emissions. He
gives here a grain of the third decimal trituration of digitaline
every second morning, saying that if taken at night it is
liable to disturb the sleep. I have often confirmed this expe-
rience.
These are the main points of the action of Digitalis. If
you would enlarge them, I would refer you to Teste's article
on the drug--who says, by the way, that sadness is a charac-
teristic feature of its action, both in men and animals; and to
Dr. Bähr's excellent treatise, most of the recommendations of
which he has reproduced in his no less excellent Science of
Therapeutics.
Digitalis finds a good many parallel medicines in its many-
sided action. As a myotic, its only fellows are Arnica,
Arsenic, and Physostigma; myalgia, cramp, and fibrillary
contraction being to these drugs respectively what paralysis is
to Digitalis. In its influence on the pneumogastrics Digitalis
resembles Tartar emetic, Lobelia, and Tabacum; as a renal
poison its analogues are Colchicum and Scilla. In its action
on the heart it stands quite alone-Arsenic and Kalmia only
approaching it at all in character.
The question of dose as regards Digitalis has some inte-
resting points about it. It seems strange that a drug so
perfectly and primarily homœopathic to weakness of the heart
should not aggravate rather than improve this condition in
the full doses prescribed in the old school. Yet they seem to
468
DROSERA.
obtain none but beneficial results from doses of the tincture
varying from 5 to 15 minims. Lately, a still more surprising
administration of the drug has taken place. The tincture
has been given in half-ounce doses, several times repeated, as
a remedy for delirium tremens, and does not seem to have
done any harm. Any attempt, however, to give the same
quantity of the infusion will bring on distressing and some-
times alarming symptoms,-while yet the tincture is eight
times stronger. It is a fair inference from these facts, that
the presence of alcohol-as in the tincture-directly opposes
the action of the drug which in its turn may be antidotal to
alcohol, and perhaps in this way be beneficial in delirium.
tremens. If, then, the tincture be used for homoeopathic
purposes, the counteracting influence of the alcohol must be
borne in mind, and the lowest potencies selected. I have
never seen any benefit from the dilutions above the Ist
centesimal, and generally use the 1st decimal or mother-
tincture; which also seems to be the general practice.
:
f
A word in conclusion about
Digitaline, which appears to possess at least the cardiac and
renal influence of the mother-drug. It has occasionally been
used in heart disease with dropsy instead of Digitalis, as in a
case recorded in the seventh volume of the North American
Journal of Homoeopathy. Dr. Meyhoffer highly esteems it
here. It would be a suitable form of the drug when given to
check its characteristic vomiting. Digitaline may be triturated,
or "dissolved in alcohol of 90°; or it may be given in the
granules of Homolle and Quevenne, each of which contains
a milligramme, ie., about the sixty-fifth of a grain. These
have to be used cautiously, however, if the assertion of their
designers is correct, that digitaline is a hundred times as strong
as the powdered leaf of the plant.
Dr. Allen gives a separate and very full pathogenesis of
this alkaloid, and a single experiment with "digitoxine,"
which seems more potent still.
We will occupy the remainder of our time with the sun-
dew,
Drosera.
The tincture of homoeopathic practice-in which alone
Drosera is used-is prepared from the entire fresh plant.
The pathogenesis appears in the sixth volume of the Reine
DROSERA.
469
Arzneimittellehre, containing 132 symptoms from Hahnemann
himself, 152 from three fellow-observers, and 3 from authors.
The most significant fact in this pathogenesis is the spas-
modic cough induced by the drug. Hahnemann's wonted
sagacity led him to perceive this; and he recommended the
medicine accordingly in pertussis. If after-experience has not
quite verified his statement that a single dose of Drosera 30
will cure whooping-cough in a week,* it has nevertheless
sustained the drug in the first rank of remedies for the
disease. The common experience is that of Dr. Bayes, that
repeated doses of the first or first decimal dilution will bring
most uncomplicated cases of whooping-cough to an end
within two, three, or four weeks, greatly mitigating the
severity of the paroxsyms meanwhile. I myself prefer
Aconite and Ipecacuanha in the catarrhal stage; but quite
agree in the praise given to Drosera when the cough has
become spasmodic.
The virtues of Drosera in whooping-cough have formed one
of the recent discoveries (save the mark!) of the old school.
At a meeting of the Société Thérapeutique of Paris, on April
10, 1878, Dr. Lamarc reported his favourable experience with
the remedy, and several other members present corroborated
him. As with all thefts (I must call them so, as long as the
borrowing is unacknowledged) from homœopathy, the small dose
goes with the similar remedy: the tincture is administered
goutte par goutte "†.
(C
It is of course not essential that a spasmodic cough should
be true pertussis for Drosera to cure it: in sympathetic and
nervous coughs of this kind it often acts admirably. Dr.
Jousset considers its power here one of the best illustrations
we have of the efficacy of infinitesimal doses. "Cough from
tickling in the larynx, with vomiting of food," being the
precise definition of its sphere of action, he communicates
107 instances of it, of which 101 were relieved or cured by the
medicine. The 3rd, 12th, and 30th dilutions were found
alike efficacious, and superior to the mother-tincture.
One of Hahnemann's provers had a hoarse voice and
expectoration of yellow mucus with his cough, which sug-
gested to him its use in laryngeal phthisis when he remem-
* Dr. Buchmann has recently affirmed the correctness of this observa-
tion of Hahnemann's, and adduces several other testimonies in its
support. See Brit. Journ., xxxvi., 268.
† See Bull. de Thérapeutique, 8° livraison, 1878, p. 381; and Ľ’Art
Médical, xlvi., 457.
‡ See Brit. Fourn of Hom., xxvi., 210.
470
DROSERA.
bered the statements of the herbals and of the country people,
that the sundew causes a violent cough in sheep, under which
they waste away. He says that some of the older physicians
have cured certain kinds of malignant cough and purulent
phthisis with it; but that in modern times its acridity has
caused its disuse. Influenced by such facts, Dr. Curie, of
Paris-whose doings with Bryonia have already come before
us-determined to ascertain by experiment its real action.
He reported to the French Academy of Sciences* that he had
slowly poisoned three cats with daily doses of Drosera. Diar-
rhoea at the commencement, and weakness of voice about six
weeks later, are the only symptoms mentioned as observed
during life. But, on post-mortem examination, the trachea
was found unchanged, while the pleural surface of both lungs
was studded with what the microscope decided to be true
tubercle. In one cat the mesenteric glands were much
enlarged; in another the submaxillary glands, with the solitary
glands of the large intestine and Peyer's patches. Now as
cats are not at all liable to tubercle, I think it cannot be
doubted that Drosera here caused the deposit, with the con-
sentaneous enlargement of the lymphatic glands. Putting
this together with the effects ascribed to it in sheep, it looks
very much as if Drosera would turn out a true simile for
phthisis pulmonalis. Dr. Curie, indeed, asserts that in the
incipient stage of the disease a cure may nearly always be
brought about by Drosera, given in doses of from four to
twenty drops of the mother-tincture in the twenty-four hours.
I can only say that I once gave drop doses four times a day,
with the effect of setting up a most violent spasmodic cough,
which subsided to the ordinary cough of phthisis when the
medicine was discontinued. Dr. Jousset found a similar
aggravation in two cases out of six which he treated on Dr.
Curie's plan. In two others the effect was nil, and in the
remaining two a primary amelioration did not last. I know
of no other trials of the remedy.
Acidum hydrocyanicum, Acidum nitricum, Belladonna, Che-
lidonium, Cina, Corallium, Cuprum, Hyoscyamus, Ipecacuanha,
Nux vomica and Sambucus should be compared with Drosera
in their relation to spasmodic coughs.
I suspect that Dr. Curie's mother-tincture will have to be
modified no less than Hahnemann's 30th. I myself have been
very well satisfied with the Ist dilution.
* See Brit. Fourn. of Hom., XX., 39.
LECTURE XXXI.
DULCAMARA, ELATERIUM, EUPATORIUM PERFOLIATUM AND
PURPUREUM, EUPHORBIUM, EUPHRASIA, FERRUM.
My first medicine to-day is the bitter-sweet or woody night-
shade, Solanum
Dulcamara.
We use a tincture prepared from the leaves and green shoots.
The proving of Dulcamara appears in the first volume of
the Reine Arzneimittellehre, where the drug has 318 symptoms
from Hahnemann and ten fellow-provers, and 83 from authors.
Most of these last are taken from Carrére (of whom more
anon) and his German editor, Starke, and are nearly always
critical and curative effects of the medicine when given to
patients. They cannot, therefore, without great caution be
used as pathogenetic phenomena. The proving in the Chronic
Diseases has only 8 additional symptoms. Dr. Allen, how-
ever, is able to give some valuable new observations of the
effects of the plant, both when proved and when taken in
excess.
Hahnemann found Dulcamara in use for a variety of affec-
tions supposed to depend upon a vitiated state of the blood,
which it seemed to benefit by determining to the periphery or
increasing the secretions. The fullest account of its applica-
tions is that published by Carrére in 1789.* He relates
many cases of gout, rheumatism, and cutaneous disease, and
of suppression of the latter or of the secretions, in which it
proved very effectual, always, however, by inducing some
critical evacuant phenomena. Hahnemann, whose numerous
citations show how largely he has used Carrére's work, cites
these phenomena-eruptions, diarrhoeas, sweatings, and urinary
depositions as pathogenetic effects of the drug. This I con-
ceive to be unwarrantable, unless the same results can be
obtained on the healthy, of which (save as regards the
* Traité des propriétés, usages, et effets de la Douce-Amère. Paris,
1789.
472
DULCAMARA.
diarrhoea) there is no evidence. It is therefore very doubtful
whether its benefit in the squamous forms of cutaneous disease,
so largely vouched for by the older physicians, is of a specific
and homoeopathic nature. It neither causes such affection of
the skin in the healthy,* nor does it cure without evacuation.
It does, however, excite erythematous and urticarious rashes,
and pruritus; and it is in urticaria, and in such forms of
eczema as crusta lactea, that it has found place in homœo-
pathic practice.
But there are other effects of the drug observed by Carrére
which Hahnemann has incorporated into his pathogenesis,
and which seem to be truly physiological. This author
says that, after seventeen years' use of the drug, he has
seen no inconvenience from full doses, save occasionally some.
twitching of the eyelids and lips, and slight convulsive
movements of the hands; heat and itching, with desire, in
the genitals; heaviness of the head, with dimness of sight;
and sore throat. The critical eruptions, moreover, were often
preceded by restlessness, insomnia, and even a febrile state.
Of the first-named phenomena-those of the eyelids, lips, and
hands he makes the curious observation that they only
occurred when the patient was exposed to cold, damp weather,
and that they could be readily removed by external warmth.
Hence has arisen one of those happy defining rules which
abound in homoeopathic therapeutics, viz., that Dulcamara is
indicated for the result of exposure to damp. It is certainly
an excellent remedy here. I am myself very liable to catch
cold if I get at all wet; but since I have (acting on a sugges-
tion of Dr. Chapman's)† taken Dulcamara on such occasions as
a prophylactic, I have hardly ever suffered. Twice, too, I
have arrested in myself incipient results of moist air by
Dulcamara; the first time it was angina, the second time stiff
neck. The medicine is also useful in diarrhoea resulting
from a chill in damp weather; in catarrh of the bladder from
the same cause-even, Dr. Drury says, when chronic, with
much mucus and offensive urine; and indeed in almost any
mild catarrhal irritation of the mucous membranes owning
this origin. Its influence extends also to subacute articular
rheumatism in this way set up,§ and indeed to any malady not
utterly beyond its range of influence, when there is a marked
* The symptom assigned to it in Allen's Supplement, "in some cases
lepra, nausea, and headache" would seem to say otherwise; but
"of" should have been inserted before “lepra.'
""
* See Brit. Journ. of Hom., viii., 33.
‡ Ibid, xxviii., 174.
§ Ibid, xxiii., 630.
DULCAMARA.
473
aggravation of the symptoms at every change of the weather
to damp and cold. Hahnemann, who was the first to indicate
these anti-catarrhal properties of Dulcamara, says also that it
is specific in some epidemic fevers, but does not identify them.
Of the genital irritation ascribed by Carrére and Starke
to Dulcamara Stillé writes-" Should this statement be correct,
as well as the one made by several physicians, that it has the
power of subduing the sexual appetite of maniacs and others
in whom this propensity is morbidly active, both facts should
be borne in mind as illustrating the opposite effects sometimes
produced by medicines when administered in health and
disease." Dr. Guernsey commends the remedy when the
slighter forms of nymphomania in women are associated with
heat, itching, and herpetic eruptions about the genitals. Stillé
further mentions the paralysis of the tongue which is said to
have resulted from its protracted use, but which also occurred
in three of the poisoning cases cited by Allen. I am not
aware of any therapeutic use having been made of this effect
of the drug.
So far extended our knowledge of Dulcamara before its
active principle was isolated. This is known as solania, and
is found to be common to it and the Solanum nigrum, though
Dulcamara possesses it in much smaller proportion. Solania
has now been pretty fully tested by experiments on animals,
of which the most satisfactory are those of Professor Clarus,
who also took it himself: you may read them in English in
the eighteenth volume of the British Journal of Homœopathy.
Two very important phenomena were observed, the one
neurotic, the other of irritant character. The first was that
the respiration became much slower, the heart's action much
quicker (though at the same time feebler). Since this curious
antagonism is also caused by division of the vagi in the neck,
Professor Clarus infers that solania acts by depressing these
very nerves. Such depression is further indicated by the
filling of the pulmonary tissues with a serous exudation, and
the emphysematous distension of isolated portions of the lung,
which were observed in the rabbits killed by solania :-these
phenomena having resulted from division of the vagi. Other
symptoms also indicate an action on the medulla oblongata,
as vomiting long after taking the drug, spasms of the thoracic
muscles extending to those of the extremities, snapping of the
jaws, and a pendulum-like motion of the head. After death,
the membranes of the medulla oblongata, and of the parts just
above and below it, were found highly injected, but the nervous
substance itself healthy.
474
DULCAMARA.
Subsequent experimentation (of which a good account is
given by Dr. Phillips) has confirmed this neurotic action of
solania, only giving as its first effect a hurried state of the
respiration, which is probably the earliest response of the
medulla to the disturbing influence of the drug.* It supports,
moreover, Clarus' second observation, viz., hyperæmia of the
kidneys with albuminous urine, and shows the engorgement
sometimes going on to inflammation, and involving the liver
also. The effects of the alkaloid on the human subject have
been ascertained by Schroff. Giving it to healthy persons in
various doses, from one thirtieth of a grain to three grains, he
observed “increased cutaneous sensibility, itching of the skin,
gaping, general numbness, sleepiness, slight tonic cramps in
the legs, and increasing frequency of the pulse, which at the
same time grew feeble and thready; there was some dyspnœa
and oppression in breathing, with nausea and ineffectual
efforts at vomiting; the head was hot, heavy, and dizzy, with
drowsiness, yet with inability to sleep; the extremities were
cold, the skin dry and itching, and there was marked general
debility. The pupil remained unchanged: the sleep was rest-
less, and disturbed by frightful dreams" (Stillé).
I know of no application to practice of the effects of
solania on the kidneys, though it might seem indicated in the
first stage of Bright's disease. But I have now for years
been in the habit of relying upon it in the threatening
paralysis of the lungs which we often encounter in the
bronchitis of old people and young children. It has several
times done me excellent service in this condition; and not
less so in a minor form of the trouble in the aged, when
from weakness they have to cough a long time to expel the
phlegm.
After the facts now brought forward, especially as regards
solania, you may estimate the value of Dr. John Harley's
recent experiments, which lead him to consider Dulcamara
altogether inert! It proved so, indeed, in his trials of it, as it
has before in other hands;† but it would be wiser to seek to
ascertain the cause of this occasional absence of activity,
instead of dismissing the counter-observations of so many
competent persons. Dr. Harley's iconoclasm will not exclude
Dulcamara, any more than it will Æthusa, from our Materia
Medica.
*"It is a general principle says Dr. Burdon-Sanderson " ap-
plicable to most toxical action, that paresis of a central organ is pre-
ceded by over-action." (See p. 74)
† See Stillé, sub voce.
""
ELATERIUM.
475
Dulcamara has so very unique an action that I hardly see
my way to putting down any other medicines as true analogues
of it.
The medium dilutions have seemed to answer very well.
Solania I have always given in the second attenuation of the
acetate.
We now come to an old acquaintance,
Elaterium.
The dried sediment of the juice is triturated for our use.
There is a short proving of Elaterium, made with the second
dilution, in the Materia Medica of American Provings.
Dr. Allen adds several other observations.
It is needless to describe to you the physiological action of
Elaterium. Nevertheless, it has been so graphically put by
Dr. T. K. Chambers, that I cannot refrain from quoting his
account of the drug. "It causes," he says, "an enormous
flow of watery serum from the first mucous membrane that
absorbs it. If its vapour be drawn up into the nostrils for
a short time, it is a powerful errhine, and is followed by the
secretion of floods of water from the Schneiderian membrane :
if it is dissolved in the œsophagus it causes such a deluge
of the gastric fluids that the stomach cannot contain them,
and they are rejected by vomiting: if it succeeds in passing
the pylorus, a choleraic diarrhoea gushes forth, stripping the
membrane of its epithelium, just like its morbid prototype."
Elaterium would thus seem homoeopathic to choleraic diarrhoea
and vomiting. There is this difference, however, that the
prolonged action of Elaterium sets up gastro-enteritis, which
the cholera poison never does. I think that nevertheless I
should be disposed to try it where the excessive quantity of
the evacuations was especially noticeable. There are several
cases of endemic cholera reported at the end of the proving,
in which Elaterium was successful after Veratrum had failed.
It might be useful in "cholerine," which seems to be the
ordinary cholera nostras modified by the presence of the
Asiatic variety. Some well-marked rheumatico-neuralgic
pains, also, appear in the proving, and have led to a cure of
one case of rheumatic sciatica. Intermittent fever, too, counts
Elaterium among the numerous medicines which at various
times have cured or seemed to cure it.
Elaterium forms a group with Colchicum, Croton, and Vera-
trum.
476
EUPATORIUM PERFOLIATUM.
The 2nd dilution was given in nearly all the cases
reported in the proving.
We have next an American medicine, the thorough-wort,
bone-set, ague-weed,
Eupatorium perfoliatum.
The tincture is prepared from the whole plant.
The original proving of Eupatorium, also, is in the Materia
Medica of American Provings. Cases of cure with it are
there given; and a full account of its virtues is to be found in
Dr. Hale's New Remedies.
Eupatorium has long been highly esteemed on the Ameri-
can continent as a remedy against intermittent fever; hence
its popular name among the Indians, "ague-weed." Its other
appellation, "bone-set," is obtained from the remarkable
power it showed in relieving the bone-pains of dengue in an
epidemic of this disease. The pains were so severe that the
malady was spoken of as the "break-bone fever." The
provings of Homœopathy have enabled us to define the pre-
cise sphere of Eupatorium in the treatment of these maladies.
In intermittents the setting in of thirst before the chill, which
usually occurs in the morning, bilious vomiting during the
paroxysm, and scanty perspiration at its close, are charac-
teristic symptoms calling for its use. If, also, the peculiar
bone-pains are present, the medicine is doubly indicated: you
may read a case of this kind by Dr. Bayes in the first volume
of the Annals of the British Homœopathic Society. I have
no experience of Eupatorium in intermittents or dengue; but
can bear my testimony to its extreme value in relieving the
bone-pains of influenza. Dr. Carroll Dunham directed atten-
tion to the marked hepatic action of Eupatorium, which he
compared with that of Bryonia.* The group of symptoms to
which he referred are-intense headache with soreness of the
scalp, soreness of the eyes, redness of the face, nausea and
prostration, soreness in the region of the liver, constipation,
and high-coloured urine. He gives a capital case of “bilious
fever," in which these symptoms, with violent bone-pains, were
present, and which was broken up by Eupatorium 3 with
marvellous rapidity.
Besides the Bryonia already referred to, I do not know of
any true analogue of Eupatorium. Dr. Dunham points out
* Amer. Hom. Rev., vi., 229; and Lectures, sub voce.
EUPATORIUM PURPUREUM.
477
as elements of distinction between these two-first, that the
perspiration is free with Bryonia, deficient with Eupatorium;
second, that Eupatorium pains make the patient restless, those
of Bryonia make him keep very still.
The range of recorded use has been from the 3rd dilution
to the mother-tincture.
More recently, another species of Eupatorium has come into
notice, the
Eupatorium purpureum.
A tincture is prepared from the fresh root.
A capital proving on a woman, and some cases of cure, are
given in the second edition of Hale's New Remedies.*
The interest of E. purpureum centres in its action on the
urinary organs. In moderate doses, it acts as a powerful
diuretic; and the frequent emptying of the bladder which is
necessary seems almost entirely due to the excess of urine
secreted. But even thus there are some symptoms of vesical
irritation; and, when larger doses are taken, these unmistake-
ably increase. Micturition now becomes more frequent, urgent,
and painful: the urine is scanty, mucus appears in it, and
later on it is high-coloured and dense. The reading of these
phenomena is plain; and the therapeutic indications are
easily perceived. Three good cases of inflammatory irritation
of the bladder are given in Dr. Hale's article, and others are
referred to. The drug has become my favourite remedy for
vesical irritability in women: I have not tried it upon men.
It has effected a cure of some intermittents. Their cha-
racters, according to Dr. Hale, are-irregular advent of the
paroxysms, chills beginning in the small of the back, and
running upwards and downwards; lips and nails blue, violent
shaking, with comparatively little coldness; during the sweat,
any attempt on the part of the patient to change his position
ever so little causes a chilliness to pass through the body. In
other respects, the symptoms are like those of the E. perfo-
liatum. These characteristics are clinical only, no fever-
symptoms having appeared in the solitary prover the drug
has yet had. Dr. Bayes has communicated to the Monthly
Homœopathic Review for January, 1878, a case of chronic
Burmese fever somewhat of this kind, in which E. purpureum
Arrangements of the symptoms, pathogenetic and curative, of both
species of Eupatorium are given by Dr. Hering in his volume of
Materia Medica.
478
EUPHORBIUM.
proved curative, the chief indication for it being the presence
of a somewhat hysterical condition during the attack, which
was developed by the drug in its (feminine) experimenter.
Dr. Bayes seems to consider that the strictly mental symptoms
also of patient and prover coincided. But I can hardly think.
that "first the brain became very active, the mind apparently
exceptionally clear, and of greater capacity for work than
ordinarily," with which the paroxysms began, is represented
by "the mind is possessed by various delusions" of the
pathogenesis.
The chief analogues are Cantharis, Copaiba, and Ferrum.
The second dilution was used in the cases on record; and I
have myself never required any other.
My next medicine,
Euphorbium,
is, according to Dr. Allen, the gum-resin of the Euphorbia
resinifera, commonly called E. officinarum. Of late, the
American Euphorbia corollata has been introduced into prac-
tice; it is prepared by triturating the dried root. Other
varieties of the spurge are being proved, as Allen's Encyclo-
padia shows.
Euphorbium was proved by Hahnemann: its pathogenesis,
containing 281 symptoms from himself and two others, is in
the second edition of the Chronic Diseases. There is an article
on Euphorbia corollata in Hale's New Remedies.
Euphorbium, belonging as it does to the family which in-
cludes Croton, Ricinus, and Jatropha, is another instance of
the drastic purgative, and gives us another remedy for endemic
cholera and choleraic diarrhoea. The E. corollata has been a
good deal used in America in cholera infantum. It is much
less liable to cause inflammation than the other Euphorbiæ,
and is accordingly better suited to these non-inflammatory
disorders. When applied to the skin, Euphorbium, like Croton,
causes an eczematous inflammation; but it is not known
whether this is a specific effect of its action.
Dr. Chapman* relates a case of spasmodic cough, charac-
terised by accompanying stitches from the pit of the stomach
to both sides of the chest, in which Euphorbium proved
rapidly curative. He (as also Noack and Trinks) commends
it for red inflammatory swelling of the cheek, with sensation
of burning heat.
* Brit. Fourn. of Hom., viii., 34.
EUPHRASIA.
479
·
Besides the members of its own family already mentioned,
Euphorbium is closely allied with Veratrum and Colchicum,
with Elaterium, and with Tartar emetic.
We have no records in any degree fixing its dose.
We now come to a medicine for which I confess an especial
penchant, the eye-bright,
Euphrasia.
The homœopathic tincture is prepared from the whole
plant.
Hahnemann has given us a pathogenesis of Euphrasia in
the fifth volume of the Reine Arzneimittellehre, containing 37
symptoms from himself, 58 from three fellow-observers, and
2 from authors. A proving by four other persons is translated
from the Allgemeine Homöopathische Zeitung in the sixteenth
volume of the British Journal, and yet another-by six more
-is added by Allen.
The great charm of Euphrasia as a medicine is that it has
a distinct and limited sphere of action, beyond which it
advances no pretensions, but within which it manifests virtues
which are as unvarying as they are potent. It acts upon the
upper portion of the respiratory mucous membrane, ie., upon
its conjunctival and nasal portions, only just reaching the
larynx. It developes in this region a catarrhal inflammation,
generally characterised by profuse secretion. Hence it takes
a first place among the remedies for fluent coryza, when this
is a local affection, and not a symptom of general influenza,
in which latter case Arsenic is preferable. The involvement
of the conjunctiva in the catarrh is a special indication for
Euphrasia; and sometimes the secretion from the eyes is acrid,
while that from the nares is bland, the opposite condition
obtaining with Arsenic. The coryza which accompanies the
commencement of measles is one to which Euphrasia is well
suited :* and I nearly always give it in this stage in alterna-
tion with Aconite, and have reason to believe that the eyes
are the better for it at the time and afterwards. The eyes
themselves, indeed, are the special seat of the influence of
Euphrasia. Its name in most languages refers to its healing
power over these organs (in English it is eye-bright; in Ger-
man, Augen-trost; in French, casse-lunettes): and you know
* Brit. Journ., xi., 484.
480
EUPHRASIA.
how the Archangel in Milton, when he would clear the vision
of our first parent,
"purged with euphrasy and rue
The visual nerve, for he had much to see.
This is one of the many instances in which Homœopathy
has revived and confirmed, while defining, the old traditions
about herbs. Conjunctivitis is very marked in the provings,
especially of the palpebral margins, with photophobia, and
there are even indications of affection of the deeper tissues,
and of vision, which is dimmed. Correspondingly, Euphrasia
is among the chief of our eye-medicines. In simple acute
conjunctivitis it is rare that any other remedy is required;
and in the chronic stage it has often effected cures. Given at
the commencement of strumous ophthalmia, it will nearly
always check incipient ulceration; but its action needs sus-
taining by constitutional medicines, especially Sulphur. It
comes in again later to remove specks on the cornea, for which
it is very efficacious. Dr. Dudgeon has communicated two
cases to the British Journal of Homœopathy,† in which a rapid
cure of rheumatic ophthalmia (sclerotitis and iritis) was effected
by Euphrasia, after other remedies had failed. There is, more-
over, an interesting communication by Dr. Robert Jackson in
the twenty-third volume of the Medical and Physical Journal
(1810), in which he relates several cases where chronically
impaired vision, coexisting with signs or feelings of disorder
in the eyeballs, was greatly benefited by an infusion of the
plant. Used in this manner, I know of no medicine which
will less frequently disappoint expectation than the little
eye-bright.
Drs. Allen and Norton say of it—“ Euphrasia is one of our
most important remedies in diseases of the eye, especially
superficial." Profuse acrid and burning lachrymation they
find a good indication for it in conjunctival disorders. They
have also found it curative in paralysis of the oculo-motor
nerve, coming on after exposure to cold and wet. They say
that its characteristic discharges are thicker than those indi-
cating Arsenicum and Mercurius, which otherwise it much
resembles in its action upon the eye.
The analogues of Euphrasia are Æthusa, Allium Cepa, Apis,
Argentum nitricum, Arsenicum, Hepar sulphuris, Kali bich-
* I might also quote Shenstone :
***
† Vol. xxii., p. 355.
"Yet euphrasy may not be left unsung,
That gives dim eyes to wander leagues around.”
COM
FERRUM.
481
romicum, Kali iodatum, Mercurius solubilis and corrosivus, and
Pulsatilla.
Small doses of the mother-tincture, as recommended by
Hahnemann himself, appear to answer all purposes excel-
lently well.
We have, in conclusion, to consider the action and uses of
one of the most celebrated of medicines,
Ferrum.
For the preparation of the salts of iron used in homoeopathic
practice I must refer you to the Pharmacopoeia. Our only
peculiarity is the frequent use of the acetate, as with this were
made nearly all the provings of the metal we possess.
Ferrum was proved by Hahnemann and three others: their
261 symptoms, with 37 from seven authors, appear in the
second volume of the Reine Arzneimittellehre. Dr. Hempel
has accidentally omitted this pathogenesis in his translation;
but the deficiency has been supplied in the thirty-second
volume of the British Journal of Homœopathy. In the ninth
volume of the same journal may be read another proving of
the metal by five of Rademacher's followers, where the blood
was examined before and after the experiments; and Dr.
Allen supplies a third, conducted by the American Provers'
Union. His supplement also contains some experiments
made with Ferrum phosphoricum by Dr. J. H. Morgan, of
Philadelphia.
The primary interest of iron lies in its remedial power over
anæmia. Whether this condition arise as the chlorosis of
defective menstruation, or the simple "poverty of blood" in-
duced by hæmorrhages, by deficiency of air, light, and suitable
food, or by exhausting diseases-iron is its one great remedy.
It so rarely fails to cure, and its action is so tuto, cito, et jucunde,
that it would be unpardonable to deprive any patient of its
benefits, whatever be our theory of its action or the manner in
which it must be given. The treatment of anæmia by iron is
one of the few satisfactory and certain things in modern
medicine, and we who believe in the supreme value of the
homoeopathic method may not neglect it because it does not
seem conformable thereto, unless we can do better. That we
cannot is the general confession; we must, therefore, give our
anæmic patients the iron they need, in whatever quantity may
be necessary.
2 I
482
FERRUM.
But while we follow facts rather than theory, it is never-
theless of considerable importance that we understand the
theory of our facts, that we may know what we are about.
How does iron act in the treatment of anæmia? Is it a food
or a medicine? and, if a medicine, is it homeopathic or
antipathic to the condition present? These are questions
which have been largely discussed in both schools of medicine,
and which can hardly be said to be closed. I shall submit to
you a few facts and considerations bearing upon them, which
may help us to come to a decision.
First of all we notice that iron, like lime, is a normal con-
stituent of the body, and is continually being supplied with
the food. It is, again, in the red corpuscles of the blood that
the metal finds its habitat and performs its functions. Now
it is the deficiency of these very corpuscles wherein the " poverty
of blood" we call anæmia consists. It is impossible to deny
the significance of such facts, or to resist the conclusion that
the relation of iron to the blood is a fact of the same order as
that of lime to the bones.
You will perceive that, in so speaking, I am identifying
anæmia with oligocythæmia. I am well aware that, in many
cases, this deficiency of the red corpuscles of the blood is
associated with a similar poverty in the solid constituents of the
plasma-with hypalbuminosis, and that we may even have
such a condition existing alone, or almost so. Etymologically,
this is anæmia, or oligamia; but practically we call it rather
impaired nutrition. We need a term for that peculiar state of
system showing itself in pallor of skin and mucous membrane,
with breathlessness, palpitation, cardiac and venous murmurs,
&c., and which may exist without any marasmus. We have
long had it in " anæmia," and with this meaning we shall (I
think) continue to use the term. When hypalbuminosis is
present, hygienic and dietetic treatment is of paramount im-
portance; and medicines like Argentum nitricum, Calcarea
phosphorica, Natrum muriaticum, Zincum and Plumbum, are
of most service. But when oligocythæmia shows its existence,
all the food and air in the world yield in value to the suit-
able administration of iron.
C
Is iron, then, a direct food? Is it merely by supplying a
want of its normal proportion in the body that it cures
anæmia? This position cannot, I think, be sustained. The
malady does not ordinarily arise from any failure in the
quantity of iron supplied in the food: if the element is
deficient in the blood, the fault lies in the assimilative pro-
cesses. But Reveil, according to Trousseau and Pidoux, has
FERRUM.
483
}
ascertained that in anæmia there is no change whatever in
the amount of iron present in the blood. However few the
corpuscles, they contain within them the full proportion of
the metal normal to health; and, though under the influence
of iron itself they increase to double and treble their number,
they yield no more of it.
Not, then, from want of their metallic constituent, but from
deficiency of the red corpuscles themselves, is the blood poor
in the condition we call anæmia. And why are the corpuscles
few? Their development is the ultimate result of the elabora-
tion of the vital fluid: their defect must be owing to a fault
somewhere existing in the blood-making processes.
Can
we remedy such fault merely by giving an increased quantity
of one constituent of the pabulum from which they are built
up? It can hardly be so. If the parts concerned in sanguifica-
tion have proved unable to perform their task hitherto, they
will not work the better because more material is supplied for
their operations. What is wanted is a stimulus, elective in its
affinity for the parts concerned, and specific in its corre-
spondence with the morbid condition induced.
That we have such a stimulus in iron appears from two
classes of facts-first, its effects on the healthy; second, its
operation in small doses in disease.
I. The hæmatic effect of iron on the healthy does not appear
with any distinctness in the provings of Hahnemann. The
pale face and lips he cites from Ritter were the result of
metrorrhagia induced by iron, not its primary effect. But in
the experiments conducted by Löffler, the Rademacherian,
the blood itself was examined before and after the experi-
ments. In all cases there was increase of the water, and a
corresponding diminution of the dry residuum. The general
condition and appearance, moreover, which at first improved
during the ingestion of the medicine, rapidly fell off after-
wards, and assumed all the characters of debility and
hydræmia. It is a fair inference that Ferrum, when given in
health in quantities beyond those required for nutriment,
disorders the very processes of sanguification in which it
takes part as a food. We need yet more precise experimenta-
tion as to its effect on the number of the red corpuscles,
which can now be counted without difficulty. If, as has been
shown with Mercury and syphilis, it is found to reduce
their number in health while augmenting it in chlorosis,
its homœopathicity to anæmia will be established. In such
experimentation, however, it must be borne in mind that few
persons are in such perfect health that a small addition to the
484
FERRUM.
pabulum of their tissues is needless and injurious. It is only
when these are as it were saturated that morbid phenomena
can be expected to appear.
Our only other source of information as to the effects of
iron on the healthy is the condition of people who habitually
drink ferruginous waters. Hahnemann gives a grievous list of
maladies as those to which they are subject, all implying great
depression of the nutritive powers. But I know not on what
authority he makes his statements, nor am I acquainted with
any careful observations on the subject. Brandis, indeed,
"states that the waters of chalybeate springs are habitually
drunk by man and beast without the slightest injury'
(Stillé).
2. But, in the next place, we have evidence that iron, in
doses far too small to be of any use as pabulum, has proved
curative in anæmia. Dr. Russell relates one case in the twelfth
volume of the British Journal of Homœopathy (p. 376).
Dr. Drysdale, in his excellent discussion on the action of iron
in the twenty-seventh volume of the same journal, cites
another. But the most forcible testimony is that of Dr.
Bayes, who speaks of one or two drops of the first dilution of
the acetate as an excellent chalybeate; and writes “The
exhibition of iron in doses of the thousandth of a grain (the
third decimal dilution) has been, very generally, followed by
more rapid amendment in the ferruginising of the blood (and
the consequent cure of diseased conditions and states of parts
and organs) than I have hitherto seen result from the gross
and material doses of the chemical physicians." Such ex-
perience (and I myself have lately had some of the same kind)
may be exceptional, but it could not have been gained at all
had Ferrum no action as a specific stimulus on blood-making
over and above that which makes it a food.
and
pa
"}
The conclusion, then, I think must be that the metal has
such action-that it probably hinders the formation of red
blood in health and certainly promotes it in disease in the
same manner in which other drugs affect the functions. But
while this is true, and Ferrum may be given for anæmia in
small doses as a homœopathic medicine, it must not be for-
gotten that it is also a food, and is required as such. Doubt-
less a larger supply of nourishment would meet the want;
but this is not always possible to obtain, or even then to
digest. Iron may therefore with advantage be given as food
in most cases of anæmia, even though itself or some other
medicine should be administered at the same time. The
latter should be given on an empty stomach, that it may act
FERRUM.
485
as a stimulus; the former should be taken at meal-time, since
it is part of the pabulum of the body. These conclusions are
the same as those of Dr. Drysdale, whose exhaustive paper on
the subject I would strongly urge you to read.
The conclusion to which I am led as to the treatment of
anæmia by iron is that it should always be commenced after
a dynamic fashion, i.e., by giving such small doses as I have
mentioned. If the improvement be not rapid, it may be
hastened by administering the metal as a food also. By this
method the risk will be avoided of producing those disastrous
results in the production of hæmoptysis and subsequent
phthisis with which Trousseau has to reproach himself.
I should say that in that idiopathic anæmia lately described,
and bearing the ominous titles of "pernicious" and "pro-
gressive," iron has proved of no service. In chlorosis, more-
over, it is less suitable in the febrile form, and where there is
much debility and oedema. In all these cases its place is
taken, as we have seen, by Arsenic.
But now, over and above the hæmatic action of iron, it has
properties, pathogenetic and curative, of no mean importance.
In the infinitesimal doses of the older homoeopathists, it did
little save occasionally check vomiting of the ingesta and
lienteria. But, given in a less attenuated form, it has received
strong testimony to its value in many disorders of the head,
the lungs, and the pelvic organs in general.*
I. The determination of blood to the head which follows
overdosing with iron is well known, and ought to be utilised
in our practice. Dr. Kidd has found the pyrophosphate (first
decimal) very useful in the headaches of passive congestion;
I have also learned to depend upon it, in preference even to
China, in the pseudo-hyperæmic headaches following large
losses of blood. Dr. Cooper (and my own experience confirms
his) has much confidence in it in recurrent epistaxis, giving
the first trituration of the phosphate,
2. The provings of iron show that it determines blood to
the lungs no less than to the head. It has accordingly become
a favourite remedy in our school for hæmoptysis. Drs. Kidd
and Pope concur in esteeming the acetate, in the first decimal
dilution, above all other remedies for this accident, especially
when a tickling cough and oppression of the chest are present.
Trousseau has pointed out (as I have said) how often the in-
M
* Statements made without references in what follows are mostly
taken from a paper by Dr. Cooper "On the Action of Iron," with the
discussion following its reading, contained in the fifth volume of the
Annals.
486
FERRUM.
cautious use of the drug causes this hæmorrhage, and so leads
on to phthisis. On this subject I refer you to Dr. Cl. Müller's
remarks in the eighteenth volume of the British Journal. He
recommends it from experience in the so-called "phthisis
florida,” in the form of the chloride, from 1 to 3.
X
3. Iron is a decided irritant of the urethra and neck of the
bladder, and the chloride has some repute in the treatment of
vesical catarrh and of gleet: Dr. Kidd also speaks highly of it
in urinary irritation. But we owe to Dr. Cooper a very pretty
bit of precisionising, which indicates the especial sphere of
action of Ferrum in this region. You will find his original
paper in the fifth volume of the Annals of the British
Homœopathic Society, and his more detailed observations in
the twenty-eighth volume of the British Journal. The enuresis
calling for it is characteristically diurnal,-depending on an
irritability of the trigone and cervix vesicæ, which diminishes
when the pressure of the urine is taken off by the recumbent
posture. He gives ten well-marked cases of this affection
cured by the phosphate in the 1st or 2nd decimal trituration.
I have verified his suggestions with much success. But iron
has been also found curative, especially in the form of the
iodide, in nocturnal incontinence of urine; and here too it is
homœopathic, three of the American provers having expe-
rienced this casualty under its use. There is some reason to
think that iron acts also on the kidneys. Its repute in Bright's
disease is well known, and it is admitted (by Dr. George
Johnson) that the urine may become more scanty or more
deeply coloured and albuminous after its use. In the discus-
sion on Dr. Cooper's paper, Dr. Metcalfe mentioned a case in
which from a single overdose of iron suppression of urine
occurred, with head-symptoms like those of uræmia,
relieved as soon as the secretion was restored, and the iron
eliminated.
4. The pelvic symptoms of Ferrum are analogous to those
of the head and the thorax. Dr. Kidd recommends it in
uterine congestion and menorrhagia : Dr. Cooper in tenesmus
of the cervix uteri similar to that of the bladder in diurnal
enuresis. But the strongest testimony to its value as a uterine
remedy comes from our American colleague, Dr. H. C. Preston,
to whom we owe Hamamelis. He tells us that the first
trituration of the iodide has proved a most useful medicine in
his hands in uterine displacements, including retroversion and
prolapsus. You will find his observations in the twenty-fifth
volume of the British Journal of Homœopathy.
5. When, as in one of his cases, the rectum is much irri-
FERRUM.
487
1
tated in sympathy with the womb, Ferrum will set it right.
But the provings evidence an independent action on this part
in the male subject also, showing itself mainly by tenesmus.
Dr. Cooper finds it the best remedy for prolapsus recti in
children. Dr. Markwick has put on record a case in which
its over-use caused dysenteric symptoms*-a fact which may
find practical applications.
Dr. Cooper, who has done much useful work in enlarging
and defining the applications of Ferrum, has lately given us†
another paper on the subject. In this he lays down" painless
irritability of fibre " as the condition especially calling for it,
thus giving it place as a remedy for some forms of cough, as
well as for those other expulsive actions whose impatience and
excess it has already been seen to moderate.
Another advocate for a more extensive use of Ferrum is
Dr. Schussler, of whose " tissue remedies" I have already
spoken to you. The presence of iron in the blood, and its
power of causing congestions and hæmorrhages in divers
places, make it—according to him—the prime remedy in all
active hyperæmic conditions, even in inflammations before
exudation has taken place. He gives the phosphate, in the
12th decimal trituration.
Dr. Guernsey considers the most suitable subjects for
Ferrum to be weakly and complaining women and children
whose faces nevertheless tend to be fiery-red.
As a hæmatic, Ferrum has no true analogue, unless it be
Manganese. The medicines which act like it on the head are
Belladonna, Nux vomica, and Quinine; on the lungs, Mille-
folium and perhaps Arnica; on the bladder, Cantharis,
Copaiba, and Eupatorium purpureum; and on the uterus and
rectum, Sabina.
The best doses have been mentioned as we have proceeded.
As a chalybeate food I like nothing so well as the Ferrum
redactum of the British Pharmacopoeia, of which a grain or
two daily answers every purpose. The pyrophosphate is an
elegant preparation when a liquid form is preferred.
* Brit. Fourn. of Hom., xix., 309. † Ibid, xxxii., 409
1
LECTURE XXXII.
GAMBOGE, GELSEMIUM, GLONOIN, GRAPHITES, GRATIOLA,
GUAIACUM.
I begin this lecture with a drug which generally appears in
homoeopathic works under its old name of "Gummi gutta,"
but which may as well stand here as
Gambogia.
The Siamese resin so called is dissolved in rectified spirit to
form a tincture for our use.
There is a pathogenesis of Gamboge in Allen's Encyclopædia,
chiefly taken from an unpublished monograph by Cajetan
Nenning, the "Ng." of Hahnemann's provings.
There is no evidence, here or elsewhere, of any action of
Gamboge beyond that which belongs to it as a drastic purga-
tive; and in this sphere only has it received homeopathic
applications. Dr. Hilbers has much esteem for it in summer
diarrhoea accompanied by severe colic; and Dr. Phillips has
the following paragraph:-" Malgaigne and Betz found the
use of very small doses (about of a grain in twenty-four
hours) to be exceedingly valuable for dysentery, especially in
young persons-an apparently paradoxical fact, but estab-
lished on good evidence; and, after all, not more strange than
the completely opposite action of small and large doses of
strychnia, and of many other drugs."
Dr. Hilbers gives the 2nd dilution.
3
4
The medicine we have next to discuss is one of the most
valuable of the American contributions to the Materia Medica.
It is the yellow jasmine,
Gelsemium
(for it seems that we have been wrong hitherto in calling it
Gelseminum). The tincture of the root is the preparation used
GELSEMIUM.
489
+
in our practice; and Dr. Bartholow, who has devoted much
attention to this drug, recommends the fresh root to be em-
ployed, as the alkaloid gelsemia, on which so much of its
activity depends, is lost during desiccation. We should,
therefore, prescribe by preference the tincture made in America,
where the plant is indigenous.
Gelsemium was first introduced into homoeopathic practice
by Dr. E. M. Hale, who, in concert with Dr. Douglass, made
a number of experiments with it, and published, in 1862, a
monograph on its properties. Since then it has acquired an
ever-growing reputation among us, and has been proved and
tested in a variety of ways. Of late years, it has attracted
attention in the old school; and Berger in Germany,* Bartho-
low in America,† and Ringer and Murrell in England,‡ have
experimented largely with it,—the last-named having proved
it, more Hahnemanniano, on six persons, in doses sufficient to
produce decided effects. Dr. Allen is thus able to give us a
pathogenesis containing 682 symptoms, obtained by upwards
of 80 observers. In referring you to this article for the
physiological effects of the plant, I would add a commenda-
tion of Dr. Hale's fourth edition, as supplying the best résumé
we possess of its therapeutic virtues.
The effects on the healthy human subject of full doses of
Gelsemium are almost identical with those we have lately
studied as resulting from the action of Conium. The first
symptom is heaviness of the eyelids, so that the eyes can
hardly be kept open with this there is giddiness on stand-
ing. Then ensues diplopia; and shortly afterwards the legs,
arms and lower jaw become powerless, and the patient cannot
stand, move, or speak. At this time there is also ptosis, and
sometimes internal strabismus. Here is an illustration of its
action :-
"To see what the effects of the drug would be when pushed, I gave
tỏ a patient, a sailor, convalescent from periostitis, three doses of
twenty minims each-two hours intervening between the first two doses,
and one hour between the second and third. About half an hour after
the second dose, the usual complaint was made of difficulty of keeping
the eyes open from the heaviness of the lids. He saw things double,
one image appearing beside the other. During this time the pulse did
not appear to be much affected, remaining at 77; but after the third
dose it became quickened, rising gradually to 96. About two hours
after taking the third dose he got out of bed to go to the lavatory, being
perfectly conscious. He reached the lavatory, but found himself then
*See Monthly Hom. Review, xx., 82.
† Practitioner, v., 200.
‡ Lancet, 1875-6.
490
GELSEMIUM.
powerless, and quietly sank first on his knees and then at full length.
He was quite unable to raise his lids. His lower jaw dropped, and he
could not articulate. He was put into bed, and some warm stimulating
drink given him, when he soon became better. He told me when I saw
him, with the most open-eyed simplicity, that the medicine had done
him a great deal of good; that he could make water very much better
since he had had it (I should observe that he previously had suffered
from the effects of a troublesome stricture); that he knew everything
that was going on around him when he sank to the ground, but that he
was unable to move, and that his feelings were like those which he had
experienced after commencement of intoxication.”
We have to enquire in what way Gelsemium produces these
effects,—whether it acts upon the nervous centres like Conium,
upon the trunks of the motor nerves like Curare, or upon the
muscles themselves. The experiments on animals made by
Dr. Bartholow point to the cerebro-spinal axis as the seat of
the drug's action, and he is sustained in this view by Berger
on the one side, and by Ringer and Murrell on the other. The
provings of the last-named show that the pathogenetic effects
begin to appear within an hour and a half after ingestion, and
-unless repeated doses be taken-subside in about the same
time. The whole action is therefore what is called functional.
The ocular phenomena occurring under the influence of
Gelsemium require somewhat detailed study. They closely
resemble, as I have said, those which Conium produces; but
ptosis is more marked than defective power of accommoda-
tion of vision, and diplopia is far more frequent. This may
be either transient or constant, and in either case seems to
depend upon loss of power on the part of the sixth nerve,
which (as you know) dominates the rectus externus, and is
especially affected by the drug. Its paresis probably accounts
for the confused vision so often mentioned by the provers, as in
S. 152-159 of Allen's pathogenesis. The behaviour of the pupils
seems at first sight somewhat contradictory. In poisoning cases
they are dilated and insensible to light. Drs. Ringer and
Murrell found the same condition set up by dropping the
fluid extract or a solution of gelsemia into the eye; but the
internal employment of the drug, in the moderate doses used
by them (a drachm of the tincture), caused the pupils to con-
tract. This would at first seem like an opposite action of
large and small doses. But the observations of Dr. Tweedy
suggest a different explanation.* He found the application
of the alkaloid to cause at first ciliary (not conjunctival) in-
jection, with slight contraction of the pupils: then ensued
dilatation, whereupon the hyperæmia disappeared. This looks
* Lancet, June, 1877, p. 832.
GELSEMIUM.
491
rather as if the contracted pupil were connected with an
approach to congestion of the ciliary vessels, and corresponds
with that which obtains in iritis and apoplexy. In connection
herewith we may note the pain in the brows and eyeballs
experienced by several of the provers, and by none more than
those of Ringer and Murrell, in one of whom it extended to
the occiput, with a sensation as if the crown of the head were
being lifted off in two pieces. No such sensations are felt
under the influence of Conium; and, with the weight and
oppression of head and limbs so often mentioned, they forcibly
suggest that our present drug, besides being a paralyser, is also
somewhat of an inflamer, its action not going indeed beyond
congestion, but certainly reaching so far.
Such being the physiological effect of Gelsemium,-to those
with whom contraria contrariis seems an axiom, it at once
suggests itself as a remedy for muscular cramp and spasm :
and without doubt there are certain ephemeral conditions of
this kind in which we may, with advantage, avail ourselves of
the antipathic action of the drug. Thus it has effected speedy
relaxation of hysterical trismus, of laryngismus stridulus, and
of rigidity of the os uteri during parturition. I have myself the
highest opinion of its efficacy in simple dysmenorrhoea, and in
after-pains, both of which I suppose to be spasmodic in their
nature. (I must add, however, that Dr. Guernsey finds it of
great value-and in the doses in which he gives it the medi-
cine cannot act otherwise than as a similar-when during
labour a cutting pain extends from before backwards and
upwards, and is so violent that it impedes the natural pains.)
But for spasm of long standing, or of frequent recur-
rence, we should greatly prefer a homoeopathically-acting
remedy; and, on the other hand, should prescribe Gelsemium
rather in paralytic conditions. The enuresis of old persons,
from weakness of the sphincter vesicæ; the corresponding
state of this and its fellow muscle in debilitated subjects,
which shows itself by a tendency to involuntary micturition
or defecation upon emotional impressions; loss of voice
during menstruation, and the post-diphtheritic paralysis of the
parts about the throat, and of the eyes and body generally,—
all these morbid conditions have yielded to its use.
No less beneficial is its influence in disorders corresponding
to its congestive action. The following case of Dr. Madden's
illustrates what it can do when the head is thus affected:
'A gentleman had constant, gradually increasing headache
for three or four months; dull, heavy pain, extending to the
nape of the neck, frequent throbbing in the temples, and ver-
492
GELSEMIUM.
tigo on rapid movement. I gave Gelsemium, a drop of the
mother-tincture night and morning. For thirty-six hours the
headache markedly increased after each dose; then a sudden
throb like a snap took place in the centre of the head. The
headache at once and entirely ceased, and has not since
returned." Another headache which calls for this medicine is
a sensation as if a band encircled the temples, which goes off
after copious urination. The cerebral congestion of Gelse-
mium, as also its headache and vertigo, is seen especially in
depressed conditions of system, and causes inability to con-
centrate the thoughts. It is passive rather than active. In
spinal congestion, I have (as I have mentioned in my Manual
of Therapeutics) had results so striking and constant from the
use of Gelsemium, that the medicine and the malady have
become inseparable in my mind.
In affections of the eyes, Gelsemium displays the same
double kind of action which we have seen in the sphere of the
nervous system., Its paralysing influence makes it an apt
remedy for ptosis, and other affections due to loss of power
on the part of the ocular muscles. Among the testimonies
in its favour, I may cite that of Dr. Vilas, of Chicago, who
says* :—“ Gelsemium has been of great value in my hos-
pital and private practice in cases of this nature. Morbid
states which failed to respond to other means have been
ameliorated or cured by it; and electricity has ceased to be
the specific for such troubles." It rivals Conium here, and
exceeds it when affections of deeper parts are the cause of
the loss of power, as in diplopia of central origin.† But
Drs. Allen and Norton have carried the use of the drug a
step farther, viz., to inflammatory affections of the retina and
choroid. Retinitis albuminurica, coming on during preg-
nancy, chorio-retinitis, in which there seemed to be a bluish
snake before the vision, and serous choroiditis, have been
cured by them with it; while the latter physician has put on
record several cases of recent detachment of the retina, in
which it seems to have greatly aided in recovery.
In therapeutics, as in pathogenesy, it is the motor nervous
system which is the main sphere of action of Gelsemium. It
must be observed, however, that it is as remedial of toothache
and neuralgia that it has of late found place in the practice of
the old school. It is not easy to understand its action here
upon the antipathic principle, as it is only in toxic doses that
* American Homœopathist, i., 5.
† Brit. Journ. of Ãom., xxxiii., 569,
‡ Monthly Hom. Review, xx., 80.
GELSEMIUM.
493
it affects sensibility. Dr. Ringer found this unimpaired in the
subjects of his drachm doses of the tincture, whether gene-
rally or in the gums. But, he writes, " one patient, on both
occasions on which I experimented on him, complained spon-
taneously of a numb pain and a little tenderness along the
teeth and the edges of the gums of the upper jaw." Dr.
Douglass long ago observed the occurrence, under its use, of neu-
ralgic pains."In my own provings," he says, "I frequently
experienced a succession of acute, sudden, darting pains,
evidently running along single nerve-branches, in almost
every part of the body or limbs, sometimes so sudden and
acute as to make me start. At one time, a quick succession
of these pains coursed down the outside and front of the tibia
for about half an hour, leaving a line of considerable tender-
ness marking its track." Both he and Dr. J. C. Morgan
esteem it very highly in neuralgia, and, while the former
speaks of "pretty large doses" as being required, the latter
gets excellent results from dilutions like the 5th and 12th.
He mentions "indistinct or double periodicity as indicat-
ing it."
Another important action of Gelsemium is in the sphere of
the circulation. In persons sensitive to its influence Dr.
Douglass states that he has repeatedly seen it produce a
decided febrile chill with subsequent re-action. It is thus on
the homœopathic principle that it prevails as a febrifuge, of
which it is one of the most potent. It is not in the acute fever
of Aconite, with its agonized restlessness and burning thirst,
nor in the delirious heat with dry tongue of Baptisia and
Belladonna, that Gelsemium proves beneficial. Its fever is
much less active; the patient's condition is rather torpid and
heavy; the pulse is not very rapid, and inclines to be full and
soft; the tongue has a moist white fur. The main symptoms
are those of languor and oppression, with dark crimson face,
and dull pains in head, back, and limbs,-the head feeling large
and full. Such a fever is no uncommon effect of a chill, and
sometimes presents itself in connection with the exanthemata,
(especially measles, in which Gelsemium may the more appro-
priately come in, as it has caused the peculiar rash of this
disease). Whenever you meet with it, give Gelsemium in place
of Aconite, and you will have every reason to be satisfied with
it. From clinical observations, moreover, I am disposed to
consider the remittent type of fever as that to which Gelse-
mium is specially applicable. Whether this would hold good
with malarial remittents, I cannot say; but Gelsemium is one
of the many medicines which have repute in the treatment of
494
GLONOIN.
ague. I have especially in my mind the remittent fever of
childhood, for which, on the recommendation of Dr. Ludlam, I
have used Gelsemium instead of Aconite for many years past.
I know that it is now denied that the "infantile remittent
is a pathological entity. Still, whatever it may be, it is a
clinical reality; and it is a great thing to have a remedy
which breaks it up as surely as Baptisia does with gastric and
Aconite with synochal fever. This Gelsemium effects; and
wherever such type of fever manifests itself, having marked
exacerbation towards night, and decline of the heat without
perspiration towards morning, the medicine may be given with
sure benefit.
ور
These are the leading forms of disorder in which Gelsemium
plays a curative part. Other indications for it may be derived
from a study of Dr. Hale's article, which shows it likely to
be serviceable (among other things) in nasal and Eustachian
catarrh, and in the inflammatory stage of gonorrhoea. Dr.
Morgan praises it in sleeplessness from emotional disturbance,
as when evening company is too stimulating to the brain.
The nearest analogue of Gelsemium is, as I have said,
Conium. As an antipyretic it is allied to Baptisia.
The 1st dilution is that which I have always given for
remittent fever; from the Ist to the 2nd for congestions. The
2nd and higher potencies have been used in paralytic and
ocular affections, and for antipathic purposes small doses of
the mother-tincture.
Glonoin
is the substance commonly known as nitro-glycerine, and
valued for its explosive properties. It is the result of a
mixture of glycerine with nitric and sulphuric acids, at an
ice-cold temperature. The name Glonoin was formed by its
introducer into medical practice, Dr. C. Hering, out of the
chemical formula (G1 O NO5) denoting its composition.
Dr. Hering proved Glonoin on himself and others in 1848,
and the experiments were published in the following year.
In 1853 Dr. Dudgeon instituted some further provings in this
country, the record of which may be read in the eleventh
volume of the British Journal of Homœopathy. An exhaustive
collection of the symptoms thus obtained and of the cures
effected by the drug may be found in Hering's Amerikanische
Arzneiprufungen, and is translated in the New England
GLONOIN.
495
Medical Gazette for 1874-5. Dr. Allen has few symptoms to
add to those herein contained.
The action of Glonoin lies within a very small compass.
If any one will touch his tongue with a five-per-cent. solution,
he will pretty certainly find in a few minutes that his pulse
has increased by twenty, forty, or even sixty beats. He may
feel a sense of throbbing all over his body, but will almost
always experience it in the head, which will go on beating
until a pretty violent bursting headache has developed itself.
With this there will probably be some giddiness, a sense of ful-
ness in the head and at the heart, and one of constriction about
the throat. If he is sensitive to its action, nausea and vomit-
ing may supervene, faintness may be felt, and even complete
insensibility may ensue. Let me read you, in illustration, the
record of one of Dr. Dudgeon's provers.
"In good health; pulse 60. At 9 p.m. took one drop of Glonoin,
Ist dec., on a piece of sugar. In about half a minute perceived a
throbbing of the temporal arteries, soon accompanied by a rather severe
throbbing pain in both temples. In a few seconds more the pulse was
found increased from 60 to 100, and the heart throbbing most violently
and rapidly. In a minute or two a faint, warm, sickening sensation
was perceived in the chest and stomach, resembling the threatenings of
sea-sickness; also slight giddiness, especially on moving about. The
throbbing pain in the temples continued to increase for about ten or
fifteen minutes, then gradually diminished, and in about half an hour
became considerably easier; the feelings of nausea and giddiness also
were lessened; but on returning up stairs very fast, about three-quarters
of an hour after taking the medicine, all the symptoms recurred with
double force. The temples ached and throbbed excessively, and there
was great nausea and giddiness. However, in a few minutes, there
was an abatement of these sensations, but leaving slight nausea and
throbbing pain in the temples.
"A supper of oysters and stout, at half-past ten, removed the
nausea; but the pain in the temples continued, and was very readily
aggravated by any exertion of walking, talking, or reading. Went to
bed at twelve; had less pain in the recumbent posture, especially when
lying on either side; slept well at night. On waking in the morning,
felt slight pain, or rather uneasiness, in the temples, with tendency to
nausea and giddiness, which have continued all day. Feel fulness of
the temples, and very slight nausea, whilst now writing at 8 p.m."
What is the rationale of these striking symptoms? The
sudden increase in the frequency of the heart's action may
be caused either by direct stimulation of its substance or
ganglionic nerves, or by depression of the influence of the
vagi. The rapidity with which it supervenes, and the lack of
tension in the pulse, lead one to ascribe it to the latter mode
of action. That such depression is present is confirmed by
Dr. Brunton's experiments on cats, in whom he found the
496
GLONOIN.
third eyelids drawn half over the eyes "as in division of the
vagi." On what, then, depend the head symptoms? At
first sight they would seem secondary to the increased action
of the heart. But this theory is excluded by the fact that in
one of Dr. Dudgeon's provers the head was not affected at
all, although the pulse rose very high indeed. We need a
special action on the arteries themselves to account for the
cerebral phenomena present. And for this we have only to
suppose that Glonoin affects the neighbouring vaso-motor
centre in the same manner as that of the pneumogastrics.
The same sedative influence would then, through the inhibi-
tory fibres of the vagi, set the heart off palpitating, and
through the vascular nerves would dilate the arteries. In
confirmation of this view, we often find the provers describing
the sense of throbbing as felt all over the body, though
especially in the head.
All this forcibly reminds us of Amyl nitrite, whose action
we lately studied. But a little attention will show that the
effects of the two drugs are not identical. Amyl causes a
general flushing, without marked sense of throbbing or special
localisation in the head; nor is the pulse much affected by
it. Glonoin differs from it in all these points. Accordingly,
it seems to have been demonstrated that Amyl produces its
dilating effects on the arteries by directly paralysing their
muscular coats, and acts similarly on other muscular
parts; while Glonoin affects the nervous centres of the circula-
tion, and is limited to this sphere.
It is clear that, if the homœopathic principle is worth any-
thing at all, Glonoin ought to be a remedy for some active
disturbances of the cerebral circulation. It would not act, as
Belladonna does, upon such congestive states as depend on
irritation of the brain substance, and tend to inflammation.
With Belladonna the circulation within the cranium is excited
because the brain is irritated; with Glonoin the brain is
irritated because the circulation is excited. But it would be
indicated in such hyperæmiæ as can be produced by excessive
heat or cold, by strong emotions, by mechanical jarring, by
suppression of the menses or other hæmorrhages and excre-
tions. The first and last of these causes come most frequently
before us in connection with the drug, and demand special
notice.
I. The cerebral hyperæmia of excessive heat is, in its full
development, sun-stroke. For this casualty Glonoin has
many a time proved a rapid and efficient remedy. It is not
a malady often seen in this country; but I have obtained
GLONOIN.
497
striking benefit from the drug in its distressing after-effects.
In minor degrees of the same trouble, in headaches brought on
or aggravated by hot sunshine, and in those which occur in
workers by gaslight, Glonoin is very effectual.
2. Perhaps the greatest boon which Dr. Hering has con-
ferred upon patients in introducing Glonoin to medicine is
the relief it gives to menstrual disturbance of the cerebral
circulation. Every one knows the intense congestion of the
brain induced in plethoric constitutions by sudden sup-
pression of the menses. Glonoin is an exquisite simillimum
here; for in one of Dr. Dudgeon's provers, who took it
while the catamenia were present, these immediately ceased,
and the headache went on increasing in violence till night.
Glonoin is recommended by all under these circumstances, and
there are cases on record illustrating its virtues. It is of course
no less useful in minor degrees of the same condition. While
thus helping the weaker sex during their menstrual life, it
becomes especially serviceable as this draws to its close. It
does not act, like Lachesis or Amyl nitrite, on the general
flushings of the climacteric epoch; but it is most valuable
when these are localised in the head. It was from a sug-
gestion of Dr. Kidd's that I first began to use Glonoin for
this common trouble, and I have since learned to place the
utmost confidence in it. It is also very useful in the congestive
conditions of the brain incident to pregnancy.
The consideration of the cerebral hyperæmiæ thus caused
has illustrated the form of the disorder in which Glonoin is
indicated. But we are of course not limited to such or
similar origins in our applications of the drug. Whenever
we see fulness of the head with throbbing of the arteries
present, and are not led to Aconite or Belladonna (or their
congeners) by fever or inflammation, we should think of
Glonoin. It thus becomes a frequent remedy for headache.
It was the statement of its discoverer, Sobrero, that “ even a
very small quantity placed on the tongue causes a violent
headache of several hours' duration," which led Dr. Hering to
investigate its action. Here again Dr. Brunton's experiments
(which, I should have mentioned, are in the twelfth volume of
the S. Bartholomew's Hospital Medical Reports), come in con-
firmation. "One of the most remarkable effects of nitro-
glycerine," he says," is the intense headache it produces, even
in infinitesimal doses.
None of the poison was taken by
the mouth, and as it is non-volatile the amount taken in by
the lungs must have been infinitesimal. It is possible that, as
some writers suppose, a little of it was absorbed by the skin,
2 K
498
GLONOIN.
but the quantity thus taken must have been excessively
minute." In his own case the headache was several times
accompanied by vomiting. The kind of headache it produces.
has been already illustrated. Fulness, tension, throbbing,
bursting-these are the phrases used by the provers to
describe it; one of them felt as if he were hanging with the
head downwards, and as if there was a great rush of blood
thereinto in consequence. When headaches so characterised
come before us we may look for the best effects from Glonoin.
Dr. Coxe, of Philadelphia, has communicated some excellent
illustrative cases, which may be read in Dr. Dudgeon's paper.
The medicine is seen to act as rapidly in disease as in health,
for in from five to twenty minutes all distress had ceased.
As regards conditions, the Glonoin headache is increased by
shaking the head or moving the body, and relieved by external
pressure; but the patient cannot bear the head covered. In
those more serious forms of cerebral hyperæmia which we call
puerperal convulsions and apoplexy the place of Glonoin has
hardly been determined. In the former there is much more
than congestion of the head to be thought of: still, Glonoin
may be and has been useful in relieving that part of the
disorder. For the simple determination of blood to the head
which sometimes precedes apoplexy Kafka says it is very
effectual, and also for that which often occurs in softening and
tumours of the brain.
In what has now come before us we see the main sphere of
the action of Glonoin, and the kind and conditions of the
same. The only other obvious application to practice of its
pathogenetic effects was to use it for some forms of palpita-
tion, which has been done with success. But Glonoin has had
two episodes of old-school history. In 1858 its powers
became accidentally known to my friend Mr. Field, then prac-
tising as a surgeon in Brighton, who communicated it to his
brethren in the pages of the Medical Times and Gazette.
Some contradictory experimentation followed; but on the
whole the effects of Glonoin were admitted to be identical
with those observed by the homœopathic provers. It was not
of course to be expected that the drug should be used thera-
peutically on our principle; it was given rather as a "seda-
tive." In this capacity it manifested in many hands a striking
power of relieving paroxsyms of neuralgia; and we have occa-
sionally availed ourselves of its virtues in this direction.
Whether it has any specific action in neuralgia I cannot say;
but certainly cases have been relieved by the third attenua-
tion, and some permanently cured. More recently, Dr. Mur-
GRAPHITES.
499
rell, whom I have often mentioned as co-operating with Dr.
Ringer in his experiments, has had his attention directed to
nitro-glycerine, and in the Lancet for January and February,
1879, has communicated some interesting observations of its
action. He entirely confirms Mr. Field's experience of the
potent effects of the drug, even when taken in a 1 per cent.
solution (our first attenuation); and noticed in his own person
the marked aggravation on movement which we have seen in
the narrative of Dr. Dudgeon's prover. The sphygmograph
showed considerable dicrotism of the pulse under its influence.
Dr. Murrell was of course struck by the analogy between its
action and that of nitrite of amyl, noticing this difference,
that its full effect on the circulation took longer to establish,
but was slower in departing. He tried it as a substitute for
the amyl in four cases of angina pectoris, giving it (in doses
increasing guttatim till ten or fifteen drops were taken at a
time) regularly, as well as on the occurrence of the paroxysms.
It acted less rapidly in relieving these, but, on the other hand,
had a more permanently good effect,—the last report of all
the cases speaking of almost, if not quite, entire freedom from
their attacks.
Besides Amyl nitrite, Hamamelis (q. v.) has once at least
acted like Glonoin on the head.
It has proved beneficial in all dilutions from the 3rd decimal
to the 12th centesimal. The first and second decimals have
been used, but are liable to aggravate.
Graphites
is plumbago, the black-lead of our pencils, in which form
Hahnemann proved it, and the British Homœopathic Phar-
macopoeia directs it to be used. It is understood to be an
allotropic form of carbon, with some small admixture of iron
and silica. It is prepared by trituration.
A pathogenesis of Graphites appeared in the first edition of
the Chronic Diseases, containing 590 symptoms. It was then
proved by Nenning on several persons, and by Hartlaub. In
the second edition of the Chronic Diseases Hahnemann in-
corporated the 200 symptoms thus obtained, and added a few
from Rummel and Kretchmar and a number from his own
observation, raising the total to 1,144. Dr. Piper subsequently
proved it on himself, taking increasing doses of a one-fifth
trituration, but his results were exceedingly meagre. You
will find them in Allen.
500
GRAPHITES.
In his preface, Hahnemann tells us that a German physi-
cian, Weinhold, when travelling in Italy, found black-lead
used by the workmen in a mirror manufactory as an external
application for herpes. He himself adopted the practice,
giving the substance internally also; and wrote a book to
record its success. Hahnemann was led to include Graphites
among his "anti-psoric" medicines; and its use in cutaneous
disease, long obsolete in the old school, flourishes among
homœopathists to this day. Dr. Hale has reported a remark-
able case of eczema impetiginodes, of twenty years' standing,
cured by it in the dilutions from the fifth to the 30th ;* and
Bähr, who praises it highly in chronic eczema, also gives three
cases of that troublesome disease, mentagra, in which it proved
radically curative. I mention these, as easily accessible illus-
trations of its efficacy; but if you hunt through homoeopathic
literature you will find numerous testimonies and narrations
to the same effect. Dr. Bayes commends it in "psoriasis pal-
maris," which is, of course, a chronic eczema; and suggests
that the frequent occurrence of this complaint in domestic
servants may have something to do with the black-lead used
by them for fire-grates.
It is not easy to define the precise place of Graphites in
skin disease. The presence of rhagades generally suggests it
to me. Dr. Guernsey says that its characteristic symptom
here is the exudation of a thin, sticky, glutinous, transparent
fluid from raw places or sores. It probably exerts, like
Arsenic, a general influence upon the nutrition of the skin, which
may lead to varying effects, pathogenetic and curative, accord-
ing to the subjects of its influence.
Graphites is also very useful in unhealthy states of the
appendages and prolongations of the skin. Dr. Guernsey
commends it for falling off of the hair and abnormal growth
of the nails. He also speaks well of it in tinnitus aurium, with
deafness which is improved by external noise: such an affec-
tion is probably due to a morbid state of the meatus or
membrana tympani. Dr. Cooper uses it successfully in
blepharitis ciliaris, where inflammatory symptoms are absent;
also in stillicidium lachrymarum, from obstruction of the
nasal duct. Dr. Bayes ranks it with Aurum in crusts about
the nostrils in scrofulous children. Dr. Marston has left on
record a cure of fissure of the anus by it.
Beyond the cutaneous region, the best-established action of
Graphites is on the ovaries and testes. Hahnemann himself
recommended it for delayed menstruation, especially when
* Brit. Journ. of Hom., xxviii., 353.
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GRATIOLA.
501
་
accompanied with great costiveness. I should mention, by
the way, that for constipation itself Graphites is one of our
main remedies: the stools are large and knotty, requiring much
straining for their expulsion. The use of the drug in catame-
nial deficiency has become established among homœopathists.
Dr. C. Wesselhoft has recorded* a series of cases showing
its efficacy in this complaint and for its accompanying dis-
orders. He thinks it especially suitable when the patient is
on the wrong side of thirty, saying that Graphites is to the
climacteric period what Pulsatilla is in youth. It is, perhaps,
better when the menses are infrequent, scanty, and pale, than
when they are altogether absent.
Dr. Dudgeon has lately given us an interesting account of
the disappearance of an indurated enlargement of the ovaries
themselves under its employment;† and in their male ana-
logues, the testes, Graphites has more than once proved cura-
tive of hydrocele. It is highly esteemed in indurations and
cicatrisations of the mammæ consequent upon inflammation
and abscess.‡
Graphites has lately been selected as the subject for the
prize-essay of the Central Homœopathic Society of Germany,
-the source from which we have had Reil on Aconite, Bähr
on Digitalis, and Sorge on Phosphorus. The successful
essayist on this occasion is Dr. H. Goullon.
I have not yet
been able to get access to his work; but from some extracts
from it translated in the North American Journal of Homœo-
pathy it appears to be so complete a collection of clinical
experience with the drug, that it can hardly fail to enlarge our
knowledge of its use.
Graphites may be compared in its respective spheres with
Pulsatilla; with Arsenic; and with Alumina and Plumbum.
It appears to act almost equally well in substance and
dilution, from Weinhold's twelve-grain doses to the lower
triturations employed by Bähr, Cooper, and Marston, and
thence to the twelfth dilution of Dudgeon, Hale, and homœo-
pathists generally.
I have now to speak of
Maak
Gratiola.
This is the Gratiola officinalis, the common "hedge-hyssop."
* N. Engl. Med. Gazette, xi., 459.
† Brit. Journ. of Hom., xxxi. 183.
‡ N. Engl. Med. Gazette, xi., 334; and Guernsey's Obstetrics, 3rd
ed., p. 475.
1
502
GRATIOLA.
The homoeopathic tincture is prepared from the whole
plant in the usual manner.
A pathogenesis of Gratiola appears in the Arzneimittellehre
of Hartlaub and Trinks. Of its 604 symptoms, 72 are
warranted by Trinks himself, and 10 are taken from authors:
the remainder are from the copious "Ng." But, in addition
to this, we have some excellent provings of the drug in full
doses, which have been translated from the Archiv (xvii, 165)
by Dr. de Moor in the third volume of the Révue de la
Matière Médicale Spécifique; where also will be found the
history of its previous uses. Dr. Allen adds some symptoms
from Lembke.
The general knowledge about the physiological action of
Gratiola is summed up by Pereira in saying that it "is
cathartic, emetic, and diuretic, acting in large doses as an
acrid poison." Its dynamic action appears limited. and
uncertain. Some provers took gtt. xx-1 of the tincture,
and gr. x-xx of the dried plant, without appreciable disturb-
ance of health. The few genuine and frequently recurring
effects of the drug seem worth noting here, as so little is
known about it. They are
I. Determination of blood to the head, with heat and som-
nolence.
2. Sense of coldness on the vertex, changing to heat.
3. Pain in the occiput on early waking, relieved by rising
or lying prone.
4. Sensation in the face as if it were swollen.
5. Objects, even green ones, appear white (after S. 1.).
6. Every morning for weeks swelling of the upper lip, dis-
appearing after a few hours.
7. Teeth ache from cold.
8. Great distension of the stomach after meals.
9. Great somnolence and lassitude after meals.
IO. "Pressure at the pit of the stomach, as from a stone
rolling from side to side, with cramp-like drawing which
mounts into the chest ; at the same time frequent urgings to
vomit and eructations; this condition lasts several days, and
is always worse after taking food [four days after]" (Trinks).
II. Diarrhoea, greenish yellow and watery.
12. Constriction of and itching at anus.
13. Great rectal and anal irritation, with passage of fœtid
*
mucus.
* In animals_poisoned by Gratiola, Orfila occasionally found the
rectum inflamed, even when the drug had not been introduced into the
alimentary canal.
GUAIACUM.
503
14. Burning in urethra after urinating.
I may add a quotation from Taylor (p. 515). "A series of
cases observed by M. Bouvier are reported by Orfila, in four
of which the plant was used, under the form of a decoction,
as an enema. The result was that in one instance violent
vomiting and purging, with syncope, was induced, and in
all a strong attack of nymphomania. In other cases there
was constriction of the throat, with hydrophobic symptoms
and convulsions.'
"*
Gratiola, employed in the past to remove " visceral obstruc-
tions," and so relieve mental diseases, dropsies, &c., has
fallen into disuse in the common practice; nor has it yet.
found any defined place in homoeopathic therapeutics. It is
unmentioned by Hempel, Bayes, Guernsey, and Espanet.
Teste only seems to have some practical acquaintance with it.
He says" Gratiola will be found particularly useful in cases.
bordering upon such as would, by their symptoms, unequi-
vocally point to Chamomilla. Gratiola would seem to be to
chronic affections what Chamomilla is to acute. In nervous
diseases for example (such as mania, nymphomania, delirium
tremens, &c.), and in neuralgic affections caused by the pro-
longed abuse of coffee, Gratiola often renders good service.
I have often given it after Causticum: this seems to be its
antidote."
As to dose, it can only be said that less than twenty drops
of the tincture failed ordinarily to affect the healthy system.
My last medicine to-day is one not unfamiliar to you,
Guaiacum.
Our tincture is a solution of the gum-resin.
The proving of Guaiacum appeared in the fourth volume of
the Reine Arzneimittellehre, where it has 29 symptoms from
Hahnemann, 113 from three fellow-observers, and 3 from
authors. Guaiacum appears also as an antipsoric in the
second edition of the Chronic Diseases; but only 15 additional
symptoms are credited to it.
I can but refer you to the list of symptoms given by
Hahnemann in these records. There is little in them of a
Referring to the original, I find that in one of the cases the nympho-
mania was permanent. The last sentence is (not very correctly) based
on the following of Orfila :-"In a fifth case, there was added to the
fureur utérine a spasmodic constriction of the throat, with hydro-
phobia, convulsions, and death in two days."
504
GUAIACUM.
1
significant character. So far as they go, however, they make
it probable that Guaiacum is homoeopathic to some of those
rheumatic and gouty pains for which it has so long been
employed. Dr. Phillips likewise (though I know not on what
authority), summing up the effect of large doses, says—" Stiff-
ness, of a rheumatic character, is felt in the nape of the neck
and the small of the back, with pains in the bones of the legs,
the limbs feeling as if swelled; darting pains, apparently of a
rheumatic neuralgic character, extend also from the feet to the
knees." Hahnemann recommends it in "gouty lancinating
pains in the limbs, especially in contractions produced by
tearing, shooting pains in the limbs, the pains being excited
by the slightest motion and accompanied by heat in the
affected parts, especially when the patient had been injured
by the abuse of Mercury."
We are here reminded of the quondam repute of the decoc-
tion of the Guaiacum wood in syphilis, which gave it the
name of "lignum vitæ." It is quite discredited now; and
probably Hahnemann hit the nail on the head when he cited
the ancient saying, “Luis venereæ mercurius antidotum, mer-
curii guaiacum."
The only observation Dr. Allen has added to those of
Hahnemann is one in which a decoction of six ounces of the
wood in half a quart of water was drunk, and produced
"violent spasmodic inflammatory affection of the air-passages,
especially the larynx, with such violent palpitation of the
heart that suffocation seemed imminent."
Of late there has appeared some evidence that Guaiacum
specifically affects the throat. It has been recommended by
some writers as abortive of quinsy; and one of our American
colleagues speaks highly of it in diphtheria. It is esteemed by
some also in dysmenorrhoea, I presume of rheumatic origin.
It is a medicine deserving, I think, of further investigation.
The mother-tincture, which Hahnemann recommends, will
probably have to be given in most cases. In diphtheria it is
best administered in warm milk.
LECTURE XXXIII.
HAMAMELIS, HELLEBORUS, HELONIAS, HEPAR SULPHURIS.
Our first medicine to-day is another precious contribution
from America to our remedial store, the witch-hazel,
Hamamelis Virginica.
We prepare a tincture from the bark.
A proving of Hamamelis conducted by fourteen persons,
mainly with the attenuations, was presented to the American
Institute of Homœopathy at its meeting in 1874 by Dr.
Wallace McGeorge, and is published in its Transactions for
that year.
year. All other knowledge of the pathogenetic and cura-
tive effects of the drug is collated by Dr. Hale in the article
upon it in his New Remedies. You will also find the results of
Dr. McGeorge's experiments in Allen, with those of ten other
provings or observations.
Hamamelis has long had a popular reputation in America,
and is the basis of a patent medicine known as
"Pond's
Extract," which is largely used as an anodyne application to
injuries. Dr. Hering, being in attendance on the proprietor
of this preparation, was led to test its real virtues. `Dr. Okie
did the same, and reported his results in a letter to Dr.
Hering published in 1853. Dr. H. C. Preston had already, in
1851, proved the drug on himself, and found it cause marked
determination of blood to the head and chest, with epistaxis.
The latter symptom was observed upon another, and metror-
rhagia in two female subjects.
Dr. Preston was naturally led to use Hamamelis as a
remedy for hæmorrhages. But he found it to be no less
efficacious in affections of the vessels from which the blood
proceeded. It had already been commended for piles: he
now used it, internally and externally, for varicosis of the
legs. Its next application was to phlebitis, and here also it
succeeded excellently well. He was thus led to consider the
506
HAMAMELIS VIRGINICA.
drug as acting specifically upon the venous system, and, in a
series of papers in the North American Journal of Homeopathy
(1853), developed and illustrated this doctrine. Dr. Ringer,
who vouches for the remedy, does well in putting Dr.
Preston's name forward as the chief authority for its
virtues.
The three leading forms of venous disorder are phlebitis,
varicosis, and hæmorrhage.
1. In simple phlebitis you can hardly put too much con-
fidence in Hamamelis. It acts even better than Pulsatilla,
which has great virtue here. Dr. Preston commends it for
phlegmasia alba dolens; but I think that it will often cause
disappointment there. The lymphatics are, I take it, more
frequently at fault than the veins in that disease.
2. In the various forms of varicosis Hamamelis is the
prince of remedies. In varicose veins of the leg you will be
delighted with the way in which the first or second dilution.
will ease the pain, while the external application of the diluted
tincture will cause the dilated vessels to shrink up. Varicose
ulcer of the leg may be healed by similar treatment; to which
also varicocele and circocele have often yielded. It is good.
for varicosis of the throat, where the parts look bluish from
distended veins, and there is more or less discomfort, with
pain on swallowing, and hawking of mucus with blood. Such
a throat is often seen in gouty subjects. But it is in this
same condition at the other end of the digestive tube, viz., in
hæmorrhoids, that Hamamelis has won its greatest triumphs.
I have cured case after case of "bleeding piles" by the
internal use of this medicine; and indeed can safely say that
in an experience of it dating some seventeen years back, I
have never failed with it. Numerous testimonials to the same
effect are to be found in Dr. Hale's article; and we can now
add to them that of Dr. Ringer, who says that he has found
it singularly successful and prompt in arresting bleeding from
this source, even when excessive and amounting to half-a-pint
a day, repeated almost daily for months or years. It not
only checks the bleeding, which by itself might not always
seem beneficial; but does so in the only way in which
homœopathic remedy can act, namely, by removing the proxi-
mate cause. Even where there is not much bleeding Hama-
melis will cure piles, if they are a local manifestation of a
general tendency to varicosis.
3. We are thus led to the use of Hamamelis in hæmor-
rhages generally, for which mischance it is perhaps more
frequently indicated than any other remedy. The general
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HAMAMELIS VIRGINICA.
507
#
evidence of those who have used it agrees with that of Dr.
Preston, that it is in venous hæmorrhages, where the blood
flows steadily and without expulsive effort, that Hamamelis is
likely to cure. I have myself also suggested* that it is more
suitable when the state of the vessels leads to the hæmorrhage
than where this is dependent upon altered composition of the
blood itself. If this canon be true, it defines the place of
Hamamelis in purpura. There are many cases on record
showing its efficacy. I have myself seen more than one; but
I think that in all the vessels and not the blood itself were at
fault. Dr. Ringer speaks of being disappointed with it in
epistaxis occurring in a lad with the hæmorrhagic diathesis;
where, perhaps, the same explanation will hold good. Other-
wise, this form of bleeding is remarkably under its control, as
also are hæmatemesis, melæna, and hæmoptysis of passive and
venous type. Dr. Ringer has known it arrest hæmaturia
in four cases which had resisted many other remedies, and to
check the oozing of blood which sometimes goes on for weeks
after delivery. Dr. Dyce Brown finds it very successful in
uterine hæmorrhage generally. It has also cured vicarious
menstruation, and helped much in the treatment of dysentery.
I have myself used it in most of these affections, and have so
much confidence in its power that I would never be without
it in my pocket-case.
If you ask me what is the rationale of this hæmostatic
power of Hamamelis and other medicines of ours, I can only
answer that it is but an instance of the general homeopathic
principle. They cure hæmorrhages because they cause them.
Hamamelis certainly does not owe its virtues to the tannin
which, like many other barks, it contains; for it acts well as
high as the second and third dilutions, whose very infini-
tesimal proportion of tannin could hardly prove astringent.
The only other sphere of action in which we know Hama-
melis to be capable of vigorous work is that of the generative
organs. Its potent pathogenetic influence on these, in the
male subject, was first brought to light by that indefatigable
prover, Dr. Burt. He experimented on himself with the drug
in 1864 (as you may read in the twenty-third volume of the
British Journal of Homœopathy), and suffered severely from
neuralgic pains in the testicles, which-when strong doses
were taken—were so intense as to compel him to discontinue
Brit. Fourn. of Hom., xxiii., 256. I have there related a case
where, in a sensitive subject, the administration of Hamamelis for
epistaxis caused much dilatation and throbbing of the cerebral vessels.
+ Monthly Hom. Review, xiv., 473.
508
HAMAMELIS VIRGINICA.
the proving. Sometimes the pains migrated suddenly to the
stomach, causing nausea and faintness. They were accom-
panied by frequent emissions, and much hypochondriacal
depression and irritability. The latter symptom was very
marked in Dr. McGeorge's provers.
Dr. Okie had already used it successfully in ovaritis; and
Dr. Burt gives three cases of what he calls "ovarian neur-
algia" cured by it. The first was probably of a subinflam-
matory nature: the second and third may have been pure
neuroses. But the most important testimony to the value of
the medicine in ovarian affections is that of Dr. Ludlam.
I quote from his excellent Lectures, clinical and didactic, on the
Diseases of Women (p. 138). "During the summer term of
lectures for the year 1864, I called attention to the efficacy
of the hamamelis virginica in ovaritis. The remarkable
effects of this remedy, locally and internally, in orchitis led
me to infer that it would also be useful in some forms of
ovaritis. I have prescribed it in numerous cases with remark-
able results. It seems appropriate to the subacute attacks of
this disease which are incident to pregnancy and menstruation.
In the former case, I have no question of its power, in some
instances, to prevent abortion, where such a mishap threatens
in consequence of ovarian irritation and inflammation. In the
latter, it allays the pain and averts the menstrual derangement
which is so liable to follow. It is also useful in gonorrhoeal
ovaritis, in which variety the suffering is sometimes extreme.
This affection bears a close analogy to the gonorrhœal
orchitis of the male, in which Hamamelis is also specific." In
this last affection Dr. Franklin also, in his Science aud Art of
Surgery, commends it. It probably has a similar action on
the whole genito-urinary apparatus. Dr. Payne, an "eclectic"
practitioner in America, states that in large doses it causes
in women violent contractions of the vagina, and a smarting,
burning sensation, followed by pruritus: in men he has known
it produce irritation of the urethra, and a discharge, with
ardor urinæ. With apparently unconscious homoeopathicity
he recommends it for the cure of these very conditions. It
ought to be useful for gonorrhoea occurring in the female.
Dr. McGeorge, in the clinical observations he adds to his
provings, speaks warmly of its power, when applied locally, to
give permanent relief to vaginismus. It is also attaining a
good deal of reputation in dysmenorrhoea (especially, Dr. Pat-
tison says, in the form of hamamelin): it is probably
where this trouble depends upon ovarian irritation that it is
beneficial.
HELLEBORUS NIGER.
509
There are several points about the action of Hamamelis
which lead me to think it likely to prove a useful remedy in
gout; but I must reserve this part of the subject until I have
been able to develope and test it further.
The only true analogue to Hamamelis is Pulsatilla.
I have generally used the Ist decimal in acute hæmor-
rhage; the 1st and 2nd centesimal in other cases.
Our next medicine to-day is the Christmas rose,
Helleborus niger,
of which we prepare a tincture from the fresh root.
The proving is in the third volume of the Reine Arzneimit-
tellehre, and contains 92 symptoms from Hahnemann, 162
from eight fellow-observers, and 34 from authors. The latter
describe mainly the drastic properties of the plant. The
provings do not seem to have been very heroic, judging from
a letter of Hahnemann's to Stapf, cited by Dudgeon (Lectures,
p. 189), in which an eighth of a drop of the tincture is ordered
to be taken every hour or two until some violent effects are
experienced. Dr. Allen adds a thorough proving by Lembke,
and several other observations and experiments.
The black Hellebore seems to have been occasionally used
(as an adjunct to or substitute for the Veratrum album) by the
Greek physicians in the treatment of mental disorders.*
They supposed it to act by its evacuant properties; but it is
probable that it had some specific influence. Hahnemann
makes the following remark in point: "I infer from various
observations that stupor, an obtusion of the inner sense
(sensorium commune)-imperfect and heedless sight, although
the eyes are perfectly good, imperfect hearing, although the
organ of hearing is perfectly sound, imperfect or no taste,
although the organ of taste is in good condition, constant or
frequent absence of thought, want of recollection of the things
which have just taken place, indifference, light slumber without
the sleep being refreshing, desire to work without having the
power or attention necessary to do anything—is a primary
effect of Hellebore." Knorre has reported a cure of melan-
cholia following typhus by it, and recommends it in the same
condition occurring in girls at puberty.† I should mention
that the condition of brain found post mortem in the subject
* So Hahnemann says; but Dr. Hamilton (Flora Homœopathica)
considers that it was the H. officinalis they employed.
† Brit. Fourn. of Hom., xii., 47Ɛ.
510
HELLEBORUS NIGER.
of S. 80 among Hahnemann's "Observations of others" must
not be supposed to have been caused by Hellebore, as the
man was a melancholic.
But the chief use of Hellebore is in the various forms of
dropsy. Hahnemann gives, as one of his own observations
(S. 66), "sudden dropsical swelling of the skin;" and remarks
upon it "This symptom, with others belonging to the kid-
neys, appears to show that Hellebore will be a great remedy
in certain dropsical affections." The renal symptoms referred
to are among those of his fellow-observers,-
S. 104. Abundant urination, without much urging (Lang-
hammer).
S. 105. Frequent urging to micturate, and scanty emission
(Ibid).
S. 106. Emission of a quantity of watery urine (Stapf).
The opposite character of the first two, though occurring
in the same prover, is explained by the fact that the
scanty urine with urging was observed within the first four
hours after the dose, the abundant and free passage of the
secretion twenty-four hours after it. This precisely corre-
sponds with later observations, which show that one of the
glucosides of Helleborus-helleborein-is a diuretic to
animals, but causes hyperæmia of the kidneys. Thus the
primary effect of Hellebore would be to congest the renal
organs and diminish their secretion; while, as the effect was
passing off, an opposite condition would obtain. Now this is
just what we have in post-scarlatinal dropsy, where the drug
has gained its chief laurels. There is a general consensus of
testimony to its value here, Dr. Bayes being the only one who
speaks of disappointment.
Hellebore is also occasionally used with benefit in other
dropsies, as in that left behind by intermittents, and in the
ascites of scrofulous children.* But the question of main
interest is as to what it can do in hydrocephalus. It produced
marked congestion of the brain in Lembke and another;
and its other glucoside-helleborin-causes paralysis in
animals, the cerebral meninges being found after death con-
gested, and the substance diminished in consistence and show-
ing extravasation. It would thus be homoeopathic to the
second stage of encephalitis; while its power over serous
dropsies elsewhere might well extend to the cranial arach-
noid, making it useful in such cerebral effusions as occur from
* See Brit. Fourn. of Hom., X., 124.
HELONIAS DIOICA.
5II
insolation, after typhus, or from the retrocession of mumps or
the exanthemata. In chronic hydrocephalus it might well
aid the constitutional remedies-Sulphur, Calcarea, and such
like-on which we mainly rely. All these are well-attested
uses of the drug; but whether it can help in true tubercular
meningitis is another question. It is recommended for it, in
the stage of effusion, by all the older homoeopathic writers;
but those of later date seem to have less confidence in it. I
have tried it several times myself, in varying dilutions, but
never with any benefit.
In all these dropsical affections, very scanty and dark-
coloured urine, depositing a sediment like coffee-grounds, is
given by Dr. Guernsey as "characteristic " for Helleborus.
The only other sphere of action of Hellebore is the ovario-
uterine. Pereira says that it stimulates the pelvic circulation
like Aloes, and is an emmenagogue. In the female animals
poisoned by helleborein the mucous membrane of the uterus
was always found congested. It has some repute among
homoeopathists in amenorrhoea.
The medicines most allied to Helleborus are Apis, Apocynum,
Cantharis, and Kali bromatum.
The medium and higher dilutions have been those most
frequently used; but Dr. Phillips states that he gets excellent
results in post-scarlatinal dropsy with ten or fifteen-drop doses
of the tincture. I should say that I am indebted to his book
for the facts about the glucosides of the plant.
We have now once more to turn to America, which sends
us a medicine whose importance is growing upon us of late,
the
Helonias dioica.
A tincture is prepared from the root; and the concentrated
preparation, helonin, is triturated for our use.
A full account of Helonias is given by Dr. Hale in his New
Remedies. You will do well to supplement his remarks by
reading the excellent article on the drug by Dr. Samuel Jones
in the twenty-second volume of the North American Journal
of Homœopathy, who presents us also with a full schema of its
pathogenetic effects, to which Dr. Allen has little to add.
Dr. Jones is one of the two chief provers of Helonias. He
took three ounces of the mother tincture and a scruple of
helonin in the course of a week, and noted the results at the
512
HELONIAS DIOICA.
time and subsequently. It had been reported as beneficial in
diabetes and Bright's disease; and he was desirous to ascertain
whether it would cause sugar or albumen to appear in the
urine. He found neither; but he did get an excess of urea, to
the extent of a sixth part of the normal amount. At the same
time his urine, which was apt to be alkaline, and to deposit
amorphous phosphates, became acid, even after a meal; and
the phosphatic deposition ceased to be anything more than an
exceptional occurrence. During the time, and for twelve days
afterwards, he was weak and irritable, and full of aches and
pains. Then all these left him, and for a week he felt un-
usually well. But, he writes, "on the nineteenth day after
the last dose had been taken a profound depression of spirits
supervened. I was filled with the most abject despair." This
condition continued nearly two weeks; and then, three weeks
later, he "became 'bilious,' sleepy during the day, head dull
and stupid, poor appetite, food had no taste." He thinks
that at this time an examination of the urine would have
shown a minus of urea; but, strangely enough, he omitted to
make it.*
I have dwelt fully on these phenomena, as Helonias has
gained a considerable reputation as a "tonic," and it is in-
teresting and important to ascertain its action in health. I
cannot think that the "bilious" condition occurring seven
weeks after omitting the drug had anything to do with it;
but the depression of the fourth and fifth week seems fairly
traceable to its influence. Dr. Burr, the other chief prover of
Helonias, who took smaller doses, experienced the same feel-
ings from the fifth day of his proving. He says little of
debility, but nothing of increased strength; and Dr. Jones was
decidedly weakened by the drug, so that the healthy reaction
subsequently was keenly enjoyed. The changes in the urine
have hardly yet received their interpretation.
Helonias, accordingly, may fairly have its "tonic" action
explained upon the principle of similarity; and, judging from
the cases Dr. Hale relates, it need not be given in large doses.
Its action is compared by all who have used it to that of iron.
It possibly acts on the blood-making processes, and may be
useful in chlorosis and anæmia where iron disagrees. I once
cured an exquisite case of chlorosis with it with considerable
rapidity. Dr. Jones (and also Dr. Carroll Dunham) speaks
well of it in such mental depression as follows over-dosing
* I have received a letter from Dr. Jones, acknowledging the justice
of my rejection of this last group of symptoms, and explaining the
omission of testing at the time.
HELONIAS DIOICA.
513
with bromide of potassium; and no less so in post-diphtheritic
debility.
The local actions of Helonias are on the kidneys and the
uterus. In the former pain and weight are experienced, and
a sensation of burning, as if the kidneys were two bags of hot
water; there is also increased urination. The drug has not
been proved npon women; but Dr. Clark, of Portland, states
that in six or eight female patients to whom Helonias had
been given in the first decimal dilution there occurred “pain
in the lower part of the back, through to the uterus, like in-
flammation, piercing, drawing." The breasts also swelled,
and the nipples became sensitive and tender. Finally uterine
hæmorrhage set in, and continued till the medicine was given
up. Upon the male subject it has acted as an aphrodisiac.
Correspondingly, the chief use of Helonias has been in renal
and uterine affections. It is reported curative in phosphatic
urine, urinary irritation with impotence, diabetes, and albu-
minuria it reminds one here of Phosphoric acid. From its
power over affections of the womb it has obtained the appella-
tion of "uterine tonic." In prolapsus, menorrhagia, leucor-
rhoea, and other atonic states of this organ-even when
causing sterility or tendency to miscarriage-it seems really
possessed of very great curative virtues. I can hardly claim
these uses of the medicine for homœopathy, as it is a stimulant
rather than a depressant to both urinary and sexual organs.
Dr. Hale would bring in his "secondary homoeopathicity"
here, arguing that all stimulation is followed by subsequent
relaxation; so that Helonias is primarily homœopathic to
renal or uterine irritation, and secondarily to atonic conditions
of the same organs. But I must maintain (as I have done in
my fifth lecture) that such "secondary homœopathic " action
is essentially antipathic; and, if really curative, only shows
that contraria contrariis as well as similia similibus plays a
part in specific medication.
A
Dr. Jones thinks that the key-note of the subjective
symptoms of Helonias is "amelioration while doing some-
thing." "The headache," he says, "disappears when the
attention is engaged. The pains vanish when one is busied.
The sense of profound debility is lost when exercising. When
one turns from the book and goes into a half reverie then
comes the headache. When one sits purposeless then come
the burning-aching pains. When one feels as if he could
scarcely drag one foot after the other he is astonished to find
that the sense of rest is gotten, not by lying on the couch, but
by walking."
2 L
514
HEPAR SULPHURIS.
I have already mentioned the analogy between the virtues
of Helonias and some of the effects of Phosphoric acid and
Ferrum. As a uterine remedy, it most resembles Stannum.
The mother tincture of Helonias, and the 1st decimal tri-
turation of helonin, have generally been used.
My last medicine to-day is one of the old Hahnemannian
stock, the calcic sulphide,
Hepar sulphuris.
It is prepared for homœopathic use by "mixing equal parts of
finely-powdered clean oyster-shell and quite pure flowers of
sulphur, and keeping the mixture for ten minutes heated to a
white heat in a crucible hermetically closed." These are
Hahnemann's own directions; and the resulting compound is
plainly a sulphide of calcium. The potencies are made by
trituration.
A pathogenesis of Hepar appears in the fourth volume of the
Reine Arzneimittellehre, containing 282 symptoms from Hah-
nemann, 16 from two fellow-observers, and 10 from authors—
of which 8 are effects of the sulphuretted waters of Neundorf
and Aachen. In the Chronic Diseases another pathogenesis
appears, in which the last-named symptoms are omitted, but
others are added by Hahnemann himself, raising the number
to 661.
The term Hepar sulphuris—“ liver of sulphur "—appears to
have been given in old time especially to the sulphide of
potassium. The virtues ascribed to this drug, however, so
closely correspond as far as they go with those of our own
calcareous compound, that we may fairly use them in connec-
tion with it. Again, since sulphuretted hydrogen is unmistak-
ably evolved when Hepar is brought into a state of solution, it
must share in the pathogenetic properties of that gas and
inherit its repute as a remedy. Lastly, being a compound of
the two great constitutional medicines, Sulphur and Calcarea,
itself becomes an agent of the same character, having points
of resemblance to each of its elements. Like Sulphur it
affects the skin, and like Calcarea the glands. It is, however,
far more like the Sulphur than the Calcarea it contains. That
the other alkaline sulphides act much in the same manner, and
that in the Materia Medica Pura Hahnemann treats of
Sulphur and Hepar together (though giving their patho-
geneses separately), is sufficient to indicate this,
HEPAR SULPHURIS.
515
But, like many other compounds, Hepar is something over
and above its constituent parts; and strikes out (so to speak)
an action of its own. I think that Hahnemann pretty closely
defined the nature of this action when he recommended the
drug as an antidote to the effects of Mercury. In the first
instance, indeed, he used it to neutralise mercurial influence
chemically, as converting the metal into an insoluble sulphide;
and gave largish doses accordingly,-in one bad case three
grains every hour." Later, however, he seems to have recog-
nised a dynamic antidotal virtue in it; and his indications in
this direction have been so frequently acted upon with success
that there seems little doubt of their being well founded.
They have lately received some valuable illustrations from
Dr. Bryce, of Edinburgh.† He finds Hepar (whlch he gives
mainly in the sixth trituration) of great use in the treatment
of non-patent forms of mercurial poisoning, i.e., in the suffer-
ings of those who have used blue-pill, calomel, and such-like
medicines largely or frequently without actual mercurialisa-
tion having been induced. The congested livers and follicular
throats, as well as the general ill-health, of such patients he
shows to be greatly benefited by a course of Hepar. Now
for a drug to be a dynamic antidote, in minute doses, to a
chronic medicinal disease, it must act upon the principle of
similarity; and the symptoms induced by Hepar sufficiently
resemble those of Mercury to support the inference drawn
from therapeutics. Hepar accordingly has affinities with Mer-
cury, as well as with Sulphur and Calcarea; and its range of
influence is consequently a wide one.
Before proceeding to special therapeutics, let me say a word
about the general characteristics of the drug. These are well
put forward by Dr. A. K. Hills, in a paper which you will find
in the Transactions of the American Institute for 1872.
Depressed and irritable frame of mind (Dr. Bryce always
found this present in the mercurial hepatic disorder cured by
it); pains of a bruised and sore feeling, the part affected being
very sensitive to touch; craving for sour and strong-tasting
articles; difficult expulsion of stools and urine; the patient
very chilly, and very sensitive to cold air, which will (e.g.)
bring on his cough immediately--these are the principal points
he specifies. Dr. Bryce found his patients much affected by
change of the weather to damp.
The most important application of Hepar resulting from
its analogy to Mercury is its use in suppuration.
The power
* See Lesser Writings, p. 156, 186.
† See Brit. Journ. of Hom., xxxiv., 489.
516
HEPAR SULPHURIS.
of the latter to induce suppurative inflammation is well
known; and its employment in inflammatory states of the
organs it influences when matter threatens to form is as
obvious as it is successful. Hepar acts similarly (Hahnemann
has observed it to cause suppuration of the axillary and in-
guinal glands), but it goes farther. It will often check sup-
puration when impending :* but, when it is inevitable, it has
wonderful power in promoting it, and conducting it to a
speedy termination. Drs. Allen and Norton think the result
dependent on the potencies employed; the higher check sup-
puration, the lower promote it. This has been the doctrine
and practice of the homœopathic school for many years; and
testimony to its soundness has now been given by Dr. Ringer.
The later editions of his Handbook reiterate the statements
made by him on the subject in the Lancet for February, 1874.
He recommends the use of the sulphides to prevent or mature
suppuration generally, for unhealthy ulcerations, for boils and
carbuncles, for those indolent subcutaneous swellings which
may be called scrofulous nodes, and for suppurating scrofulous
glands. He prefers the sulphide of calcium to the others, and
finds the eightieth of a grain generally sufficient as a dose,
though sometimes giving the tenth.
You will not hesitate, moreover, to act on these principles
when more important organs are involved. Dr. Bähr speaks
of "brilliant cures" of pneumonia with Hepar, when the
exudation had become purulent; and cites one which bears
out his commendations. Twenty weeks after the commence-
ment of a pneumonia, treated allopathically, his advice was
sought for the patient, a boy of six. "The child was exceed-
ingly emaciated, had a slight hectic fever, was constantly
troubled by a sometimes spasmodic cough, with purulent and
fœtid expectoration, diarrhoea, and loss of appetite. The
right side of the thorax had become considerably hollowed, the
left was abnormally bulging; on the right side the percussion-
sound was perfectly empty, with intense bronchial respiration
and slight râles. We diagnosed pleuro-pneumonia of the
right side, with absorption of the pleuritic exudation, but
continued presence of the pneumonic infiltration in a state of
purulent dissolution. After various ineffectual remedies, the
child was finally put upon Hepar, third trituration, with such
excellent results that in eight days already the hollowing of
the chest was considerably less. In about four weeks the
right lung had almost been restored to its normal condition,
and the curvature of the thorax had entirely disappeared, so
* See Brit. Journ. of Hom., vi., 233.
HEPAR SULPHURIS.
517
that the child now looks perfectly straight and thoroughly
sound and healthy." He recommends the drug also in
empyema, which was possibly present in the foregoing case.
The use of Hepar in pleurisy, however, has mainly lain on the
other side of suppuration, viz., in copious plastic exudation
into the sac of some long standing. Wurmb praised it highly
here, and Dr. H. Gross has put on record a striking case of
cure by it after some months' interval, which you may read in
the eighteenth volume of the British Journal of Homœopathy.
2. Hepar next follows Mercury in acting on the liver. Of
its value here we have the fullest account from Dr. Bayes.
"Those chronic states of engorgement of the liver," he writes,
"inducing great abdominal distress from their interference
with the return of blood through the vena portæ, are greatly
benefited by a course of Hepar sulphuris. ... Hæmorrhoids
arising from this source are readily cured by this medicine.
The obstruction to the abdominal venous circulation often
gives great distress to the patient, preventing the abdominal
respiration, and hence inducing oppression of breathing. In
other cases it induces obstinate constipation, from a congested
condition of the veins in the rectum." He gives from the
third decimal to the sixth centesimal attenuation. I know
that other practical physicians have the same confidence in
the power of Hepar to relieve engorgement of the liver and
portal system; though Dr. Bryce thinks this to hold
good only when the hepatic derangement is traceable to mer-
curial influence. Hæmorrhoids were among the affections for
which sulphuretted hydrogen was given of old; and the patho-
genesis has some icteric symptoms.
3. We now follow the line of the Sulphur which enters into
the composition of our medicine, and find it influencing the
skin. Like Sulphur itself, it can cure scabies by its lethal in-
fluence on the acarus when locally applied*; but Hahnemann
points out that it is also homoeopathic to the eruption.
"Others besides myself," he writes, "have observed an erup-
tion produced very similar in character to the itch;" and
again, "baths impregnated with sulphuretted hydrogen excite
the same itch-like eruption, in the flexures of the joints espe-
cially, which itches most at night." Hepar thus becomes suit-
able for several other eruptions of papular or vesicular cha-
racter, and Dr. Guernsey thinks this location in the flexures of
the joints, as in those of the elbow and knee, a special indica-
tion for it. He also recommends it in crusta lactea and inter-
trigo, when "the eruption spreads by new pimples appearing
* See Brit. Fourn. of Hom., xxvi., 46.
518
HEPAR SULPHURIS.
just beyond the main disease, which finally become incor-
porated with it." Dr. Hills thinks it indicated when the skin
is unhealthy, so that it chaps and becomes sore at the least
provocation. In the old school it is coming much into vogue
as an internal remedy for acne. My chief experience with it
has been in the local eczemas incidental to certain employ-
ments, as the "grocer's itch," and the "psoriasis palmaris" of
those who have to handle much mineral matter. It is often
beneficial in the treatment of ulcers, especially when of
scrofulous origin, and having the characteristic sensitiveness
of the drug.
4. But, next to its power over suppuration, the most im-
portant action of Hepar is that which it exerts upon the
respiratory mucous membrane. The conjunctiva is, as we have
often had occasion to remember, an offset of the commence-
ment of this tract: and in its affections Hepar plays an
important part. It is very useful in blepharitis, especially
when the meibomian glands are much involved, and in acute
phlegmonous inflammation of the lids. Its influence seems
to penetrate to the cornea. Dr. Peters, in a Treatise on
Diseases of the Eyes, has collected many recorded instances
of its value where this membrane was affected; and you
may there see how often it has cured cases where onyx,
hypopion and prolapsus iridis were present, and also what
power it has over recurring ulceration of the cornea in oph-
thalmia scrofulosa. Drs. Allen and Norton fully confirm its
value in every form of keratitis save the syphilitic, mentioning
great photophobia and relief of pain by warmth as charac-
teristic of it. Then it acts upon the ethmoid cells at the root
of the nose, where Hahnemann's recommendation of it when
boring headache is present has often been verified: the pain
comes on, he says, every morning, and lasts from 7 to 12 o'clock.
It has less influence on the nasal mucous membrane itself, but
acts powerfully on that of the larynx and trachea. Hahne-
mann pointed out that pathogenesy indicated Hepar and
Spongia as the cardinal remedies for croup; and they remain
so to the present day among most homoeopathists. There is
a general agreement in the canon laid down for its employ-
ment by the late Dr. Elb, and excellently illustrated by
Dr. Hale,* that it is after resolution has been initiated by
Aconite or Spongia, so that the breathing has a rattling rather
than a sawing sound, that Hepar is useful. The same prin-
ciples, mutatis mutandis, apply to less formidable affections of
the larynx. Dr. Guernsey speaks of its cough as a choking
* See his Lectures on Diseases of the Chest.
HEPAR SULPHURIS.
519
(C
one, the patient, he says, "coughs into a choke." Dr. Bayes
says that the
sensation as of a clot of mucus or of internal
swelling when swallowing" (which is one of Hahnemann's
original symptoms) is characteristic for it here; and Dr. Hills
says the same thing of the symptom, " sticking in the throat,
as from a splinter, on swallowing, and extending to the ear on
yawning." Swallowing ice, he says, will sometimes cause this
feeling. Bähr recommends it also in croupous and Hempel
in capillary bronchitis.
5. In a recent discussion on diphtheria at the British
Homœopathic Society,* Drs. Drury and Leadam agreed in
placing Hepar in the front rank of its remedies. The expe-
rience of these excellent physicians, and the tendency of the
diphtheritic exudation to invade the larynx, would justify its
full trial in the disease.
Dr. Guernsey agrees that whenever Hepar is indicated there
will be found great sensitiveness to touch, draught of air, or
other impressions on the senses. The presence of this symp-
tom may often guide to its employment, as in whitlow when
the patient dreads the least approach to the finger, in rheu-
matic headache when the pressure of the hat is intolerable,
and so forth. Herein it resembles Silica, which is its analogue ·
in relation to the suppurative process.
Besides Sulphur, Calcarea, and Mercurius, Hepar has a
close analogue—especially in the respiratory sphere-in Kali
bichromicum.
Dr. Ringer's experience bears out that of many of our own
practitioners in indicating the lower triturations of Hepar as
containing all its curative virtues. Dr. Bryce is the only one
who prefers the 6th.
* See Brit. Journ. of Hom., xxviii., 740.
LECTURE XXXIV.
HYDRASTIS, HYDROCOTYLE, HYOSCYAMUS, HYPERICUM,
INDIGO.
We will begin this lecture, as the last, with one from among
the American contributions to our Materia Medica, the golden
seal,
Hydrastis Canadensis.
The tincture of the fresh and the triturations of the dried root
are used in our practice.
Dr. Hale's article in his second edition contains two excel-
lent provings of Hydrastis in substance by medical men (one
of which-that of Dr. Burt-is omitted by Allen), and some
experiments with the dilutions by a class of students. His
fourth edition fairly summarises its curative powers.
It seems that the golden seal has long been in repute
among the American Indians as an application to sore eyes
and legs. It then came to be considered a “ tonic ;" and when
taken up by the "botanic" practitioners of the country, was
used largely by them as a "detergent" in chronic catarrh of
the mucous membranes. It has not made its way into
ordinary practice, being unnoticed by Stillé and the elder
Wood; and the same silence regarding it prevails in the later
treatises of the younger Wood and of our own Ringer. But
it had long been in use among homoeopathists even before
their first public notices of it appeared, which were those of
Dr. Hastings in the British Journal in 1860, and of Dr. Hale
in the North American in 1858. Dr. Phillips' article contains.
a full account of the reputation it has gained in the school of
Hahnemann, save as to its employment in cancer; and he en-
dorses our estimate of its activity.
Hydrastis has been found to contain two alkaloids, on which
most if not all of its efficacy depends. One, hydrastin, is of
yellow colour, and is believed to be identical with berberin;
HYDRASTIS CANADENSIS.
521
like it, it is “tonic" and "anti-periodic," resembling quinine
also in causing ringing of the ears. The other, hydrastia,
occurring in white crystals, seems to be that element of the
plant which affects the mucous membranes. It is commonly
used as a muriate; and this—in the proportion of a grain to
an ounce of water-seems the best form of the drug for local
application.
I. Used thus, or as a weak infusion of the dried root,
Hydrastis has a marvellous control over chronic catarrh of
mucous membrane wherever situated. Dr. Hale and Dr.
Phillips give each a long list of local disorders of this nature,
in which they or others have found it curative. Their lists.
include syphilitic coryza; all forms of sore mouth; chronic
angina; leucorrhoea, both uterine and vaginal; chronic con-
junctivitis, otorrhoea, and ozæna. Both recommend the
coincident internal administration of the tincture; and agree
that in catarrh of parts which cannot be locally reached the
latter alone is sufficient. Thus jaundice from catarrh of the
bile-ducts has often yielded to it. Dr. Yeldham praises it as
an injection in gleet; and Mr. Clifton has excellently de-
scribed* a form of dyspepsia calling for it, whose sodden-
looking face, yellow slimy tongue, sour or putrid eructations
and combined feeling of distension and empty "goneness
after meals unmistakably point to mucous flux of the stomach.
In chronic nasal catarrhs Dr. Lucius Morse (who has written
a useful little book on this disorder) esteems it very highly
when there is accompanying atony of the digestive organs.
Symptomatically, he finds it indicated by the frequent drop-
ping down of mucus from the posterior nares into the throat
a hint of which I have more than once availed myself with
advantage.
What is the rationale of this influence? The provings
suggests its being of homoeopathic nature. Catarrh of the
eyes and nose, with profuse thick white secretion, was Dr.
Burt's most prominent symptom; another had sticky mucus
about the fauces, with a broad yellow stripe down his tongue.
Dr. Hale writes :-" its action on all mucous surfaces is of a
similar character. The natural secretion is at first increased;
then it becomes abnormal in quantity and quality. At first
clear, white, transparent, and tenacious, it becomes yellow or
thick, green, and even bloody, and nearly always tenacious ;
so that the discharge may be drawn out in strings, as with
Kali bichromicum."
>>
The power which Hydrastis displays over catarrh and even
Monthly Hom. Review, xvii., 157.
522
HYDRASTIS CANADENSIS.
erosion of mucous membrane attends it also in the treatment
of ulceration of the skin. In most forms of chronic ulcer its
application is beneficial; and as a glycerole it is very healing
to excoriations-as of the nipple, to fissures, and to intertrigo.
Dr. Phillips has cured two cases of rodent ulcer with it, and
Dr. Maclimont three of lupus,-by both the internal being
recommended together with the external use. Dr. Jousset
confirms this favourable experience with Hydrastis in lupus
exedens, saying that it has procured him several cures even in
advanced cases. He prefers it now to Arsenic. He also
speaks of having obtained a "brilliant success" with it in a
case of genuine leprosy, in the second (ulcerative) stage. He
gave the mother-tincture internally, and applied locally a lotion
of one part of the same to five or ten of water. His mode of
using it in lupus is very similar. We have only the analogy
of its action on mucous membrane to suggest that the curative
influence here is specific and homœopathic.
2. The next great sphere of operation for Hydrastis is that
weakened and congestive state of the lower bowel whose chief
expression is constipation. The earlier writers on the drug in
this country-Drs. Hastings, Rogerson, Bradshaw, and Bayes
-all praise it here; and I myself know no remedy so constantly
efficacious. I agree with Dr. Rogerson in finding it most
useful when the constipation is the fruit of sedentary habits,
and of the frequent resort to aperient medicines. I have
tried various dilutions and modes of administration; but
have found the best to consist in giving a drop of the mother-
tincture in water before breakfast, at first every day, and then
at increasing intervals. Dr. Phillips praises it in prolapsus
ani and in hæmorrhoids,-Dr. Yeldham also in the latter
trouble.
3. But by far the most interesting aspect of Hydrastis is
its relation to cancer.
It was first introduced-without name-
in 1854, as a new remedy for this disease, by the late Dr.
Pattison, who used it as an ingredient in the caustic paste with
which he enucleated scirrhous tumours. Its internal use was
taken up by homoeopathic practitioners-ever foremost in
seizing on any fresh means of aid to their patients, and in
1860 and 1861 Drs. Hastings and Bradshaw reported their
experience with it, which was hardly favourable. But in the
latter year Dr. Bayes, and in 1863 Drs. Marston and Macli-
mont, were able to speak of much better results. The latter
found relief of pain and improvement in general health nearly
always following its administration; and in some instances its
conjoined external application as a lotion so improved or even
HYDRASTIS CANADENSIS.
523
removed the symptoms that a contemplated operation was
abandoned.
Here is one of their cases :-
"Mrs. F- had suffered for six months from a swelling in her left
breast, for which she sought relief. The pain, which was compared to
knives being thrust into the part, had become almost unbearable, and
the patient was already beginning to assume that worn appearance so
characteristic of the cancerous diathesis. The tumour, which had
attained a considerable size, was hard, heavy, and adherent to the skin,
which was dark, mottled, and very much puckered, the nipple being
also retracted. The patient was at once advised to come into town in
order to the enucleation of the tumour. This, however, her circum-
stances prevented; and without any expectation of affording much
relief, a lotion of Hydrastis was ordered, with the internal use of the
same medicine. The pain almost immediately ceased, and the tumour
so speedily decreased in size that at the end of two months it had alto-
gether disappeared, leaving but the puckered skin, which had otherwise
regained its natural appearance. When we last heard of this patient
she continued perfectly well. It is needful to state that her health
rapidly improved during the treatment, and that her countenance
regained the aspect of health.”
Dr. Marston, writing a year and a half later,* says that
this patient "has not again come under notice, though I
have no doubt that she would have put in an appearance
had anything occurred which would have called for our
assistance."
To Dr. Bayes, however, we owe the best knowledge we
possess of the power of Hydrastis over cancer. In papers in
the nineteenth and twentieth volumes of the British Journal
of Homœopathy, and in the third volume of the Annals of
the British Homœopathic Society, he gives a number of cases
treated by the drug both internally and externally. His final
conclusion is that it has no influence over the cancerous
dyscrasia as such, and is of little use in epithelial or uterine
carcinoma; but that in scirrhous tumours developed in
glandular structure-as in that of the breast-it is often of
great value, through a specific influence upon the gland itself.
When it fails in mammary scirrhus, it is generally found that
the gland has become absorbed or deeply involved in the
cancerous mass, so that there is little healthy tissue to act
upon. Dr. Marston also assents to this theory; and what
makes it more probable is that Hydrastis has great power of
dispersing simple glandular tumours of the breast. But
however this may be, I think that these physicians express
the general experience of the homoeopathic body in this
country; and that in suspected mammary scirrhus we are
* Brit. Fourn. of Hom., xxiii., 196.
524
HYDRASTIS CANADENSIS.
well justified in withholding the knife or the caustic, and first
giving our patients the benefit of the local and internal use
of Hydrastis.
The present state of opinion among British homoeopathic
practitioners as to the virtues of Hydrastis in cancer may be
gathered from two papers read within the last three years
before the British Homœopathic Society, with the discussions
following, the report of which you will find in the eighth
volume of the Annals. One is "On the treatment of intract-
able forms of disease," by Dr. Gutteridge; the other "On the
antecedent symptoms to local cancerous deposit," by Mr.
Clifton. You will see there that whilst some of our colleagues
have been disappointed in the remedy, several testify unequi-
vocal confidence in it. Dr. Gutteridge says: "I should
contend, led by my own experience, that the Hydrastis
treatment is the very best yet known for this dire disease.
. . It improves the appetite and condition of the patient
generally; under its use the complexion alters, the state of
the blood improves. . . It marvellously allays the pain of
cancer, in this respect altogether surpassing opium, morphia,
or any so-called anodyne. It retards the growth of cancer.'
Mr. Clifton calls attention to a group of symptoms which he
has often met with in patients who have afterwards developed
cancerous growths. They are those of "atonic dyspepsia"-
obstinate constipation, flatulence, pains in the bowels, kidneys,
and liver, &c., but without the altered tongue and the pain
after food generally seen in such cases, The complexion, too,
was not "bilious," but brownish or earthy; and the skin was
generally dry or harsh. He has found the "dyspeptic" symp-
toms in these subjects quite unamenable to the usual remedies
of homoeopathy, as to those of the ordinary practice; but
since he has recognized their significance, and treated them
with more positively anti-cancerous medicines, he has had
very beneficial results. "I may say," he adds, "that Hydrastis
Canadensis has been found more beneficial than any other
drug ;" and I need hardly point out to you its appropriateness
to the condition he describes.
""
Another important testimony to the (at least) occasional
value of Hydrastis in cancer has been given by Dr. Kidd, in
the appendix to his recently-published Laws of Therapeutics.
"In an extensive practice during thirty years," he writes, "I
have been three times encouraged as to the possibility of
curing cancer." In two of the cases he refers to-incipient
scirrhus of the breast, of undoubted malignancy-complete
recovery took place under our present medicine.
HYDROCOTYLE ASIATICA.
525
Judging from Dr. Hale's book, our American confrères do
not seem to have followed us in this application of the remedy
we have derived from them. But a case is cited there from a
Belgian source, in which an apparently hopeless scirrhus of
the stomach occurring in an old man was so greatly influenced
for the better by Hydrastis, that the patient enjoyed the rest
of his life in tolerable comfort.
I have said nothing as to the rationale of the two latter
uses of Hydrastis, for they cannot as yet be explained, either
on antipathic or on homœopathic principles. We must know
more about the physiological action of the drug, on various
subjects and under prolonged use, ere we can theorise on
the point.
The analogues of Hydrastis in its action on mucous mem-
brane are Pulsatilla, Kali bichromicum, Ammonium muriaticum,
and Antimonium crudum. On the lower bowel it acts like
Collinsonia, Aloes, Sepia, and Sulphur; and on the mammary
gland like Phytolacca and Conium.
The dose, as has been seen, and as is evident from the
quarters from which the praises come, need not be a very
minute one; though unquestionably the drug acts well in at
least the lower dilutions.
A favourite indigenous Hindoo medicine now comes before
us, which has become the property of homoeopathy by being
proved. I speak of the
Hydrocotyle Asiatica.
A tincture is prepared from the entire plant.
An article by Dr. Audouit, of Paris, containing a patho-
genesis of the drug chiefly obtained from provings on his own
person and observations on patients, appeared in the Journal
de la Société Gallicane in 1856, and was (in substance) trans-
lated in the sixteenth volume of the British Journal of
Homeopathy. This monograph-which, as reprinted sepa-
rately,* I lay before you-constitutes my chief source of infor-
mation regarding the drug.
Hydrocotyle came to France from the east, recommended
from both East and West Indies as a remedy for leprosy.
The first to use it was a Dr. Boileau, of the island of St.
Maurice, who has reported as the final result of his experience
* Etudes pathogénétiques et thérapeutiques sur l'Hydrocotyle
Asiatica. Bailliere, 1857.
526
HYOSCYAMUS.
that in fifty-seven cases of this dire disease* treated by
him with the plant, in all, without an exception, its progress
was arrested. It is a curious comment upon his statement
that he himself subsequently died of this very malady. Other
Eastern practitioners, however, found good results from it;
and it was tried in the Paris hospitals by Cazenave and
Devergie. They could not say much of its power over the
few cases of leprosy they had to treat; but they found it very
efficacious in some chronic eczemas. Dr. Audouit himself
reports cases in which it proved curative of lepra tuberculosa,
lupus exedens, and chronic eczema impetiginodes. Alto-
gether, there can be no question of the influence of Hydro-
cotyle upon the skin; and further provings and more extensive
experience may define it.
The pathogenetic symptoms hitherto elicited are not strik-
ing. The drug evidently stimulates the cutaneous surface,
causing redness, erythema, itching, and much perspiration;
also there appears under its use increased secretion of urine,
often with deposit. The nerves of sight and hearing, and the
trigeminus, become hyperæsthetic; and there is decided irri-
tation of the uterus, even to visible redness of the cervix.
Acting on this last hint, Dr. Audouit has given Hydrocotyle
with much success in granular ulceration of the neck of the
womb, and in pruritus vaginæ. It ought to find a place in the
treatment of facial neuralgia.
Dr. Salzer, of Calcutta, states that the repute of Hydro-
cotyle in elephantiasis led him to try it in a less obstinate
thickening of the skin-acne rosacea, and with good effect.
I have lately cleared a lady's face of a troublesome eruption
of this kind with the drug, being led to it by the evident
connexion of the acne with uterine disorder, which had now
ceased.
Hydrocotyle reminds me somewhat of the crude action of
Silica and Lycopodium, and of that of Dulcamara.
Dr. Audouit's usual dilution was the sixth; and this I
myself used in the case I have mentioned.
My next medicine is the familiar henbane,
Hyoscyamus.
The homoeopathic tincture is made from the herbaceous part
of the fresh plant of the H. niger.
* Dr. Helmuth, in his Surgery (p. 136) says “lupus;" but this is a
mistake.
HYOSCYAMUS.
527
The proving of Hyoscyamus is in the fourth volume of the
Reine Arzneimittellehre. It contains 104 symptoms from
Hahnemann, 123 from six fellow observers, and 355 from
forty-four authors. Most of these last are recording cases of
poisoning; but Greding's observations were made on epilep-
tics, melancholics, and maniacs, and hence—especially when
the symptoms belong to the nervous system-must be used
with caution. Hyoscyamus has also been proved by the
Vienna Society, of whose experiments you may read an ac-
count in the sixth volume of the British Journal of Homœo-
pathy; and by Dr. John Harley, as recorded in his Old
Vegetable Neurotics. Dr. Allen, incorporating the above, adds
some more poisonings and provings. Besides these sources of
information, I may refer you to an exhaustive monograph on
Hyoscyamus by Dr. Laurent, constituting one of the theses
for the doctorate of the University of Paris (An. 1870, tome 7),
and to some recent experimentation with the alkaloid hyoscy-
amine, carried out by Dr. Lawson, and recorded by him
chiefly in the West Riding Medical Reports for 1875-6.
Toxicologists were wont to tell us that the virtues of Bella-
donna, Hyoscyamus, and Stramonium depend upon a common
"active principle," and that their action is therefore essentially
identical. I say "were wont," for they seem receding from the
position of late. But when we turned to writers on thera-
peutics, we heard nothing more about the relation of henbane
to these "deliriafacients;" but found it classified as a sub-
stitute for Opium in cases where the cerebral or intestinal
influence of the latter drug is undesirable. If "contraria
contrariis " be the rule by which it acts, one of these views
must have been wrong. But as they are both founded on
indubitable facts, the influence can only be that the "calming,
soothing, and tranquillising effect" for which the drug is
ordinarily administered is a homoeopathic action. It is
especially observed, Pereira goes on to say, "in persons
suffering from great nervous irritability, and from a too
active condition of the sensorial functions." He would have
been more correct had he said that it is in these only that it is
observed.
Hyoscyamus has indeed nearly all the actions we have seen
in Belladonna, though in a milder degree. It irritates the
nervous centres, the mucous membranes, and the skin; but
the functional excitement is only moderate, and the circulatory
disturbance never goes on to inflammation. Indeed, when the
drug is pushed, the phenomena are rather those of congestion
with oppression of function. Hence the somnolence so often
528
HYOSCYAMUS.
noted as resulting from it. It requires full doses to produce
it-two ounces of the succus (according to Harley) or an
equivalent quantity of hyoscyamine; and is accompanied
with giddiness and weight across the forehead, flushed cheeks,
and injected eyes. It is full of dreams, and is often broken by
mutterings and slight jerkings of the limbs. Such a condition
is totally different from natural sleep, with its cerebral anæmia.
In cases of poisoning, the peculiar condition known as coma
vigil" or "typhomania" is sometimes induced; or a complete
apoplectic coma may supervene.
(C
When functional excitement predominates over vascular
engorgement, delirium is induced. This is rarely furious; it
is either a vivacious talkativeness with hallucinations of the
senses, or a spiteful, quarrelsome moodiness. Dr. Lawson
describes it as "a mental condition which partakes of all the
leading symptoms of simple mania" in a "subdued form."
There is no hyperemia with it. "Muscular twitchings," says
Dr. Harley," and restlessness of the eyeballs are more fre-
quently seen during the action of Hyoscyamus than with
that of Belladonna." With this condition insomnia is always
present.
The differential diagnosis of the three mydriatics in the
treatment of head affections as recognised in the old school (at
least as regards henbane) is fairly stated by Dr. Phillips; and
precisely corresponds with what we have now seen as the phy-
siological action of the drug. "In cases of cerebral hyperæmia
the severer forms are removed by belladonna, while hyoscyamus
proves its value when there is little or no congestion, but much
excitement. So in the case of delirium; the forms of this
disorder for which hyoscyamus is adapted are the milder and
less inflammatory ones, whereas the severer cases are better
dealt with by belladonna and stramonium. Hyoscyamus is
specially useful again in those cases of delirium with hallucina-
tions which are accompanied by little or no cerebral congestion,
but where there is great excitability of the nervous system, and
where there is reason to fear that the operation of opium would
prove injurious."
The two types of cerebral disorder, accordingly, in which
Hyoscyamus is useful are those occurring in fever and in
delirium tremens.
1. Hahnemann himself, in relating his treatment of the
fever-typhus and relapsing-which ravaged Germany after
the campaign of 1813, speaks of Hyoscyamus as the suitable
medicine when head symptoms became prominent; and it has
ever since been the favourite remedy for this condition among
)
HYOSCYAMUS.
529
his disciples. It is exquisitely homoeopathic thereto, as may
be seen from this picture of Dr. Harley's :-" after one hour,
pulse increased four beats; sclerotic and conjunctiva a little
injected; the face-chiefly the checks-hot and flushed;
tongue dry and brown down the centre, the rest of the mouth
very clammy; much somnolency and giddiness." The urine
always manifests an increase of urea, and of the phosphates
and sulphates, just as during the action of Belladonna. Stillé
also compares the somnolence with incoherent mutterings
produced by Hyoscyamus to that which is so common in
typhoid fever. It is the form of typhus which used to be
called "febris nervosa versatilis" in which Hyoscyamus has
proved most useful, with coma vigil and muttering delirium.
It is also very helpful in the typhoid form of puerperal fever.
Painless, and it may be involuntary, diarrhoea calls for it in
the latter (and indeed in the puerperal state generally); and
in both a key-note for the drug is that the patient will not
remain covered.
2. The delirium of Hyoscyamus corresponds most nearly
with that seen in delirium tremens. "The connexion," says
Dr. Harley—and Dioscorides had noted the same thing before
him-"between alcoholic intoxication and the effects of
henbane on the cerebrum and motor centres is undoubtedly
very close."
The experiments of the Vienna provers show
that the drug has the power also of producing the gastric
mucous derangement so often present in this disease. It is
an excellent remedy for it, calming the whole system and
promoting sleep. It is also of use in nymphomania, in which
the tendency to uncover the person is so strong; and in puer-
peral mania. Dr. Phillips says that "in hypochondriacal
monomania, when the patient suffers from such mental symp-
toms as syphilophobia, when really he has no reason to think
himself the subject of any venereal taint, hyoscyamus will
relieve the distressing despondency, and in many instances
remove the hallucination.' Hahnemann thinks that the
delirium of Hyoscyamus closely resembles that of hydro-
phobia, to which it is undoubtedly homoeopathic along the
whole line; but Belladonna and Stramonium, which act so
similarly, have been hitherto selected in its stead. It is never
curative in chronic insomnia, to which it acts as a mere pallia-
tive; but it is useful where sleep is restless or too dreamful
from cerebral excitement or feverishness.
>>
Dr. Lawson has considerably added to our knowledge of
the value of Hyoscyamus in cerebral derangements. He finds
it of great value in "simple mania, characterised from the first
2 M
530
HYOSCYAMUS.
more by agitation than excitement, and due to the existence.
of obscure delusions and hallucinations ;" also in recent cases
of chronic mania, and in the recurrent form of the disease,
where the paroxysms present as their main features bodily
restlessness," an amiable but troublesome officiousness," and a
destructive tendency. It is hardly less useful in the excite-
ment of general paralysis, and in the incessant incoherent
talking occurring in some forms of mania. The homeo-
pathicity of the remedy to these morbid. conditions is
obvious; and Dr. Lawson admits it in other words. "The
succussion," he says, “produced in the mind already muddled
with delusions and hallucinations by the antagonism of new
forms of mental aberration, together with the subsequent deep
and prolonged sleep produced, may tend to leave the mental
state more composed after the artificially produced delusions
and hallucinations have passed away." This is, like Trous-
seau's "substitution" and Dr. Harley's mutual interference of
circles of water, merely homoeopathy in other words. Dr.
Hayward has lately shown us that such large and paralysing
doses as Dr. Lawson employs are not always necessary,* and
Drs. Ringer and Bury have found atropia and daturia-the
alkaloids of Belladonna and Stramonium-to have quite as
calming an effect in mania as hyoscyamine itself.†
I have mentioned, on Dr. Harley's authority, the frequent
occurrence of muscular twitchings during the action of
Hyoscyamus. Dr. Oulmont, of Paris, has lately published ‡
some interesting observations upon its use in mercurial and
senile tremors, and even paralysis agitans. Dr. Hammond,
and also Dr. Lawson, praises it in the tremors of sclerosis of
the nervous centres. We have long known its value in what
might be termed "local chorea" in children, as squinting,
stammering, twitching of the face, &c.; but this is an exten-
sion of its field of action which, being thoroughly homœo-
pathic, we shall do well to follow up. Dr. Guernsey seems
to consider jerking and twitching of the muscles, including
those of the face and eyes, an actual "key-note" for the
remedy.
The only other recognised use of Hyoscyamus in the
homœopathic school is in the relief of cough. Hahnemann
observed it cause dry cough at night, constant while lying
down, but relieved on sitting up; and such a cough is daily
being eased by the drug, even in infinitesimal doses. Dr.
* Brit. Fourn. of Hom., xxxv., 162.
† Practitioner. March, 1877.
‡ Ibid, X., I.
}
HYOSCYAMUS.
531
Phillips transfers this use of it to his pages, and leaves it to be
understood that it is as a "sedative " that it acts. But, if so,
why this precision as to the kind of cough it relieves? A
sedative merely deadens nervous susceptibility, and would do
so as readily were a cough nocturnal or diurnal.
Hyoscyamus may yet receive wider applications. Hahne-
mann says that it causes epistaxis and frequent catamenia,
and refers to its repute in chronic hæmorrhages. He describes,
moreover, a form of toothache in which it is remedial.* “It
occurs," he says, "only from cold air, mostly in the morning,
with rush of blood to the interior of the head, that makes the
tooth loose with a formicating pain in it, and on chewing
there occurs a sensation as if it would fall out, whilst at the
same time there is a tearing pain in the gum." It is also
worth noting that Wepfer, in a case of poisoning observed by
him, records severe pains in the iliac region and in all the
joints as having occurred; while Schneller, one of the Vienna
provers, experienced similar sensations. He speaks of draw-
ing and tearing pain in the joints, especially in the wrists and
knees. Stillé says that while general sensibility is, in most
cases, very much impaired, there may at the same time be
some neuralgic pains in the course of the principal nervous
trunks.
In Belladonna and Stramonium I have named the only true
analogues of Hyoscyamus.
As regards dose, Hahnemann recommended the 12th dilu-
tion, and those from the Ist to the 4th decimal have been
much employed in later times. But Dr. Harley's experiments
would indicate that the juice of henbane is not always a very
active poison, as much as three ounces of the succus of the
Pharmacopoeia being necessary to develop its full physiological
effects. I, however, have seen its dryness of mouth and throat
supervene under the use of drop doses of the first dilution.
There is probably a good deal of variability in the activity
of the plant; and it might be well to follow Dr. Oulmont's
recommendation, and try whether the substitution of the
alkaloid would give us as good results. Dr. Allen gives
a separate pathogenesis of it. One eighth of a grain of
hyoscyamine, according to Dr. Harley, has the same potency
as three ounces of the succus; and Dr. Oulmont gives it in
granules each containing a milligramme (gr. ¿). Dr. Lawson's
dose in mania is three-quarters of a grain, given once, and
rarely repeated.
5
* Lesser Writings, p. 642.
532
HYPERICUM PERFORATUM.
I have next to speak of the S. John's wort,
Hypericum perforatum.
A tincture is prepared from the entire fresh plant.
A proving of Hypericum is recorded in the fifth and sixth
volumes of the Hygea. Three women took each one dose of
four drops of the mother tincture, and the effects lasted for
some weeks. Several other persons have tested it, as you will
see in Allen's Encyclopædia.
>
The S. John's wort was of some ancient renown in medicine.
Dioscorides praised it for sciatica and agues. The following
extract from Johnson's edition of Gerarde's Herball will show
the account that was made of it in 1633. "S. John's wort
with his floures and seed boyled and drunken, provoketh
urine, and is right good against the stone in the bladder, and
stoppeth the laske," whatever that may be. "The leaves
stamped are good to be layd upon burnings, scalds, and all
wounds; and also for rotten and filthy ulcers. The leaves,
floures, and seeds stamped, and put into a glass with oyle
olive, and set in the hot sunne for certaine weeks together, and
then strained from those herbes, and the like quantity of new
put in, and sunned in like manner, doth make an oyle of
the colour of blood, which is a most precious remedy for
deep wounds, and those that are thorow the body, for
sinewes that are pricked, or any wound made with a venomed
weapon." He then describes a "compound oyle," prepared
with Hypericum, white wine, and oil of olives and tur-
pentine, which he says is the finest balsam in the world.
This repute of Hypericum as a vulnerary, after slumber-
ing for some time, has awakened again in the homoeopathic
school. Its action on the nervous system, as inferred from
the provings, led Dr. Franklin to use it in injuries involving
the nerves; and, in the large opportunities he enjoyed during
the American war, he learned to place the utmost confi-
dence in its use. You will find his recommendations in his
Science and Art of Surgery. "Injuries of parts rich in nerves,
particularly the fingers and toes, and the matrix of the nails,"
open painful wounds, with general prostration from loss of
blood, and great nervous depression; and lacerated wounds—
these, he says, are the special spheres of its action. He con-
siders that it stands in the same relation to laceration as
Arnica to contusion of the tissues. He recommends the
higher dilutions internally, and locally one part of the tincture
}
M
INDIGO.
533
to twenty of warm water. Dr. Ludlam had previously pub-
lished* two good cases of injury to the spinal cord benefited
by Hypericum, and had suggested that it might prove to be
the Arnica of the nervous centres.
My friend Dr. Edward Madden has made a short proving of
Hypericum for me, taking at length as much as 260 drops of
the mother tincture in the day. It had little effect save the
diuretic one noted in the old herbal, and a few neuralgic
shoots in the eye-balls and the right ulnar nerve. Dr. Brinck-
ner experienced this last pain (but in the left arm) while
proving the dilutions.
Time will not allow of my beginning upon Ignatia to-day,
so I will in conclusion say the few words that are necessary
about
Indigo.
The dye of commerce is triturated for homœopathic use.
Indigo has been well proved, in substance and the lower
triturations, first by Professor Martin and his pupils, and then
by Lembke. Their results, with a few other observations,
make up nearly 590 symptons in Allen's Encyclopædia.
A feeling as if the brain were distending at the centre;
epistaxis; toothache, of a rheumatic character; bloating of the
stomach; and a good deal of irritation of the bladder, with
mucus in the urine-these are the only noteworthy effects I
can discover in the pathogenesis of Indigo. As a remedy, it
has been used in the old school with occasional success in
epilepsy and chorea. Teste states that he has cured with it
some worm-fevers in children, and has found it of service in
chronic catarrh of the bladder, and in urethral stricture
threatening after gonorrhoea. It is a drug I have never myself
used; nor has Espanet or Bayes anything to say about it.
Dr. Guernsey mentions it once only, as indicated by burning
in the mammæ during the menses.
* See Brit. Fourn. of Hom, xvii., .523.
LECTURE XXXV.
IGNATIA, IODINE AND THE IODIDES:
We begin to-day with a medicine which owes its fame almost
entirely to Hahnemann and his disciples, the seed of the
Strychnos S. Ignatii, S. Ignatius bean,
Ignatia.
It is ordinarily treated with alcohol to form a tincture; but
the results of Jörg's provings seem to show that a tritura-
tion of the bean would better preserve the virtues of the
drug.
Ignatia was fully proved by Hahnemann himself, and 620
of the 795 symptoms ascribed to it in the third edition of
the second volume of the Reine Arzneimittellehre are his.
121 of the remainder are from Jörg; they are marked
"Hartlaub and Trinks," being taken from their compendium.
They were obtained by the Professor himself and twelve of
his pupils, who took doses of from 10 to 200 drops of the
tincture, and from one to four grains of the powdered bean.
Ignatia contains a considerable amount of strychnia, more
indeed in proportion than Nux vomica itself It is doubtless
to this alkaloid that it owes much of
much of its energy. Yet
strychnia could not take the place of either, nor could Ignatia
and Nux vomica be given interchangeably. The study of the
effects of our present medicine will show its own distinctive
individuality, and this study could nowhere better be carried
out than in Hahnemann's pathogenesis. He has bestowed
special pains upon it, enriching it with notes and references
between the symptoms; and his preface is full of important
observations.
In poisonous quantities Ignatia simply produces tetanic
spasms, and death by dyspnoea. But these phenomena are
resolved into their elements by the symptoms resulting from
smaller doses. Ignatia exalts the impressionability of the incident
IGNATIA.
535
nerves all over the body. We have hence pains and other morbid
sensations well-nigh everywhere; increased susceptibility of
the special senses; emotional sensitiveness; and-probably
from reflex excitation-twitchings, constrictions, and spasms.
This action of the drug, however, is not deep and lasting. An
alternating series of symptoms-numbness, torpor, depression
-soon appear, which are themselves as superficial as their
predecessors. The febrile symptoms which the drug causes
have the same characteristics. Its chill is readily removed
by external warmth; and its heat is unaccompanied by thirst.
So is it with the mental and moral phenomena which occur.
The sense of being in a hurry; the ready starting, irritability,
impatience and querulousness which mark its first effect,
often alternate with undue hilarity or silent melancholy.
These symptoms have naturally led to the use of Ignatia in
the treatment of hysteria. Comparing the moral state it suits
with that which indicates Nux vomica, Hahnemann says:-
"it is not where anger, urgency, violence predominate, but
where there prevail rapid alternations between hilarity and
desire to weep." I do not say that Ignatia will follow
hysteria into all its ramifications; but it will remove many of
its painful, spasmodic, and convulsive phenomena (some of
which will come before us directly), and by its continued use
will greatly improve the fundamental perversion of the ner-
vous functions, especially the emotional instability. It is also
of frequent service in other neurotic affections. Before
Hahnemann's time it was in use for epilepsy, when brought
on by violent emotions. He agrees that in a first attack so
caused, when assuming a threatening aspect either on account
of its duration or rapid recurrence, it may even be permanently
cured by a single small dose: this his own experience con-
firms. He says, moreover, that epileptic fits which only occur
after chagrin or grief about a moral wrong, and never appear
from any other cause, may be prevented by the drug. But he
cannot allow that chronic and settled epilepsies are
curable by it. This "chagrin " (that is, sense of offence) is a
causa mali to which he thinks Ignatia specially adapted, when
it affects persons who are not in the habit of breaking out
into vehemence or of seeking revenge, but who keep it con-
cealed and dwell upon it in their recollections. But when
fright or grief are the exciting emotions Ignatia has been
found hardly less useful. It is often of service in the eclamp-
sia of children* or of puerperal women, when thus caused or
from reflex irritation, where the phenomena are spinal rather
* See Dr. Hirsch in Brit. Journ. of Hom.. xxvi., 221.
ever
536
IGNATIA.
than cerebral. In neuralgia, also, it has found a place. This
is excellently characterised by Gerson in his article on the
therapeutics of prosopalgia, which you will find translated in
the twentieth volume of the British Journal of Homeopathy.
Its neuralgia is that of hyperæsthetic patients, which never-
theless is borne patiently, or at most with quiet weeping; it is
not deeply rooted, and often alternates with pain of the same
kind elsewhere. Dr. Nankivell has communicated a striking
cure of sciatica with it.*
Ignatia also causes, and has cured, several local affections,
though probably acting always on the nervous elements of the
part. It readily excites headache, especially a pressive aching
in limited spots, shifting from one to the other. Sometimes
the concentrated pressure is described as if from a pointed
body, and resembles the "clavus hystericus," in which the
medicine has often been found useful. In the fifteenth volume
of the Monthly Homeopathic Review you will find a graphic
picture of the headache of Ignatia, by Dr. Shuldham: it is
of course accompanied with great impressionability of the
senses, and frequently passes off with the evacuation of a
large quantity of pale limpid urine. At its height it is often
agonising; there is restlessness then and chilliness throughout.
Then there occurs a peculiar disturbance of vision which
Hahnemann compares to the "spurious vertigo" of Herz: “a
circle of white, shining, flickering zig-zags when looking out
of the line of vision; the letters at which one looks becoming
invisible, and those which are close by becoming so much
more bright." In the throat Ignatia causes a sensation as if a
lump were there; there is a sore pain when swallowing, but
between the acts of deglutition the lump is felt most, and
there is then (and then only, Hahnemann says) a sense of
sticking. Nervous sore throats so characterised are readily
cured by the medicine; the "lump" is no real swelling. A
peculiar feeling of weakness at the pit of the stomach was
complained of by more than one of the provers; and this is
said by Hahnemann to be a characteristic symptom of Ignatia.
The great formation of flatulence which is noted is a frequent
hysterical symptom. Then we observe in several of the
provers a remarkable tendency to prolapse of the rectum at
stool. This trouble when occurring in children, and also proc-
talgia in sensitive adults, has often been removed by Ignatia.
Dr. Hirsch finds it no less useful in constipation from weak-
ness of the lower bowel; and confirms the general impression
of its usefulness when ascarides infest this part. The menses
* Monthly Hom. Review, xv., 30.
IODUM.
537
are premature and profuse. There is itching of the skin, of
which Hahnemann observes that it is characterised by ready
disappearance after scratching. Sleep is absent, or very light,
or prevented by startings.
Besides the epilepsy I have mentioned, Hahnemann found
Ignatia in use for intermittents. His own observations led
him to lay down that "only those forms of ague can be cured
by it which are characterised by thirst during the cold, and
absence of thirst during the hot stage."
Chamomilla, Coffea, Nux vomica and Stramonium are the
general analogues of Ignatia. It is, like the first-named, pre-
eminently a women and children's remedy.
The medicine seems in favour alike with those who use
infinitesimals and those who prefer more substantial doses.
We shall be engaged during the rest of our time to-day
(and perhaps longer) with Iodine and the iodides.
Iodum
(as it is now called) is prepared for homoeopathic practice in
à saturated alcoholic solution, which contains about one tenth
part of the drug, and is reckoned as 1x in making the subse-
quent attenuations. These should be freshly prepared when-
ever the drug is to be employed in acute disease.
The extensive use into which Iodine soon came after its
discovery in 1812 led to a rapid accumulation of observations
as to its physiological effects. It was soon selected for prov-
ing by Jörg, who, with five of his pupils, took it in doses of
from half a grain to two grains. The symptoms thus ob-
tained were collated by Hartlaub and Trinks in the second
volume of their Arzneimittellehre, and a few added as observed
by themselves and Schreter. Hahnemann had already pub-
lished in the first edition of his Chronic Diseases 153 symp-
toms of his own as caused by the drug; and in the second
edition he incorporated these with the collection of Hartlaub
and Trinks, and some new observations from Gross and von
Gersdorff, making 724 in all. Of this total 348 are from
authors. Some of Hartlaub and Trinks' citations are effects
of iodide of potassium-Kali iodatum; and of these Hah-
nemann has not availed himself. We must therefore go back
to their work for them; and we shall also find there a separate
pathogenesis of the compound, apparently from provings, but
without name or other indication of origin. It contains 383
538
IODUM.
symptoms. Dr. Allen, in accordance with his usual practice,
gives separate pathogeneses of Iodum and Kali fodatum,
under these headings respectively. He omits from the former
all Hahnemann's citations from authors, on the advice of Dr.
Hering, strengthened by the investigations regarding them
with which I have been able to supply him. On the other
hand, he supplies numerous fresh observations of undoubted
validity. His pathogenesis of Kali iodatum is chiefly made
up of collections from periodical medical literature, and so far
is excellent; but it is, in my judgment, marred by the admis-
sion of the more than dubious symptoms furnished by Dr.
Houat, in his Nouvelles Données. I must warn you against.
accepting as genuine any effects of the drug warranted by this
writer only.
For the general literature of Iodine, I would refer you,
besides the articles in Stillé and Ringer, to Dr. Cogswell's
Essay on Iodine and its compounds; to a collection of "Obser-
vations on the curative and noxious effects of Iodine," by Dr.
Wilcox, in the first volume of the Annals; and to a "Study
of Iodine," by Dr. Madden and myself, in the twenty-first
volume of the British Journal of Homeopathy. In this last
you will find references to authorities for any unsupported
statements I shall make on the present occasion.
You will notice that I have spoken of Iodine and of its
compound with potassium in the same paragraph. I have
done so advisedly. I am quite unable to see any difference in
kind between the physiological effects of the two substances ;
although the presence of the alkali undoubtedly modifies these
as regards force and frequency of appearance, and makes a
considerable difference in practical use. Chemistry points in
the same direction. M. Sée* justly argues that Iodine must
necessarily unite with sodium in the stomach and potassium
in the blood, and circulate so compounded throughout the
frame; so that to give Iodine is virtually to give an alkaline
iodide. On the other hand Professor Binzt has shown that
when iodide of potassium reaches the tissues it is decom-
posed, and free Iodine liberated. The presence of protoplasm
and of carbonic acid is all that is necessary to effect this
change, as he has demonstrated by experiment.‡ Kämmerer
* London Medical Record, i., 757.
+ Practitioner, xii., 15.
No such decomposition takes place when bromide of potassium is
similarly treated, and we have already seen that the compounds of
Bromine with the alkalies have an action entirely different from that of
the pure substance, and requiring separate discussion.
}
IODUM.
539
J
had been previously led to the same conclusion; but Stillé
justly points out that only a small proportion of the iodide
undergoes this decomposition, the greater part escaping un-
changed by the urine, and therefore-unless it has destructive
work to do, of which more anon-being literally wasted. Thus
the ultimate effect of giving iodide of potassium is to supply
free Iodine to act on the living matter of the body; and we
may speak of the effects of either as belonging to the action
of Iodine. The chief difference is that the local irritant in-
fluence of the metalloid is greatly diminished by its union with
the alkali, so that large doses can ordinarily be introduced
through the stomach without resentment on the part of that
organ. A good many of the noxious effects of Iodine noted
by the older observers arose from its being given in simple
alcoholic solution. Such a tincture, unless largely diluted,
would precipitate the drug on entering the stomach, and leave
it there in substance to irritate the mucous membrane as we
all know it does the skin. Hence the violent gastro-enteric
irritation, the vomiting, colic and diarrhoea, which Hahne-
mann cites from many authors. Those who, like Coindet and
Gairdner, used the drug more carefully had no such acci-
dents; and since iodide of potassium has been the form of
administration they have been rarely seen. The "iodism
observed by such therapeutists belongs either to the nervous
system or to the distant tissues, as we shall see presently: it
is set up subsequent to absorption.
"}
What, then, are the remote effects of Iodine when intro-
duced into the circulation and diffused through the frame?
1. They are, first of all, irritative in nature. The peculiar
form which iodic irritation takes is best studied in its most
frequent seat-the upper portion of the respiratory mucous
membrane. "There is first noticed," says Dr. Ringer, "some
slight running at the nose, with occasional sneezing, and a
little frontal headache; these symptoms become more marked,
when the conjunctiva of the eyes is injected, and the tears
abundantly flow.* The loose tissues about the orbit become
swollen, reddened, and oedematous, while occasionally a pecu-
liar rash appears on the skin of the face.
The nose is
sometimes reddened, especially at the tip, and is at the same
time rather swollen. The rash has not always the same look.
It is often very much like acne, and is always hard, shotty,
and indurated, but the papules may be broad and large, and
covered with what looks like a half-developed vesicle or pus-
This conjunctival irritation may go on to acute oedematous inflam-
mnation with chemosis, as observed by Ricord.
-
540
IODUM.
tule." Some instances of the occurrence of this coryza-always
from Kali iodatum—are collected in the twenty-third volume
of the British Journal of Homœopathy; where you will find it
noted of the watery nasal discharge that it feels cool, and
causes no excoriation, herein differing from that of Arsenic.
Erythema, with oedema, of skin and mucous membrane are
the phenomena here presented to us; and we see it going on
to infarction of glandular structure in the acne of the former,
and to copious flux in the latter. Similar effects may at times
be seen from the drug over the whole cutaneous surface, and
in nearly every part of the mucous tracts. There is a stoma-
titis incident to its use, accompanied with desquamation and
ptyalism. Angina is a characteristic symptom of saturation
of the system with it. Besides the gastritis and enteritis of
its local influence, there is a gastric-and also an enteric-
catarrh occasionally resulting from small doses, and seen
after introduction of the drug into the circulation otherwise
than by the stomach.* It seems under these circumstances
largely eliminated by the peptic glands, and may cause their
degeneration in the process, as in a case of Rose's cited by
Boehm (Ziemssen, xvii., 296). The lower portions of the
respiratory tract exhibit signs of the same irritation that we
have seen in the upper. In the larynx and trachea we may
have hoarseness, aphonia, and chronic inflammation, even
simulating laryngeal phthisis; and while the bronchi are but
moderately affected, the lungs show the influence of the drug
by congestive oppression, hæmoptysis, and even pneumonia.
The genito-urinary tract is the only part which seems to resist
its action. The skin manifests it sometimes in such intense ery-
thema as that described by Dr. Inman,† or, more commonly,
in eruptions of acne or of pustules, and, more rarely, of bullæ.‡
Nor does the iodic irritation limit itself to skin and
mucous membrane. Serous membrane also feels it, if the
effusion into pleura and peritoneum found in autopsy means
anything;-Wallace also noting that, among his patients who
took full doses of iodide of potassium for syphilis, several had
acute pain over the left false ribs, with cough, dyspnoea, and
fever.§ Glandular structure also is very frequently affected.
The first result is stimulation to increased action, whence we
have the salivation and diuresis|| often noted, and the increasc
* See Stillé, ii., 850.
+ New Theory and Practice of Medicine, p. 270.
‡ Stillé, ii., 853.
§ Lancet, 1835-6, i., 9.
|| In children albuminuria has more than once been produced by its
external application.
}
IODUM.
541
of the biliary and pancreatic secretions, as observed (among
others) by Jörg's provers and by Gairdner. The testes feel
its influence in increase of sexual appetite, and the ovaries
show it in menorrhagia. The ultimate effect is either chronic
inflammation, as recorded by Christison of the liver and by Sée
of the kidneys, or atrophy, of which the mammæ and testicles
are the subjects. The last result of the action of Iodine has
been much doubted by recent writers; but their scepticism
only arises from ignorance of the older observations. Hahne-
mann cites some of these; and to every one he mentions I could
add two others. Diminution in the functional energy of the
ovaries makes it probable that these organs are similarly
affected, barrenness having occurred from the use of the
drug in young females previously prolific, and the menses
being often suppressed.
Whether the lymphatic glands are similarly influenced by
Iodine is a question of much interest in its bearing on
therapeutics. Hahnemann cites Röchling as having observed
"induration of the axillary glands" from its use. But when
we examine the original, we find that the author is re-
porting the treatment by Iodine of glands already enlarged,
which it caused to suppurate readily; and that his "Vereite-
rung" has been transcribed "Verhärtung." The mistake is
Hartlaub and Trinks', from whom Hahnemann has copied.
Dr. Cartwright, however, has put on record two cases in which
the glands of the neck enlarged under the action of the drug
given for other complaints.* This has also been observed
(in three instances) as a pathogenetic effect of the waters of
Hall, in Upper Austria, whose power over goitre shows that
the Iodine they contain is one at least of their active
ingredients.
For the effects I have now ascribed to Iodine abundant
evidence is given in the works I have mentioned at the outset.
And as we study them the interesting fact comes out that
all these irritations belong to the class of medicinal actions
which Dr. Drysdale has distinguished as "contingent.”
They are not "absolute " effects of the drug, requiring only
its administration in certain quantity, and their absence being
the exception to the rule. It is rather the other way. Iodine
locally applied, whether to skin or mucous membrane, will
certainly irritate. But introduce it into the circulation, and
this result cannot be predicted. Often enough it produces no
obvious physiological effect at all, even when given in large
Monthly Hom. Review, xii., 411.
542
IODUM.
doses.* When it does irritate, in one person its influence will
fall on the Schneiderian mucous membrane, in another on the
mouth or stomach, in another on the pleura, in another on the
skin. And of all these actions that is true which Dr. Imbert-
Gourbeyre has noted and formulised, that with contingenter
goes omni dosi. It is frequently remarked by Dr. Ringer,
when speaking of the various phenomena of what he calls
iodism, that "even minute medicinal doses will sometimes
produce" this or that effect. He explains in one place that
he means a grain of iodide of potassium or even less. We
shall see this even more strikingly exhibited when we come to
the phenomena of iodism as described by the older observers.
2. Of these I now proceed to speak as the neurotic effects
of the drug. I suspect that they are really irritative in nature,
peculiar only in the seat being the various portions of the
nervous substance. But, phenomenally, they are best classed
separately.
It was early noted by the introducer of Iodine into practice
-Coindet of Geneva-that when the system became satu-
rated with the drug a peculiar train of symptoms manifested
themselves. These were insomnia, palpitation, tremors, and
anxietas; and therewith rapid emaciation, often associated
with bulimia. The obviously nervous symptoms first men-
tioned were largely seen and recorded during the Iodine-
mania which set in on the publication of Coindet's results.
Gairdner has fully described the tremors, which resemble
those of Mercury. Manson and Cooper have seen these go on
to twitchings and other convulsive movements, and Brodie has
known them end in paralysis. The action on the brain mani-
fested in the insomnia has shown itself in various other ways.
Determination of blood to the head is frequent, causing head-
ache with sense of fulness, giddiness, drowsiness, epistaxis,
and even a sort of intoxication. One of the subjects of
Wallace's large doses of iodide of potassium was seized while
taking it with violent headache, and had dilated pupils and an
incessant motion of the eyes like that of a child with con-
genital cataract. Muscular tremors then supervened, and
lastly hemiplegia; from which he recovered but slowly.
-
((
* This fact is universally known as regards iodide of potassium, and
Gairdner says of Iodine itself—" Some persons take it in large doses for
a length of time with perfect impunity." Others," he adds, "from
that peculiar, undescribed, and unintelligible state of constitution called
by physicians an idiosyncrasy, are speedily and violently affected by
very small doses.'
""
Essay on the effects of Iodine on the human constitution.
London, 1824.
>
IODUM.
543
Gairdner has observed and described the anxietas characteristic
of the drug. It differs, he says, from hypochondriasis in this
respect, that the patients occupy themselves with the present
rather than with the future.* They describe it commonly as
a feeling of (psychical) sinking and faintness which is
particularly depressing; and they have been heard to com-
plain of this even when suffering violent pain. The sensory
centres are also affected, as by obscuration of vision, partial
deafness, and illusions of the sense of touch. The first of
these may depend on irritation of the retina. Hempel cites
a case in which the symptoms suggest retinitis (the patient,
however, was an hysteric); and Ricord states that he has seen
iodide of potassium produce transitory amaurosis, like that of
Bright's disease, and dependent on sub-retinal œdema.
But the most complete observations of this form of iodism
are those of Rilliet, of Geneva. A memoir presented by him
to the French Academy of Medicine was referred to Trousseau,
and his report thereon may be read in the twenty-fifth volume
of its Bulletin. It seems that Geneva is singular in the
entire absence of Iodine-so universally diffused elsewhere-
from its air and waters; so that its inhabitants offer a virgin
soil in which the drug can bear fruit. Hence, says M. Chatin,
the frequency of goitre there; but hence pretty certainly the
remarkable susceptibility displayed to the influence of the
substance when administered medicinally. The Genevan
bronchoceles are cured with doses of iodide of potassium of
less than a milligramme in amount; and it is while taking
such "nearly infinitesimal quantities," as Trousseau calls them,
that the "grave accidents" he cites from Rilliet occur. They
have been seen in these sensitive subjects from taking a ten-
thousandth part of the iodide in their table salt; and even
from staying at the sea-side, where it is calculated that they
inhale from the fiftieth to the tenth of a milligramme in
a day.
The first symptom of iodism which manifests itself is the
emaciation. It sets in suddenly and proceeds with startling
rapidity. The goitre (if there is one), the mammæ, and the
"
* Dr. Allen (S. 16) gives this observation in the converse sense, but
he is in error. Gairdner's statement, as extracted above, may be read
at p. 12 of his Essay. [Dr. Allen has corrected himself in his supple-
ment.]
† Ringer also has observed that "iodide of potassium sometimes pro-
duces distressing depression of mind and body. The patient becomes
irritable, dejected, listless, and wretched. Exercise soon produces
fatigue and even fainting.
See also Rilliet's own Memoire sur l'iodisme (Paris, 1850).
544
IODUM.
testicles go first; then the face falls in; then the whole body
wastes. There is no gastro-enteritis; but exaggerated appetite
is present, going on to bulimia: there is also much nervous
palpitation. Then supervenes a condition of hypochondriasis
or hysteria with weakness, sadness, insomnia, and nervous
susceptibility. The younger Coindet is quoted as charac-
terising this state as "a very troublesome condition of the
nervous system, which the subjects can hardly describe; it is
an internal agitation, similar to that caused by hearing bad
news, or by remorseful feelings after a quarrel; together with
inability to fix the attention when reading or drawing, weep-
ing, and intolerance of the slightest opposition." There are
painful sensations in the stomach, especially at its greater
curvature; and the face is pale, green, or yellow.
I cite these observations especially for the light they throw
on the emaciation of Iodine. This phenomenon has early and
constantly attracted attention; and it has been noted that it
is commonly accompanied by profuse sweats and accelerated
pulse, thus making it resemble closely the wasting of tuber-
culosis. There are three ways in which it has been accounted
for. The first and most common is to say that Iodine is a
stimulant to the absorbents; and that thus, absorption being
rendered over-active, atrophy follows upon its use. I shall
show reason for objecting to this explanation even of the
local effects of the drug; and I think that it quite fails when
applied to the emaciation of the system at large. The
absorbents are set for the nutrition, not for the wasting, of the
body as a whole. The lacteals take up the chyle from the
intestines, and the lymphatics absorb the not altogether effete
products of the disintegration of the tissues, and the residue.
(if any) of the liquor sanguinis which has been poured forth
from the capillaries for their nutrition. Chyle and lymph,
thus selected and taken up by the absorbent vessels, are
passed through the chain of absorbent glands, in which they
undergo that progressive elaboration which fits them to be
discharged, as blood, into the torrent of the circulation. It is
evident, therefore, that a drug which has the property of
stimulating the absorbent system must promote rather than
lower the nutrition of the frame.* A second view would
account for the atrophy of Iodine by the gastro-enteritis
which it is undoubtedly liable to occasion, attributing it to
* The notion here combated is identical with the Hunterian theory of
ulceration, which supposed this process to depend upon an over-active
state of the absorbents. Long given up in this sphere, it still holds its
place in speculation on the modus operandi of drugs.
IODUM.
545
the impairment of digestion which must result from this state
of the prima via. But a larger survey of the facts will at
once show this view to be untenable, as there is no constant
connexion between the gastro-enteric symptoms and the
emaciation; while Arsenic, which affects the alimentary canal
far more certainly and severely, causes by no means so rapid
and intense a wasting. Lastly, Iodine has been styled a
"liquefacient" of the tissues, and is supposed to promote
their disintegration with such rapidity that the waste is in
excess of the supply, and hence atrophy. We may have to
call up some such action when we come to consider the power
of the drug over syphilitic and other neoplasms; but we can-
not, I think, use it to explain the general wasting which is
induced. To begin with, the quantity which needs to be
introduced is quite insufficient to effect such a process. We
have, moreover, called to mind that the very function of the
lymphatic absorbents is to take up such tissue-substance,
disintegrated but not altogether effete, and, having elaborated
it into blood, to pour it back into the circulation. Thus, sup-
posing the absorbent system to continue healthy, the result of
such increased rapidity in the disintegration of tissue would
only be an increase in the purity of the substance and the
energy of the functions of the entire organism.
In this "supposing" I have indicated what I believe to be
the true direction in which to look for an explanation of the
atrophy of Iodine. Its sphere is the great absorbent system,
especially in its lacteal portion; but its action there-probably
by irritation of the active protoplasm-is depressant * rather
than stimulant. Given a sluggish taking up of the chyle by
the lacteals, and an insufficient elaboration of their contents
by the mesenteric glands, and we have at once a most im-
portant channel of nutrition choked up and rendered useless.
The fatty aliments being those which the lacteals chiefly
select, the emaciation becomes more rapidly apparent than if
it had been the albuminous elements whose supply was cut
off. But you will remember how Hughes Bennett, following
Ascherson of Berlin, has shown that the presence of oil is
essential to the assimilation of albumen; and infers that if
the fatty elements of food be insufficiently supplied, the
albumen remaining unassimilated in the blood will be de-
posited in the tissues as tubercle. If it is still tenable to
explain in this way the occurrence of primary tuberculosis,
* Dr. H. Goullon says that the mesenteric glands are found reduced in
size after poisoning by Iodine; but I know not his authority for the
statement.
2 N
546
IODUM.
it may account for the occasional development of phthisis
pulmonalis in iodised patients in whom no previous tendency
thereto had existed.
3. One word yet upon the possible hæmatic influence of
Iodine. It can hardly be imagined that so universal an
irritant of the living matter should circulate in the blood
without affecting its corpuscles. But whether this be the
rationale or not, it is certain that iodide of potassium every
now and then causes petechiae and purpura, and that under
the long-continued influence of Iodine the blood and the
secretions become thin and watery.
I may here also note the evident influence on the heart
which the drug has displayed. The palpitations of the
iodism of Coindet and Rilliet, the faintness noted by
Gairdner and Ringer, the death by syncope of Rose's patient
(who was poisoned by an Iodine injection into an ovarian
cyst) all these, combined with the dilatation of the right
ventricle of which we shall presently hear from Goullon, point
unmistakeably to a lethal influence on the substance of the
organ like that we have seen exerted by Arsenic. The
importance of this fact will appear as we proceed.
We have now completed our survey of the physiological
action of Iodine: its therapeutic applications we must reserve
for our next lecture.
LECTURE XXXVI.
IODINE AND THE IODIDES (continued)-IRIS.
In our last lecture we reviewed at some length the physio-
logical effects of Iodine. We have now to consider its recog-
nised uses as a medicine, and see what relation they bear to
its action as a poison; subsequently reviewing the further
applications of it which have been made, derived from the
latter according to the principle of similarity.
I. The earliest and the prerogative application of Iodine
is its use in bronchocele. "From time immemorial," as Stillé
says, “sponges and other marine products containing Iodine
have been recognised as popular remedies for goitre." When
this substance was discovered in one of such products, the
fucus vesiculosus (as well as the sponge itself), it was the happy
thought of Coindet to see if it would not prove to be the
active ingredient of the weed. He found it to be so; and from
that time to this the curative action of Iodine in bronchocele
has been one of the few certainties (with rare exceptions) of
ordinary medicine.
What is the rationale of its action? Let me read you a
short narrative: it is from the pen of one of the veterans of
Homœopathy, Dr. Goullon, sen.
*
"A man, 62 years of age, very bilious, and from his youth
affected with gout, got from an allopathic doctor for sciatica
two scruples of Kali iodatum in four ounces of water, with
directions to take morning and night a tablespoonful. After
about eight days there came on a rapidly growing swelling of
the thyroid gland, with some sensitiveness to the touch, and a
feeling of oppression. He was, however, ordered to continue
the medicine, and in the second week he got all the signs of
endocarditis-oppression, weakness almost amounting to faint-
ing, tumultuous throbbing, intermitting and unequal beats of
heart and pulse, tensive pain across the chest. The right
ventricle gradually became dilated." The medicine was
* Translated fron Allg. hom, Zeit., xlv., 63, in Brit. Journ. of Hom.,
xi., 335.
548
IODUM.
omitted, and Mercurius, Arsenicum and Sepia in succession
removed the symptoms.
I give you this for what it is worth. Let no one say, how-
ever, in derogation of homoeopathic doctrine, that Iodine has
never produced goitre; and do not let the singularity of the
occurrence weigh too much with you, having regard to the
peculiarly contingent and idiosyncratic nature of all the
effects of the drug. But let us consider what bronchocele
is, and what are the phenomena of its disappearance under
Iodine.
The thyroid body, whose enlargement constitutes the dis-
ease, is one of those ductless glands whose operation is doubt-
less concerned with the composition of the blood itself. It may
be (as Mr. Simon thinks) a diverticulum for the cerebral cir-
culation, as the spleen is for that of the stomach; but its
structure forbids the supposition that this is its only function
any more than that is of the spleen. The albuminous matter
it separates from its large supply of blood is contained in the
interstices of its honeycomb-like structure; and is probably
taken up from thence by its no less abundant lymphatics.
Simple bronchocele (with which alone we are at present con-
cerned) seems to be a failure on the part of the lymphatics to
undertake this absorption, so that the secretion accumulates ;
and this, and not any increase in its fibrous or connective
tissue, constitutes (at first, at least) the hypertrophy of the
gland. It may come on rapidly, like the splenic enlargement
of ague; and, like that, may rapidly subside. In old and hard
goitres, of course, the stroma itself must have become
thickened, and the fluid possibly absorbed. These are per-
Bag
manent.
Now the conclusions at which we have already arrived as to
the action of Iodine on the lymphatic system, and the case of
Dr. Goullon's just related, suggest forcibly that Iodine acts
homœopathically in the cure of the simple, recent and soft
goitre which depends upon unabsorbed secretion. Another
fact pointing in the same direction is the frequent occurrence,
noted by all observers, of increase of the tumour, with hard-
ness, pain, and tenderness, when needlessly large doses are
given. But still more convincing is the minute quantity which
often suffices for the cure. I have already mentioned the
experience of the Genevese practitioners. But in regions whose
inhabitants are less susceptible to the drug we have obser-
vations of the same kind. Dr. Kidd records a case in which
a large but soft goitre, of many months' standing, entirely
disappeared in two months under the hundredth of a grain of
IODUM.
549
Iodine night and morning.* A still more striking instance is
related in the Revue homœopathique Belge for August, 1874.†
The enlargement was of fifteen years' standing, and had
reached the size of a child's head; but was soft. Iodine 6
was given on August 3rd, 1873, and repeated every few days
up to the end of the year. Improvement was felt after the
second dose, and on January 1st, 1874, the tumour was found
to have completely disappeared. Mr. Cameron has even had
a case in which the 30th dilution effected the purpose; but it
took a twelvemonth in doing it.‡
It is otherwise, I think, with the old hard goitres we some-
times meet. Mr. Cameron treated two such cases with his
30th dilution, but effected little more than relief of distressful
sensations, that is, of irritation of the tumour such as large
doses cause. Dr. Kidd, in the valuable paper on the subject
to which I have already referred, mentions a hard goitre in
which he could get no effect from Iodine till he gave half a
grain three times a day; but with these doses he did cure
it, and with still larger quantities the most indurated bron-
choceles have been known to be melted down. I think that
we must here suppose a destructive action of the drug
to be exerted, such as we shall have to invoke to account for
its power over syphilitic gummata; and that we shall often
do well to use its local instead of internal exhibition. The
success of the application of ointment of biniodide of mercury
in India is, I understand, very constant and gratifying.
When goitre is cystic, Iodine must be still more locally
applied. It must be injected into the cavity; though even
there, as we shall see with hydrocele, it may act after a
specific manner. But it may find place as a homœopathic
remedy in yet another form of the disease, the exophthalmic.
The coincident affection of the heart in Dr. Goullon's case
rather suggests that the thyroid enlargement was vascular;
and Trousseau, commenting on the iodism described by
Rilliet, says he has seen the same condition in cases of Graves'
disease. Dr. Horatio Wood says of Iodine, that "experience
has demonstrated its value" in exophthalmic goitre also; but
I know of no record thereof.
II. The transition from bronchocele to scrofula is natural.
Enlargement of the thyroid was supposed to be so intimately
connected with the scrofulous diathesis that the name" struma"
* Brit. Fourn. of Hom., xxv., 180. Dr. Kidd's first decimal is
cvidently our present first centesimal.
† See ibid., xxxii., 720.
‡ Ibid., iii., 469.
550
IODUM.
was applied to it; and when Dr. Stillé says that the marine
products containing Iodine have long been recognised as
popular remedies for goitre, he adds, "and for scrofula."
Accordingly, when this substance was discovered to be their
active ingredient, and was found powerfully curative of bron-
chocele, it was at once applied to the treatment of scrofula.
The names of Manson* and Lugolf stand foremost among
those who have tested and written upon it; and their testi-
mony to its virtues is very earnest.
What is scrofula, and what is Iodine calculated to do in its
treatment in the light of the physiological action of the
drug?
According to the doctrine of Niemeyer, now generally
received, scrofula is that vulnerability of constitution which
we call "delicacy" plus a tendency on the part of the lym-
phatic glands in the neighbourhood of any disordered part to
take on hyperplasia and become enlarged. The other so-
called “strumous" affections are in no way specifically distinct
from the same diseases in non-strumous subjects, though they
are more readily induced and more difficult to cure. But this
doctrine, though it well connects the facts, does not explain
why the lymphatic glands are so apt to take on the morbid
action specified. It leaves out of sight, moreover, what I
think cannot be gainsaid, that these glands may be and often
are primarily affected. I must agree with Dr. H. Goullon, in
his excellent treatise on Scrofulous Affections, that scrofula is
essentially a morbid condition of the lymphatic and lacteal
system, whereby the lymph and chyle are supplied in an im-
perfect or vitiated state to the blood, and the nutritive pro-
cesses thereby impaired.
If this be so, we can well understand that Iodine may
change for the better the whole scrofulous diathesis, owing to
the profound action we have seen it to possess upon the lacteo-
lymphatic system; and that we are quite within the range of
homœopathy when we so use it. It must be especially suit-
able to the sanguine form of the scrofulous constitution, and
where the tendency is to emaciation rather than to the flabby
plumpness indicating Calcarea. As regards the several local
disorders, it must depend upon the elective affinity of the drug
for the part affected whether it shall have any specific influence
over its morbid conditions. Of these we shall speak farther
on. But we must consider here the action of Iodine upon the
* On the effects of Iodine. London, 1825.
+ On Iodine in Scrofula, translated by O'Shaughnessy. London,
1831.
IODUM.
55I
#
I
:
absorbent glands themselves when affected by scrofula.
have shown its power of engorging them; and I have no
doubt that here, as with goitre, the recent affection is fully
under the homœopathic action of the drug, and may be dis-
persed by small doses. My colleague Dr. Belcher has the ut-
most confidence in it when the glands of the neck are the part
affected he gives grain doses of the first decimal trituration
of Kali iodatum, and applies a weak solution locally. Dr.
Goullon relates two cases of laryngismus stridulus obviously
dependent on enlarged bronchial glands, where Iodine in small
doses was curative. Dr. Dunham mentions another, saying
that he was guided to the choice of Iodine by the fact of the
child having previously suffered from marasmus. I have
myself great confidence in it in this marasmus itself, the
"tabes mesenterica" of childhood. Under its use the hectic
first subsides; and the remaining symptoms, if proper diet
and hygiene can be secured, steadily disappear. I give the
third decimal dilution.
Here also, however, I suspect that any power which Iodine
may have over old indurations and suppurations of the cervical
glands is due to its destructive action, and requires substantial
doses. It was early noted that it promoted the formation of
matter in these adenopathies.
*
III. I have next to speak of the action of Iodine in syphilis.
Why it should have been tried in this disease, unless it were
from the analogy between its effects and those of Mercury, I
cannot say. But it was so tried; and the results-especially
when it was given freely by Wallace of Dublin as iodide of
potassium—were highly satisfactory. It is now the accepted
remedy for tertiary, as Mercury is for secondary syphilis.
That it is as Iodine that it cures, though given in combination
with potassium, appears from Dr. Guillemin's experience, who
finds the simple tincture do all that can be done by the iodide.†
I think that there is no reason for doubting that Iodine,
like Mercury, finds much in constitutional syphilis to which it
is homœopathic. As regards the general state, it is unquestion-
ably an impoverisher of the blood and a waster of the tissues as
the syphilitic virus is. "I would remark," says Trousseau,
* Lancet, 1835-36, vol. i.
† Gaz. Hebd. de Méd et de Chir., 1865, p. 134, et seq.
"By the syphilographers it is held that the iodides promote con-
structive metamorphosis; and that a gain in body-weight is a result of
their use.
In the physiological state the iodides increase waste
and the elimination of the products of waste, and emaciation with a
general depression of the vital functions ensues, when they are ad-
ministered for lengthened periods." (Bartholow).
552
10DUM.
Dr.
"that in some circumstances certain cachexiæ, and the syphilitic
among them, take a form identical with that ascribed by M.
Rilliet to iodism." He then relates a case of the kind: it was
cured by iodide of potassium. Skin and mucous membrane,
moreover, are very similarly affected by drug and by disease-
the former especially. Iodide of potassium has even been ob-
served (by Ricord) to cause a cachectic-looking rupia on the legs
in a non-syphilitic person. The evidence of dose, moreover, is in
the same direction, especially when Iodine itself is given.
Guillemin's doses are very small compared with the corre-
sponding quantities of the iodides ordinarily administered,
and Zeissl speaks of obtaining excellent effects from two
minims of the compound tincture twice a day; while from
our own school we have the testimony of Dr. Jousset, who
(following Tessier) has“ obtained very rapid results from Iodine
in the 30th, and even the 500th dilution." Here, therefore, I
think that it is reasonable to suppose that it cures, as Mercury
does, in virtue of its power to affect the same parts and in
a similar manner. But the benefits of largely increased dosage
in the tertiary gummatous deposits on bones and in viscera are
so great and indubitable that I think we must look now to
a different modus operandi. What this is has been discussed
by Dr. Madden in a very interesting paper which you will
find in the twenty-sixth volume of the British Journal of
Homœopathy. He points out that these affections are of the
nature of organized new growths, which are therefore quasi-
parasitical to the body, and require parasiticides to destroy
them. The strong antiseptic power of Iodine suggests, he
thinks, that it may have such an action; or, as seems to me
more probable, it deals with these foreign deposits as it does
with the lead or mercury it is so successful in eliminating from
the system.* Either way, it must be given for such purpose
in full doses, and the indications for its use must not be looked
for in its pathogenesis.
IV. The same explanation probably applies to the virtues
of Iodine in chronic rheumatism, gout, and rheumatoid
arthritis. They are undoubted; and in the latter obstinate.
affection Iodine really seems the most hopeful remedy we
have. This is the testimony of Laségue,† of Trousseau,† of
* Stillé seems to take the same view, for he thinks that the iodide
should be used in preference to iodine itself "whenever the elimination
of some effete, imperfectly organised, or abnormal material is the object
to be accomplished," the latter being chosen "whenever it is intended
to modify the living and normal elements of the economy."
+ See Trousseau's Clinical Lectures (New Syd. Soc.), iv., 430.
IODUM.
553
Fuller,* and of Horatio Wood. Full doses and local applica-
tion are ordinarily required.
V. We have now passed in review the diathetic relations of
Iodine. It only remains to consider the disorders of those
parts to which it is a specific irritant, and note how far it has
proved useful in their treatment. The homoeopathicity of the
action here needs no argument.
I. Iodine is not a leading remedy in affections of the mucous
membrane of the alimentary canal, though it will often control
these-as the diarrhoea of phthisis and marasmus-when given
for the diseases of which they are an accompaniment. Some
references to its occasional uses here may be found in the study
of the drug (by Dr. Madden and myself) which I mentioned
when I began. I may add to these the vomiting of pregnancy,
and perhaps some chronic alterations of the glandular system
of the stomach characterised by the same symptom. But
while thus inferior to Arsenic as a remedy for affections of the
alimentary mucous membrane, it just as far excels the latter
drug in those of the respiratory tract. It is very useful in severe
local coryza, where the nose is red and swollen. Kali iodatum
may be given internally, or Iodine applied by olfaction.† The
latter mode of treatment is commended by Ringer in the
daily attacks of coryza from which some people suffer, and,
conjoined with the internal administration of the drug, has
proved highly beneficial in strumous ozæna. A case of re-
covery of the sense of smell, lost for three years, under the
use of Iodine, is cited by Wilcox: the patient was taking the
drug for a chronic ophthalmia. In a case of my own of
profuse dark discharge from the nose, without constitutional
symptoms, occurring in a child after exposure to the contagion
of diphtheria, when other apparently well-indicated remedies
had failed the first dilution of Kali iodatum effected a rapid
cure. Over the extension of this mucous tract to the eye
Iodine has little influence, though its constitutional action
may make it helpful in strumous ophthalmia. But on that
which penetrates the Eustachian tubes it exerts much power,
and has often proved curative in catarrhal deafness.‡ In
affections of the larynx and trachea Iodine takes the highest
rank.§ Before its discovery in the ashes of burnt sponge
Hahnemann had proved that substance, and discerned its
* On Gout, Rheumatic Gout, &c.
↑ See Brit. Fourn. of Hom., xxiv., 168.
See a case of mine in Monthly Hom. Review, xii., 538.
§ See case of syphilitic laryngitis treated by it in Brit. Fourn. of
Hom., vi., 68.
554
IODUM.
specific laryngeal action; so that as a remedy for catarrhal
and inflammatory affections of the part, and even for croup
itself, Spongia has long been in high repute in the homoeo-
pathic school. It has been with croup as with goitre: Iodine
has been suspected to have the chief credit of the curative
power of the sponge, and experiment has confirmed the sug-
gestion. Koch was the Coindet of this revolution; and since
his communication to the Hygea in 1841 Iodine has taken in
most hands the place of Spongia in membranous croup, the
other being given only in the catarrhal form. Dr. Elb's
excellent essay on the disease, which you will find translated
in the tenth volume of the British Journal of Homœopathy,
will tell you all that is necessary about this piece of thera-
peutics. As soon as he has satisfied himself as to the existence
of true croup, he gives a dose of Iodine, from the 2nd to the
6th decimal dilution. "Like the sudden subsidence of a
storm," he writes, "so wonderfully quick is its action. The
anxiety and imminent suffocation and whistling cough cease
as if by magic, and the dyspnoea becomes so much diminished
that we may safely wait an hour before giving a dose of
Aconite, which speedily procures remission of the fever, with
perspiration.” He then continues the two every hour alter-
nately as long as there is need. Drs. Arnold and Dake have
added the recommendation-supported by their experience—
of giving inhalations of the drug in rebellious cases.
You will ask, remembering that I have spoken in similar.
terms of the action of Bromine, how we are to differentiate
between them. I can only repeat Dr. Meyhoffer's suggestion,
that constitutional prostration is the characteristic indication
for the preference of Bromine, which is thus suited to diphthe-
ritic croup, while Iodine suits the sporadic and more sthenic
form. If, however, you should agree with those who think
that true croup is always connected with diphtheria, I may
mention that Dr. Kidd regards Iodine as the most important
remedy we have for the latter disease.
Dr. Kafka would have us esteem Iodine as highly in
pneumonia as in laryngitis membranacea. The term "croup-
ous" applied by the German pathologists to acute primary
inflammation of the lungs implies for him the pathological
identity of the two processes, and he treats them accordingly.
He maintains, on the strength of a prolonged experience, that
if Iodine be administered when the physical signs first appear
it will arrest the progress of localisation, and abort the whole
disease. He gives a drop of the 1st, 2nd, or 3rd decimal
dilution every hour or even half-hour, and says that improve-
IODUM.
555
ment may generally be looked for after the fifth or sixth dose,
and that within twenty-four hours the disease will be evidently
conquered. He does not consider Aconite necessary, but says
that the stronger the fever the smaller should be the dose of
Iodine, lest aggravation should ensue.
These doctrines about the treatment of pneumonia have
lately been the subject of an interesting controversy in the
pages of the Revue homeopathique Belge,—the Belgian phy-
sicians mostly adhering to Jahr's prescription of Aconite
followed by Sulphur, and Dr. Jousset joining in the discussion
to maintain the sufficiency of Tessier's Bryonia and Phosphorus.
As, however, neither class of Dr. Kafka's opponents claim his
aborting results, it seems reasonable that his recommendations.
should be tested.
Before leaving the respiratory sphere, I must speak of the
use of Iodine in pulmonary phthisis. Its potent action on
the lungs, its modifying influence over scrofula, and the hectic
character of its emaciation and fever would make it from a
homœopathic point of view the most hopeful of remedies for
this disease. My own experience is that of Bähr, that "more
than any other remedy it effects curative results, especially if
tuberculosis is the result of scrofulosis, in the case of young
and robust individuals." This means, I take it, when phthisis
is scrofulous pneumonia rather than primary tuberculosis of
the lung. Nevertheless, in a case where the severity of the
constitutional symptoms and the deficiency of physical signs
gave me every reason to dread the presence of tubercle,
Iodine alone effected a speedy and most satisfactory cure.
I
am firmly persuaded that, so far as medicines go, our best
hope of future success in phthisis lies in our knowing better
how to use Iodine for it. Tessier and Jousset recommend a
course of Sulphur and Iodine, in high attenuation, as the best
ordinary medication for the disease.
As regards the genito-urinary mucous membrane, I have
only to say that Dr. Bumstead finds Kali iodatum in
ordinary doses increase urethal discharge in gleet, and that
Dr. Franklin esteems it, in the 3rd decimal dilution, highly
conducive to its cure.*
2. The action of Iodine on the serous membranes has been
little utilised in the homoeopathic school; but to it belongs, I
think, the occasional curative power of iodide of potassium in
hydrocephalus and hydrothorax. To it, also, I am inclined to
Science and Art of Surgery, i., 400.-" Discharges from the
urethra or vagina which have recently been cured are very prone to
recur under the influence of this medicine " (Stillé).
556
IODUM.
refer the usefulness of Iodine when locally applied or injected
to remove effusions into serous or synovial cavities. It is com-
monly supposed to act here by setting up adhesive inflammation
of the walls of the sac. But Dr. Jousset has disproved this
hypothesis in the case of hydrocele, and shewn that in-
flammation is not essential, or even favourable, to the cura-
tive process.
Iodine is found in the serous effusions of
hydrocele and hydrarthrosis when it is taken internally: to
apply or inject it is merely to intensify its influence by concen-
tration, and, when the disorder is local, seems the most rational
practice.
*
3. I can hardly say anything definite of the power of Iodine
in cutaneous affections apart from syphilides and scrofulides.
Dr. Neligan thinks the iodide of potassium superior to any
other drug in these cases, and Mr. Hunt extols cod-liver
oil as the only medicine to be compared with Arsenic in its
power over skin disease. We shall have to inquire directly
how far the power of this oil is to be ascribed to the Iodine it
contains. I think that the acne-like character of some of the
iodic eruptions hints at an action on its part upon the sebaceous
glands, and suggests it as a leading remedy in seborrhœa,
molluscum, wens, and the several forms of acne itself. In the
two last-named affections it has actually been found curative.
Dr. Thin, indeed, examining microscopically specimens of skin
the seat of bullæ induced by Kali iodatum, found no altera-
tion in the sebaceous glands, and that the lesion had occurred
at points in the coats of the blood-vessels. He thinks that to
extravasation thus caused the acne, the bullæ and pustules,
and the purpura, which characterise the progressive degrees of
the iodic skin affection, are due.†
4. And now as to the glands. Iodine has cured mercurial
salivation, and that of pregnancy. Pereira and Watson rank it
next to Mercury in chronic disease of the liver, and Dr.
Dudgeon once cured with it an obstinate case of jaundice in
which he suspected organic disease. Iodine is the leading
remedy for diseases of the pancreas in the organology of
Rademacher; and several cases of acute and chronic disease
of this gland are cited by Dr. Wilcox in which it effected a
cure. You will think of it if you ever encounter the diarrhoea
adiposa; and perhaps Dr. Herbert Nankivell's observation,
that Iodine enables fatty food to be digested which otherwise
* See Brit. Fourn. of Hom., xvi., 259.
† Lancet, 1878, ii., 696.
‡ Brit. Fourn. of Hom., xxii., 357. See a similar case in vol. xxxiv.,
p. 381.
IODUM.
557
could not be given, belongs to this action of the drug. If, too,
it can improve the functional action of the pancreas, it is the
better fitted to aid in phthisis.
The specific influence of Iodine upon the glands of the
generative system would suggest its frequent employment in
morbid states of these glands, especially when occurring in
scrofulous and tubercular subjects. In such patients prosta-
titis in the male, and amenorrhoea, galactorrhoea and leucor-
rhoea in the female subject have been cured by it. I speak
with more diffidence when I suggest that to such an influence
is due the dispersion of mammary, ovarian, and uterine
tumours which has sometimes been accomplished by Iodine.
It is worth noting, however, that the tumours of the uterus.
which have—in Dr. Ashwell's words*___" melted down” under
the action of Iodine appear invariably to have originated in
the cervix, i. e. in the glandular and secreting portion of the
organ. In inflammation and induration of this part, more-
over, Iodine is a remedy of tried value. Here, probably, what
has been said about strumous glands holds good (Trousseau
and Pidoux speak of its having caused metritis, with dis-
charge); and the ovary seems to bear to Iodine just the same
relation as the thyroid. Ovarian dropsy (at least of the
unilocular kind) is analogous to cystic bronchocele, and, like
it, is far more amenable to the injection than to the adminis-
tration of the drug. Iodine should be borne in mind, I think,
in cases of sterility where the strumous diathesis exists.
5. The group of symptoms I have described as constituting
the iodism of Coindet and Rilliet point to the action of the
drug on the nervous and circulatory systems, and on the blood
itself. Trousseau compares them to false chlorosis, simulat-
ing phthisis. The tremors suggest mercurial palsy and para-
lysis agitans, and perhaps chorea, in which affection, and in
some cases of paralysis, Manson has found it very useful. I
often give it with advantage in the chronic congestive vertigo
of old people. It ought to be (perhaps in high dilution) bene-
ficial in insomnia, and in hypochondriasis of the kind it causes.
It may be useful in palpitation;† and its power over the
muscular substance of the heart perhaps explains the un-
doubted good done by iodide of potassium in internal aneurism,
* See Guy's Hospital Reports, vol. i.
"In a case altogether exceptional, "Trousseau writes, "M. Rilliet
has seen palpitation cease, instead of appearing or increasing, under
iodism; the patient was one habitually subject to it. Dr. Guernsey
praises it in cases of debility where at every exertion all the arteries
throb painfully.
""
558
IODUM.
1
which does not always require the large doses of it now in
vogue. I have had one of the innominata under care, in which
great relief has been obtained by the persistent use of this
remedy, in grain doses twice a day; and it is worth noting
that Dr. Neligan speaks highly of the biniodide of mercury in
the treatment of organic-especially valvular-disease of the
heart. The Iodine is surely the prepotent agent in this pre-
paration. I shall also have to speak of Spongia as a cardiac
remedy.
I have now done with Iodine-this drug which M. Sée, re-
echoing Hahnemann, calls an" heroic but dangerous medicine,
requiring the greatest prudence on the part of the physician."
Here again magis venenum, magis remedium. Iodine, so
recently discovered, already stands in the front rank of thera-
peutic agents; and I know of none which promise so much
in the future.
A word before closing on the iodides. The compound Iodine
forms with potassium has already come before us, and the
substitution of sodium or ammonium makes little difference in
the result; though Dr. Bartholow finds small doses of iodide of
ammonium specially effective in affections of the respiratory
mucous membrane, where he admits that the drug acts
"substitutively." With the alkaline earths-as barium and
calcium; with the metals-as iron, mercury, and lead; and
with sulphur, Iodine forms compounds which owe their energy
mainly to their bases, though its presence gives them a some-
what distinctive character and special direction. The iodide
of carbon forms a substance quite unique, save as it corre-
sponds with the sulphide of the same element, which has
already come before us. It is unknown to medicine. "Iodo-
form" (a teriodide of formyl), taken internally, acts both patho-
genetically and curatively like Iodine; but it is—as its name
suggests—an analogue of chloroform, and has anæsthetic pro-
perties, of which much use has been made by way of local
application. But of all iodic compounds the most important
is cod-liver oil-
All
Oleum jecoris aselli. When this potent therapeutic agent
was first introduced into practice, it was a common opinion
that its peculiar virtues were due to the Iodine it contained.
To the homoeopathic physician, the infinitesimal proportion
(one part in 40,000) in which the drug existed occasioned no
difficulty; and he could point triumphantly to the perfect
homœopathicity of Iodine to most of the maladies in which
cod-liver oil was found beneficial. Of late years, however, so
much evidence has accumulated as to the importance of oily
IRIS VERSICOLOR.
559
matters in the nutritive operations, that it has become usual
among ourselves as well as in the old school to regard cod oil
as a purely dietetic agent. I cannot myself subscribe to this
conclusion. Without questioning for a moment the great
value of an easily digested animal oil as an article of diet in
badly nourished frames, I do strongly doubt whether the
whole virtues of cod-liver oil can be ascribed to this mode of
action. When we remember that in a teaspoonful of this oil
we are adminstering a dose of Iodine equal to a drop and a
half of its third decimal dilution, and that we are generally
giving it in cases to which the drug is thoroughly homoeo-
pathic, can we doubt that it exerts a curative action? If we
disbelieve this, we have no reason for believing in the action
of infinitesimals anywhere. Moreover, were it the oleaginous
matter per se which cures, why should all attempts to find a
substitute for the oil of fishes be so unsuccessful? and how
was it that the first disease in which cod oil won its laurels was
not scrofula or phthisis, but chronic rheumatism? I conclude,
then, that the virtues of cod-liver oil are due, in a great
measure, to the Iodine it contains; and that the pathogenesy
of this drug should always be borne in mind in our prescrip-
tion of the oil. Iodine will obviously be given best in the form
of cod-liver oil where there is much wasting; as we then
introduce at one and the same time both the specific to cure
the pathological tendency, and the most suitable pabulum
wherewith to repair the organism after the ravages of disease.
I must again pass by the strict alphabetical order, as it will
be impossible to discuss Ipecacuanha to-day. I will, in its
stead, bring before you a plant which, though not peculiar to
the American continent, has been made known as a medicine
by American practitioners. It is the common blue-flag,
Iris versicolor.
A tincture is prepared from the root.
Iris has been well proved, both in substance and in the
attenuations. Dr. Allen gives symptoms from seventeen
experimenters. Some of these provings are recorded in
detail in the second edition of Dr. Hale's New Remedies, and
in the fourth edition you can read a full account of the exten-
sive clinical experience which has been obtained with it.
Iris has long had a reputation among those who employ the
indigenous plants of America as a very active emetic and
560
IRIS VERSICOLOR.
y
purgative, and as an excitant of the salivary and biliary secre-
tions. Our provings, while they agree with this description,
both enlarge and precisionise it. Enlarge, for they show
that the pancreas is irritated as much as or more than the
salivary glands and liver. This is shown by the continual
burning felt in this region by one of the provers, who at the
same time was passing frequent watery evacuations; and by
the highly congested state of the organ in animals poisoned
by Iris.
And precisionise,-for they indicate the vomiting
and diarrhoea of Iris to be the result of hypersecretion along
the alimentary tract, and that the morbid condition set up
has little tendency to run on to inflammation. The vomiting
is often acid; and the purging is accompanied by severe colic
and burning in the rectum, suggesting that the stools also
have this acid quality. With the salivation there is a thick
and flat, or even greasy, taste in the whole mouth, but no,
fœtor.
These gastro-intestinal symptoms of Iris were the first to be
turned to account in homoeopathic practice. Dr. Kitchen
called attention to them in the North American Journal of
Homœopathy in 1851. He stated that he found the drug of
eminent value in many forms of vomiting and diarrhoea,
several of which he instanced and illustrated from practice.
The two definite maladies in which, consequent upon his
statements, Iris has achieved a reputation are cholera nostras
and sick headache. To the first the drug is completely
homoeopathic, and many testimonies from America coincide
with those of Dr. Lade and myself in this country in warrant
of its striking efficacy. About cholera infantum the evidence
is more conflicting. I have myself been disappointed with it
in this disorder: the vomiting is often checked by the Iris,
but the purging rarely. Cholera infantum is not so character-
istically bilious as is the autumnal attack to which adults are
liable.
As regards the so-called sick-headache, there is more to be
said. It was the vomiting which accompanies the malady by
which Dr. Kitchen was led to prescribe it, and he found it
very effectual in relieving both this feature of the paroxysms
and the pain itself. Iris thus found a place among the reme-
dies for sick-headache; but it was natural to suppose, from all
we knew of its physiological action, that it was the gastro-
hepatic variety of the disease to which it was applicable, and
not true nervous migraine. In the North American Journal
of Homeopathy for February, 1875, however, I came across an
observation by Dr. Bigler, of Rochester, U.S., that " Iris
IRIS VERSICOLOR.
561
hardly ever fails to cure a case of sick-headache when pre-
ceded by a blur before the eyes." Now just at that time
migraine, under the impetus given by Dr. Anstie, was being
studied in its neurotic aspect, and Liveing especially had
brought out the frequency with which the preliminary pheno-
menon was a disturbance of vision on the affected side very
like the "blur" mentioned by Dr. Bigler. I had hitherto
given Iris in sick-headache only when I supposed it to be of
gastro-hepatic origin; and had every reason to be pleased
with it. I now, however, began to give it in true migraine,
when ushered in by the characteristic blur, and have obtained
at least one decisive result in the treatment of this very
obstinate malady.
I am the more confirmed in the validity of this application
of the drug by a variety of facts which indicate a true action
on the nervous system, especially in relation to neuralgia, as
exerted by it. Drs. Kitchen and Holcombe have each re-
ported success in the treatment of facial neuralgia by it; and
the latter caused a pretty severe attack of the same in his
own person by taking two or three drops of a strong tincture
four times daily for a few days. It was on the right side,
involved all the divisions of the trigeminus, and was accom-
panied with copious diuresis. Again, Dr. Conrad Wesselhoft,
also proving the drug on himself, found it induce a genuine
sciatica of the left leg, which was a trouble quite unknown to
him previously.
It is interesting to notice that this last result followed the
taking of the fifth dilution,-the drug in substance having had
but little effect on the prover. It is thus suggested that, in an
attenuated form, Iris may develope properties unknown to
those who (as the practitioners mentioned above, including
myself) have used it only in a comparatively crude state. A
striking series of experiences in point have lately been com-
municated by Dr. Claude, of Paris.* He was led, by a
German recommendation, to try the drug in high dilution as
a remedy for constipation, and got results which surprised
him. He relates nine cases in which Iris, in the dilutions
from the 12th to the 30th, acted-often with marvellous rapidity
-as what would be called an aperient, relaxing the most
obstinately constipated bowels. It does not seem to cure the
evil radically, but is always effective as a temporary remedy.
Below the 12th dilution, its effect in this direction is nil. I
may mention that several of the subjects of Dr. Claude's
treatment were migraineuses, and one laboured under chronic
* L'Art Médical, vol. xlv.
20
562
IRIS VERSICOLOR.
ptyalism the last was cured, and the others were much
benefited. This is a very valuable contribution to our know-
ledge of the drug.
Iris has in other cases cured salivation, mercurial and idio-
pathic; also some cutaneous affections (especially, Dr. Hale
says, when connected with acid secretions in children), and
sthenic seminal emissions. It should be thought of in acute
affections of the pancreas.
The analogues of Iris are Antimonium tartaricum, Col-
chicum, Iodum, Ipecacuanha, Mercurius, and Podophyllum. The
neurotic properties it is now displaying give it other allies.
Of its dosage I have already spoken.
LECTURE XXXVII.
IPECACUANHA, JABORANDI, KALI BICHROMICUM.
I have to-day to bring first before you the famous medicine
Ipecacuanha.
From the powdered bark of the root a tincture is made by
percolation; or (which I think better) we triturate it.
There is a pathogenesis of Ipecacuanha in the third volume
of the Reine Arzneimittellehre. It contains 146 symptoms from
Hahnemann; 46 from 3 fellow-observers; and 41 from II
authors. Of the last, those of Geoffroy, Scott and Murray
are alone to be depended on; the rest are too impure. Dr.
Allen adds several other experiments and observations. But
the most complete collection of the effects, physiological and
therapeutical, of the drug is that of Dr. Imbert-Gourbeyre,
It has been reprinted in a separate form (Paris: Baillière and
Son) from L'Art Médical for 1868, where it first appeared;
it is also translated in vols. xxvi-xxviii of the British Journal
of Homœopathy. In one of these shapes it should be before
you in your study of the medicine; and my remarks here will
to a large extent be a summary of and commentary on its
contents.
I. I must first speak of the relation of Ipecacuanha to
vomiting. It has long been known as a certain, though tardy
and mild, emetic; and has been used accordingly. An inter-
esting paper was furnished a century ago to the Medical
Observations and Inquiries (vol. vi.), showing how small were
the doses needed to effect this purpose, from two to four grains
nearly always proving sufficient. Physiological investigation
has since proved that this action is specific, that is, it is set up
when the drug is introduced into the system otherwise than
through the stomach. But it has also proved that-unlike
Tartar emetic and Apomorphia-Ipecacuanha always, how-
ever introduced, excites vomiting through the stomach.
1
564
IPECACUANHA.
Divide the pneumogastrics, so that their gastric extremities
shall not be impressionable; and no vomiting can be set up
by Ipecacuan, while the two other emetics act as usual.*
This explains why Ipecacuan operates so much more freely and
quickly when introduced into the stomach than when injected
subcutaneously, while exactly the opposite is true of the
others.
Other investigations have shown what is the nature of the
action of the drug on the stomach. An increased production
of gastric mucus is the usual effect in man; but the catarrhal
nature of this is shown by experiments on animals, in whom
the hypodermic injection of emetia (the alkaloid of Ipecacuan)
causes a slight inflammation of the gastro-intestinal mucous
membrane.
The emetic action of Ipecacuanha was naturally seized upon
as a point d'appui for the application of similia similibus, and
from Hahnemann's time onwards it has been the main remedy
in the Homœopathic school where vomiting had to be checked.
But it was a curious thing to see the practice adopted, small
dose and all, by the practitioners of traditional medicine.
When Dr. Ringer, in the first edition of his Handbook of
Therapeutics, stated that several forms of vomiting could be
cured by drop doses of Ipecacuanha wine, and when subse-
quently his experience was echoed from all parts of the
country, it seems to me that the small end of the wedge made
an effective entrance. If this were true, there was no reason
why any other piece of homoeopathic medication might not
be true; and the tuto, cito et jucunde of the practice was
obvious. A feeble attempt was made to evade the inference
by ascribing to Ipecacuan a "tonic effect on the sympathetic
system generally." Under the cover of this shield cases
illustrative of the practice were for a time admitted into the
pages of the Practitioner, even from Homœopathic sources.
But when it appeared to be successful in doses too small for
even “increased frequency of administration" (by no means
always present) to bring them up to an orthodox amount,
and when Tartar emetic (to which no ingenuity could ascribe
a tonic action) was shown to have a similar effect, the ground
became dangerous; and the subject was abruptly dropped.
De mortuis nil nisi bonum would never be my wish more
strongly than in the case of Anstie; but I must regretfully
feel that in this instance prejudice was too much for his
candour.
* Practitioner, xiii., 282; see also St. Barth. Hosp. Reports, v.
and vii.
IPECACUANHA.
565
While, therefore, the older treatises on Materia Medica
spoke of Ipecacuanha only as a means of causing vomiting,
their successors all devote some space to showing how it may
check it. To Dr. Ringer's catalogue of the forms of the
trouble in which it is useful or useless we can mainly
subscribe. The former embraces the vomiting of pregnancy,
suckling, and menstruation, that of acute catarrh and cancer
of the stomach, of whooping-cough, of chronic alcoholism,
and of simple debility; the latter consists of the vomiting
of infants from intolerance of milk, and that of hysteria.
But I cannot at all agree with Dr. Phillips that it is
almost solely when the vomiting is sympathetic that
Ipecacuanha is useful. That of chronic alcoholism, which
he himself specifies, is surely as much gastric as nervous.
On the contrary, I should say, the more purely sympathetic
the vomiting is, the more it is effected by an impression on
the nervous centre of the action which does not take the route
of the stomach, the less valuable Ipecacuanha becomes.
Thus it is of no avail in vomiting from cerebral disease. In
pregnancy, where it is so useful, the stomach itself is always
more or less affected; and even here I find that Nux vomica,
which meets the reflex nervous irritation, materially assists its
action. Hahnemann recommended it where there is chronic
disposition to vomit without bringing anything away; and
Dr. Guernsey thinks constant nausea characteristic of it.
Nor is it for the vomiting only of gastric irritation that
Ipecacuanha helps us; it goes a long way in curing the
disorder itself. În acute catarrh of the stomach, especially
in children, it wins the applause of both schools; and in
many dyspepsiæ depending on chronic catarrh of the same
organ it is highly beneficial. Upon the intestines it acts
in the same manner. In moderate doses it causes mucous
diarrhoea, with much griping, the stools being often green or
greenish yellow; and when emetia is injected subcutaneously,
the intestinal lining is always found inflamed. Correspond-
ingly, it has been used largely in the school of Hahnemann in
the mucous diarrhoea of children, even when inflammatory
symptoms appear. Dr. Ringer's experience is no less favour-
able. "The dysenteric diarrhoea of children," he writes,
"whether acute or chronic, will generally yield to hourly drop
doses of Ipecacuanha wine. The especial indications for this
remedy are slimy stools, green or not, and with or without
blood." Vomiting, he says, if present, is an additional
reason for giving it.* It has often been found useful in cholera
* Dr Bartholow, who substantiates this testimony to the value of the
-
566
IPECACUANHA.
nostras, and even in the cholerine which prevails during the
epidemics of the Asiatic form of the disease. Our excellent
Hindoo colleague, Dr. Mahendra La'l Sircar, has just put on
record a case of poisoning by 35 grains of the powder,* in
which the symptoms (save for the greenish tinge of the stools)
presented, as he says, "a complete picture of cholera at the
onset." Cramps, abdominal and general, were very marked.
This leads us to the use of Ipecacuanha in dysentery. It
was in the treatment of this disease, so prevalent at the end of
the seventeenth century, that it first won its spurs; so that
it became known as the "radix anti-dysenterica." But the
practice ere long fell into neglect and disuse, and Hahnemann
could speak of it in his day as abandoned. It has been
revived in our own by means of a different mode of adminis-
tration. Formerly an infusion was used; but now the drug
is given in powder, in a single dose of twenty or thirty
grains. By rest and a little laudanum this is prevailed upon
to keep down; and then the most beneficial results appear.
"The tormina and tenesmus," writes Dr. Maclean,† "sub-
side; the motions quickly become feculent; blood and slime
disappear; and often after a profuse action of the skin
the patient falls into a natural sleep and awakes refreshed."
A second dose is sometimes required; but rarely a third.
This Ipecacuanha treatment of dysentery is now prevalent
throughout India; and is most highly esteemed.
Is it homœopathy? Hahnemann argued that Ipecacuanha
was incapable of curing the essential symptoms of dysentery,
since it was incapable of producing similar ones in healthy
persons. "Incapable" is a perilous word to use in patho-
genesy; and subsequent experiment has shown that Ipeca-
cuanha can inflame the intestines, so that its relation to
dysentery might fairly be argued to be that of similarity.‡
But I am not sure whether we can claim the present practice
for our method. The large dose required, and the advantage
gained by giving it in substance, point to a local action of the
drug, which indeed (as Dr. Noel de Mussy has pointed out)§
drug in the dysenteric diarrhœa of children, endeavours to connect its
modus operandi here with that which obtains in epidemic dysentery.
But though he speaks of giving from two to five grains for a dose, when
we come to his actual prescription we find that he orders one only,
though to adults he gives from twenty to sixty. Dr. Ringer's drop-
doses of the wine still more completely decide the question.
* Calcutta Fournal of Medicine, vii., 447.
+ Reynolds' System of Medicine, vol. i., art. Dysentery.
I See London Medical Record, iii., 59.
§ Brit. Journ. of Hom., xxxiii., 752.
IPECACUANHA.
567
·
is often given with advantage in injection. It seems to cause
a transpiration of the intestinal mucous membrane analogous
to that seen on the skin, and so to promote the resolution of
the disease. Homœopathic practitioners have not found it
very efficacious in their small doses, save as an adjunct to
other remedies. Hahnemann admits that it may diminish the
quantity of blood, and relieve the tormina, of the affection;
as to these symptoms it is quite homoeopathic. But there is
another feature of dysentery which Ipecacuanha, though it
has never caused it, may well relieve. I mean the tenesmus.
This is an action very analogous to the vomiting we have seen
and the cough we shall soon see caused by the drug; and like
these it may be quieted by it, as Teste has affirmed.
2. We come now to the action of Ipecacuanha on the
respiratory organs. When these receive it by inhalation as
those by ingestion a similar train of phenomena is wont to
appear. Irritation of the mucous membrane is set up-in-
creased secretion going on to catarrhal inflammation. But
more marked than this, and often out of all proportion to it,
is the involvement of the extremities of the incident nerves.
Continual sneezing, spasmodic cough, and especially dyspnoea
of asthmatic kind, are the sufferings of those who have the
misfortune to be susceptible to Ipecacuanha whenever they are
exposed to its emanations.
Dr. Imbert-Gourbeyre has collected numerous instances of
this effect of the drug. It is of the contingent order, only
appearing in certain persons. But with them it results omni
dosi. They may be at the top of the house, while Ipecacuanha
is being powdered on the basement; yet ere long they will
feel the influence of their enemy. Sometimes their conjunc-
tival and Schneiderian membranes are most affected; the eyes
are reddened, smart, and water, and there is a copious defluxion
from the nose, with incessant sneezing. More commonly the
influence is felt lower down, in dyspnoea, wheezing, and
cough, ending in profuse mucous expectoration. They suffer
like the subjects of hay-fever and -asthma: only the irritant is
different.
This being so, Ipecacuanha should play an important part
in the disorders of the respiratory apparatus; and it does so
in both schools of medicine. In coryza it should be given
where sneezing is very troublesome. In hay-fever it does all
that a palliative can do, though nothing seems really curative
save destruction of the living matter which, in the form of
pollen, Dr. Blackley has demonstrated to be its cause. It is
of great service in croup and in pertussis. Its repute as an
568
IPECACUANHA.
emetic in these disorders is probably due to its dynamic pro-
perties. For croup M. Teste strongly recommends the
alternation of Ipecacuanha with Bryonia. There is certainly
a spasmodic as well as an inflammatory element in most cases
of croup; and as Bryonia, which we have seen to have the
power of setting up membranous inflammation of the air-
passages, controls the latter, Ipecacuanha may well help by
its influence on the former. In whooping-cough I have the
utmost confidence in it as long, as, or whenever, catarrhal
symptoms are present. When the cough is pure spasm
Drosera, Corallium, or Cuprum is preferable. It is thus (often
in alternation with Aconite) the usual remedy for the malady in
its first two or three weeks, and gives unequivocal relief. In
simple spasmodic coughs resembling pertussis, with much
retching and mucous expectoration, Ipecacuanha is often
rapidly curative. Dr. Guernsey praises it also for incessant
and most violent cough with every breath, such as sometimes
occurs in children with measles. It relieves, he says, "like a
charm." It is hardly suited to pure spasmodic asthma, where,
if it relieves the paroxysm, it must do so as any other
nauseant would, by inducing general relaxation. Nor has it
power over acute bronchitis. But in bronchitic asthma its use
is most beneficial, in small frequent doses during the attack,
and at longer intervals subsequently. And there are cases of
bronchitis which are half asthma, neuroses as much as phlo-
goses; and here Ipecacuanha acts beautifully. I have put
one such case on record in the fifth volume of the Annals of
the British Homœopathic Society (p. 199).
Dr Ringer has lately extended the influence of Ipecacuan
over the disorders of respiration, by introducing the wine
into the chest in fine spray. By this means he is able greatly
to relieve and even cure chronic cases of winter-cough,
where the bronchial membrane is always engorged, and the
incident nerves in continual excitement. The success he has
obtained should encourage us to repeat the experiment, and
perhaps to use the drug in this form in hay-fever and in the
asthmatic paroxysm. It is the more rational so to do, as the
power of Ipecacuan to cause respiratory troubles through the
stomach is less than it has when inhaled, in which case it does
so (as we have seen) in the minutest dose. That the action,
however, is specific, and not merely local, is certain. In
poisoning by impure emetia the mucous membrane of the
bronchiæ is found inflamed; and Stillé relates an interesting
case in which a person susceptible to it had a violent paroxysm
of asthma from a dose of the wine.
"After the paroxysm,
IPECACUANHA.
569
and when expectoration became free again, a large quantity
of sputa was ejected, which any person at first sight would
have pronounced to be a mass of small, nearly transparent
worms. These bodies were no doubt formed of concrete
mucus moulded in the smaller air-tubes," and shew that the
action of Ipecacuanha reaches even to these. Dr. Jousset
esteems it highly in alternation with Bryonia (both in the 12th
dilution) in the treatment of acute capillary bronchitis.
I think that, both in the digestive apparatus and in the
respiratory organs, the condition indicating Ipecacuanha may
be defined as "a moderate inflammatory irritation of the
mucous surface, resulting, through a reflex excitation conveyed
by the incident nerves of the part, in vigorous expulsive mus-
cular movements."
3. I have now to speak of the use of Ipecacuanha in
hæmorrhages. Dr. Imbert-Gourbeyre has collected various
testimonies to its value here, and has convincingly shown it
to be homoeopathic in its modus operandi. Several authors
have seen it produce epistaxis and hæmoptysis in connection
with its respiratory troubles; and in an observation of asthma
caused by its emanations, and lasting some days, it is noted
that menstruation appeared prematurely, and not only the
sputa, but also the stools and urine, were sometimes tinged
with blood. It is now forgotten in ordinary practice, save
when, as by Higginbotham and Peter, it is recommended as
hæmostatic by producing vomiting; but among homo-
opathists, and in their non-perturbative doses, it holds high
rank as a remedy in intestinal hæmorrhage, in hæmoptysis,
menorrhagia and metrorrhagia, and hæmatemesis. The pre-
sence also of blood in the ejecta is always held to strengthen
the indications for it in vomiting, dysentery, and pertussis.
4. What amount of direct action Ipecacuan exerts on the
nervous system in health is uncertain. But it has found an
occasional place in the treatment of neurotic affections in both
schools of medicine, as may be seen from Dr. Imbert-Gour-
beyre's collection. I can speak only of cerebro-spinal menin-
gitis and of intermittent fever. In an epidemic of the former
disease occurring at Avignon in 1846-7, Dr. Bechet was led
to Ipecacuan as the medicine most similar to the symptoms
present; and he gave it (in the mother tincture) in every case
with such great relative success that it was appropriated (of
course without acknowledgment) by the practitioners of the
old school in the place, and vaunted as a specific.*
it has long been in esteem as an emetic; but Sauret at least
* See Brit. Fourn. of Hom., xi., 305.
In ague
570
IPECACUANHA.
has published an obstinate case in which it cured without
causing nausea and vomiting. Roux observed, in the same
journal, that such facts were long since known in the school
of Hahnemann. The presence of much gastric derangement,
and vomiting during the paroxysms, have always been held
to indicate it, also supervention of the fit in the evening or
night; but Jahr says that he always commences with it in
the treatment of ague unless some other remedy is distinctly
indicated, and that by pursuing this course he has cured many
cases by the first prescription. Bähr thinks its place to be in
intermittents when epidemic in a district ordinarily non-
malarious. If in any of these visitations it cures the first
case, it will cure all the rest.
Our contention that it is by its specific action that Ipeca-
cuanha checks intermittents, as it does hæmorrhages, has been
powerfully sustained by a recent treatise from the pen of an
old-school practitioner-Dr. Woodhull, of the United States
Army. It is entitled "The non-emetic uses of Ipecacuanha"
(Philadelphia, 1876). Besides the other applications of the
drug I have mentioned above, he relates as his experience in
ague that he has treated with it fifty cases, giving one or two
grains at intervals of from three to six hours. In no uncom-
plicated case did it fail; and in one half of those treated no
chill appeared after its administration.
G
Among the miscellaneous facts adduced by Dr. Imbert-
Gourbeyre in his exhaustive collection is one where intense
pain, with profuse lachrymation, congestion of the eyes, photo-
phobia going on to blindness in one eye, and appearance of
iridescent rings of fire before the other, occurred four times
from exposure to the dust of Ipecacuanha. He gives also a
case of choroiditis (by which name I think we must designate
this attack), where coloured haloes surrounded all bright
objects, rapidly removed by the medicine in medium dilu-
tions.
Dr. Guernsey, besides the constant nausea I have already
mentioned, considers a pain about the umbilicus, passing off
into the uterus, and a continual flow of bright red blood, to be
infallible indications for its use in uterine hæmorrhage. Teste
considers that its symptoms generally, and not only its fever,
are wont to supervene during the night; and Dr. Chargé
warns us against giving it to sensitive children in the evening,
for fear of producing nocturnal exacerbations.
Hahnemann esteemed Ipecacuanha an antidote to opium-
poisoning; and it has been found of great value in weaning
the system from the opium-habit.
JABORANDI.
571
The analogues of Ipecacuanha are Antimonium tartaricum.
and Arsenicum.
The first and second decimal triturations, and the first
decimal dilution, answer well for all the homoeopathic appli-
cations of Ipecacuanha. The drop doses of the wine made
so fashionable by Dr. Ringer are about equal to a drop and
a half of our Ix.
I have next to make some remarks upon a South American
plant which has recently been introduced into general medi-
cine-the pilocarpus pinnatus, or
Jaborandi.
The leaves are the medicinal portion of the plant, and appear
to owe most if not all of their activity to an alkaloid con-
tained in them, which has been called pilocarpia. An alcoholic
solution of this last, and triturations of the dried leaves as
imported, will probably be the officinal homœopathic pre-
parations.
The physiological effects of full doses of Jaborandi have
been so thoroughly ascertained by physicians of the old
school-among whom I may especially name Gubler, Robin,
and Ringer—that they have left nothing for us to do in this
direction. Provings of smaller doses, however, are required,
and have been supplied by two members of our own body-
Drs. Watkins and Thayer, both of the United States. The
pathogenesis in Allen's Encyclopædia comprises a full view of
the results thus obtained.
Jaborandi was introduced into practice at Paris in 1874 by
Dr. Coutinho, of Pernambuco, who showed that in the form
of an infusion of the leaves it displayed uncommon activity
as a diaphoretic and sialogogue. I cannot better display its
operation than by reading you (from Allen) the description
given by Robin of the general effects of its administration.
"Very soon," he writes, " the face becomes red; the tem-
poral arteries throb more strongly; then there is a peculiar
feeling of heat in the mouth and on the face, and the flow of
şaliva begins. In a little while the forehead becomes moist,
and the face more red; then beads of perspiration appear on
the forehead, cheeks, and temples. The flow of saliva in-
creases, all the salivary glands successively contributing to this
effect; the mouth is filled with immense quantities of fluid,
and expectoration is incessant; at the same time perspiration
572
JABORANDI.
covers the face and neck; then the whole body becomes red
and moist, and a pleasant warmth is experienced; in a few
minutes perspiration breaks out over the whole surface, and
soon runs down on all sides. Meantime other symptoms have
supervened. The eyelids first become moist, then the
lachrymal secretion gradually augments, and, after collecting
in the canthi, rolls slowly over the cheeks; at the same time
there is a copious discharge from the Schneiderian membrane,
increased by the tears which escape through the nasal canal;
moreover, there is increased activity of the mucous glands of
the pharynx, trachea, and bronchi. All these effects reach
their maximum of intensity in about three-quarters of an
hour after taking the drug, continuing thus for thirty or forty
minutes. Lying on one side, that the saliva may run more
freely, the patient spits ten or fifteen times a minute; the flow
is so rapid that he can hardly speak; the salivary glands are
enlarged, and the mouth becomes hotter. The body is bathed
in perspiration; a shirt is wet through in a few moments. Now
a feeling of comfort, or of weakness, as the case may be, is
experienced. Thirst is intense. The pupils are slightly con-
tracted. By degrees the excessive activity of the secretory
processes is diminished; in an hour and a quarter, or an hour
and three quarters, the lachrymation, the nasal discharge, the
bronchial expectoration, and finally the flow of saliva and the
perspiration, are sensibly lessened, and the parts involved
gradually return to their normal condition. When the per-
spiration and flow of saliva have ceased, the subject is prostrated
and drowsy. The parts which secreted so copiously are now
very dry, especially the mouth and the pharynx. There is
also much thirst." These are the effects of six grammes of
the powdered leaves, given in infusion; but similar results may
be obtained from the subcutaneous injection of minute quan-
tities of pilocarpia.
J
Later experimentation has filled in the outline of this
picture. It has been ascertained that the rapidity of the cir-
culation is notably increased by Jaborandi, but the arterial
tension and the temperature lowered. The secretion of the
kidneys is ordinarily unaffected. The medicine acts strongly
upon the eye, contracting the pupil, and causing tension of
the accommodative apparatus, so as to induce a temporary
myopia.
Jaborandi is thus a medicine analogous on the one hand to
Amyl nitrite, on the other to Physostigma and Muscaria, and
in both spheres of action precisely antagonistic to Atropia—a
minute dose of which will accordingly arrest the whole group
JABORANDI.
573
of symptoms caused by it. It goes beyond Amyl nitrite in
that perspiration succeeds its flush. Its diaphoretic effect
may be regarded as neurotic in origin; though the same can
hardly be said of its ptyalism, as this occurs even when the
nerves-cerebro-spinal and sympathetic-of a salivary gland
are divided. It becomes, accordingly, in our hands a remedy
for excessive perspirations connected with nervous depression.
When the flushes of the menopausia are accompanied with
sweating, Jaborandi or its alkaloid should be their best aid,
and I have recently had a case at the hospital where it has
reduced their recurrence from half-hourly intervals to two or
three a-day. In the hands of Dr. Chase, of Cambridge, U.S.,
it has proved curative of the sweatings of convalescence from
acute disease and palliative of those of phthisis. In all these
cases Jaborandi itself was given, in the first trituration. Dr.
Ringer has obtained similar results with small doses of pilo-
carpia in perspirations, including those curious unilateral sweat-
ings which sometimes occur in connection with disease-func-
tional or organic-of the nervous centres.* The drug should
be tried in the salivation of pregnancy and in that which
sometimes results from cold; although the former, being a
reflex phenomenon, is hardly likely to yield to it. I have
myself tried it in one case without result. Allopathically,
it would seem a possible help in uræmia, especially as the
urea of the perspiration is found greatly increased by its
use.
An application of Jaborandi to morbid perspirations has
recently been made on a larger scale by Dr. Murrell, whom
association with Dr. Ringer has naturally predisposed in
favour of similarly-acting medicines. Giving either the
twentieth of a grain of a salt of pilocarpia, or about fifteen
minims of a tincture of Jaborandi, he treated thirty-three
cases, mostly phthisical. "In every case the drug did some
good, and in most cases it was a great success." It acts
somewhat slowly, producing little effect the first night; but
when once the sweating has been checked by it "there is, as a
rule, no return for many weeks."†
I have nothing further to say of the analogues or of the
dose of Jaborandi.
Our third and last medicine to-day is a salt which, known
only as a caustic in the old school, has through physiological
* Practitioner, Dec., 1876.
† Ibid, Dec., 1879.
574
KALI BICHROMICUM.
proving become among homœopathists a widely used and
most valued remedy. It is the bichromate of potash,
Kali bichromicum.
It is prepared by trituration or aqueous solution up to the
third potency; above that with alcohol.
This substance was first proved in England, under the
superintendence of Dr. Drysdale, on II men and 5 women.
The results, with experiments on animals and observations on
the workmen engaged in its manufacture, were published by
him in the British Journal of Homœopathy for 1846. In 1845
the Austrian Society selected the drug for proving, which
they carried out on 12 men and 2 women, publishing the
results in their journal for 1847. Dr. Arneth, who conducted
the proving and undertook the publication, has embodied in
his article all that was known upon the subject up to that
date. These ample materials form the pathogenesis of Kali
bichromicum given by Allen, and from them Dr. Drysdale has
constructed the arrangement of the drug which appears in the
first part of the Hahnemann Materia Medica. Numerous
clinical cases are appended there; and a series of others has
been furnished by the same physician to the fifteenth volume
of the British Journal.
We have thus in Kali bichromicum a fully proved and
largely tried medicine. As it may be quite strange to some
of my hearers, I must expound it ab initio.
(C
Dr. Drysdale well characterises it as a pure irritant to the
organic tissues." Comparing it with Arsenic, we observe
that neurotic, hæmatic and myotic influences are altogether
wanting; but its sphere of tissue-irritation is wider, omitting
indeed the serous membranes, but extending beyond the
mucous membranes and the skin to the fibrous tissues on the
one hand, and to some of the glands on the other. I will
endeavour to describe its physiological effects under these
headings.
I. The action of Kali bichromicum on the mucous mem-
branes is as marked as that of Arsenic and of Tartar
emetic. It causes a morbid increase in the quantity of mucus
formed, which mucus sometimes is tough and stringy, and
sometimes degenerates into pus. Higher grades of the in-
flammatory process are seen in the respiratory mucous mem-
brane, and (when the poison has been swallowed) along the
alimentary tract. In the former region, false membranes have
KALI BICHROMICUM.
575
been formed; in the latter, the tendency is towards ulceration.
The portions of the mucous tracts chiefly affected are the
mouth, throat, cardiac portion of the stomach, duodenum and
jejunum, and rectum; and the whole respiratory membrane,
including the conjunctiva. These toxicological actions are
pictured in the physiological provings. The provers have sore
and injected fauces; sour eructations and heartburn, slow di-
gestion, bitter taste, nausea and vomiting, with thickly
coated tongue; dysenteric purging; coryza, hoarseness, and
cough.
2. The action of Kali bichromicum on the skin, like that of
Croton and Tartar emetic, is most fully displayed as the
result of its external application; although, as also with them,
the effect is specific, and may appear under other circum-
stances. In the account of the English proving given in the
British Journal you will find some coloured engravings of the
effects of the poison upon the skin. Papules, pustules and
ulcers are the most characteristic forms: the ulcers have hard
bases and overhanging edges, are deep and generally dry.
3. The glands chiefly affected by Kali bichromicum are the
liver and the kidneys. On the former its action is very
marked. Here is a group of symptoms occurring in one
prover:-" aching for some days in the right hypochondrium;
scanty, pale, clay-coloured stools, sometimes twice a day;
metallic taste, fœtid breath, and confusion in the head." In
animals poisoned by it, the liver is found congested, enlarged,
friable, of a dark reddish-brown colour, but presenting on its
surface whitish-yellow spots extending into its substance, of
soft consistence, and slightly depressed. The kidneys are also
found intensely congested, the tubular portion softened and
undistinguishable from the rest, and the urine either purulent
or altogether suppressed.
4. The fibrous tissues are much irritated, as shown by the
marked tearing pains experienced by the provers, especially
about the joints. Still more striking is the effect upon the
periosteum, which manifests not only pain at certain spots,
but its characteristic hard swellings. These symptoms are
observed especially in the parietal, malar, and maxillary bones,
and in the tibia. I see no evidence that Kali bichromicum
influences the bones themselves; but its curious effects upon
the nasal septum show a decided power of destroying the
cartilages. Dr. Drysdale thus describes what happens to the
workers in chrome. "For the first days there is discharge of
clear water from the nose, with sneezing, chiefly on going
into the open air; then soreness and redness of the nose,
576
KALI BICHROMICUM.
with sensation of a fœtid smell. Then they have great pain
and tenderness, most at the junction of the cartilage, and the
septum ulcerates quite through, while the nose becomes
obstructed by the repeated formation of hard elastic plugs
(called by the workmen clinkers). Finally, the membrane
loses its sensibility and remains dry, with the septum gone,
and frequently loss of smell for years.
"}
The pathogenetic effects I have now described are faithfully
represented in the clinical use of the drug. Kali bichromicum
is of no service in idiopathic nervous affections, or in toxæmic
fevers. The apparent exception of supra-orbital neuralgia,
which it has often cured (especially when occurring on the
left side), is probably not a real one; as this is the neuralgia
most frequently induced by gastric derangement. Two lead-
ing forms of cachexia, however, are prominently pictured in
its pathogenesis, viz., syphilis and chronic rheumatism.
I. Of syphilis Dr. Drysdale writes:-"the resemblance in
many respects between the action of this medicine and that of
the syphilitic virus, and also its analogy to Mercury, would
lead us to hope that we may find in it another remedy for
that disease. Though we would not place any weight on such
a merely superficial resemblance, yet we cannot refrain from
noticing the likeness that the chrome ulcer when healed.
presents to the indurated chancre. A more correct way of
judging of the resemblance is in the further development of the
constitutional symptoms. We have in this remedy the rash
on the skin; then the sore throat, which has been mistaken
for syphilitic; then the periosteal pains; then the rheuma-
tism; and lastly the diseases of the skin, chiefly of the pus-
tular character, which have the hard dark scab, and leave the
depressed cicatrix." Experience has confirmed the hope here
expressed, as will be seen in the remarks I shall make upon
its curative power over affections of the throat, eye, skin and
periosteum.
II. The rheumatoid pains induced by Kali bichromicum
are so numerous and characteristic, that it can hardly fail to
take its place as a remedy for rheumatic affections. Experience
has here also confirmed the indications of pathogenesy. It is
especially on the middle ground between rheumatism and
syphilis-in periosteal and syphilitic rheumatism-that Kali
bichromicum plays so distinguished a part. It will be seen,
however, that its action is by no means limited to cases such
as this. The rheumatism calling for Kali bichromicum is
chronic, and of the "cold" variety.
Let us now follow the curative action of the drug along
KALI BICHROMICUM.
577
the road we have already traversed in describing its patho-
genetic effects.
I. In chronic catarrh and ulcerations of the alimentary
mucous membrane Kali bichromicum is often our very best
medicine. The common chronic ulcer of the pharynx rapidly
heals under its action. I agree also with Drs. Watzke and
Russell in rating it very highly as a remedy for syphilitic sore
throat. It will not, I believe, arrest the destructive ulcera-
tion sometimes set up (requiring Mercury or Iodine); but
will subdue chronic inflammation and heal up superficial
ulcers very effectually. Then it is very useful in dyspepsia
and vomiting from chronic gastric catarrh, where the tongue
has a thick yellowish coat, differing herein from the white coat
of Antimonium crudum. Mr. Clifton has contributed some
valuable indications for the medicine here.* He agrees with
Dr. Lippe (of whose remarks I shall speak hereafter) that it
is especially useful in the dyspepsia of beer-drinkers, and
where weight (not pain) is complained of after food. He
notes that under the rough yellow fur of the tongue the
surface of the organ is red; and he confirms the general
experience of alternation of gastric sufferings with rheumatism
being characteristic of the drug. Kali bichromicum is hardly
less useful in helping to heal the round ulcer of the stomach,
and those of the duodenum resulting from burns; and in
chronic diarrhoea from intestinal ulceration it vies with Mer-
curius corrosivus, and has effected some brilliant cures.
Still more striking is the power of this remedy in affections
of the respiratory mucous membrane. In acute coryza, and
in catarrh of larynx, trachea, and bronchi, such as occurs in
influenza, it is often rapidly curative; especially (I think)
when the digestive mucous membrane is simultaneously in-
volved. There is also a large accumulation of evidence
tending to show that it is a potent remedy for true mem-
branous croup, whether diphtheritic or apparently primary.
I cannot yet compare it with Iodine and Bromine here, save
that thickness and tenacity of the false membrane will always
be an indication for it. It seems gaining in reputation as an
anti-diphtheritic medicine among our American confréres, who
see more of the disease now-a-days than we do. I have
myself seen it act exceedingly well when the deposit invaded
the nares. It is, however, more especially in the chronic
affections of the respiratory tract that Kali bichromicum is
efficacious. The great indication for it in these is the tough,
tenacious, glutinous character of the expectoration, which
* Monthly Hom. Review, xvii., 154.
2 P
578
KALI BICHROMICUM.
may often be drawn out in long strings. Dr. Meyhoffer
esteems it highly in chronic laryngeal catarrh, and when bron-
chitis lingers long in a sub-acute condition. He administers
it by inhalation as well as internally. It might be useful in
ulceration of the larynx, syphilitic or simple.
*
The lining membrane of the nose, and its offset to the eyes,
is therapeutically as well as physiologically a special seat of
the action of Kali bichromicum. It is very good for chronic
coryza, where the discharge is thick, yellow, and glutinous, and
the nose tender. Used locally as well, it has cured polypus
narium in many instances." It is worthy of trial in ozæna
after the same manner. The internal use of the drug alone
I have never seen curative of this disease; though Mr. Lord
found it very successful in horses, with whom it is a frequent
Occurrence. In acute glanders affecting these subjects Mr.
Moore has found it curative; and the suppurating nostrils
and pustular skin of the disease plainly indicate it, at any
rate in alternation with the Arsenicum or Lachesis required
by the constitutional condition. In the sphere of the eyes Kali
bichromicum stands high among the remedies for catarrhal
and strumous ophthalmia; and its action on the fibrous
structures has enabled it to cure even rheumatic† and syphilitic
inflammations of the ball. It is especially useful in catarrho-
rheumatic ophthalmia. Drs. Allen and Norton mention a
case of pannus from granular lids, in which the eyes cleared
up wonderfully under the medicine. They have found it
useful also to remove opacities of the cornea.
The other uses of the drug may be more briefly passed
over.
2. It has often been used with great advantage in pustular
eruptions; and is a valuable remedy, externally as well as
internally used, for ulcers on the legs. Dr. Edward Blake
has lately communicated some interesting experience with
it in lupus non-exedens, which he has several times succeeded
* See one in Brit. Journ. of Hom., xxviii., 356. Dr. Ransford has
communicated (Ibid., xxiv., 304) a case which he calls "malignant
ulceration of the nose, "cured by the internal use of the bichromate.
I should rather have called it polypus, possibly malignant. Dr. Rans-
ford has found fault with this criticism (Ibid., xxxii., 651); but his only
reply is to repeat testimonies as to the malignancy of the affection.
This I do not question: I only submit that it was a polypoid growth
rather than an ulcerative process.
+ One of the Austrian provers, who took the second trituration, had
"several bright red spots and streaks on the white of the left eye."
which looks like sclerotic injection.
Brit. Journ. of Hom., xxxii., 643.
KALI BICHROMICUM.
579
in curing with the 5th decimal attenuation. I have had a
similar result in one case of my own.
3. Kali bichromicum is a decided hepatic medicine, much
resembling Mercurius. Dull pain in the right hypochondrium,
especially when limited to a small spot, and whitish stools,
are indications for its use. Its action on the kidneys has
led to its use in the suppression of urine which sometimes
follows upon Asiatic cholera; and so far with apparent
success.
4. The action of Kali bichromicum upon fibrous tissue has
led to its successful use in a number of local rheumatisms,
and such-like maladies. In Dr. Drysdale's article you will
find cases of rheumatic headache, of lumbago and sciatica,
and of periostitis, which have been very satisfactorily cured
by it.
Two of our American colleagues, Drs. Lippe and Kitchen,
have within the last few years written upon Kali bichromicum.
The concurrence of their experience is interesting, as the
former uses the higher infinitesimals while the latter gives
semi-material doses. Dr. Lippe compares its eruption to that
of measles, and says that in this disease the cough and ex-
pectoration are often such as to indicate the drug. Dr.
Kitchen mainly confirms our experience with it in chronic
affections of the respiratory tract, where he thinks yellow
expectoration a great indication for it.
Hepar sulphuris, Kali iodatum and the mercurial preparations
are the medicines which have most analogy to the general
action of Kali bichromicum. In its effects on the mucous
membranes and skin it resembles also Arsenic and Tartar
emetic. Spongia, Iodine and Bromine act like it upon the
larynx and trachea; Mercurius on the liver; and Mezereum
and Phytolacca on the periosteum.
I recommend by way of dose the first six dilutions. The
3rd is most commonly used, except in syphilis, where the lowest
potencies of this salt and of the neutral chromate have been em-
ployed with most benefit. In acute affections, however, I nearly
always prefer the 6th, unless I give the 12th. For external
use, as to ulcers, one grain of the pure salt to eight ounces of
water will be found quite strong enough.
LECTURE XXXVIII.
KALI CARBONICUM, CHLORICUM, NITRICUM, AND PERMAN-
GANICUM; KALMIA, KREOSOTE, LACTUCA.
OF the compounds of potassium we have already studied
the iodide, the bromide, and the bichromate-all of which
belong less to it than to the other element entering into their
composition; and free potash itself has come before us under
the name of Causticum. We have now to consider the re-
maining drugs of this order which we use in homoeopathic
practice.
The first of these is the carbonate,
Kali carbonicum.
It is prepared by solution in distilled water, or by tritu
ration.
Hahnemann published a proving of Kali carbonicum in
the first edition of the Chronic Diseases, containing 938
symptoms, a good many of which were contributed by Rummel
and von Gersdorff. In the second edition the list has swollen
to 1,650, a few of the additions being Hartlaub's and Goullon's,
but most of them coming from Nenning. Dr. Allen's addi-
tions are few and unimportant.
The carbonate of potash is not credited with any specific
action of its own in old-school therapeutics; but is classed
with the acetate, citrate, and other vegetable salts of the alkali.
The only exception is whooping-cough, where it has some
reputation. This-as with cochineal-has been sustained
in homœopathic practice: von Bönninghausen thought it
specially indicated where there was much puffiness of the
upper eyelids present. Dr. Drury recommends it also in
cough from relaxed uvula.* It is in affections of the respira-
tory organs that it has found its chief use. Dr. Bayes com-
* Annals, iv., 543.
KALI CARBONICUM.
581
mends it in ulceration of the nostrils; and in a series of cases of
ozana-or, rather, chronic nasal catarrh-published by Dr. S.
C. Jones in the American Journal of Homœopathic Materia
Medica, Kali carbonicum was the remedy most frequently
successful. He thinks the presence of ulceration within the
nose the special indication for its use. Hahnemann says-
"it is rarely that ulcerative pulmonary phthisis can be cured
without this antipsoric," and the suggestion has been gene-
rally carried out and substantiated by his disciples. It seems
agreed that the chief indication for it is—as with Stannum-
profuse purulent expectoration, but also—which is peculiar to
it-much pain in the walls of the chest. It will so often
remove these pains, and the pains themselves are so frequently
pleuritic in nature, that it has come to be thought that Kali
carbonicum is a true remedy for pleurisy, and not only when
occurring in connection with phthisis. I suspect that it is
only when the pleuræ are affected by extension from the lungs
that it proves useful, and that the "phthisis" in which it has
been beneficial is pneumonic rather than tubercular.
Another specific action of Kali carbonicum is that which it
exerts upon the ovario-uterine system. Hahnemann com-
mends it in suppression of the menses, or when these delay in
making their first appearance at the time of puberty; and to
such negative conditions of the periodic function it has
generally been considered applicable. But Dr. H. Goullon
has of late commended it to us as no less valuable in menor-
rhagia. It is spoken of very highly in Noack and Trinks'
Handbuch for aching in the back, with sense of weakness there,
in pregnant women (an experience I have often confirmed), and
for the effects of want of care after miscarriage and childbirth.
Besides these more defined uses of Kali carbonicum, it is
a medicine which not unfrequently comes into play in the
treatment of complex cases of chronic disease. When the
symptoms present are, on consulting our repertories, found in
its pathogenesis, we may generally use it-preferably in the
higher dilutions-with good hope of benefit. A good many
such cases have been at various times contributed to the
Allgemeine homöopathische Zeitung by Dr. Schelling, who is
an enthusiast for the medicine. Dr. Guernsey considers the
sharp, stitching, jerking pains we have seen it removing from
the walls of the chest an indication for its employment gene-
rally, and Hahnemann himself had remarked that "stitching
is the most characteristic pain of Kali."
* Oct. and Nov., 1875.
† See Brit. Fourn. of Hom., xxv., 515.
582
KALI CHLORICUM.
It will be seen from this that Causticum is not so close an
analogue of Kali carbonicum as their chemical relationship
would suggest. Natrum muriaticum and Stannum are per-
haps the medicines which most resemble it.
As Kali carbonicum was used by the earlier Hahneman-
nians much more than it is now, I should have supposed that
the higher dilutions were the most efficacious. Dr. Clotar
Müller, however, writes :-" as long as I employed this medi-
cine in 6 or 30, I saw little or no benefit. But since I have
for many years, by Dr. Gruber's advice, given it in 1 and 2, I
have seen better results, especially in some cases of pulmonary
tuberculosis." Dr. Bayes, also, seems quite satisfied with the
third and lower potencies.
Before passing to other salts of potash which have an in-
dividuality of their own, I would mention that the presence
of this substance as a natural constituent of the body has
given it a place among Dr. Schüssler's "tissue-remedies.”
He uses the chloride, phosphate, and sulphate (Kali muria-
ticum, phosphoricum, sulphuricum); and thinks the first of
great value in croupous inflammations of mucous membrane
and severe affections of the skin; the third in catarrhs and
superficial disorders of the same parts; and the second in
nervous debility and septic conditions of the blood. I mention
these points, though Dr. Schüssler's structure seems to me
much founded on guess-work. The large proportion of potash
normally present in muscle is the only fact of the kind which
I should regard as practically significant.
We come now to the chlorate of potash,
Kali chloricum,
which also is prepared by trituration or aqueous solution.
A proving of Kali chloricum was published in the sixteenth
volume of Stapf's Archiv, by Professor Martin of Jena. Eleven
persons took part in it, using the crude drug. Dr. Allen,
giving Martin's results, adds several other observations.
The chlorate of potash was found by Stevens, when taken
internally, to give the venous blood an arterial hue; and the
same result was obtained by O'Shaughnessy when he injected
it into the vessels of animals. Taking this in connection with
the large amount of oxygen it contains, and the readiness
with which it parts with it, the salt was supposed to be a
KALI CHLORICUM.
583
means of conveying oxygen to the blood and tissues; and
was given accordingly in scorbutic conditions, in scarlet
and other adynamic fevers, and in diphtheria. This theory is
now considered invalid, as the salt is found unchanged in the
urine, and other alkaline salts (as nitre) produce a similar
effect on the blood. But practical men seem no less to believe
in its power of improving cachectic states of the system; and
give it accordingly in such diseases as syphilis, cancer* and
phthisis, where the general condition is of this nature. Dr.
Charles Drysdale and Mr. Allingham treat infantile syphilis
with this medicine alone, and with excellent results;† Drs.
Cotton and Chambers find it very beneficial in phthisis occur-
ring in patients of broken-down constitutions. I venture to
suggest that the agent of these effects is not the oxygen of the
drug, but the chlorine. The liberation of this gas when hydro-
chloric acid is applied to the salt is well known, and it finds
plenty of this acid in the stomach. Chlorine water, prepared
by mixing the two in aqueous solution before administration,
is in the same repute as chlorate of potash in acute disease,
and might have like effects in chronic. This view is further
supported by the deodorising influence of the chlorate when
applied in solution, which is well known, but nowhere better
illustrated than in a
than in a paper by Mr. Evan Fraser in the
eighteenth volume of the British Journal of Homœopathy. It
is far more likely that chlorine is at work here than oxygen,
for the foul surfaces are already freely exposed to the latter
element. The small quantity required for this purpose, more-
over-Mr. Fraser finds ten grains to a pint of sufficient strength
-quite corresponds with the fact that the larger part of the
doses ordinarily given passes out unchanged in the urine (some-
times, I may mention, causing nephritis on its way). The
decomposition of a very small quantity would liberate chlorine
enough to do plenty of work.
However, whether it be chlorine or oxygen by which the salt
influences cachectic conditions, the practice seems to belong
to iatro-chemistry rather than to dynamism and homoeo-
pathy. But we can justly claim for the latter a still better
established use of chlorate of potash-its power over stomatitis.
I will state this in the words of Dr. Ringer. "It is of signal
service in mercurial and simple salivation, in ulcerative sto-
matitis and aphtha. It is particularly useful in ulceration of
the edges of the gums. The influence of the chlorate on this
form of ulceration is almost magical: in one or two days it
See Brit. Journ. of Hom., xxv., 518.
+ Treatment of Syphilis without Mercury (1st ed.), pp. 130—132.
584
KALI CHLORICUM.
cleans the dirty-looking sores, and heals them in a day or two
more. It is said to cure follicular and phagedenic ulceration
like a charm." Let me now read you a case reported in the
Medical Times and Gazette for May 22nd, 1858. A child had
been taking from March 16th to May 18th, three times daily, at
first ten and then five grains of the salt for strumous cph-
thalmia. "On May 18th she came with a very sore mouth.
The saliva dripped from her lips, there were numerous folli-
cular ulcers on the tongue and inside of lips, and one large one
occupied a surface the size of a shilling on the back part of the
dorsum of the tongue. The salivary glands were enlarged and
tender, and the mouth full of saliva, although the ptyalism was
not extreme nor were the gums sore.
In this latter respect
and in the existence of the larger ulcers on the tongue, the
stomatitis differed from that caused by mercury." Nor is this
an isolated occurrence. Mr. Hutchinson reports three other
cases, and Mr. Traill a fourth,—the former describing the form
of stomatitis it causes as exactly resembling that over which it
exerts curative powers; and salivation is ascribed to it by
Isambert and other writers. It is eliminated by this secretion
as freely as by the urine.
I hardly know whether Kali chloricum is as much used in
the homoeopathic treatment of affections in the mouth as it
deserves to be. I never require any other medicine for simple
stomatitis-that exudative inflammation of the buccal mucous
membrane which the French call "muguet." I have lately
found it very beneficial in one of those rare cases of epithelial
degeneration of the mucous membrane of the mouth which
Paget has described as often forerunning cancer, and an
instance of which Dr. Cooper has mentioned as cured by him
with Muriatic acid. In my case I gave that medicine with
little effect. Mr. Fraser thinks that Kali chloricum has a
specific power over ulceration in this region, and gives a
good case where the process in the throat of a syphilitic patient
was arrested by it. Dr. Joslin found it of eminent service in
an epidemic of gangrenous stomatitis occurring in a Children's
Home.
The pathogenesis may possibly guide us to further uses of
the salt. Dr. Drysdale has recorded* a case of facial paralysis,
beginning with face-ache, in which a rapid cure was effected
by the first decimal trituration of Kali chloricum after the
failure of Belladonna and Rhus. He was led to the medicine,
not by the paralysis, but by the presence of tenderness on
touch or pressure of the affected side, which is prominent
* Brit. Fourn., xxv., 316.
KALI NITRICUM.
585
among its symptoms. It produced, however, in a person who
took fifteen grammes a sensation as if half the head, face, and
nose were paralysed.
In its action on the mouth Kali chloricum has for analogues
Mercury, Iodine, Nitric and Muriatic acids, and Iris.
The 1st decimal trituration has been that which I have
always used.
The third salt of potash which comes before us to-day is
the nitrate, the saltpetre or nitre of common parlance,
Kali nitricum.
The nitre of the shops, dissolved in hot water and deposited
in crystals as it cools, is triturated for our use.
Nitre is one of the best-proved medicines we have. The
pathogenesis in the second edition of the Chronic Diseases
contains 588 symptoms from Schreter, Tietze, and Nenning
(very few being from Hahnemann), and 122 from authors.
second pathogenesis, obtained by ten persons chiefly from
good-sized doses of the first trituration, was published in the
Archiv, and is translated in the first volume of the Révue
de la Matière Médicale specifique. Jörg and eight pupils have
also contributed to its proving,* besides Alexander of old;
and numerous cases of poisoning with the salt are related in
the Révue (p. 336) and by Hempel. Dr. Allen embodies all
thes ematerials, giving 1,119 symptoms to the drug.
Before I practised homoeopathically, nitre was a very
favourite remedy of mine in the febrile affections of child-
hood. I supposed it to act chemically on the hot and hyperi-
notic blood, and dynamically on the excited circulation.
I see no reason for supposing that I was wrong. Hahnemann
says that “inasmuch as the production of cold in the system
is the primary effect of Nitrum, its action in inflammatory
fevers must be palliative only.' It is so; but in these
ephemeral affections a palliative answers much the same
purposes as a curative, as Hahnemann himself has said in
reference to Opium. I have better remedies now; but I re-
member with affection my formerly used nitre.
I confess, moreover, that I have not found a place for it in
""
-
* In my last edition, I spoke also of Löffler (and four associates) as
having joined in the proving of nitre. In this I was mistaken, having
been misled by Hempel. It was the nitrate of soda (Natrum nitricum)
which Löffler proved, as Dr. Allen shows.
586
KALI PERMANGANICUM.
my new therapeutics; nor, it would seem, have others in our
school. There is little trace of its use in homoeopathic litera-
ture Bayes and Teste omit it altogether, and Hempel and
Espanet give but theoretical indications for its employment.
All I can do, therefore, is to tell you what has been ascertained
as to its physiological action.
Nitre shows the general properties which are now recognised
as belonging to the salts of potash: it paralyses the spinal
cord and the heart, arresting the action of the latter in
diastole. This effect-seen best in experiments on animals-
is pretty obvious in the poisonings and provings. It further
acts like the alkalies generally on the blood, exerting there a
spoliative and antiplastic influence. It is, moreover, an un-
doubted diuretic, and the solid constituents of the urine seem
increased pari passu with the liquid. Sugar was found in it
in one case of poisoning. The irritant influence on the
kidneys suggested herein is also manifested elsewhere,—in
poisonings by gastro-enteritis, and in provings by irritation of
the respiratory mucous membrane (including the conjunctiva),
the testicle and epididymis, the joints, and (in one instance)
the salivary glands. There was often much pyrexia. In one
case of poisoning there was acute cedema of the whole body:
in another, after recovery from the first effects, chorea and
great irritability of temper.
From these facts therapeutic indications may yet be drawn.
Some hints, moreover, for dynamic uses of the salt may be
got from its reputation in old-school therapeutics. Its action
in acute rheumatism is hardly that of a mere alkali; and
Alexander and Frank, among its provers, have experienced
great pains in joints and muscles. The value of nitre-paper
in relieving asthma is undoubted, and is not traceable to any
known action of the drug; Hahnemann mentions asthma as
a morbid state especially calling for it. It has been praised
in enuresis, to which, if that affection be paretic in nature, it
is surely homoeopathic.
K
I hope that thus we may some day find a place for nitre
among our remedies, and that its extensive provings may not
always remain barren. At present I can say nothing about
allied medicines or dose.
The permanganate of potash,
Kali permanganicum,
is the last of its salts which I have to mention. It has been
KALI PERMANGANICUM.
587
((
best known hitherto in the solution of it sold as "Condy's
Fluid," where it disinfects and deodorises by means of the
large proportion of oxygen it contains, and yields to organic
matters. It has now received a most heroic proving from Dr.
H. C. Allen, of Cleveland, which you may read in the twenty-
fifth volume of the British Journal of Homeopathy. Its power
is shown herein to set up acute inflammation of the throat,
extending to the nares (whence the discharge was sanious),
larynx, and salivary glands, and along the Eustachian tubes.
With these symptoms there were diuresis and obstinate con-
stipation, and much weakness. Putting together this elective
affinity for the throat and its neighbourhood (for its action is
not local,-as Stillé says, upon mucous surfaces it causes
neither pain nor irritation"), and the chemical power of the
drug in dissolving the false membrane and destroying the
offensive emanations of diphtheria, Dr. Allen tried it in a
desperate case of the malignant form of this disease, with the
most rapid and brilliant results. The usual remedies had
been given without effect: the odour of the breath had become
almost unbearable; a dark-coloured offensive diarrhoea had
set in, while, "with vomiting, fluids taken by the mouth were
returned by the nose, and a general prostration seemed to be
the precursor of a fatal termination. At this stage," says Dr.
Allen, "I dissolved three grains of the permanganate in one
half-glass of water, and gave her a teaspoonful at 9 p.m., to
be repeated every hour until I saw her. Called at 12 p.m.,
found her much improved, breathing easier, and a warm per-
spiration had made its appearance. Continued the medicine.
The next morning I found her sitting up in her bed, and her
whole appearance changed. On examining the throat, to my
astonishment I found the membrane hitherto so extensive
almost gone, a small patch on the left tonsil only being visible.
The offensive character of the breath was completely changed;
in fact, I could discover no odour at all. Continued the medi-
cine every three hours while awake, and she went on to a
speedy convalescence."
Dr. Allen adds: “This is only one of a number I could
relate treated with the permanganate, all with equally good
results." To my mind it recalls many a case in which I would
have given anything for such a medicine, but which went down
to the grave, untouched by the ordinary means. I have only
had one good opportunity since of trying it; and though the
effect was nil, the case was hardly a fair one to be the test of
any remedy, as paralysis of the velum palati occurred early,
and allowed fluids to return through the nose. The tender
588
KALMIA LATIFOLIA.
mucous membrane, thus irritated, broke out in hæmorrhage,
and the poor little fellow sank exhausted. I have also failed
to meet with more than one* communication of its use, suc-
cessful or otherwise, at the hands of others.
Drs. Drummond and Woodgates speak highly of a gargle
of the permanganate (grs. iv. to 3viij) in ulcerated sore-
throat.†
My next medicine, the mountain-laurel,
Kalmia latifolia,
is another of those which have been proved by Dr. Constantine
Hering. His pathogenesis, obtained by several persons
with the dilutions from the 1st to the 30th, is contained in the
Materia Medica of American Provings. Dr. Allen adds
provings, made with substantial doses, by five other persons.
Kalmia sometimes proves poisonous to animals eating it,
and even to human beings partaking of the honey of bees
which have ransacked its blossoms or of pheasants who have
lived upon it. From instances of the latter kind (confirmed
by the more heroic provings given by Allen) it has been ascer-
tained to act like Digitalis, diminishing the force and frequency
of the heart's action in a very marked manner, and causing
nausea and dimness of sight. Much pain is complained of in
the region of the cervical vertebræ, which suggests that like
its analogue it acts through the medulla oblongata. It has
been comparatively little used in disease. Dr. Hering thinks
it shares the relation of Ledum and Rhododendron to rheu-
matism-certainly few medicines cause so many rheumatoid
pains; and that it will be found useful in rheumatic affections of
the heart. Dr. Bayes says he has found it curative in face-pains
of this character, worse at night, and seemingly situated in the
periosteum. Mr. Clifton reports a still fuller experience; he
has frequently used it with beneficial results in rheumatism, in
organic heart-affections, and in neuralgia. The rheumatism
in which it is indicated is acute, but non-febrile; it shifts
much, especially from above to below; the pains are worse on
the least motion and towards midnight. It gives relief when
the pains seem suddenly to leave the extremities and go to
the heart, without actual inflammation of the organ being set
* See Brit. Fourn. of Hom., xxxiv., 386.
† Monthly Hom. Review, vols. xi. and xii.
KREOSOTUM.
589
up. In organic disease of the heart, with pain and slow weak
pulse, he has often seen benefit from it. He argues that the
neuralgia in which it is useful is "rheumatic," i.e., excited by
cold in otherwise tolerably healthy subjects. It is nearly
always, he says, on the right side, and often goes down the
arm. The pain is generally succeeded by numbness, and may
be associated (as in a case of brachialgia he records) with the
characteristic slow pulse of the medicine. I would advise you
to read Mr. Clifton's remarks in full: you will find them in
the twenty-first volume of the Monthly Homeopathic Review
(p. 423).
In the twenty-second volume of the same journal you will
find an interesting study of Allen's pathogenesis of Kalmia, by
Dr. Dyce Brown. He analyses especially the symptoms which
point to its action on the cerebro-spinal system, the muscles,
and the joints, and points out its homœopathic appropriateness
to many morbid conditions of neurotic and rheumatic nature.
Dr. Dunham, in his Lectures (I. 194), relates a case of rheu-
matic endocarditis so completely cured by it, that no valvular
murmur remained.
The tincture is made from the leaves. Dr. Bayes gave the
third decimal attenuation.
Let us now consider the place occupied in specific thera-
peutics by that product of the distillation of wood tar called
Kreosotum,
of which we make alcoholic attenuations for use.
A proving of Kreosote was carried out on seven persons
(five of whom were females) by the late Dr. Wahle of Rome,
and published in the sixteenth volume of the Archiv. Small
doses only were employed, none taking over a drop. Dr.
Syrbius also has proved it (rather more boldly) on himself
and seven others. The results of these and other observations
are given by Allen. Much interesting matter is contained in
Dr. Cormack's monograph on the drug; and Teste's article
should by all means be consulted.
The results of Dr. Cormack's experiments on animals seem
to me negative as respects the medicinal value of Kreosote.
It appears to suspend the functions of the first organ through
whose capillaries it passes, causing vertigo and stupor if intro-
duced into the carotids, asphyxia if injected into the veins.
These effects are probably due to the coagulation of the
590
KREOSOTUM.
albumen of the blood, since Kreosote exerts an influence of
this kind under all circumstances. Upon this influence, indeed,
the remedial powers of the drug when applied locally seem to
depend. If your experience leads you to think favourably
of these uses, pray do not abandon them till you get some-
thing better. The point is quite outside the domain of homœo-
pathy; she says neither yea'nor nay to the practice.
When we come to the dynamic effects of Kreosote, however,
the aspect of things is changed. Pereira is never more
homœopathic in his unconscious honesty than in treating of
the properties of this drug. "Swallowed in large doses," he
writes, "it causes vomiting and purging;" and again, "when
the dose has been considerably augmented, diarrhea, or even
dysentery, has been produced." And then he goes on to tell
us that “as an internal remedy, Kreosote has been principally
celebrated, in this country, as a medicine possessing extra-
ordinary powers of arresting vomiting," that in Sweden it was
found very useful in a wide-spread epidemic of dysentery;
and that Mr. Spinks and Dr. Kesteven have published cases
of its successful employment in common diarrhea. While to
crown all, we have this sentence :-" occasionally it increases
the quantity of the urinary secretion; but in diabetes it some-
times has an opposite effect."
The power of Kreosote over vomiting is the only one of
these actions upon which I need dwell. It is recognised by us
with our small doses as heartily as by the old school with
their large. We agree, moreover, that it is in sympathetic
vomiting that Kreosote proves specific-where the irritation
starts from some other organ than the stomach. Thus the
vomiting of phthisis, of hepatic and uterine cancer, and of
chronic kidney disease, is often checked by it. I must
say, however, that I once had a chronic case of suspected
cancer of the stomach under treatment, the vomiting of which
was always arrested by Kreosote when it became troublesome.
I believe that some esteem it very highly in hysterical vomit-
ing.
-
Dr. Hilbers considers that Kreosote has great power of
sustaining the strength in some of these exhausting diseases,
as well as of checking the vomiting; and relies much upon it
in the treatment of phthisis. Like the other antiseptics,
moreover (as Arsenic and Carbo), Kreosote has a dynamic
influence over foul discharges and putrescent processes. I
once made a very pretty cure with it of persistent lochial dis-
charge, which had become brown and offensive. Wahle's
provings, indeed, show that it has a very decided action on the
KREOSOTUM.
591
uterus, vagina, and vulva, causing much leucorrhoea-yellow,
offensive, and acrid, with itching, biting, smarting, and burning
in the pudenda, and between the labia and the thighs; also
menorrhagia, generally of dark colour and acrid character.
These symptoms have naturally led to its use when uterine
discharges have assumed morbid features of this kind, and
frequently with success. You will find its indications very
clearly given in Dr. Guernsey's Obstetrics. Besides those
already mentioned, he notes two other among its pathogenetic
effects as guiding symptoms for its choice-viz., a paroxysmal,
intermitting character of the menstrual flow, and sharp stitches
darting from the abdomen into the vagina. The morbid nature
of the uterine discharges of Kreosote have, naturally enough,
led to its trial in cancer and gangrene of the womb; but I
am unable to speak of any success.
But we owe to the fertile and original mind of M. Teste a
remarkable development of the uses of Kreosote. He calls
attention to the effects of the continued use of smoked meat—
"a sort of scurvy carrying off the teeth, foul breath, costive-
ness, a general malaise, and a real cacohymia." He then
suggests that the power of Kreosote when locally applied, not
merely to relieve temporarily the pain of toothache, but to
arrest the progress of caries, is of a dynamic nature. Putting
these facts together, he justifies by them the following state-
ment drawn from his experience :
1. Kreosote is in children of all ages, as well as in adults,
the chief remedy for odontalgia, when it is caused by caries of
the teeth.
2. When dentition is so badly performed as to become a
disease, comprising general irritation and cachexia with de-
generation of the teeth themselves, especially when the child
is constipated, Kreosote is the specific remedy.
These statements I can confirm from repeated trials in my
own practice, which have yielded me almost uniform success.
Dr. Madden also writes :-" I like Kreosote in dentition very
much. My first case was our own baby. She had been
extremely fretful and irritable and sleepless for three or four
days, and Chamomilla had done no good. I gave Kreosote
24, and in a quarter of an hour she was asleep, and slept
eleven hours right off, and woke cheerful. The nurse was
almost frightened, thinking I must have given an opiate." Dr.
Guernsey also speaks of Kreosote as "an invaluable remedy
in difficult dentition," giving similar indications to those of
Testé; and adding that the symptoms are usually worst from
6 p.m. to 6 a.m., so that the child (and nurse) gets little sleep.
592
LACTUCA VIROSA.
I cannot follow M. Teste, however, when he goes on to extol
Kreosote as "the specific for syphilis in nursing children." If
he limits it, as he seems to do subsequently, to cases
"where
the disease manifests itself under the exanthematous form,” I
shall not disagree. But I have failed to see any effect from
Kreosote upon the profound cacohymia which this sad disease
so often manifests.
M. Teste further adds that Kreosote is most suitable to de-
licate cachectic children: and, when given to those of a lively,
vigorous, and sanguine constitution, makes them feel so un-
comfortable that the exhibition of Ferrum metallicum as an
antidote becomes necessary.
It may be well to remember, when we are studying the con-
stitutional action of Kreosote, the virtues ascribed of old to
tar water, as by Bishop Berkeley in his Siris. Dr. Sharp has
called attention to these, characterising the condition of body in
which it was so commended as a "dyscrasia where there is
a strong tendency in the fluids to decomposition, and in the
solids to disorganization." Kreosote, which is one of the most
important constituents of tar, may possibly inherit its renown.
You will see from what I have now said that I cannot ac-
cept the present identification of Kreosote with Carbolic acid
as a remedy. The two have similar chemical properties, and
coincide at some points of their spheres of action; but these
are quite distinct. Closer analogues of Kreosote are Carbo
animalis and vegetabilis; Mercurius; and Petroleum.
I have used from the second to the sixth dilution for vomit-
ing and uterine discharges; but have followed M. Teste in
giving the 12th in toothache, and the 24th in morbid dentition
and infantile syphilis.
I conclude this lecture with a short account of the virtues of
the wild lettuce,
Lactuca virosa.
The milky juice of this plant and of the milder Lactuca sativa
has long been in use as lactucarium In homœopathic
practice a tincture prepared from the entire plant is employed.
The general knowledge about the action of lactucarium is
well epitomised by Pereira. There is a proving of Lactuca
virosa in the fifth volume of the Hygea; and a summary of
the experiments, with remarks and observations from authors,
is given by Dr. Seidel in the second volume of the Journal
LACTUCA VIROSA.
593
für Arzneimittellehre, and translated in the first volume of the
Révue de la Matière Médicale specifique. All the provers
(fifteen in number) took considerable doses of the tincture or
extract. Dr. Allen gives a few additional symptoms.
As very little is known about this drug (it is not mentioned
by Hempel or Teste) I will read you in full the summary of
its effects furnished by Dr. Seidel.
"The general character of the action of Lactuca virosa can
be traced from the preceding experiments as follows:-
"Immediately after taking it, there was a sensation of heat
in the stomach, accompanied by an uneasiness which mounted
into the throat, and an insipid taste. After a quarter of an
hour, this sensation gave place to an icy coldness in the
stomach and throat. At the same time, the prover experienced
a contraction at the pit of the stomach, which was followed by
real præcordial anguish; the thorax seemed compressed and
narrowed, especially while sitting with the body bent. He
felt a desire to breathe deeply, an ardent longing for the open
air; and had frequent yawnings. It was not till after this
that the head became confused and giddy, without, however,
the judgment being obscured. He had a sensation (a physical
one) of wavering in the brain, whieh rendered every posture
of the body uncertain, and was accompanied with buzzings in
the depth of the ears. After from fifteen to thirty minutes
there supervened, in the midst of eructations which gave but
slight relief, gurglings in the abdomen with emission of flatu-
lence, which last did good. The præcordial anguish diminished,
and alternated with heats, flying shootings, and sensations of
cold in the chest. Deglutition became difficult, not because
of any obstacle in the throat, but because the muscles of the
pharynx refused their office. There were also constant sigh-
ings. Keeping himself seated with the body bent relieved the
stomach; and sitting upright did good to the chest. The
thorax could not bear any pressure; there was cloudiness of
the head, but the veil which covered the sight disappeared
when he fixedly regarded an object. At the end of an hour
mucosity had accumulated in the throat, which with some was
at the same time rough; and a cough was set up whose short
paroxysms grievously pained the chest and the head. This
cough became more violent afterwards, and the headache
grew worse.
This last was characterised at one time by con-
fusion merely, at another by painful pressings. In some
subjects, there was at this time a 'clavus hystericus.' With
these there were fulness in the abdomen, obscuration of sight,
and difficulty of breathing. The above symptoms increased
2 Q
594
LACTUCA VIROSA.
I
up to the third or fourth hour, and then diminished little by
little. Those of the chest, especially the oppression and desire
to breathe deeply, continued several days. Those of the
abdomen went off most frequently with emissions of flatulence
or with a scanty stool, pappy or loose, which took place the
first day, and was followed by a long constipation. During
the first few hours, the secretion of urine was restrained, but
later it increased considerably. There was shuddering, with
great prostration and lassitude, for the first days; and in the
nights deep sleep, quiet, sometimes lethargic; but afterwards
the sleep was agitated and interrupted. The pulse was some-
what less frequent during the first days. The disposition
manifested itself in sadness, anxiety, and causeless chagrin.
Besides these symptoms, I note the hepatic sufferings of
many of the
of the provers: with one "the liver was swollen, hard,
the pressure of the hand under the false ribs could not be
borne, with a rather pressive pain.”
The facts here given warrant Dr. Seidel in further saying
that "the pure milky juice of the lettuce, as it is contained in
'lactucarium,' seems to act principally on the brain and nervous
system, and to exert less sensible effects in the vegetative
sphere than preparations in which the juice of the whole plant
is employed." The observations summarized by Pereira
embrace the neurotic properties only of the drug. It is re-
garded as a “sedative," diminishing the force and frequency of
the pulse, and disposing to sleep. Hence its name of "lettuce-
opium." It differs, however, from Opium in causing no excite-
ment either of brain or circulation.
"}
In ordinary practicę, lactucarium has been employed as an
"anodyne, hypnotic, antispasmodic, and sedative" but its
operation is considered uncertain. In the school of Hahne-
mann Lactuca has hitherto found little if any employment;
the only symptom indicated by Allen as having been fre-
quently verified is "incessant spasmodic cough, which
threatens to burst the chest: it is always caused by a peculiar
tickling in the fauces, which in turn seems to be produced by a
sensation of suffocation in the throat." It seems indicated
however, in some forms of hepatic and pulmonary congestion,
of clavus, and of cerebral weakness with somnolence. At any
rate, should a repertory ever direct us to it, we may prescribe
it with confidence that the symptoms are genuine effects of
the drug.
The dilution best suited to obtain the homœopathic action
has not yet been ascertained.
LECTURE XXXIX.
LACHESIS AND THE SERPENT-POISONS.
I shall devote to-day's lecture to the medicine we call
Lachesis, taking occasion thereby to discourse upon the
medicinal use of serpent-venom generally, and upon the other
members of the family which, as Crotalus, Naja, Elaps, and
Vipera respectively, have place in the Materia Medica of
Homœopathy.
We prepare such substances by triturating the virus, or dis-
solving it in glycerine. Alcohol is not considered a suitable
menstruum for the lower attenuations; but it seems to make
no difference when we get into the region of infinitesimals.
Of our sources of information as to the physiological effects
of snake-venom we must place first in order the Wirkungen
des Schlangengiftes of Dr. Constantine Hering. A copy of
this rare book I am able to lay before you. Published in 1837,
it contains a full collection of the phenomena of snake-bites,
as observed and recorded by authors before that time. These
àre arranged in the Hahnemannian schema, and incorporated
with them are numerous symptoms obtained by the author
and seventeen fellow-observers on both healthy and sick
persons. This collection contains symptoms obtained from
the lance-headed viper, Lachesis trigonocephalus; the rattle-
snake, Crotalus horridus; the cobra, Naja tripudians; and
from the Italian and German species of viper-Vipera Redi
and torva. The provings of Lachesis venom were all made
with the thirtieth dilution; but some of the symptoms
recorded appeared in Dr. Hering himself while triturating
it, and from taking the first and second attenuations so pre-
pared. Crotalus was proved in these last-named potencies,
and among the effects referred to are some obtained from
swallowing the poison-bag made into pills with cheese.
The next great contribution to our knowledge on this sub-
ject was made by Dr. Rutherfurd Russell, who—in conjunction
with Dr. Stokes-proved the poison of the cobra on ten male
and three female subjects, using the first, third, and sixth
596
LACHESIS AND THE SERPENT-POISONS.
attenuations. An account of these excellent experiments is
given in detail in the eleventh and twelfth volumes of the
British Journal of Homeopathy.
Dr. Allen, as is his wont (and in this case I think with ample
warrant), separates the pathogeneses of the various snake-
poisons. Those of Lachesis, Crotalus, and Naja, while con-
taining the material specified above, add fresh observations,-
of the effects of bites with the two latter, of symptoms
observed in patients taking the drug with the former. He
gives us, for the first time, a complete pathogenesis of Elaps
corallinus, the Brazilian coral-snake, made of three provings
instituted by Drs. Mure and Lippe—the 3rd and 4th attenua-
tions being used.
GA
Dr. Russell prefixes to his proving several fresh narratives
of poisoning by cobra-bites. But this branch of the subject
has received special attention of late. Sir Joseph Fayrer's
great work on The Thanatophidia of India is known to all;
but, as it is too much of a livre de luxe to be generally
accessible, I will make my references to the narratives of
poisoning extracted from it which Dr. Pyburn has collected
in the sixteenth volume of the Monthly Homeopathic Review.
I would also commend to your notice the essay of Dr. Weir
Mitchell, "On the Venom of the Rattlesnake," contained in
the twelfth volume of the Smithsonian Contributions to Know-
ledge (Washington, 1860); and also an account of a series of
inoculations of the same virus, practised with the hope that
they would prove prophylactic of yellow fever, given by Dr.
Neidhard in his treatise On Crotalus horridus in Yellow Fever
(second edition, New York, 1868). Finally, I would refer you
to a useful account of some recent experimentation on animals
as to the effect of serpent-bites, contributed to the thirty-
fourth volume of the British Journal by Dr. Bayes, under the
title of "The Differential Symptomatology of Naja tripu-
dians and Crotalus poisons."
I must repeat here what I said under the head of Apis, that
it is no longer necessary to apologize for our use of serpent-
venom as a medicine introduced through the ordinary channel.
It is now fully admitted, by those most qualified to judge, that
such virus does act however admitted into the circulation,
though most certain and rapid in its influence when it enters
the blood direct.
I think that the results of serpent-bites, or of the inocula-
tion of their venom, will be found to fall into three groups,
corresponding to three leading forms of disease.
I. In the first group the symptoms are those of direct
LACHESIS AND THE SERPENT-POISONS.
597
poisoning of the nervous centres without local inflammation
or blood changes. From the experiments of Dr. Brunton and
Sir J. Fayrer on animals, it would appear that "the great
shock of the poison is first felt in the nervous centres of the
cord, gradually involving those of the medulla oblongata and
of the ganglia of the mesocephale, and lastly implicating the
functional integrity of the hemispheres of the brain." The
sympathetic system (at any rate in its cardiac portion) they
think the last to suffer; as though paralysis of the vagus is
indicated by augmented pulsation of the heart as well as
cessation of the respiration, by inducing the latter process.
artificially the heart can be kept going and life prolonged for
a considerable period. I am inclined to think that-at any
rate with Naja-the medulla and mesocephale are sometimes
affected even earlier than the cord. Mr. F. Buckland, in his
interesting Curiosities of Natural History, relates how, having
skinned a rat which had been killed by a cobra-bite, he
omitted to notice that on one of his fingers, near the nail, there
was a small raw place. Shortly afterwards, however, while
walking, "all of a sudden I felt," he writes, “just as if some-
body had come behind me, and struck me a severe blow on the
head and neck, and at the same time I experienced a most
acute pain and sense of oppression at the chest, as though a
hot iron had been run in and a hundredweight put on top of
it." Sometimes the symptoms are those of epilepsy, as in the
second case in Dr. Pyburn's paper; sometimes they are te-
taniform, as in the fourth; most frequently there is nothing
but profound prostration with speedily supervening uncon-
sciousness. From the sense of being heated all over ex-
perienced in the third and fourth cases, we may infer paresis
of the vaso-motor system. A bitten person who recovered
speaks of a "violent throbbing headache" soon coming on
(case 6). Inoculation of the rattlesnake virus produced at the
moment vertigo, which soon passed away; more rarely a
nervous trembling of longer duration. Other neurotic effects
of the inoculation were headache, generally occupying the
frontal and orbital region, and lasting on an average twenty-
one hours; and neuralgic pains in the head and neck.
The outline thus given us in the effects of direct intro-
duction of snake-venom is filled in by the experiments which
have been made with the diluted virus taken internally.
These must be studied in the records I have mentioned. The
main effects here also are seen in the parts supplied from the
nerves arising at the base of the brain, especially the pneu-
mogastric. The throat and laryngeal symptoms of Lachesis
598
LACHESIS AND THE SERPENT POISONS.
are very numerous and distinctive. Beyond hawking of
mucus they are purely subjective; but they include well-nigh
every form of distress from which the parts can suffer. Dry-
ness, pain, burning, rawness, swelling is complained of, also
a sense as if a morsel of food had remained after eating; swal-
lowing is difficult and painful, but more so when "empty
than when ingesting food, and more for liquids than for solids.
The larynx is painful and sensitive; there is hoarseness, with
continual tickling cough, and a constant desire to draw a deep
breath. All the symptoms are aggravated by external pres-
sure, and the contact and weight of mere covering are resented.
The headache produced by Naja (its seat being chiefly in
one or other temporal region) was often very severe, and
accompanied with profound depression. The headache of
Lachesis was especially marked by a tendency to extend into
the root of the nose.
""
II. The second form of serpent poisoning which seems to
obtain is the purpuric or hæmorrhagic. Dr. Pyburn refers to
some instances of this,* but a fuller account of it is given by
Dr. Neidhard and by Dr. Mitchell.
Dr. Neidhard shows the inoculations to have produced, in
from eighteen to twenty-four hours, the hæmorrhagic con-
dition of the gums which authors regard as a characteristic
symptom of yellow fever, and pathologically identical with
its black vomit. With this there were febrile heat, thirst and
anorexia, red countenance, and injected conjunctiva; then
jaundice and swelling of the face, with angina tonsillaris.
Dr. Mitchell found, when death was not caused by the
ordinary nervous shock, decomposition of the blood set up,
resulting in its complete diffluence and non-coagulability.
Ecchymoses and hæmorrhages were constant in the animals
poisoned by him. He thinks the fibrin affected rather than
the corpuscles, but Sir J. Fayrer found the latter altered in
form and non-adherent.
In a later contribution to the Medical Times and Gazette,†
Dr. Mitchell speaks again of the striking power of snake
venom to cause hæmorrlages. You have only, he says, to
moisten the intestinal peritoneum with it, and blood will be
forthwith effused at the spot.
He concludes his account of the action of the rattlesnake
venom by "calling attention to the singular likeness between
the symptoms and lesions of Crotalus poisoning and those of
certain maladies, such as yellow fever." He points out that
* Pp. 675, 677.
† Feb. 6, 1869.
LACHESIS AND THE SERPENT-POISONS.
599
((
in either there is "a class of cases in which death seems to
occur suddenly and inexplicably, as though caused by an
overwhelming dose of the poison." This holds good also
of scarlatina. A second class of cases survive the first
shock of the malady, and then begin to exhibit the train of
symptoms which terminate in more or less complete degrada-
tion of the blood. All these maladies, varying among them-
selves, exhibiting, as it were, preferences for this or that
organ, agree in the destruction of the fibrin of the blood which
their fatal cases frequently exhibit. In yellow fever the like-
ness to the venom-poisoning is most distinctly preserved, as
we trace the symptoms of both diseases to the point where
the diffluent blood leaks out into the mucous and serous
cavities." The effects of inoculation, as I have cited them,
quite sustain Dr. Mitchell's comparison; and the angina
tonsillaris noted there again adds scarlatina to the similar
diseases.
The jaundice of snake-bites is one element in the resem-
blance of their phenomena to those of yellow fever. Fre-
richs* mentions several cases of its occurrence. It is not
caused by obstruction to the flow of bile; and it depends
either upon disordered innervation, or upon changes in the
blood hindering the due metamorphosis of the reabsorbed
secretion. Of jaundice from the former cause we have an
instance in that form of it which has followed (often suddenly)
from mental emotions. The rapidity with which yellowness
sometimes supervenes upon bites, especially of the viper (“in
less than an hour" Mead says he has seen it†), suggests this
explanation of it. But there is a jaundice which appears later
on in the course of snake poisoning, which rather denotes
that which is characteristic of yellow fever, and which not
unfrequently complicates pyæmia, typhus, and other acute
blood infections. In these maladies there is no change in
the secreting structure of the liver, and hardly enough in its
circulation, to account for the deep and lasting jaundice
observed. Moreover, "it is worthy of notice," writes Frerichs,
"that when the diseases just alluded to are complicated with
jaundice, a group of severe symptoms, such as hemorrhages
from the gastro-intestinal mucous membrane, ecchymoses of the
surface, albuminuria, hæmaturia, suppression of urine, &c.,
manifest themselves." Such symptoms plainly point to an
extensive disorganization of the blood, and have already come
before us as effects of serpent poisoning. I have in another
* Diseases of the Liver (New Syd. Soc.), vol. i, p. 160.
† Ibid.
600
LACHESIS AND THE SERPENT-POISONS.
*
place gone into the theory of their causation, and will only
here suggest that they depend upon some destructive agent
which may either be furnished by the liver itself, as in acute
atrophy of that organ, or formed independently of it as in
these fevers. In the former case they find their simile in
Phosphorus; in the latter in snake-venom.
You will observe that it is almost entirely from the poison
of the rattlesnake that we obtain the hæmatic effects of ser-
pent venom. The comparative experiments of Dr. Brunton
and Sir J. Fayrer led them to the conclusion that "there is a
greater tendency to both local and general hæmorrhage and
extravasation of blood and of the colouring-matter of the
blood" in poisoning by the rattlesnake than in that of either
the cobra or the viper. So in Hering's pathogenesis of
Crotalus we have (as from bites) "hæmorrhage from all the
organs of the body, eyes, ears, nose, mouth, and urethra,” to
which there is nothing corresponding under Lachesis and
Naja.
III. In the third place we have those symptoms which
result from the local affection induced by the bite. The in-
flammation set up is always of an asthenic character. In
form it is a cellulitis or an erysipelas. Its sanies is absorbed
either by the lymphatics, causing angioleucitis, abscess of the
lymphatic glands, and inflammation of the areolar tissue
higher up; or by the veins, resulting in pyæmia. The local
inflammation often goes on to gangrene; and with this, and
the other secondary consequences described, there is consti-
tutional disorder of a typhoid type.
These phenomena at once open a wide range of action for
serpent venom, when administered as a remedy according to
the principle similia similibus. Whenever a local affection
assumes a malignant character, and from thence proceed
poisoning of the blood and prostration of the nervous ener-
gies, its use is indicated. Traumatic gangrene, carbuncle,
malignant pustule, malignant erysipelas, putrid sore throat,
are instances of such a pathological state. The effects of
dissection wounds, and pyæmia in general, come within the
same category; and the second stage of malignant scarlatina
often belongs to it, where, as Watson puts it, "the system is
reinoculated from" the ulcerated and gangrenous throat.
We have now to inquire how far these indications have
been carried out in practice. The materials for such an in-
quiry are scattered throughout our literature; but there are
three records of especial fulness to which I shall make re-
* Brit. Fourn. of Hom., xxii., 127.
LACHESIS AND THE SERPENT-POISONS.
601
}
<<
ference. The first is an article on Lachesis by its introducer,
Dr. C. Hering, in the second volume of the British Journal
of Homœopathy. The second is a series of cases of severe
disease, illustrating the action of the same remedy, by Dr.
Carroll Dunham, in the fourth volume of the American
Homœopathic Review.* The third is a paper on the snake-
poisons, by Dr. Bradshaw, of Nottingham, which you will
find in the first volume of the Annals of the British Homœo-
pathic Society.
I. In the neurotic sphere of these poisons they have proved
most valuable remedies. They heal, as they hurt, especially
when the nerves having their centres in the medulla oblongata
are disordered. Hence their usefulness in affections of the
throat and larynx, the bronchi, and the heart.
Lachesis is a great medicine for what may be called a
nervous sore throat." In its acute form the sense of aching
is out of all proportion to the visible mischief. When chronic,
it is the "irritable throat," always uneasy, and causing choking,
hawking, and coughing. The feeling as of a dry spot in the
throat, or of general dryness of the part, especially on waking
from sleep, also of a lump in the throat on empty deglutition,
is characteristic of it. Several of Dr. Hering's cases are of this
kind; and there is a striking one in the twenty-second volume
of the British Journal of Homœopathy (p. 488). It is thought
by some that Lachesis even controls inflammations of the
throat, as tonsillitist and syphilitic angina.‡ Naja certainly
effected, in Dr. Russell's hands, a rapid cure of an acute
pharyngo-laryngitis.§ He considered it indicated when the
fauces had a dark-red colour.
The affection of the larynx in which Lachesis has been
found curative is a catarrh with little secretion and much
sensitiveness. The cough is dry, coming as it were from a
sense of tickling in the larynx, provoked by deep inspiration,
by speaking, and especially by external pressure, which cannot
be borne, and aggravates the whole trouble. "There is
moreover a sense of fulness in the trachea and a very painful
aching in the os hyoides." I quote from Dr. Carroll Dunham,
whose comparison of Lachesis with Belladonna, Phosphorus,
Causticum and Rumex crispus is a masterly piece of work.||
*See also the article on the drug in the second volume of his
Lectures on Materia Medica.
† Amer. Journ. of Hom. Mat. Med., i, 126.
Hering, Case 4. Amer. Hom. Rev., iv, 410. Brit. Journ. of
Hom., xxxi, 127.
§ Brit. Fourn. of Hom., xii, 213.
See Hom. the Science of Therapeutics, p. 417.
602
LACHESIS AND THE SERPENT-POISONS.
Naja has proved in my hands very useful in cough, laryngis-
mus, and even spasmodic stricture of the oesophagus, when
these are the result of spinal irritation affecting the nucha.
Lachesis has no power over bronchitis, as such; but it has
rendered great service in this affection as a neurotic ally. It
is indicated when the cough is spasmodic and suffocative; and,
though abundance of fluid mucus is heard in the chest, it is
not expectorated,* or only after long effort.† Such coughs
occur especially in the subjects of cyanosis and cardiac disease;
and in their bronchial attacks Lachesis should always be
thought of.
Both Lachesis, and Naja are of great value in cardiac
affections; not, I think, by direct action on the substance
of the organ, but by influencing its innervation. In the
"tremulous irritability of the heart" left behind after
scarlatina and such-like fevers, and in the sympathetic
cough of cardiac affections, Lachesis is highly praised. Dr.
Hale has lately recorded a case of rapid heart's action (the
pulse was 160) from paresis of the vagus in which it was
rapidly curative.§ Naja was Dr. Russell's favourite remedy
for chronic nervous palpitation, for the restoration of a heart
damaged by acute inflammation, and for assuaging the suffer-
ings of chronic hypertrophy and valvular disease. Its power
of removing valvular murmurs (apparently from fibrinous de-
position) remaining in young persons after acute rheumatism
is really very striking; and I have lately seen it do the same
thing in a man of fifty. Dr. Bradshaw reports a case of angina
pectoris cured with it (Case 1).
Besides these pneumogastric disorders, we have headache as a
trouble in which both Lachesis and Naja have done good
service. The headaches of Lachesis are fully discussed and
illustrated in Dr. Black's papers in the fifth volume of the
British Journal of Homœopathy (pp. 403, 424-435). The
"nervous" and the "sick "headache are its spheres; the pain
is unilateral and the face pale. It is also good for the burning
vertex headaches of the menopausia. The headache of Naja
is a dull but severe pain in the temporo-frontal region, with
much depression of spirits.** Dr. Russell also speaks well of
* Amer. Hom. Review, iv, 415.
† Bayes, Applied Homœopathy, p. 109.
Annals, iv, 167.
§ American Homeopathist, ii.
|| Brit. Fourn. of Hom., xii, 372, 549; Annals, i, 297.
¶See also Brit. Journ of Hom., xx1i, 482.
** Brit. Fourn., xii, 214.
LACHESIS AND THE SERPENT-POISONS.
603
it in weight and pressure at the vertex, with cold feet and
flushes of the face.
*
I have no knowledge of the application to practice of the
epileptic and tetanic phenomena occasionally induced by snake
venom, though it would seem specially homoeopathic to trau-
matic tetanus, and no less so to hydrophobia. But one of the
most valuable uses of Lachesis hangs on the paresis of the
sympathetic which we have seen induced in sufferers from the
bite. It is in that vaso-motor ataxy, or ganglionic nervous-
ness, which is exhibited chiefly in the "flushings" of the
climacteric period, but which has other manifestations. It
constitutes or complicates most affections occurring at this
time of life, and Lachesis is helpful in all of them. This is
the general testimony of those who have used it. The eighth
case of Dr. Hering's series is one of nervous dyspepsia, which
reads like a neurosis of the solar plexus.
In these nervous affections "characteristic" symptoms of
drugs, however trivial, are often useful guides. One of these,
as regards Lachesis, is that symptoms especially appear, or are
aggravated, on waking from sleep; another, that external
pressure, even of the clothes, is intolerable to the patient;
another that (where the organ affected is bilateral) the
symptoms begin on the left side and tend to pass over to the
right. I should have said that in graver maladies such nugæ
would be out of place, but they seem to influence our trans-
atlantic colleagues in the most serious cases-the commence-
ment on the left side in diphtheria and scarlatina anginosa,
the aggravation after sleeping in croup. A sense of mental
depression and uneasiness on waking is often noted by Dr.
Guernsey as characteristic of Lachesis.
II. Next, what use has been made of the hæmatic action of
serpent venom?
Of purpura I find two cases in which Lachesis was given.‡
In both it rapidly dissipated the symptoms. The hæmorrhage
was subcutaneous only. The constant oozing of blood from an
ulcer remaining after post-scarlatinal abscess led to its use in
one instance, and with the best results. Dr. Liebold and
also Drs. Allen and Norton consider the snake-poisons, and
*The symptoms induced in dogs by the bite of the cobra often
shadowed out, and in one case strikingly imitated, even to the rage, the
phenomena of hydrophobia (Brit. Journ. of Hom., xi, 82-84).
† Monthly Hom. Review, ix, 763; Brit. Fourn. of Hom., xxxi,
127-131.
Amer. Journ. of Hom. Mat. Med., iv, 66; Brit. Fourn. of Hom.,
xxii, 489.
§ Amer. Hom. Rev., iv., 362.
604
LACHESIS AND THE SERPENT-POISONS.
particularly Lachesis, the best remedies for retinitis apoplectica.
Our information regarding its employment in yellow fever
comes from Drs. Holcombe* and Neidhard.† The former at
first used Lachesis in alternation with Arsenicum, so that his
experience was of doubtful value. But in a second epidemic,
having come to the just conclusion that the serpent-poisons
were the most truly homeopathic remedies for the disease
which we possess, he gave them in every case,-choosing
Crotalus in preference to Lachesis when blood-poisoning was
predominant. On both occasions he got excellent results.
Dr. Neidhard, in an epidemic occurring in Philadelphia in
1853, was led to rely more and more exclusively on Crotalus
in its treatment. He found the dilutions from the third down-
wards far superior to the higher. In 1858 some more cases
occurred, and again Crotalus served him well. He was thus
led to give it in cognate forms of disease (as he considers them)
-the "bilious remittents" of his neighbourhood, which often
assume a malignant form, and then closely resemble the true
"typhus icterodes." Here, also, he found the remedy of signal
value.
Serpent venom (and especially Crotalus) should be borne in
mind as a remedy :—
First, whenever jaundice, primary or secondary, is accom-
panied with ecchymoses or hæmorrhages. Here it compares
with Phosphorus, which would supplant it when the liver
was intimately affected, as in acute atrophy of that organ.
Jaundice from mental emotion would also suggest snake
venom, and here rather that of the viper, as its remedy.
་
Secondly, whenever a purpuric condition supervenes upon
other diseases, as typhus and variola, constituting their hæmor-
rhagic forms. These are very fatal, and a powerful remedy
for them is much needed. Arsenic is tolerably homœopathic,
but is hardly rapid enough in its action.
Thirdly, when the epidemic cerebro-spinal meningitis appears
in the form known as "malignant purpuric" or "spotted
fever."t Here the prostration is early and intense; the
febrile reaction slight; and the appearance of petechiæ con-
stant, with sometimes hæmorrhages.
2)
III. Malignant local inflammations, with secondary blood
infection and nervous prostration, have proved pre-eminently
the sphere of action of Lachesis. A typical instance is trau-
matic gangrene. Of this disease Dr. D. M. Dake has pub-
* North Amer. Journ. of Hom., iii.
+ Op. cit.
Brit. Journ. of Hom., xxiii, 394-5.
LACHESIS AND THE SERPENT-POISONS.
605
虐
​lished three cases, which are so decisive as to overcome even
Dr. Hempel's scepticism as to the virtue of the remedy.
They are given at length in the second edition of his Materia
Medica; and in the fourth volume of the American Homœo-
pathic Review Dr. Searle, of Brooklyn, has recorded two
others. To these I would add the testimony of Dr. Franklin,
who, as army-surgeon in the late civil war in America, had
abundant opportunity of seeing the disease. "I have used
this remedy," he writes in his Science and Art of Surgery, “in a
number of cases of gangrene following wounds, and have never
been disappointed in its results. In a case of compound com-
minuted leg-fracture, terminating in gangrene and threaten-
ing speedy destruction of the limb, the gangrene was quickly
checked by the internal and external use of Lachesis, the
inflammation subsiding, and the healing process moving on
to a complete cure. In another case of compound dislocation
of the ankle-joint, with fracture of malleolus externus, followed
by gangrene, Lachesis effected a speedy cure, the patient
making a good recovery under the surgical treatment em-
ployed. I cannot recommend too highly the use of this agent
for gangrene, and am confident that the observations of all
who have employed or may employ it will bear me out in
the assertion that it is eminently curative of gangrenous
affections."
H
It is affections of this kind, moreover, which form the bulk
of the paper of Dr. Carroll Dunham to which I have referred.
He begins with a case of septicemia occurring in his own
person, as the result of a wound incurred during the post-
mortem examination of a case of puerperal peritonitis. Both
the local and general symptoms were severe, but they rapidly
yielded to Lachesis 12, three times a day. Next he relates an
epidemic of malignant pustule, in which he treated eight cases
with Lachesis alone. "It relieved the pain within a few hours.
after the first dose was given, and the patients all recovered
very speedily." Then he speaks of three cases of phlebitis
supervening upon ulcers (probably syphilitic) of the lower
extremities. There was a great and sudden prostration of
strength, low muttering delirium, and general typhoid symp-
toms, indicating pyæmic infection. The effect of Lachesis was
all that could be desired, the patients rallying promptly, and
all symptoms of phlebitis speedily disappearing. Last, he
narrates one case, and refers to others, of carbuncle, in which
the constitutional symptoms denoted very great prostration,
not preceded or attended by the nervous and vascular erethism
which is sometimes observed in similar cases. The absence of
606
LACHESIS AND THE SERPENT-POISONS.
this condition is, he thinks, in all these disorders the indication
for Lachesis as against Arsenicum, when the asthenia is not
so complete as to call for Carbo vegetabilis.
Dr. Dunham finally refers to the usefulness of Lachesis
in certain cases of diphtheria. In these the tumefaction
of the throat was slight, and the redness of the mucous mem-
brane hardly noticeable, the diphtheritic deposits consist-
ing merely of two or three patches hardly larger than a pin's
head. But the prostration of strength was quite, alarming;*
the pulse became, in a very short time, slow, feeble, and com-
pressed; a cold, clammy sweat frequently covered the fore-
head and extremities; the breath was foetid; the appetite
entirely destroyed. "In such cases," he writes, "in all in
which the constitutional symptoms thus predominated over
the local, Lachesis produced prompt and lasting improvement,
so much so that very rarely was any other remedy given sub-
sequently." To the same effect is the testimony of Dr. Tietze,
of Philadelphia, in the fourth volume of the United States
Medical and Surgical Journal. He mentions a purple, livid
colour of the affected parts, with dull, dry appearance and
little swelling, also pain out of all proportion to the amount
of inflammation, as local characteristics of the remedy. He
places it as third to Belladonna and Apis in throat affections,
in the descent from sthenic to asthenic conditions. Dr. E. M.
Hale also contributes to the American Journal of Homoeopathic
Materia Medicat three similar cases of diphtheria in children,
which made a rapid recovery under Lachesis, while the rest
of the family (altogether eight in number) under old-school
treatment succumbed to the disease.
Cognate to diphtheria is scarlatina. We have already seen
how Dr. Mitchell suggests the similarity between the pheno-
mena of snake-poisoning in its most foudroyant form, and
those of the invasion of malignant scarlet, as well as yellow,
fever. Dr. P P. Wells sustains the comparison from the
homœopathic point of view. But there is another stage of
scarlatina in which the power of Lachesis comes into play. It
is when the throat symptoms assume a virulent character, and
therewith signs of blood poisoning and prostration show
*In acute cases
(of snake-poisoning) "the symptoms of depres-
sion are most marked, and the heart and nerve centres are suddenly
and fearfully enfeebled, so that the irritability is lessened, and is finally
lost earlier than occurs in other forms of death" (Mitchell, loc. cit.).
"The principal constitutional effect of the venom is a general prostra-
tion of the most appalling character” (Ibid).
""
† Vol. i., p. 184.
Amer. Hom. Review, iv, 335; see also þ. 556.
LACHESIS AND THE SERPENT-POISONS.
607
themselves. I am reminded as I speak of a case of this
kind where Lachesis rapidly removed the patient from the
sphere of gravest foreboding into that of happy convalescence.
I have already suggested malignant erysipelas, and pyæmic
infection in general, as morbid states of this kind, and thus
indicative of snake venom in their treatment. Severe symp-
toms resulting from insect stings would also call for it in pre-
ference to Apis or Ledum: there is on record a case of the bite
of the tarantula in which it proved very efficacious.* The
following narrative, moreover, suggests the homoeopathicity of
Crotalus to glanders. "On the Rio Grande, in October, 1857,
two horses were bitten by the same rattlesnake while grazing.
A few hours afterwards the sub-maxillary, parotid, and all
glands situated about the head and neck were greatly en-
larged; from the nostrils and gums a clear mucous discharge
ran down; the eyes were glairy, with the pupils greatly
dilated; and the coat was rough and staring." After anti-
dotes, "both horses recovered; one, although reduced in flesh
and thrown out of condition, was fit for work in a week, but
the other only just escaped with his life, became a perfect
skeleton, and only commenced to mend at the end of three
weeks."+
There are other uses of snake-venom, to which I cannot do
more than refer. Both Lachesis and Naja have a decided
ovarian action, and have proved useful in chronic affections of
this organ.‡ I am inclined to think that Lachesis acts most
on the right, Naja on the left ovary. As regards Lachesis
I am here in accord with Dr. Guernsey, but at variance with
Dr. Lippe. The ovarian action of Naja was first observed
by Dr. Holcombe in a patient to whom he was giving the
medicine for cardiac disease, and it was the left ovary in
which the "violent crampy pain" was developed. Lachesis
has cured inflammation of the cæcum ;|| and I have often seen
it arrest threatened ulceration about the ancle in cases of vari-
cosis of the leg. It is also of great value in ulcers themselves,
when of the "irritable" kind. Naja was of use in Dr. Brad-
shaw's hands (as also in Dr. Russell's) in spinal irritation, and
in the cough of pulmonary and laryngeal phthisis. Dr. Hilbers
also esteems Crotalus highly for phthisical cough. But the
Amer. Fourn. of Hom. Mat. Med., iv., 106.
† Monthly Hom. Review, xiv., 442.
Amer. Fourn. of Hom. Mat. Med., i., 44; United States Med.
and Surg. Fourn., ii., 85.
S Cincinnati Medical Advance, Sept., 1876, p. 216.
|| Brit. Journ. of Hom., v., 40.
608
LACHESIS AND THE SERPENT-POISONS.
three spheres of action in which we have seen the poison of
serpents at work are its main field of operation. It is here an
exquisite instance of the operation of the law of similars.
The circles of its poisonous and curative action exactly coin-
cide. Not only is it true here that quantum venenum, tantum
remedium, but also quale venenum, tale remedium.
In all this I have been speaking of the three great examples
of snake-venom, Lachesis, Naja, and Crotalus. Of the poison
of the viper I can say little, save that Dr. Jousset esteems it
in the treatment of chronic hepatic congestion, relating an
instance of its efficacy in his Leçons Cliniques (p. 269). Elaps,
in its proving, manifested most influence upon the eyes and
ears, causing partial amaurosis in the former, and deafness,
noises, and even discharge of matter and blood from the
latter. It has been found useful in some forms of amblyopia,
deafness and tinnitus, and otorrhoea,* and Mr. Clifton has
recorded several cases of chronic inflammation of the nasal
and pharyngeal lining in which it was curative. Mr. Hitchman
esteems it highly in the cough of phthisis.
The analogues of serpent venom are Apis of course, and
Arsenicum.
The observations of the curative action of Lachesis at least,
if worth anything at all, prove the validity, not only of our
therapeutic rule, but also of the infinitesimal dose. The results
gained with it are all due to the sixth or higher attenuations,
for we have never had lower ones in our hands. Dr. Hayward,
whose energy has recently provided us with a fresh supply of
rattlesnake and cobra poison, is endeavouring also to replenish
our stock of that of the lance-headed viper. It will then be
interesting to ascertain if Lachesis will do more in the lower
than it has done in the higher potencies. Crotalus and Naja
have usually been given in the first three attenuations: Elaps
in the 6th and 12th.
* See Brit. Fourn. of Hom., xxxiv., 466.
LECTURE XL.
LEDUM, LEPTANDRA, LILIUM, LITHIUM, LOBELIA, LYCO-
PODIUM, LYCOPUS.
I have to-day to bring before you a series of minor medicines,
with one only-Lycopodium-of primary importance.
We will begin with the marsh tea, or wild rosemary—
Ledum palustre.
The tincture is prepared from the small twigs and leaves.
The proving of Ledum is in the fourth volume of the Reine
Arzneimittellehre. It contains 186 symptoms from Hahne-
mann, 148 from six others, and four from authors. Lembke
also has proved it (in the mother tincture): his results are in-
corporated with Hahnemann's by Allen.
In his "Essay on a new principle for ascertaining the cura-
tive power of Drugs," published in Hufeland's Journal in 1796,
Hahnemann speaks of having ascertained that Ledum caused
difficult and painful respiration, a painful shooting sensation
in all parts of the throat, and troublesome itching of the skin.
Hence, he thought, upon the principle similia similibus then
just dawning upon him, were explained its virtues in whooping-
cough and asthma, in inflammatory and even maligant sore-
throat, and in chronic cutaneous diseases. In his Fragmenta
de viribus (1805) he published his first pathogenesis of the plant,
whose 75 symptoms have now swelled to the fuller list in the
Materia Medica Pura. Besides the symptoms already men-
tioned, its most noteworthy effects seem to be a determination
of blood to the head and chest, causing a sort of intoxication
in the one, and cough with bright sanguineous expectoration
in the other; pain and swelling in the joints, including that of
the great toe; and boring pains in the bones. These pains
are worst in the evening, but easy while the patient is in bed.
They shift about much. The articular pains are relieved by
movement.
2 R
610
LEDUM PALUSTRE.
In his preface to the pathogenesis, Hahnemann says that
Ledum will prove suitable only in chronic maladies charac-
terised by coldness and deficiency of animal heat. Its chief
use in the homoeopathic school has been in non-inflammatory
articular affections; of which you may read two excellent
illustrations in the ninth volume of the British Journal of
Homœopathy. Dr. Drury has several times expressed his high
appreciation of it in hæmoptysis, in which Dr. Jousset also
commends it; and Dr. Drysdale has recorded a case in which
it immediately removed a nocturnal itching of the feet.* But
I think that for our best knowledge of how to use Ledum we
are indebted to M. Teste. He thinks that it acts specially on
parts of the body where the cellular tissue is wanting, as the
fingers and toes; and hence affects the small joints rather
than the large. He recommends it accordingly for traumatic
whitlow, and for true gout of a sub-acute nature, seated in
the hands or feet, and causing little swelling. Ledum pro-
duces several of the symptoms of gout, including the distension
of the veins of the extremities in the evening. He goes on
to affirm that Ledum is to punctured wounds what Arnica is
to contusions. Besides some obvious applications of this pro-
perty of the drug, he mentions that it gives almost immediate
relief to the itching caused by mosquito-bites; and this even
when given internally in the fifteenth dilution. In the stings
of bees and wasps, he says, the result is less prompt, but still
very satisfactory.
There is a general agreement as to the efficacy of this last
application of Ledum, though the tincture is commonly used
in a less diluted form, and applied locally also.† As a remedy
for punctured wounds it supplies the gap.left by Arnica,
Calendula, and Hypericum, which correspond to contused, in-
cised, and lacerated wounds respectively. M. Teste notes the
intense coldness which sometimes accompanies these injuries.
as corroborating the choice of Ledum for them; and one of
our Belgian confrères has just communicated a case in which
daily epileptiform attacks supervened in a child after a wound
in the head from scissors, which almost immediately yielded
to the remedy.‡
On the skin, M. Teste says, Ledum causes "an eczematous
eruption, with a tingling itching, that spreads over the whole
*Brit. Fourn. of Hom., xxix., 166.
+ See Monthly Hom. Rev., xiii., 203; Brit. Journ. of Hom.,
xxxiv., 353.
Revue Hom. Belge, Oct., 1875, and Brit. Journ. of Hom., xxxiv.,
337.
LEPTANDRA VIRGINICA.
611
body, penetrates into the mouth, probably also into the air-
passages, and occasions a spasmodic cough, which is sometimes
very violent." A similar condition is sometimes met with
idiopathically in gouty subjects.
M. Teste compares Ledum with Rhus, Arnica, and Croton;
to which may be added Pulsatilla and Ruta.
His recommendations are best carried out with his dilutions,
viz. about the sixth or twelth.
My next is an American medicine, the "black root,”
Leptandra Virginica.
The tincture of the root, and triturations of leptandrin, are
the officinal preparations.
A proving of this medicine by Dr. Burt and another is given
by Dr. Hale in the second edition of his New Remedies; and
in the fourth edition you may read all that is known of its
curative effects.
The action of Leptandra is upon the liver and bowels. Dr.
Burt suffered from dull aching distress in the region of the
liver and gall-bladder, extending to the spine. With this
there were such sympathetic symptoms as frontal headache,
soreness of the eyeballs, and pain in the left shoulder. A
student who took the drug for two weeks reports that it gave
him actual jaundice. The intestinal evacuations are much
affected by Leptandra. Its most frequent and characteristic
effect is seen in stools frequent, profuse, black, fœtid, and
papescent they are difficult to retain. Under the prolonged
use of the drug the stools become watery, and later have
quantities of mucus in them.
Leptandra has not been much used as a remedy; but such
applications as it has received have been in precise accordance
with the pathogenetic effects I have now described. In certain
cases of "bilious headache" and "liver-complaint," especially
when the characteristic blackish stools are present, it has been
found very useful; and it has occasionally proved curative in
chronic diarrhoea and dysentery.
It most resembles Bryonia, Iris, and Podophyllum.
The lower potencies only have been used.
I have now to bring before you another American contri-
bution to the Materia Medica, which, though only of recent
introduction, bids fair to take an important place, especially in
uterine therapeutics. I refer to the tiger lily,
612
LILIUM TIGRINUM.
Lilium tigrinum.
The tincture is prepared from the flowers.
We owe this remedy to the late Dr. W. E. Payne, of Bath,
Maine, U.S. Provings of it carried out at his instigation-by
fourteen persons in all, of whom nine were women-have
been appearing from time to time in America; and they are
gathered up by him into one view in the Transactions of the
American Institute for 1867 and 1870. A résumé of the
symptoms produced, with an account of what has been done
with the medicine clinically, may be read in the fourth
edition of Dr. Hale's New Remedies; and the pathogenetic
effects in full are in Allen.
Dr. Payne was led to prove Lilium from the reported death
of a child in convulsions from eating the pollen. Nothing
further of this kind was manifested; but in the female provers
a series of symptoms occurred in the sexual organs which
showed a most potent influence of the plant. "The symp-
toms," says Dr. Payne, "connected with the female repro-
ductive organs, and the consecutive moral conditions, are
very pronounced and peculiar." The ovaries were the seat of
peculiar sharp and burning pains. "In the uterine region
there was severe pressing, bearing-down sensation, with the
feeling as if the whole internal parts would be forced through
the vagina, making the desire irresistible to press the hands
firmly against the vulva to prevent the parts from escaping;
the whole genital organs felt as if swollen, with smarting and
irritation of the labia, great tenderness to touch, and acrid
brownish leucorrhoea. In three of the provers the uterus was
found, on examination, to be prolapsed and anteverted." Two
women described the bearing-down sensation as not confined
to the pelvis, but causing a sense of dragging in the thorax
even to the shoulders. With it there was tenesmus of the
bladder and rectum, diarrhoea (especially on first rising in the
morning), and frequent micturition: also a mental state of
conjoined irritability of temper and depression of spirits, with
inability for mental exertion. The uterine symptoms began
to get worse about 5 p.m., and increased up to midnight. In
the male provers the sexual organs were much less affected;
but there was considerable oppression and palpitation of the
heart. When taken in moderate doses the effects were not
immediate, but were very persistent; and tended to recur at
longer or shorter intervals, and in groups which preserved a
definite order.
LITHIUM CARBONICUM.
613
Lilium has been too recently proved for any extensive
experience with it to have accumulated; and my impression
is that on the whole it has disappointed expectation. One
reason of this may be, as Dr. Hale suggests, that its slowness
of action has not been borne in mind. But it can hardly fail
to find some place in the treatment of some of the congestive
and even inflammatory state of the ovaries, uterus, vagina and
vulva which we encounter, especially when the moral symp-
toms are those of the drug. Dr. Payne found much benefit
from it in sub-involution after childbirth, and Dr. Hale in
ovarian neuralgia.
Of Lilium Dr. Dyce Brown has given us one of his best
"Studies in the Materia Medica," in which I advise you to
read up the symptomatology of the drug. You will find it
in the Monthly Homœopathic Review for August, 1877. He
makes a good point when he recommends the medicine to
be given in mental and moral disturbances connected with
uterine disorder, and those which occasionally manifest them-
selves in pregnancy, childbed, and the climacteric age,—those,
in fact, for which Actæa has hitherto been our main remedy.
Dr. Woodyatt, of Chicago, thinks very highly of Lilium in
cases of ciliary spasm, where the nervo-muscular derangement
of the eye has caused a certain degree of astigmatism. He
has recorded several cases in which such conditions dis-
appeared under its use.*
Dr. Dunham, who was specially great in comparisons, has
left us some between Lilium on the one side, and Podo-
phyllum, Sepia, Pulsatilla, Platina, and Helonias on the other.
You will find them at p. 344 of the first volume of his collected
writings. Platina and Helonias seems best to correspond,-
the former to the mental symptoms and the latter to the
uterine condition induced by Lilium; and each proved anti-
dotal to it in these spheres respectively.
And now a few words upon the carbonate of lithia,
Lithium carbonicum,
which we prepare by trituration.
A proving of this salt-made almost entirely with the lower
attenuations-is given by Dr. Hering in the third and fourth
* See Monthly Hom. Review, xxii., 143; Medical Counselor, Oct.,
1879; and Transactions of Amer. Ophthalmological and Otological
Society, 1878, p. 61; 1879, p. 99.
}
614
LOBELIA INFLATA.
volumes of the American Homeopathic Review. The schema
of symptoms has been transferred to the first volume of the
fourth edition of the New Remedies, and to Allen.
Dr. Hering considers that the symptoms of the eyes, heart
and kidneys induced by Lithium are most significant; and in
these regions its curative powers seem to have found what
little scope they have, as you may see from Dr. Hale's thera-
peutic article on the drug. Dr. Carroll Dunham has reported
a case of hemiopia from excessive use of the eyes-only the
lateral half of objects being visible-which was soon cured
by it.* This symptom is marked in its pathogenesis. The
same physician found great and lasting benefit from it in
his own case, when his heart was seriously damaged by acute
rheumatism.†
In the case of hemiopia the 30th dilution was given; but
Dr. Dunham's own recovery ensued upon inhaling the emana-
tions from the third trituration, as he was raising it to a
higher potency.
I have now to speak of the Indian tobacco,
Lobelia inflata.
From the powder as imported a tincture or triturations are
made for homoeopathic practice.
Of the pathogenetic effects of Lobelia we have much infor-
mation, from the frequent over-dosing with it which occurs
in the hands of "botanic" practitioners. It was first proved
after the Hahnemannian manner by Dr. Alphonse Noack on
himself and five others, all using substantial doses. A treatise
on the drug, embodying the results of his experiments, ap-
peared in the fifteenth volume of the Hygea (1843), and has
been translated into English in the appendix to the first
volume of the British Journal of Homeopathy. There are
articles on the drug, containing and adding to Noack's
materials, by Dr. Jeanes in the Materia Medica of American
Provings, and by Dr. Hale in the fourth edition of his New
Remedies. Dr. Allen gives also the results of a proving
recently made in the old school, by Dr. Barrallier, of Toulon,
in which eleven persons co-operated.
The name "Indian tobacco," commonly given to Lobelia,
fairly expresses its poisonous action. Like its namesake, it is
* See Brit. Fourn. of Hom., xxvi., 489.
+ See Monthly Hom. Review, Feb., 1876.
LOBELIA INFLATA.
615
nauseant, depressant, relaxant; and is used for these pur-
poses as an enema in strangulated hernia or rigid os uteri.
But its main sphere of action is the pneumogastric nerve; as Dr.
Bartholow says "Lobelia affects especially the medulla
oblongata and its respiratory centre (nucleus of pneumogas-
tric)." The symptoms of Noack's provers decisively point to
this; and they have led to its successful use in many nervous
affections of the stomach and respiratory organs. The dys-
pepsia in which Dr. Jeanes has often found it curative is
characterised by a sense of weakness and oppression at the
epigastrium, and at the same time some oppression at the
chest. There is often acidity, with heart-burn and lateritious
urine, and a sensation as of a lump in the throat-pit, impeding
respiration and deglutition. Dr. Noack gives two cases of
cardialgia in which small doses of the mother tincture were
very effectual. The pain was pressive in character. It has
also been found beneficial in "stomach-cough," and in the
cough of phthisis. "When a tormenting dry cough and an
nsufferable tickling in the throat rob the patient of rest," it is,
says Neumann, " in the highest degree beneficial.”
This brings us to the respiratory section of the pneumo-
gastric tract, and to the use of Lobelia in asthma. The
testimony to its value here is abundant and unexceptionable.
It is true that asthma, so capricious in its behaviour under
climatic conditions, is hardly less so in relation to medicines.
It is difficult to say beforehand when Lobelia will do good;
but when it does, the relief in the paroxysm is rapid, and even
a permanent cure is occasionally obtained. What is the
rationale of its action here? Dr. Hyde Salter* supposed
that it relaxed the bronchial spasm in virtue of its nauseating
property, as Tartar emetic would do it; saying that it rarely
relieves the paroxysm before it induces its physiological
effects. But he has not shown us that Tartar emetic could be
substituted for it with similar results. Elliotson,† Pereira
and Ringer, on the other hand, recommend the use of small
doses (mv) at the commencement, gradually increased up to
the point of physiological effect, and then suspended. The
first-named physician has found too large a dose aggravate
the dyspnoea. Then Darwin tells how
"fell Lobelia's suffocating breath
Loads the dank pinions of the gale with death."
One of Jeanes' provers who took the tincture in tea-spoon-
* On Asthma, 2nd ed. (1868).
† Lancet, Jan. 23, 1833, April 15, 1837.
616
LOBELIA INFLATA.
ful doses every fifteen minutes until nearly an ounce had been
ingested, without exciting vomiting, complained of a general
tightness of the chest, with short and somewhat laborious
breathing. In the other provers the influence of the drug
seemed mainly expended on the stomach; but where the re-
spiration was affected, it was always with embarrassment. Dr.
Phillips also speaks of "extreme spasmodic difficulty of
breathing," as attending the distressing condition induced by
over-dosing with Lobelia ; and Dr. Barrallier experienced, from
forty drops of the tincture, "extremely difficult breathing
caused by a very strong constriction at the middle of the chest,
which impedes the respiratory movements." I am inclined,
therefore, to think that it acts homoeopathically in asthma.
It is a confirmation of this view that it often gives relief when
administered in minute and infinitesimal doses-from the
second to the sixth dilution, as I myself can testify.
Dr. Jeanes speaks highly of Lobelia in asthma; but when
he comes to narrate a case, and to give characteristics, it seems
to be the paroxysmal dyspnoea of emphysema which he has in
mind. "The symptoms," he writes, "which I have found
most strongly to indicate the lobelia are," besides the gastric
phenomena already enumerated, "constant dyspnoea, which is
increased by slight exertion, and aggravated so much by slight
exposures to cold as to form a kind of asthmatic paroxysm."
Bähr also says that "Lobelia inflata is more adapted to
emphysema than to asthma." I have seen it decidedly
beneficial so far as the sensations are concerned in this
affection.
These have been the practical applications of Lobelia.
There are, however, certain residuary phenomena in its patho-
genesis which require noting. They are these:-
I Heat, fulness, and sometimes aching in the head.
2. Much dreaming, generally distressing.
3. Hemiopia.
4. Scratching, burning, and dryness in the throat.
5. Pain as if a nail were driven through the pit of the
stomach to the spine, spreading right and left, with twisting
sensation.
6. Circumscribed burning pain at the edge of the right false
ribs, extending across the epigastrium and round to the left
scapula. The spot originally affected subsequently became
the seat of a violent boring pain, and felt as if paralysed.
7. Distension of abdomen, disordering respiration.
8. Diuresis.
9. Urine deposits a pink sediment, in which is a small
LYCOPODIUM.
617
brown crystal resembling-under the microscope-a goose-
berry (probably uric acid).
10. Distressing heaviness of the male genitals.
II. Prickling sensation through the whole body, extending
even to the fingers and toes.
Most of these are individual symptoms; but the fourth was
experienced by all the provers, and more from small than from
large doses. One of them could not go on with the experi-
ment on account of it: he says it "far exceeded in severity
that of Mezereum, Ledum, Polygonum, and Euphorbia."
There is also in Teste a catalogue of symptoms which his
experience has furnished as those to which Lobelia is particu-
larly adapted.
The analogies of Lobelia are Antimonium tartaricum,
Digitalis, Ipecacuanha, and Tabacum.
I have already indicated the dilutions in which Lobelia has
done most service.
I now come to one of those curious medicines whose virtues
we owe almost entirely to the Hahnemannian process of tritu-
ration. It is the club-moss,
Lycopodium.
The well-known unmoistenable powder, prepared from the
spores of the plant, is triturated for our use. The value of this
mode of preparation has been peculiarly demonstrated in the
case of Lycopodium by some microscopical researches carried
on by Mr. Isaac Thompson, of Liverpool. He found, on ex-
amination of the powder, that it was made up of a number of
little particles, each about the both of an inch in diameter,
and in shape like a nut. On pounding a small quantity in an
agate mortar, these nuts were found to be fractured, and their
contents dispersed. These the addition of a drop of water
showed to be oil-globules. It seems most probable that the
medicinal virtues of Lycopodium reside in this peculiar
oleaginous matter with which its sporules are filled; and hence
the comparative inertness of all preparations of the drug which
do not involve complete fracture* or solution of the investing
envelope. No tincture but an ethereal one is found to effect
solution; and for fracture even trituration with milk-sugar
must be prolonged-in the case of the first decimal-for at
least two hours.
* Rau had made the same statement many years ago (Hygea, xiii.,
284).
618
LYCOPODIUM.
The earliest record of pathogenetic effects due to Lycopo-
dium is contained in the first edition of the Chronic Diseases,
where the drug has 891 symptoms. In the second edition the
number has swelled to 1608. Some of the additions are from
the fellow-observers Hahnemann acknowledges; but the ma-
jority of them are his own. It has since been proved on
several occasions in Germany by individual experimenters, and
twice in the collective manner-viz: by Huber and nine others
in 1856 and by Professor Martin and ten of his pupils in 1859.
The record of the last-named testing may be read in the
eighteenth volume of the British Journal of Homœopathy. Dr.
Allen combines the whole series of observations into one
splendid pathogenesis, comprising over 3000 symptoms. He
has still further contributed to our knowledge of the drug, by
giving us, in the North American Journal of Homœopathy for
August, 1877, a catalogue raisonnée of its “clinical symptoms
so far as recorded. There is an admirable study of Hahne-
mann's pathogenesis of the drug, by Dr. Pope, in the seven-
teenth volume of the British Journal.
""
Martin's provings were conducted with the crude drug, and
sometimes the first trituration. The general symptoms were
those of excitement,-quickened circulation, headache, in-
creased appetite, more frequent evacuations, stronger sexual
desire. The chief local affinity manifested was for the urinary
organs. There was frequent and sometimes painful micturi-
tion; and the urine was cloudy and sedimentous, occasionally
charged with mucus and even blood.
This may be called the crude action of Lycopodium; and
therewith correspond its traditional uses. These were confined
to urinary affections. In the spasmodic retention of urine of
children, and in catarrh of the bladder in adults, it had con-
siderable repute as a remedy even before Hahnemann's tritu-
ration developed its more extensive powers.
When we turn to the proving in the Chronic Diseases, a very
different scene is manifested. Instead of acute disorder, we
are looking upon gradually advancing chronic disease: instead
of excitement we have depression and decay. Whether we
regard the phenomena as genuine pathogenetic effects of the
drug, or (which seems to me more probable) as symptoms of
the patients to whom it was proving beneficial, in either case
they picture its sphere and kind of action. Mental, nervous,
and bodily weakness; sallow or grayish-yellow complexion,
and cold extremities; anorexia, slow and depressed digestion,
flatulence and constipation; a passive catarrh of the air-
passages; and an unhealthy state of the skin-are the morbid
B
LYCOPODIUM.
619
conditions presented to us. This is the general character of
the profounder action of Lycopodium. Let us pass on to fix
its sphere as a remedy from clinical experience.
We may lay it down that Lycopodium has no direct neurotic
or hæmatic influence. It is a purely vegetative remedy, affect-
ing the three great tracts of mucous membrane with their
cutaneous continuation.
1. The digestive canal, with the liver, is the most important
seat of the action of Lycopodium. There is a form of dyspepsia
in which it is quite specific. A typical case of this is related
by Dr. Hutchinson in the twenty-fifth volume of the British
Journal of Homœopathy. It is so illustrative of the medicine
that I will read you the patient's description of her sufferings.
She complained of "pain under the ribs and all round the
waist, with shooting pains up the shoulder-blades; pain across
the stomach and straight down on each side of it, sometimes
very severe; nausea; the food often thrown up, with a sour
and then a bitter taste; water-brash; obstinate constipation;
very painful hæmorrhoids, with great loss of blood; coldness
in the extremities; cramp in the legs and thighs; the action
of the kidneys is undue and most disturbing at night. The
last two nights I have not closed my eyes, and the pain has
been increasing. My complexion is deadly pale, with a mix-
ture of ash and yellow combined." This condition had lasted
two months or more. Lycopodium 12 was prescribed twice
a day, and the diet regulated. In a week the pain had sub-
sided, and the other symptoms were disappearing; and she
was soon restored to health.
The constituent elements of such dyspepsia occasionally
appear separately, and often require this remedy. In water-
brash it will frequently prove curative. For flatulence the
choice generally lies between Lycopodium and Carbo vegeta-
bilis. I think the former most suitable when the distension
takes place in the intestines, the latter when the wind accumu-
lates in the stomach, oppressing the breathing. Dr. Bayes
has lately noted some additional features of the flatulence of
Lycopodium.* It is incarcerated, causing bloating and dis-
tension; the pain is referred to the right hypochondrium and
intestines; and palpitation during digestion is often com-
plained of. I may add that constipation is nearly always an
accompanying symptom. For this trouble itself Lycopodium
stands very high as a remedy. Teste commends it strongly
in the constipation-sometimes so obstinate of young
children. He also praises it in a very different condition of
* Brit. Fourn. of Hom., xxx., 153.
620
LYCOPODIUM.
the bowels, viz., that most dangerous enteritis which is set
up in infants by the ingestion of food which they cannot
digest. I have more than once verified this recommendation.
I should mention that this physician thinks Lycopodium to
correspond best to the indigestions caused by heavy farina-
ceous and fermentable food.
Dr. Guernsey finds most of the characteristic symptoms of
Lycopodium in the sphere of the digestive organs. They are-
that the smallest quantity of food produces either satiety, or
a sense of fulness even up to the throat; much fermentation
of the food, causing a feeling of "working" in the stomach,
and audible borborygmi, which are most noticeable in the left
hypochondrium; and pains shooting across from the right to
the left side of the abdomen. He does not lay so much stress
on distension of the abdomen; but both in the provings, and
in Dr. Allen's collection of symptoms removed by the medi-
cine, you will find it a very prominent feature. Bähr describes
the pathological condition calling for it as chronic gastric and
intestinal catarrh (though the tongue is not much coated), and
lays stress on hopeless depression of the mind and "jaun-
diced, yellowish-gray, or dingy-sallow hue" of the complexion
as especially indicative of it.
Besides the above-named affections, acidity and heartburn
are prominent features of Lycopodium, indicating its appro-
priateness to acid dyspepsia; and it has as a marked symptom
unconquerable sleep after dinner, followed by great exhaustion.
It is probable that some of its digestive disturbance is due to
its influence upon the liver. In Professor Martin's provings,
this organ occasionally gave signals of distress; and Dr.
Pope says that in old hepatic congestions he has found Lyco-
podium more useful than any other medicine, Sulphur perhaps
excepted. Jahr and Bayes state a similar experience.
2. In the respiratory sphere Lycopodium manifests great
power in what may be called "chronic influenza : " i. e. where
catarrh becomes persistent, with much general weakness.
Some forms of chronic bronchitis and even of pneumonia come
within this category. Teste commends it highly for "chronic
pneumonia, with purulent, foul-smelling expectoration, even
when one of the lungs (especially the left) has become parti-
ally hepatised." Dr. Pope adds that few medicines are so
valuable in pulmonary phthisis as this, when perseveringly
used. "The cough," he says, "the gastric irritation, the ex-
haustion, and the intercurrent attacks of pleurisy, are wonder-
fully mitigated by it." It is probable that the phthisis of this
writer and the chronic pneumonia of the former are the same
LYCOPODIUM.
621
disease. Dr. Meyhoffer, whose opinion on respiratory affec-
tions is so weighty, says that he had no opinion of Lycopodium
until he was led to try it in chronic pneumonia; but since
then he has had for it in this disease and in chronic passive
bronchitis characterised by copious muco-serous or muco-pur-
ulent expectoration the utmost respect. I am myself very
fond of the drug in cases of suspected phthisis in young men,
where yet there is no evidence of tubercular deposition.
Mr. David Wilson has lately called our attention to the fan-
like movement of the alæ nasi noted in the pathogenesis of
Lycopodium, which he believes to be a pathognomonic indi-
cation for the choice of this drug in diseases of children and
young people. Much controversy was excited by the manner
in which Mr. Wilson put forward this statement; but I cannot
in this instance join my good friends his assailants. There is
nothing à priori improbable in his statement. "When this
symptom is clearly marked," he writes, " no matter through
what organ or tissue the symptoms of any attack of illness
may manifest themselves in children and young people, I
venture to submit that the whole group of the phenomena in
such attacks will be found under Lycopodium." This is a pure
matter of experience; and a good many cases have since been
published which go to confirm Mr. Wilson's statement. It is
of course in respiratory affections that this symptom is most
frequently present.
M
-
3. Of the action of Lycopodium on the urinary organs I
have already spoken. Dr. Arnold says that he has seen in
several cases an increase in the secretion of urine on the
administration of Lycopodium, especially when any dropsical
affection was present. He has likewise observed diminution
of the quantity of urine in cases where it was morbidly in-
creased. I find it the very best medicine where the patient is
suffering from an excess of lithic acid gravel; and look upon
copious sediments of this nature as one of the most unerring
indications for its choice in dyspepsia. Dr. Guernsey also
adopts this symptom-under the title of " red sand in the urine"
-as one of his chief general key-notes for the drug. He says
that, connected with its presence, there is frequently pain.
before passing water, shown in young children by crying and
screaming at the time, and by adults referred to the renal
region.
4. Lycopodium is very good for the intertrigo of children
and for dry porrigo capitis. It is said to be curative in
that scourge of Poland, the plica polonica; and in pruritus
ani.
622
LYCOPUS VIRGINICUS.
With three additional observations I will conclude. First, I
would mention that the 2nd trituration has caused an inflamma-
tory rheumatism of the right fore-arm, wrist, hand, and fingers.*
Secondly, that Dr. Bayes recommends it for syphilitic
ulcerations of the fauces, superficial but spreading; and that
among the high dilutionists in America it is much thought of
in diphtheria when the deposit first invades the right tonsil
(in this distinguished from Lachesis). The third point is
more curious. Lycopodium has occasionally been suggested
for aneurism, but I had thought little of it, though in a case
treated by Dr. Madden and myself what seemed an aortic
aneurism ceased to be discoverable while we were giving the
medicine for the general health. But I have since seen most
striking results from it in an unmistakeable carotid aneurism
in an old lady, for whose dyspeptic symptoms the remedy had
often proved serviceable. The shooting pains which accom-
panied the swelling disappeared in the first three days of
taking the Lycopodium; and in a fortnight the enlargement
of the artery was reduced one half, at which point it has since
continued stationary, giving her no pain or inconvenience.
You will do well also to consider the list of symptoms
prefixed by Hahnemann to his pathogenesis, as indications.
for the choice of Lycopodium in disease. They may yet yield
fresh therapeutic applications of this valuable drug.
The analogues of Lycopodium in the digestive sphere are
Bryonia and Nux vomica. I know no medicines really resem-
bling it as a whole.
The higher attenuations are those most used in practice.. I
nearly always employ the twelfth.
I have finally another wolf's foot to bring before you, but
botany has saved us from confusion by slightly varying the
nomenclature. It is the bugle-weed,
Lycopus Virginicus.
The tincture is prepared from the whole plant.
Dr. Morrisson has enriched pathogenesy by a thorough
proving of Lycopus upon his own person, the account of which
you will find in the sixteenth volume of the Monthly Homeo-
pathic Review. It is rendered especially valuable by pulse-
tracings having been obtained from the sphygmograph to show
the action of the drug upon the heart. There is also in
* Brit. Journ. of Hom., ii, 285.
X And also Vol. 18.
LYCOPUS VIRGINICUS.
623
the second edition of Dr. Hale's New Remedies a short proving
of the drug by Dr. G. E. Chandler, and Allen gives results
from yet another experimenter.
Lycopus has long had, among the "eclectic " practitioners of
America, the reputation of being an arterial sedative, somewhat
like Digitalis. Drs. Chandler and Morrisson both found it
exert an indubitable action upon the heart. In the former,
whose health was perfect, the strangeness of his cardiac
sensations, and the slowness of his pulse (which at one time
was only 48), led him to seek an examination; when the first
sound was found to be absent, and replaced by the blowing
sound of mitral regurgitation. Dr. Morrisson's heart was
somewhat feeble, and its action inclined to intermit, ere he
commenced his proving; but the pulse-tracing taken then was
of very healthy character compared with those which subse-
quently appeared. The organ was first oppressed and then
depressed by the drug :* the sphyginographic signs of debility
increased day by day until the proving was suspended, and
irregularity-not mere intermission-of pulse became the rule
instead of the exception.
Dr. Hale says that Lycopus has become one of his most
favoured and trusted remedies in functional diseases of the
heart, especially when there is cardiac irritability with de-
pressed force. Dr. Morrisson has recorded two cases of the
same kind in which the drug was very useful: in one of these
there was a great tendency to exophthalmos, showing the
cardiac symptoms to be those belonging to Graves' disease.
In the British Journal of Homœopathy for April, 1876 (vol.
xxxiv., p. 388) is a case reported from Honolulu, in which
double valvular disease of the heart, with all its associated
symptoms, was so greatly relieved by the continued use of the
medicine, that the patient was able to return to work; and,
though some abnormal sound continued audible, he considered
himself in perfect health. All this is very promising; and
the drug should be fairly tested.
The dilutions from the first to the third decimal have been
those used the provings having been conducted with full
doses of the mother-tincture.
Omitting for the present the four medicines next on our
list, I shall pass on when we meet again to speak of Mercurius.
* Dr. Morrisson explains that by cardiac "depression" he means
feeble and excitable action, by "oppression "heavy and laboured
action, as if the heart were obliged to make great efforts to do its work.
LECTURE XLI.
J
MERCURIUS.
I shall begin to-day to speak of the various mercurial pre-
parations. Under the common name of
Mercurius
-by which, and not by that of hydrargyrum, the metal has
always been known to homoeopathic therapeutics—I shall
include all those salts and compounds of it which produce
pure mercurial effects, as distinguished from such as-like the
cyanides, the iodides, and the sulphides-have peculiar pro-
perties of their own. These I shall discuss in a subsequent
lecture.
Homœopathic pharmacy embraces all the ordinary mer-
curials, triturating those that are insoluble, and dissolving the
perchloride-Mercurius corrosivus, as we call it-in rectified
spirit. But besides these we have two peculiar preparations
of the drug. One, known as Mercurius vivus, is a trituration
of the metal with milk-sugar. It answers to the blue pill and
grey powder of ordinary practice, for which it is a substitute
in our hands. The other-Mercurius solubilis-is a prepara-
tion of Hahnemann's own, and is known in Germany to this
day by his name (Merc. sol. Hahnemanni). It is made by
dissolving metallic quicksilver in nitric acid, and then pre-
cipitating it from solution by caustic ammonia. The result is
an impure oxide, of doubtful and varying composition. Thera-
peutically it is effective enough; but from the chemical side
the Pharmacopoeia seems justified in recommending its dis-
placement by Mercurius vivus, according (as it truly says) to
Hahnemann's own later practice. Its solubility is only com-
parative; and it is prepared by trituration.
We have pathogeneses of most of the mercurial prepara-
tions. Hahnemann experimented mainly with his own black
oxide,-in substantial doses, Noack and Trinks say. In the
ܝ
MERCURIUS.
625
last edition of the first volume of the Reine Arzneimittellehre,
1,264 symptoms are credited to it, of which nearly half are his
Dr. Allen
own, the rest being furnished by eight associates.*
does little more than reproduce this proving; but he gives an
entirely new and most valuable one of Mercurius vivus, chiefly
made up of observations on workmen and others exposed to
the emanations of the metal, and containing 840 symptoms. He
also presents or completes Hahnemann's provings of the
acetate (M. aceticus) and the chloride (calomel, M. dulcis).
These constitute the mercurial preparations whose action,
physiological and therapeutical, I am now about to discuss.
As regards other sources of information, I have availed
myself of the treatises on the ill effects of mercury by Dietrich,
Mathias, and Habershon, and of the later studies of its action by
Overbeck, Kussmaul, and Hallopeau.†
I have now to describe, on the basis afforded by these
materials, the pathogenetic effects of Mercury. The field is
such a wide one that you will pardon me if I traverse it some-
what rapidly. It is only at controverted points that I can
stay to adduce evidence and discuss arguments; but I will
ask you to believe that I make no statement without having
gone through these processes on my own account beforehand.
Even as it is, I find that any satisfactory treatment of the
subject will occupy an entire lecture, so that I must ask you
to wait for the therapeutics of Mercury until our next
meeting.
I. When an unirritating preparation of Mercury is gradually
introduced into the system, before any local manifestation of
its influence occurs a profound change is being wrought in the
blood. Its full hæmatic effect is thus stated by the late Dr.
Headland, in his well-known treatise On the Action of Medi-
cines:"By some inscrutable chemical power, of whose
agency we know nothing, it is able to decompose the blood:
by some destructive agency it deprives it of one third of its
fibrin, one seventh of its albumen, one third or more of its
globules; and at the same time loads it with a fetid fatty
matter, the product of decomposition." Trousseau and Pidoux
well describe the cachexia which results from this action. The
* I must express some doubt as to the validity of the contributions to
this pathogenesis of Hahnemann's son Friedrich. They are twice as
numerous as those of his seven fellow-provers put together; and many
of them are of such severity that, though not impossible effects of
mercurial poisoning, they are extremely unlikely to have been developed
in provings, as they purport to have been. I strongly suspect that
the list has been filled in from his imagination.
† Du Mercure action physiologique et therapeutique, 1878.
2 S
626
MERCURIUS.
blood loses colour and consistence; pallor of the surface occurs,
followed by oedema and anasarca. All the symptoms of
anæmia are present, such as palpitation, sighing, breathless-
ness; and in young females the menses are suppressed, and
chlorosis sets in. In other cases ecchymoses and passive
hæmorrhages appear.
The diminished number of the red corpuscles of the blood
under the influence of Mercury, indicated by these symptoms.
and affirmed by Headland, has been substantiated by recent
researches, in which the new method of counting their number
has been employed. A condition of "hypoglobulia" is always
found to exist when the drug has been given in sufficient
quantity to induce its characteristic effects.*
With the early stage of this affection of the blood there is
slight pyrexia. Hahnemann, who in his treatise On Venereal
Diseases taught that the cure of syphilis depended on the
supervention of this "mercurial fever," thus describes it in his
own graphic and detailed manner :—
"The patient gets a metallic taste in the mouth, a disagree-
able smell in the nose, a painless audible rumbling in the
bowels, an earthy complexion, a pinched nose, blue rings
round the eyes, pale leaden-coloured lips, an uninterrupted or
frequently recurring shuddering (always getting stronger) that
thrills deeply even into the interior of the body. His pulse
becomes small, hard, and very rapid; there is an inclination
to vomit, or at least nausea at everything, especially at animal
diet, but chiefly a very violent headache of a tearing and pres-
sive character, which sometimes rages without intermission in
the occiput or over the root of the nose. The nose, ears,
hands, and feet are cold. The thirst is inconsiderable, the
bowels constipated, great sleeplessness, the short dreams of a
fearful character, accompanied by frequent slight perspira-
tions. The weakness is extreme, as also the listlessness and
anxious oppression, which the patient thinks he never before
felt anything like. The eyes become sparkling as if full of
water, the nose is as if stuffed with catarrh : the muscles of the
neck are somewhat stiff, as from rheumatism; the back of the
tongue is whitish. At this period the patient experiences, if
all goes on well, some discomfort in swallowing, a shooting
pain in the root of the tongue, on both sides of the mouth a
looseness or setting on edge of the teeth (the gums recede a
little towards the roots of the teeth, become somewhat spongy,
red, painful, swollen); there is a moderate swelling of the
tonsils and submaxillary glands, and a peculiar rancid odour
* See Hallopeau, op. cit., p. 90.
MERCURIUS.
627
from the mouth, without the occurrence, however, of a notable
increase in the secretion of saliva, and without diarrhoea or
immoderate perspiration.”
All this, you will observe, is prior to the full develop-
ment of the first local effects-the stomatitis and salivation.
When the gums grow tender, the saturation of the system is
complete. This is shown by the effects which ensue in cer-
tain morbid products and conditions when present. Indura-
tions are resolved, and exudations of lymph absorbed; on the
other hand, old cicatrices grow tender and may even reopen.
All the secretions at the same time tend to increase in quan-
tity and greater fluidity in consistence.
II. If now the drug is continued, or if the patient be un-
healthy or expose himself to cold, certain inflammations are
apt to arise. I think we must distinguish these from the in-
flammations which the corrosive sublimate of Mercury is
capable of producing. It acts, like Arsenic and Iodine, by
its essentially irritant properties, selecting tissues and organs
for this influence by elective affinity. The blander prepara-
tions of Mercury have no such property; yet it is well known
that stomatitis is much more readily induced by them than
by the perchloride, and the same is true of certain other
affections. I shall, therefore, here describe the inflamma-
tions, ulcerations, and other effects specifically induced by
Mercury as such; and later on shall mention the modifica-
tions and additions which ensue when the perchloride is
given.
T
In the light of this view, let us consider the phenomena
presented by mercurial poisoning in the several parts of the
body it affects. We will begin by studying its action on the
alimentary canal and its associated glands.
I. I think that the general action of Mercury on the ali-
mentary canal may be stated as follows. The mildest degree
of its influence is shown in an increased secretion from the
whole mucous tract, and from the salivary and pancreatic
glands which open into it. The full constitutional action is
manifested in irritation with diminished secretion - often
amounting to congestion or actual inflammation-along the
whole tract, but in some regions attacking chiefly the mucous
surface, in others the glandular involutions. Thus in the
mouth we have intense stomatitis, while the salivary glands
secrete vigorously. In the small intestine, on the other
hand, the mucous membrane shows little sign of disturbance,
while the liver often becomes congested, and its secretion
diminished.
628
MERCURIUS.
Let us see how far these principles hold good in the several
portions of the tract.
a. The mercurial stomatitis I trust that you have never seen
in any severe form; but it is necessary that we should have
it before us. I will describe it in the graphic language of Dr.
George Wood. He thus pictures the onset of the affection :
"The first phenomenon presented is often a whitish appear-
ance of the lower gums, probably owing to opacity of the
epithelium. Soon afterwards the gums are seen to be some-
what swollen, rising up between the teeth, and reddened at
their edges. At the same time they are somewhat tender to
the touch, and not unfrequently pain is produced at the roots
of the teeth by firmly closing the jaws. A metallic taste,
as of copper in the mouth, is also among the first symptoms;
and I have repeatedly been able to detect the approach of
salivation by the peculiar fetor of the breath, before any other
sign had presented itself. It not unfrequently happens that
the above symptoms have existed for some time before any
increase of saliva appears; and occasionally there is at first
seen a dryish condition of the tongue." The second stage he
thus depicts: "The gums, tongue, cheeks and fauces, one or
all, swell and become painful; deglutition is painful; the
teeth, if carious, begin to ache; the tongue is somewhat
furred, and indented by the teeth at its edges; the saliva is
discharged copiously; the salivary glands swell, together with
the neighbouring areolar tissue, and the breath is very offen-
sive, having a peculiar fetor which distinguishes the mercu-
rial sore-mouth from all other analogous affections." If the
disease run on, it reaches a third stage, which Dr. Wood de-
scribes in this manner: "The swelling, internal and external,
increases; the tongue sometimes projects from the mouth, in
consequence of its greatly increased bulk, and is covered with
a very thick, soft, yellowish white fur, extremely offensive to
the smell; the parotid and submaxillary glands become much
enlarged and painful; the patient cannot open his jaws, swal-
lows with great difficulty and pain, and is wholly unable to
articulate; the saliva streams from the mouth; the odour of
the breath is insupportably fetid, and sometimes scents the
whole apartment; ulceration of the gums, cheeks, and tongue
takes place, with occasionally copious and exhausting hæmorr-
hage; the teeth loosen and fall out; and even gangrene of the
soft parts, and necrosis of the alveolar processes, sometimes
occurs." This gangrene may extend to the face and neck;
and, though most commonly spreading from the mouth or
throat, sometimes begins at once on the external surface.
MERCURIUS.
629
Sir Thomas Watson calls attention to the special character
of this mercurial inflammation. "It is," he says, "superficial,
spreading, erysipelatous: it leads to ulceration without any dis-
tinct occurrence of suppuration; the ulcers enlarge." Ulcers, I
should say, are apt to occur in the mouth under mercurial
influences without actual stomatitis, as in those professionally
engaged in the venereal wards of hospitals (see Allen's S. 47 of
M. vivus). I would notice also the peculiar fœtor of the
breath, as connected with the fatty matter of the same cha-
racter we have seen formed in the blood; and the tendency
to hæmorrhage. Observe, moreover, that while the drug is
thus raging on the mucous surface, the salivary glands are
simply stimulated, and pour out their secretion profusely.
Orfila and he is followed by Trousseau and Pidoux-states
that in mercurial salivation there is no true inflammation of
the glands, but only effusion into the cellular tissue around
them. But there is evidence that (in its ordinary forms) the drug
can cause hyperæmia of these organs; and in one case, when
under the poisonous influence of the perchloride they enlarged
and became tender, the salivary secretion was diminished.
A word as to the contents of the mouth. The tongue is
affected like the cavity generally, so far as its mucous mem-
brane is concerned. The submucous tissue is also involved
in the inflammation, as shown by the great enlargement of
the organ; but I do not know that the muscular substance is
affected. As to the teeth, there is much need of a thorough
and unprejudiced study of the infiuence of Mercury upon
them. Does it attack them immediately, setting up true
caries? or do they loosen and fall out as a consequence of the
degenerated state of the gums, themselves remaining entire?
The latter alternative seems at present to be that best sup-
ported by evidence, as the rule; but the observations made on
the workers in the metal show the teeth frequently becoming
discoloured and carious. The mercurial stomatitis begins in
the alveolo-dental periosteum (as the early tenderness there
indicates); and it is curious that it is difficult, if not im-
possible, to induce it in infants prior to dentition or in persons
who have lost their teeth.
b. The throat may be either acutely or chronically affected
by Mercury. The acute affection is identical with the mercu-
rial stomatitis, which it commonly accompanies: there is
much swelling always, ulceration often, gangrene sometimes.
Hahnemann reports, from M. solubilis-" suppuration of the
tonsils, with sharp, sticking pain in the fauces when swallow-
ing." The chronic angina of Mercury is graphically described
630
MERCURIUS.
by Dietrich. It is characterised by a dark or bluish redness;
great sense of dryness, with hawking of tenacious, glassy
mucus; and enlargement of the mucous follicles.
c. The stomach is, so far as I know, affected by the per-
chloride only of all the mercurial preparations; so I will say
nothing of it here.
d. The small intestines are very rarely inflamed by Mercury;
but the two great glands which pour their secretions into this
part of the bowel suffer from the drug in a very considerable
degree.
(1.) The physiological similarity between the salivary glands
and the pancreas makes it probable that--as with Iodine and
Iris—a drug which powerfully influences the one will affect
the other also. That it is so in the case of Mercury is argued
by Dietrich on the ground of the symptoms occasionally
occurring during life; while Hughes Bennett in experiments on
animals, and Wibmer in examination of the bodies of those
who have been long treated by mercurial frictions, have found
the gland reddened and hypertrophied. The most striking
case, however, is one cited by Dr. H. Wood. "A woman after
excessive salivation experienced deep-seated epigastric pain
and heat, with nausea, thirst and fever, and voided thin stools
containing liquid resembling salivary fluid. At the post-
mortem the pancreas was found weighing eight ounces, red,
congested, and with its duct dilated."
k
(2.) That Mercury acts upon the liver, and is a cholagogue
would have been thought till lately too obvious to need de-
monstration. But the experiments conducted by Drs. Scott
and Handfield Jones, and those carried out by a committee of
the British Medical Association under the presidency of Dr.
Hughes Bennett, ascertained the fact that in the lower animals
at least Mercury rather diminishes the secretion of bile than
increases it. Dr. Rutherford, also, whose experiments have
rehabilitated most of the vegetable cholagogues, found calomel
without effect on the biliary secretion in the dog,—though, as
we shall see, a very different result was obtained when corrosive
sublimate was administered. There is of course no proof that
the same thing happens in the human subject; but we seem
to have a strong probability that it is so.
Nor is it any
evidence to the contrary that an increased quantity of bile is
found in the stools after the administration of mercurials. It
must be remembered that this secretion is ordinarily reabsorbed
after being poured into the duodenum, so that its presence is
hardly to be traced in the stools. To find it there may thus
simply mean that the bowels have from some cause been
MERCURIUS.
631
unable to take it up. But it is not shown hereby that Mer-
cury has no action on the liver. On the contrary, the dimin-
ished secretion sometimes observed under its use may well be
a sign of the congestion of the gland which post-mortem
examination shows to be present in acute mercurial poisoning.
This may be accompanied by jaundice, of the occurrence of
which there are several cases on record,* and in continued
exposure to the malign influence it may go on to chronic
hepatitis, with enlargment or atrophy and induration.†
e. While Mercury has little influence upon the small intes-
tines, the large-cæcum, colon, and rectum-are a special seat
of its influence. Diarrhoea not unfrequently accompanies or
replaces salivation; and the tendency to tenesmus shows that
its seat is the lower portion of the bowel. In poisoning by
corrosive sublimate, as we shall see, the whole tract exhibits
marks of intense inflammation.
This is the place in which to speak of the effect of Mercury
upon the intestinal evacuations. The stools produced by it
are of various characters. When given as a purgative in the
form of calomel or blue-pill, it causes copious fluid evacua-
tions, of a dark brown or yellowish colour-sometimes, espe-
cially in children, of a green hue. I suppose these evacuations
to consist of an increased quantity of the biliary and other
intestinal secretions. The green " calomel stools" of children
are generally supposed to consist of bile, altered in tint by
superabundant acid in the intestines. Others, however, con-
sider them to be due simply to the presence of the subsulphide
of Mercury in the fæces, their colour being a phenomenon
analogous to the blackness of the stools in those who are
taking iron. The objection to this view is that they have
been induced by doses of calomel far too small to cause any
general coloration of the fæces.—The purging caused by mer-
curials always tends, if severe, to assume the dysenteric cha-
racter; i.e. to consist of slimy and bloody stools, with tormina
and tenesmus.
2. The respiratory mucous membrane is not a special seat
of the influence of Mercury. Conjunctivitis, however, is no
uncommon manifestation of its action: it occurred in Over-
beck's experiments on animals, and in Hahnemann's proving
* Taylor, On Poisons, 1st ed., p. 396. Johnson, Cheyne, and Chap-
man, quoted by Black, in Introduction to the Study of Homeopathy,
p. 119. Budd, On Diseases of the Liver, 3rd ed., p. 478. Hempel, p. 617.
† Taylor, op. cit., p. 397. Graves, cited in Med. Times and Gazette,
xix, 452. Overbeck, in Ibid., Jan. 18, 1862. Wibmer, cited by Hem-
pel, p. 506. Allen, S. 399 and 400 of M. vivus.
632
MERCURIUS.
of M. solubilis and Hering's of the biniodide. Coryza some-
times occurs in mercurialisation and among the workmen ;
and one of the dogs poisoned by corrosive sublimate in Dr.
Hughes Bennett's experiments had constant muco-purulent
discharge from the nose. Epistaxis was not an uncommon
effect of M. solubilis. Pneumonia generally complicates the
febrile mercurial eruptions of which we shall speak presently.
These phenomena, however, appear far less frequently from
Mercury than from Arsenic and Iodine.
3. The reverse of the comparison obtains in the genito-
urinary tract, which, according to Christison, suffers more
from corrosive sublimate than from Arsenic. Of this I shall
speak subsequently; but from Mercurius solubilis two of Hahne-
mann's provers had balanitis and balanorrhoea; and another
(Hornburg) reports the following symptom :-"A number of
small red vesicles at the termination of the glans penis under
the prepuce, which become converted four days later into
ulcers, which break open and pour forth a yellowish white,
staining, strong-smelling matter; afterwards the larger ulcers
bled, and, when touching them, a pain was felt in them which
affected the whole body; they were round; their edges, which
looked like raw flesh, overhung the ulcers, the base of which was
covered with a cheesy lining."* A similar symptom was ex-
perienced by one of the provers of Cinnabar.
These phenomena are of much interest with reference to
the relation of Mercury to chancre. Other facts are men-
tioned by Trousseau and Pidoux which bear on the same
point. They allow that Mercury may cause serious ulcera-
tion at the side of the penis or in the vulva. They relate how
a dog whom Bretonneau had mercurialised, copulating with
one of his kind, had his penis swelled, inflamed, ulcerated, and
finally gangrenous. And they state that women labouring
under puerperal fever, and treated with mercurial frictions,
were liable to get membranous inflammation of the vulva
followed by sphacelus.
4. I have now to speak of the action of Mercury on the skin.
I have already mentioned its diaphoresis; and will only add
that the secretion is often vitiated as well as increased, being
sometimes sour, sometimes foetid. It is especially marked
at night. But whenever Mercury has been given to any large
extent in disease, there have been seen occasional instances of
its power of causing cutaneous eruptions. These have been
noticed by several writers, and especially by Pearson, whose
eczema mercuriale "—a form of eczema rubrum-is classical.
* S. 657 in the R.A.M.L., S. 1956 in Allen.
66
MERCURIUS.
633
But the fullest account of them is given by Alley, in his Ob-
servations on the Hydrargyria (London, 1810). By this name
he denotes the vesicular disease arising from the exhibition
of Mercury. He describes it as occurring in three forms, and
Bazin confirms his observations. The first is a roseolous
efflorescence, with minute vesiculation, and without constitu-
tional symptoms. The second form is distinctly febrile; and
in this, in its appearance, and in its catarrhal complications
closely resembles measles. In the third variety the fever is
more intense, the fauces are much involved, actual pneumonia
is present, and the appearance of the surface is like that of
vesicular erysipelas. The cuticle, and often the hair and nails,
exfoliate subsequently. Other observers have seen pustulation,
and others ulceration, occur.
5. Dietrich states that periostitis is a not uncommon effect
of the long-continued use of Mercury. Pereira considers that
this affection is rather to be ascribed to the venereal disease
for which the drug had been administered. But Graves
affirms that periostitis attacked patients who had taken a
great deal of Mercury, even if they had never been affected
with syphilis, as often as they took cold; and almost all later
observers admit this action of the poison. Trousseau and
Pidoux mention a case of a worker in quicksilver who suffered
as severely from nocturnal bone-pains as if he were syphilitic,
which he was not. We have already seen that the primitive.
effect of the drug on the mouth is an alveolo-dental periostitis.
These workmen in Mercury give us many opportunities of
observing the profounder and more lasting effects of the
mineral on the frame. Thus it has been noted of those who
labour in the quicksilver mines of Idria that they are liable to
congestion, followed by enlargement or atrophy of the liver;
inflammation and abscess of the lymphatic glands; neuralgia
of the fifth pair; various eruptions and ulcers of the skin;
and swellings of the salivary glands, periosteum, and bones.*
Kussmaul, indeed, found no hepatic or osseous affections
among the Erlangen workmen whom he observed. But the
most striking effects seen here are neurotic in seat and nature;
and of these I have yet to speak.
III. The neurotic effects of Mercury are manifest chiefly
in the musculo-motor, and in the ideational and emotional
spheres.
1. The "mercurial tremor" is as characteristic an action
of the drug as its salivation. It is chiefly seen in workmen.
at quicksilver mines, or in trades-as water-gilding-where
Stillé, Mat. Med., in loc.
634
MERCURIUS.
the metal is much used. Mérat's account of the affection is
followed by most writers.* The disease, he states, may begin
suddenly; but in general it makes its approaches by slow
steps. The first symptom is unsteadiness of the arms, then
quivering, finally tremors, the several movements of which
become more and more extensive until they resemble con-
vulsions, and render it difficult or impossible for the patient
to walk, to speak, or even to chew. All voluntary motions,
such as carrying a morsel to the mouth, are effected by
several violent starts. The arms are generally attacked first,
and also most severely. The tremors have been compared
to those of chorea, of delirium tremens, and of paralysis
agitans. Of the last Watson says: "The mercurial tremor
consists in a sort of convulsive agitation of the voluntary
muscles, which is most violent when efforts are made to move
the limbs by the help of those muscles; whenever, in fact,
volition is brought to bear upon them. It differs, therefore,
from the shaking palsy, inasmuch as the tremor ceases when
the muscles are supported, or are not brought into action.”
In other respects it closely resembles this disorder, far more
so than multiple sclerosis, to which it has been compared
by Hallopeau. The concomitant symptoms of the trembling
are a peculiar brown tint of the whole body, dry skin, con-
stipation and flatus, but no colic. The pulse is always slow.
In severe or advanced forms of the disease, the tremor is
accompanied or replaced by paralysis.
،.
2. The milder effects of Mercury in the ideational and
emotional sphere are thus described by Dr. G. Wood :—
The most prominent nervous phenomenon of mercurialisation
is an increased susceptibility to impressions; slight causes
producing a disturbance of the mental equanimity, and un-
pleasant influences of all kinds having more than their
ordinary effect. A fretful, peevish state of mind, and irri-
table condition of temper, are not uncommon; and restless-
ness, wakefulness, and general uneasiness are frequently added
to the other sufferings." Naunyn describes (after Kussmaul)
a similar condition (under the title of "mercurial erethism ")
as preceding the development of tremor in the workmen.
66
Every unexpected or perplexing event," he writes, “excites
the patient in the highest degree. The visit and conver-
sation of the physician put him into a state of complete
bewilderment, even to syncope: he grows pale, and stammers
in answering the simplest questions. To perform his allotted
task requires the greatest effort, or is even impossible if he
* Appendix to his Traité de la colique metallique.
MERCURIUS.
635
sees or thinks that he is being watched. There is also great
solicitude and feeling of anxiety without any reason for it.
There is sleeplessness, or sleep which is restless, frequently
broken and disturbed by frightful dreams, headache, and pal-
pitation. In the severer forms there are frequently halluci-
nations, usually of a frightful nature." The graver cerebral
symptoms are chiefly seen in those in whom tremor has long
existed they are mental weakness, loss of memory, delirium
(often like that of alcoholism), apathy. The sufferers may
die.comatose and hemiplegic; and the cerebral hemispheres
are found after death the seat of softening, with effusion into
the ventricles.
There can be no doubt, I think, that these phenomena imply
inflammatory irritation of the gray matter of the brain and
perhaps the cord. Accordingly, a mercurial neurosis may
sometimes assume other forms. Dr. Anstie relates a terrible
case of neuralgia of the limbs induced by it,* and Dr. Bar-
tholow "has seen a well-marked case of locomotor ataxia,
characterised by pains, ocular disorders, spermatorrhoea, plan-
tar anæsthesia, and incoordination of muscular acts, result
from the inhalation of mercurial fumes."+
Such are, as fully as I can present them to you, the patho-
genetic effects of Mercury, as such. I have endeavoured to be
just to this much-abused drug,-nothing to extenuate, indeed,
but nought to set down in malice. The tendency at the pre-
sent day—perhaps in reaction from the extremes of the non-
mercurialist syphilographers of thirty years ago is to
minimise its noxious effects. That men can believe it a
comparatively harmless drug only shows that they are using
it in a comparatively harmless way; it does not negative the
observations made in days when it was given in injurious
excess or under circumstances where its influence is long-con-
tinued and penetrating. We at least can use such observa-
tions as contributing to that pathogenetic knowledge of the
metal which, upon the principle of similarity, shall enable us
to employ it beneficially as a medicine.
* On Neuralgia, p. 24.
† Hallopeau, also, relates several forms of cerebro-spinal disease
resulting from mercurial influence.
LECTURE XLII.
MERCURIUS (continued).
At our last meeting we considered in some detail the
pathogenetic action of Mercury. We may classify its effects
in three divisions.
In the first, we have the results of administering a single
evacuant dose-results manifesting themselves, as you know,
almost entirely in the sphere of the liver and the intestines.
Secondly, we have the phenomena following its gradual
but rapid introduction into the system,-in what we may call
acute mercurialisation. It here shows no direct irritant action
on the living tissue, and exerts its primary influence upon the
blood. It sets up therein a series of changes involving spolia-
tion, liquefaction, and decomposition; and thereupon follow
certain local affections, mainly of the mucous membranes and
the skin. These are of a low and diffuse inflammatory cha-
racter, and readily pass into suppuration, ulceration, and
gangrene.
Thirdly come the effects of gradual and slow impregnation
of the organism with the metal-chronic hydrargyrosis. These
include a profound disturbance of the nutritive functions, but
chiefly consist of neurotic disorders-manifested by tremor,
erethism, and neuralgic pain, and going on to imbecility and
paralysis.
Now the aim of homoeopathy must be to take up all these
forms of its physiological action, and fit them to the corre-
sponding morbid conditions of idiopathic origin which occur
in practice. That it has done so you may see by the essays
upon it by Dr. Quin in the second volume of the Annals, and
by Dr. Leadam in the twelfth volume of the British Journal of
Homœopathy; by the section devoted to it in the first volume
of Hartmann's Practical Observations; or, perhaps, the best
way of appreciating the place and value assigned to it in our
practice is to look through Bähr's Therapeutics, and see what
and how numerous are the diseases for which he indicates it,
and where it may be applied with best advantage. You will
MERCURIUS.
637
us.
find reproduced in such a list the whole series of pathogenetic
effects which on the last occasion of our meeting passed before
But we shall not be able to limit our considerations to
such applications of the medicine. The first and second of
the forms under which we have classified its physiological
action actually represent the traditional uses of the drug; and
we shall have to estimate these, and to weigh their advantages
and disadvantages in an impartial scale.
I. First, then, let us speak of the effects of the single
evacuant dose of a mercurial. To the practitioners of the old
school they indicate the usefulness of the drug when the
portal system needs depletion; and, had we no more excellent
way of accomplishing such a purpose, we might be obliged to
avail ourselves of it. Dr. Kidd has shown how a judicious
use may be made of this property of the drug, where consti-
pation and portal obstruction hinder the development of the
specific action of Digitalis in cardiac dropsy.* But the evil
that is done by the habitual use of blue-pill and other mercu-
rial purgatives for what is called "biliousness" is incalculable.
They promote the recurrence of the very attacks they at first
seem to relieve; and they gradually induce-as Dr. Bryce
has shown—a chronic poisoning by the metal, an hydrargyrosis
which, though slight, is real, and makes the patient's life a very
miserable one.
On the other hand, homoeopathic experience has taught us
that the British use of the drug in disorders of the liver (I say
the British use, for in French and German treatises this
medication is always spoken of as foreign to their practice) is
largely based on the principle of similarity, and obtainable by
small doses. I have already shown that experimentation,
while opposing the notion that Mercury directly stimulates
the secreting function of the liver, shows it to cause conges-
tion of the organ and jaundice. In both these hepatic affec-
tions the medicine ranks facile princeps among homœopathic
practitioners; and it acts well in quite minute doses, as the
third, sixth, and twelfth attenuations. It is an admirable
remedy for what is called a "torpid " liver, where deficient
secretion of bile is indicated by pale, costive, and offensive
motions, loss of appetite, and depression of spirits. That
there is congestion present in these cases seems indicated by
the dull pain in the right hypochondrium, of which the
patients usually complain. So in simple jaundice as it occurs
in children (where probably the same congestion is present),
Mercury will generally do all that is required. For acute
* Laws of Therapeutics, ch. x.
638
MERCURIUS.
parenchymatous inflammation of the liver, Dr. Gerson speaks
of calomel in our doses as highly as do the Indian practi-
tioners of the old school.
Dr. Ringer has some excellent remarks on this subject,
which might have been written by any homœopathist. Ad-
mitting the full force of the experiments which have been
made, he yet argues that they must not neutralise the experience
of generations; and that "it is not difficult to conceive that
Mercury in disease may set aside some condition hindering the
formation of bile, and thus act as a cholagogue, while yet in
health it may even check this secretion." He advises minute
doses-from the sixth to the half of a grain of grey powder
twice or three times a day; and says that were those who
decry mercurial preparations to use the drug in this way, they
would obtain the desired effect without the bad results they
fear.*
II. But it is the second of our three actions of the drug—
acute mercurialisation-upon which I am desirous of fixing
your special attention; as it is that whereby it has played so
great a part in the history of medicine, and coincidently has
wrought so great ruin and destruction among mankind. With
the exception (if it be an exception) of blood-letting, I know
of no more mischievous treatment ever devised than the in-
duction of the constitutional influence of this drug, as shown
by stomatitis and ptyalism. It was bad enough to rob a man
of a large proportion of his vital fluid; but it was intensifying
the injury indeed to poison the remainder. Hundreds of
deaths, and hundreds of thousands of ruined healths-to say
nothing of temporary suffering and disease—have attested its
influence all over Europe. It is little wonder that the wiser
practice of the present day tends more and more to abandon
its use.
The change is indicated in the two editions of Sir
Thomas Watson's classical Lectures which appeared in 1857
and in 1871 respectively. In the former Mercury takes rank
after venesection in the treatment of most inflammations; in
the latter it has followed its principal into the limbo of doubt-
*My Monthly Homeopathic reviewer objects to this explanation of
mine of the action of Mercury in torpid liver, and thinks that in
endorsing Dr. Ringer's suggestion as to its modus operandi, I am
passing by the principle of similarity. But this I am not doing; for I
mean that the condition it removes is that which it causes, viz. :—
congestion, and such an explanation seems to me as good homœopathy
(and better pharmacology) as to say that it stimulates the secreting
cells of the liver in small doses while depressing them in large. My
critic cites Dr. Rutherford's recent experiments as supporting this
position; but I cannot find any such statement made by him.
MERCURIUS.
639
ful and perilous means of practice. The same abandonment
had at one time largely, though not universally, taken place
in the treatment of syphilis.
What is the reason of this pernicious effect of a drug
supposed to be given as a medicine-an effect unique in its
instance? Arsenic and Iodine are far more potent as poisons;
yet they have not wrought this mischief. Any injurious
effects they have had have been (so to speak) extraneous and
incidental: by proper dosage and mode of administration
they have readily been avoided. But the ill-doing of Mercury
has been an essential part of its use, and so inherent therein
that because of it that use itself has been dropped. The fact
is that when Mercury has been employed (as it most largely
has been) in the treatment of syphilitic and of inflammatory
affections, it has been its physiological action that has been
used for the purpose. The cure has been sought, not directly,
but through the medium of "salivation "-that is, by the
full constitutional influence of the drug as implied by that
phenomenon. "When we fail to induce some affection of the
mouth," writes Pereira," we do not obtain the beneficial effects
of mercury." Thus, instead of the poison being transformed
into a medicine, it has been used as a poison; and hence its
prejudicial effects. When it is now employed in this way, the
nature of its action is recognised, and it is pushed to as slight
an extent as possible. To "touch the gums" now is just to
excite the mercurial fever which we described in Hahnemann's
words, and which he, at the time he wrote, conceived to be
necessary (and as much as was necessary) for the cure of all
syphilitic manifestations. This is to lessen the mischief,
indeed; yet mischief it still is. It is still doing evil that good
may come; and though such a proceeding is not so rigidly
proscribed in medicine as in morals, yet it is only to be
adopted to avert greater evils, and with full knowledge and
circumspect discreetness in its application. In our hands who
aim at specific indications-who seek to absorb all physio-
logical into therapeutical action, such an employment of a drug
must be, if ever resorted to, a rare and regretted exception to
our general practice. We should rather turn the bane into
the antidote, and use Mercury to cure instead of to cause the
morbid conditions it is capable of setting up, when, as not
unfrequently happens, they come before us from other causa-
tion.
That we have succeeded in doing this appears from the
different estimation in which the medicine is held in the two
schools of practice. It had become, as I have said, quite a
640
MERCURIUS.
badge of the more advanced section of the old practice to
renounce the use of Mercury in disease. It was declared to
have no influence on the liver; to be of doubtful necessity in
syphilis; and to act perniciously in most acute inflammations.
On the other hand, the applications of it which are made
according to our law and in our doses are continually afford-
ing us satisfaction. Few medicines are so frequently in our
hands; and in none have we more thorough confidence. This
looks a little as if we had found the clue to the right use of
this and other poisons.
It was, as I have said, mainly for the treatment of syphilitic
and inflammatory affections that the induction of acute mer-
curialisation was practised. The most celebrated use of the
drug, and that which has best held its ground in the present
day, has been as a remedy against syphilis. Let us enquire
into its relation to this disease, and its sphere of action
therein.
I assume the correctness of the modern doctrine regarding
syphilis, in so far as it refuses the name to the soft chancre
with its suppurating bubo, and allows it only to the indurated
sore and its sequelæ. I also range myself with those who
follow Hahnemann in believing the appearance of the indura-
tion to be evidence that the system-that is, the blood-is
already contaminated with the venereal poison. I have
discussed this question in an article "On Hahnemann's
Doctrine of Syphilis" in the twenty-seventh volume of the
British Journal of Homeopathy, and need not detain you with
the evidence and arguments here.
Syphilis, then, is a poisoning of the blood analogous to the
exanthemata-let us say, to inoculated smallpox. It has a
stage of incubation, which is yet (as Lancereaux has pointed
out) not without signs of impaired health. Slight feverishness,
lassitude, aching of the bones and headache are often present;
and careful observation finds chloro-anæmia to have already
set in. Hahnemann shows from earlier authors that of old
time this stage of incubation was more prolonged, and the
evidences (debility and fatigue, dulness of the sensorium,
depression of spirits, earthy complexion with blue borders
round the eyes, &c.) of ill health during its existence more
obvious. Then ensues the lesion which marks the point of
entrance of the virus. It is essentially an induration, what-
ever may be present on its superficial aspect; and it is soon
followed by a similar condition of some of the inguinal glands,
doubtless the result of absorption. This is analogous to the
pustule of variolous inoculation; and now, after a time, fol
MERCURIUS.
641
So.
lows the specific fever of the disease, with its rash and sore-
throat. The rash is macular or papular, less frequently
squamous. The sore-throat is ulcerative, generally indolently
Iritis, and sometimes laryngitis and periostitis, may occur
at this time. Lastly, we have sequela of the syphilitic as of
other blood infections; and these are in its case the infiltrations.
of the viscera and the periosteum which are known as gummata
or nodes.
It is, I think, very helpful thus (with Mr. Hutchinson) to
regard primary, secondary, and tertiary syphilis as stages of a
chronic exanthema, differing only in its prolonged course from
the acute affections which bear the same name. It is certain,
again, that Mercury has some influence over this malady, and
that of a specific kind. Few would maintain now-a-days that
it antidotes the venereal poison as an alkali neutralises an acid;
and none, I think, would suppose that it eliminates the materies
morbi by its ptyalism or other evacuation. We must look,
therefore, to its physiological effects to see what it is capable
of doing as a therapeutic agent, and how it does it.
Now it would be easy to make capital out of the admissions
of writers on the subject, and argue that Mercury does all it
can do in syphilis in virtue of its homoeopathicity thereto.
"It is singular," says Dr. Ringer, "how similar the phe-
nomena produced by Mercury are to those which result from
syphilis ;" and in so speaking he does but echo the expressions
of many who have gone before him.* But as our object is
truth, and not the support of a theory, we must not be content
with these testimonies; but, remembering that Kussmaul,
after an exhaustive enquiry into the effects of Mercury on the
workers in it, comes (as Trousseau and Pidoux had done) to
the opposite conclusion, must examine for ourselves to see how
it is.
I think that the result of such an enquiry must be that the
physiological effects of Mercury present a nearly perfect
parallel to one stage of the syphilitic history, but diverge
widely from it before and afterwards. This stage is not that
of the primary incubation. A slightly febrile chloro-anæmia
is indeed the original constitutional effect of both poisons.
But that induced by syphilis eventuates in plastic deposits-
the indurated sore and glands; while the local symptoms of
Mercury are those of liquefaction of tissue, any glands
*Thus Stillé : "Alterative medicines act to a great degree in the
same direction as the diseases which they cure; mercury, for example,
tends to produce lesions which bear a close resemblance to, if they are
not identical with, those caused by syphilis."
2 T
642
MERCURIUS.
affected by it swelling from irritation approaching to inflam-
mation, and tending to suppurate. The condition of blood
from which such opposite results proceed can hardly be really,
though it may be phenomenally, the same. Again, there is
nothing in the effects, actual or possible, of Mercury to corre-
spond with the gummy infiltrations of the tertiary period. So
that, although the drug may affect every part which is invaded
by the disease, though a mere
mere "organopathy" may regard
it as a simile thereto, true homoeopathy cannot allow that it
acts in all these parts after a like manner, and must hence (I
submit) refuse it the name. If Mercury can do anything to
resolve the primary indurations and tertiary infiltrations of
syphilis, it must do it by its physiological action; and we
must not think that we are homœopathising in so using it.
It is otherwise with the secondary stage of the disease.
Again we have a febrile chloro-anæmia, of still more marked
character, to which, with its rheumatoid pains (aggravated by
rest and the warmth of bed) in the head and face, behind the
sternum, and around the joints, and its termination in falling
of the hair, Mercury is obviously and strikingly homoeopathic.
And here it is hardly less so to the resulting local manifestations,
which may be described as low inflammatory processes in
skin, mucous membrane, and periosteum. We are strictly
within the lines of our method when we treat with small doses
of the drug the syphilitic pyrexia, and the exanthemata, the
ulcers of mouth and throat, and the subacute periostitis, of
the secondary period. As regards the chloro-anæmia, it has
been recently ascertained that Mercury, when given in syphilis,
increases the number of the red globules of the blood. We
have already seen that it diminishes them in health; and
here also it is noted that, if the drug be pushed too far, it
reduces their number again.
These seem the necessary deductions from the facts of the
case. Let us see how they agree with experience.
We have in the case of syphilis an excellent opportunity of
estimating the real effects of treatment; for we have abundant
material for the natural history of the disease. Expectant
treatment has been carried out on a large scale by the oppo-
nents of the use of Mercury. The results may be read in the
excellent treatise of Dr. Charles Drysdale, On the treatment
of Syphilis and other diseases without Mercury. Syphilis,
say the non-mercurialists, when allowed to run its course
under hygienic measures and local applications, is rarely other
than a mild and indolent disease, wearing itself out with little
injury to the frame. In the words of one of them—the late
=
MERCURIUS.
643
Mr. Syme-" the case may be tedious, and the skin, throat, or
periosteum may be slightly affected; but none of the serious
effects which used to be so much dreaded ever appear, and
even the trivial ones just noticed comparatively seldom present
themselves." This is perhaps too broad a statement, and
more exceptions should have been allowed; but it goes little
beyond the conclusions arrived at after the non-mercurial
treatment of thousands of cases in the great military hospitals
of France.
Can Mercury do better? In endeavouring to answer this
question we are much hindered by the confusion which has
existed till within the last few years between the soft chancre
and the indurated sore. Since Mercury is perfectly homo-
opathic to the former, as we have seen, it may well promote
its healing if given in moderate doses. And since this
chancre is far more frequent than the other, and is never fol-
lowed by constitutional symptoms, it may easily be supposed
by one who lumps all his cases together that the Mercury
he gives prevents the occurrence of secondaries. This is
the statement of Hahnemann,* and of two of his followers,
Schneidert and Jahr‡-all these speaking from prolonged or
extensive experience. On the other hand, Dr. Yeldham in his
excellent Homœopathy in Venereal Diseases, and Bähr in his
System of Therapeutics, discriminating more scientifically,
admit that the indurated chancre is generally followed by
secondary symptoms, whatever be the treatment adopted for
it. The latter allows nine to fifteen weeks for the continu-
ance of the chancre, which is about the same time it occupies
when left to nature. Dr. Yeldham, whose doses approach
more nearly to those of the old school, considers that he
really shortens the duration of both primary and secondary
symptoms.|| If it be so, it may be that a slight physiological
action is produced, though not enough to affect the mouth.
But I venture to think that a careful reckoning of his dates
will show that his indurated chancres and even his dry
syphilides lasted nearly if not quite as long as those of ex-
pectant treatment, as the same is related by Dr. Charles
Drysdale. The most marked effects were healing of ulcers
and improvement in general health, both of which belong to
the truly homoeopathic action of the drug.
←
* See Brit. Fourn. of Hom., xxvii, 396.
† Ibid., xxii, 620.
On Venereal Diseases.
He gives from one to three grains of the first, or from five to ten
grains of the second decimal attenuation of Mercurius solubilis (ie.,
from too of a grain) three times a day.
10 20
644
MERCURIUS.
The conclusion seems to be that it is only at certain points
and stages of the syphilitic process that Mercury can an-
tidote it after a specific manner, that is (again to quote our
own Drysdale's definition) by the absorption of its whole
physiological into its therapeutical action. But these points
and stages are important enough. The blood disorder; the
affections of mouth and throat; the sub-acute inflammation
of the periosteum; some of the exanthemata, and perhaps the
laryngitis, are to be included among them. Again, the whole
series of manifestations of hereditary syphilis are within its
range, whether they take the form of bullæ, abscesses, and
marasmus, or the slower and less fatal variety which consists
in snuffles, stomatitis, readily moistening syphilides, pale
earthy colour of skin, and epiphyseal periostitis in the
long bones. And further uses are suggested by the results of
its abuse. When the local manifestations of the disease become
destructive; when the eruptions take the form of impetigo or
rupia, when rapid ulceration affects the mucous membranes,
or when caries invades the bones:-here, when the cause is not
Mercury itself, its administration is most effective. Thus Dr.
Gerson speaks highly of corrosive sublimate in the phage-
dænic or sloughing chancre; and Dr. Yeldham has known
Mercurius solubilis arrest phagedænic ulceration when other
remedies, ordinarily recommended for that condition, had
failed. Dr. George Wood, moreover, writes of the syphilitic
cachexia: "I have seen the lowest condition of shattered
health, which for years had resisted various treatment under
the idea that it was mercurial disease, get well under a care-
ful administration of blue-pill, as if cured by a charm.”
Colles makes a similar statement.
We claim all such cures, I say, for the homoeopathic action
of Mercury. Whether we should ever go beyond it, and use
the drug for syphilitic manifestations where some measure of
physiological action must be set up, is a question. It seems
quite unnecessary to do so for the primary sore and the
secondary syphilides, as they only want time for their dis-
appearance; and to disperse the tertiary gummata when they
are causing mischief, we can nearly always depend upon the
iodide of potassium. The only disease in which the practice
has sometimes seemed needful, even in our hands, is syphilitic
iritis, in which it every now and then happens that nothing
will affect the disease until Mercury is given to touch the
mouth. You remember the vivid description of Watson:
"The instant that the patient's gums and breath acknowledge
the specific influence of Mercury upon his system, a welcome
MERCURIUS.
645
change becomes apparent the red zone surrounding the
cornea begins to fade; the drops of lymph to lessen; the iris
to resume its proper tint; and the puckered and irregular
pupil once more to approach to the perfect circle; till at
length the eye is restored to its original integrity, and beauty,
and usefulness." The eye is so precious an organ that one
would willingly submit to a temporary sacrifice of general
health, if really necessary for its restoration. Should you
ever have to push Mercury to this extent, let me remind you
of the method of Law, who divided a grain of calomel into
twelve parts, giving one every hour till the mouth was touched,
which it usually was ere thirty-six doses had been taken.
Trousseau and Pidoux have carried his plan farther, making
twenty-four doses of the grain, and giving one every two
hours only. In this way, they say, they rarely require as
much as three grains to effect their purpose.
I have said all this from the homœopathic stand-point. In
the old school men seem passing from the entire renunciation
of Mercury in syphilis to a renewed recognition of its power
over the disease. The recent deliverances of Mr. Hutchinson
are very significant on this point. His recommendations to
avoid physiological action are cautious enough; but when he
speaks of it being "desirable to introduce a considerable
quantity of the drug into the system, and to protract its use
over a very long time," we seem to be beginning the old
career again. To all disposed to enter upon it, I would re-
commend the perusal of the work of Andrew Mathias, a sur-
geon to the Queen in 1816, On the Mercurial Disease. He
argues, quite in Hahnemannian fashion, that Mercury cures
syphilis by setting up a specific disease of its own which is
incompatible with it. And he shows from numerous observa-
tions (as Hahnemann had done before) that if the drug be
given too largely or too long the venereal symptoms will cease
to improve, will take on a retrograde action, and will be com-
plicated with fresh lesions of a similar but distinctive cha-
racter. It is interesting to observe that, according to him,
when this mercurial disease has subsided, the old venereal
symptoms will reappear, having been suspended only by the
presence of the other.
Hahnemann makes such suspension,
instead of extinction, the mark of a different as opposed to a
similar disease; and so our position is confirmed, that while
Mercury is homœopathic to syphilis at points, it is not so as
whole to whole.
It would seem that Hahnemann himself was once of the
same opinion; for in his treatise on Venereal Diseases pub-
646
MERCURIUS.
(C
lished in 1789, he says "Mercury does not cure syphilis by
causing evacuations, but rather by the gradual or sudden
antipathic irritation of the fibres of a specific nature which it
sets up." It is true that in 1796 he argued that the drug was
a simile to the disease; but let us see how he characterises the
latter. Syphilis depends upon a virus, which, besides other
peculiarities that it developes in the human body, has an
especial tendency to produce inflammatory and suppurating
swellings of the glands (to weaken the tone?); to make the
mechanical connexion of the fibres so disposed to separation
that numerous spreading ulcers arise, whose incurable cha-
racter may be known by their round figure; and, lastly, to
increase the irritability." It is quite evident that the second
only of these features belongs to true syphilis. Hahnemann
himself goes on to specify a number of points in which “the
mercurial disease is very different from the nature of syphilis.”
Fault has been found with me* that I have laid too much
stress upon the absence of homoeopathic relationship between
Mercury and certain manifestations of syphilis, and that I
ought to have minimised such points of divergence in the
interest of the general similarity it possesses. Now if the
fact was only that the homoeopathicity of Mercury to syphilis
was not perfect, the exception taken to my argument would
be well warranted. But my position is that in a considerable
range of the manifestation of the disease the drug is not only
not homoeopathic, but actually antipathic; and that it can
only be by inducing its physiological and destructive influence
that it can here effect any change. This is an important
matter; and, as the general similarity between the effects of
the two agents is recognised by all, it seemed to me most
useful to you to point out wherein this relation did not hold
good, and where accordingly you must not expect to use
Mercury with benefit as a homoeopathic remedy.
The other great use which has been made of mercurialisa-
tion is in the treatment of inflammatory affections. But
before entering upon this subject (which indeed I must reserve
for our next meeting) I will speak of certain general condi-
ditions to which the constitutional effects of the drug shew it “
to be homœopathically suitable. I will not include among
these (though I might do so) scurvy and chlorosis, as the
former is so satisfactorily met by dietetic means, and the latter
by the judicious administration of iron and similar remedies.
But I shall have to say something of scrofula, of rheumatism,
and of the eruptive fevers.
* Monthly Homeopathic Review, xx, 452.
MERCURIUS.
647
I. I have shown how the very forms of venereal disease
which are ordinarily supposed to contra-indicate Mercury to
us suggest its choice. Such affections are especially met with
in the scrofulous; and it is an accepted canon in old school
therapeutics that where this diathesis exists Mercury is
strictly forbidden. We on the contrary, and for the converse
of the same reason, use it largely in many manifestations of
scrofula. It would seem capable even of developing this
diathesis, as Alibert and others have shewn that persons
exposed to mercurial influence frequently beget scrofulous
children. It is useful when the morbid phenomena show
themselves in the eye, the ear, the glands, and the bones; also
in weeping eruptions and ulcerations of the surface. In
strumous ophthalmia especially you will find it (as I shall
have to tell you when we speak of the irritant salts of the
metal) an excellent medicine. But for the whole subject of
the relation of Mercury to scrofula I would refer you to Dr.
H. Goullon's treatise on the disease, here as always the best
source of information as to its therapeutics. You will find
cases there of scrofulous otorrhoea, eczema, and periostitis in
which M. solubilis was strikingly successful.
2. Another constitutional affection in whose treatment
Mercury plays a part is rheumatism. The "mercurial rheu-
matism" is too well-known for any demonstration of its
homœopathicity to the disease to be necessary. It is common
among the workmen in the metal, as may be seen from S. 555-
565 of Allen's pathogenesis of it. When, moreover, Dr.
Anstie describes, as frequent premonitory symptoms of an
impending rheumatic fever, a "sallow and red tint of the
face," with "oily perspiration," we are at once reminded of
the pathogenetic effects of the drug. The occurrence of pro-
fuse and odorous perspirations, which give no relief, has in
all affections been regarded as a "key-note" for Mercury;
and it is a well-known and almost pathognomonic symptom
of rheumatism. It is in subacute forms of the disease,
readily relapsing, where the pains do not shift about
much, and are markedly worse at night-the patient
being very sensitive to cold-that Mercury is so useful.
Some excellent cases illustrative of its virtues are recorded
by Dr. Yeldham in the third and fourth volumes of the
Annals.
3. Again, the description I have given, from Alley, of the
febrile eruptions induced by Mercury forcibly suggests the
three great eruptive fevers, measles, scarlatina, and small-pox.
His severer degrees of "hydrargyria " very fairly correspond to
648
MERCURIUS.
these in their ascending scale. Mercury suits well the ex-
anthem and the catarrhal symptoms of ordinary measles, and
may, with Aconite for its fever, do all that is required in its
treatment. In scarlatina its place is in the anginose form of
the disease; where the swelling, ulceration, and tendency to
gangrene make it exquisitely homoeopathic, and where it is
thoroughly efficacious. In variola it takes up the treatment
where Tartar emetic has-if it has to leave it,, namely, where
in spite of the former remedy the pocks are going on to sup-
puration, and the secondary fever is setting in. It is here
highly praised by all homeopathic writers.
The remainder of the therapeutics of Mercury, and the
action of its special preparations, I must reserve for my next
lecture.
LECTURE XLIII.
MERCURIUS (continued).
I have said that it was for inflammation that the induction
of the constitutional effects of Mercury was chiefly practised.
Now here, too (as well as with syphilis), it would seem that we
might convict our antagonists, out of their own mouths, of
homœopathising in what they were doing. In the words of
Sir Thomas Watson: "When Mercury is gradually introduced
into the human body in small quantities, it produces sooner
or later very remarkable effects. It causes inflammation. Per-
haps it may be for that reason that the professors of homoeo-
pathy prescribe 'Mercurius' so often." It is, indeed. But
here also we must discriminate, though it be apparently to
our own disadvantage. The seat and kind of the phlogosis
induced by Mercury is not generally that for which it has
been so renowned as a remedy. It is in adhesive inflamma-
tions of serous membranes, in membranous croup and exuda-
tive iritis, that it has been given: it is its physiological effect
that has been desired, and this has been induced accordingly.
It has been regarded as contra-indicated in mucous and paren-
chymatous inflammations, and where the tendency has been to
ulceration and suppuration. These contras, however, are our
pros. We cannot claim for homœopathy the ancient anti-
phlogistic employment of Mercury; but we find great use for
it in the treatment of all inflammations where we desire to
check suppuration when impending, and heal ulceration when
extending.
I. In affections of the mouth Mercury naturally holds a
high place. It is not homoeopathic to the true membranous
stomatitis of children-the muguet of the French; but it is so
to the stomacace of adults, and to thrush, which always tends
to ulceration. It is rarely necessary, however, to give any-
thing but Borax in this last disease, when the morbid process
is limited to the mouth. For simple ulceration, as well as
syphilitic, of the mucous membrane of the buccal cavity
Mercury is specific, especially when followed up by Nitric
650
MERCURIUS.
acid. Cancrum oris is another idiopathic disease of this part
which closely resembles the pathogenetic effects of Mercury.
We of course treat it with this drug; but it is rather amusing
to find a writer of the old school advocating the practice.
Hempel cites such an one in the person of Dr. Duncan, of
Dublin.
The coexistence with other symptoms of the mercurial
mouth will always suggest and often establish its appropriate-
ness to the whole case.
With the mouth we class the salivary glands, the tongue,
and the teeth.
a. Mercury has cured idiopathic salivation, as from preg-
nancy. Drs. Marcy and Hunt recommend in this affection a
wash for the mouth made of two grains of the second tritu-
ration of Mercurius corrosivus to a pint of water. In in-
flammations of the salivary glands Mercury must always bẹ
the leading remedy. I may specify two-mumps, in which
we always give it, though whether it affects the natural course
of the disease I cannot say; and the tenderness and swelling,
threatening suppuration, ieft behind after scarlatina, or ap-
pearing during typhus, in which the iodides at any rate act
most efficiently.
b. In subacute inflammations of the lingual mucous mem-
brane, and even in acute glossitis, Mercury has acted very well.
Dr. Guernsey points out a very heavy, thick, yellow, moist
covering of the tongue as indicating the drug, saying that it
should rarely be given when the tongue is dry. Dr. Quin
notes sweet taste in the mouth as a characteristic symp-
tom for it.
c. In our present uncertainty as to the action of Mercury on
the teeth it would be premature to fix its curative place in
their diseases. If it is true that its abuse can cause them to
become carious, the medicine ought to be useful in check-
ing this process. More certainly it is of value in periostitis of
the sockets, a frequent cause of toothache: its steady use
here will often supersede extraction. The feeling as if the teeth
were elongated as well as tender is a special indication
for it.
2. I have now to speak of Mercury in affections of the
throat. Simple catarrhal angina is a malady in which I think
this medicine far too frequently used. It is recommended
in Domestic Guides to homoeopathic treatment whenever
there is any tendency to ulceration; and every mucous exuda-
tion on the tonsils is taken for an ulcer, and treated accord-
ingly. But these phenomena, even if truly ulcerative, are
MERCURIUS.
651
but superficial accidents of an acute sore-throat, where there
is much pain and bright redness. Cut away this inflamed
base with your Belladonna and (if needful) Aconite; the ulcer
will not remain behind. In my own experience, the angina
calling for Mercury has been of rare occurrence. It is of a
subacute or torpid character, with pale or bluish-red swell-
ing; and ulceration is often present. Its power of checking
suppuration makes it often useful in quinsy. Hartmann
praises it here; and Dr. Ringer writes: "When in quinsy
or scarlatina the tonsils are so enlarged as almost to meet, and
when the difficulty of swallowing is nearly insuperable, and it
may be there is even danger of suffocation, if at such a time
a third of a grain of grey powder be taken every hour, in a
few hours the swelling is much reduced, and the danger,
discomfort, and distress much removed. The effect of the
mercury in such cases is often most signal." Dr. Imbert-
Gourbeyre, also, has defined the place and illustrated the
virtue of Mercury in quinsy in a memoir on the treatment
of angina by mercurials, Belladonna, and Aconite, translated
from the Moniteur des Hôpitaux in the fourteenth volume of
the British Journal of Homeopathy.
When anything like the cynanche maligna or putrid sore-
throat of the old writers is present, Mercurius is an indis-
pensible remedy. On the other hand, those same character-
istics of its action which make it so suitable for the sore-throat
of scarlatina unfit it for that of diphtheria. There is so much
phenomenal resemblance between the effects of Mercury and
the symptoms of diphtheria, that the preparations of this drug
were at first extensively used in its treatment. They failed,
however, in most hands to show any power of arresting the
morbid process. Nor should we expect them to do so. For
in diphtheria there is ordinarily neither ulceration nor gan-
grene, but a false membrane formed upon a comparatively
unbroken surface. Until it has been proved that Mercury can
cause this pathological formation, there is no evidence that it
is truly homœopathic to the diphtheritic process. I reserve
the question of the action of the cyanide and iodides, which
will come before us presently.
Mercury may occasionally be useful in chronic ulcers of the
throat, simple, scrofulous, and syphilitic; and would probably
cure such a chronic angina as that described by Dietrich, were
we to meet with it as an idiopathic affection. I shall have
'to speak again of this action in relation to the iodide and to
Cinnabar.
3. The only gastric affection in which I can indicate the
652
MERCURIUS.
ordinary mercurials as specific is the sudden vomiting of milk
in infants, which so often depends upon degenerative change
of the mucous membrane of the stomach. Here Dr. Ringer
highly commends minute doses of grey powder or calomel,
which can hardly act otherwise than homoeopathically. Nor
can I say much about them in the substantive affections of
the intestinal mucous membrane, though we shall see corro-
sive sublimate playing a distinguished part here. The late
Dr. Petroz has published some cases tending to show that the
black sulphide (Ethiops mineral) has considerable control
over the enteric lesion of typhoid fever,* and Dr. von Tunzel-
mann has more recently written in corroboration.† I have
myself lately had a case in point, where the diarrhoea and
hæmorrhage from the intestinal ulceration was seriously im-
perilling an otherwise happy progress, and where the Ethiops
mineral speedily wrought a change for the better. It is the
lymphatic-glandular apparatus of the intestines which is here
in fault, and Mercury finds its proper sphere of operation.
It is obvious, upon the principle of similarity, that Mercury
should be beneficial in many forms of diarrhoea; and so it is.
Few medicines are more frequently called for in the diarrhoea
of infants and young children, when the evacuations are vitia-
ted, of various colours, slimy and offensive, sometimes ex-
coriating the anus. Dr. Guernsey adds, as indications for
M. solubilis, much pain before the stool and great relief imme-
diately afterwards; also much straining. Calomel ("M.
dulcis" of our nomenclature) is the best form in which to use
it here; as this preparation of the drug most readily causes
bowel affections in the healthy.
Here again Dr. Ringer supplies welcome corroboration to
our practice, and has contributed most practical descriptions
of the use of the medicine. In children, where "three or four
pale, clayey, pasty, stinking motions are passed in the course
of the day," frequent doses of a third of a grain of grey
powder will soon set matters right. In their dysenteric
diarrhoea, where the motions are "slimy," and often mixed
with blood, the eightieth of a grain of corrosive sublimate will
cure "with remarkable speed and certainty."
"The great
indication for the bichloride," he writes, "is the slimy charac-
ter of the motions." Here he is curiously at one with Dr.
Guernsey, who says, " Mercurius is rarely indicated in diarrhoea
when there is no slime." A sixth of a grain of grey powder
given hourly will soon check cholera infantum and chronic
* See Brit. Fourn. of Hom., xxiii., 634.
† Monthly Hom. Review, xviii., 77.
MERCURIUS.
653
diarrhoea with green stools in the same subjects. His whole
section on this subject may be commended to your study, and
affords a most gratifying instance of the progress made by our
ideas. If such teachings prevail, Mercury will soon be found
a blessing where so long it has been a curse.
4. The mercurial preparations occupy a less important place
as remedies for affections of the respiratory mucous mem-
brane. M. solubilis has a high domestic reputation as a
remedy for "running colds;" but I confess that I myself
prefer Euphrasia and Kali bichromicum. I can confirm, how-
ever, Dr. Bayes' statement that "catarrhal cough, with yellow
muco-purulent expectoration, often yields very readily" to it
in the sixth dilution. Perhaps we in this country undervalue
Mercury in bronchitis, for our German brethren seem to esti-
mate it very highly, judging from the testimony of Trinks,
Bähr, and Hirschel. Here is what the latter writes about it.
"How the allopaths, and much more their patients, are to be
pitied, that their school should lack a knowledge of Mercurius
as a cough remedy! Where is there a more certain, a more
specifically acting remedy for the appropriate kinds of cough
of a catarrhal, inflammatory, organic nature, running down
from the fauces through the trachea and into the finest
bronchi, decisive in acute affections, ameliorating in the
chronic, slime-loosening, resolvent, restorative, where there are
roughness, burning, feeling of soreness from the fauces down
to the sternum, hoarseness of voice, dry cough, raw, concus-
sive, exhaustive; sputum ropy, watery, spittle-like, nasty,
bloody; catarrhal headache, coryza, diarrhoea, fever, non-
ameliorating night-sweats-here is the province of Mercurius.
It is the sovereign remedy of inflammatory bronchial catarrh."
5. Coming now to the uro-genital organs, I have already
pointed out the homoeopathicity of Mercury to the soft
chancre, as to any non-syphilitic ulcer forming on the genitals.
I will only add that Dr. Yeldham recommends M. solubilis as
the best medicine in balanitis. Bähr treats gonorrhoea with
Mercury almost throughout, but his results are not striking.
6. The traditional use of Mercury in inflammations of the
serous membranes has (as I have said) no relation to its
specific influence upon them, and is upon our principles quite
inadmissible. We hold it of very questionable advantage to
prevent lymphous exudation by a poison which causes a lower
form of effusion to take its place. I shall have something to
say presently of the specific relation of M. corrosivus to
peritonitis.
7. As to cutaneous diseases, I have already spoken of those
654
MERCURIUS.
of a syphilitic nature. You will always bear in mind exces-
sive perspiration, especially when of a viscid consistence and
strong odour, and occurring chiefly at night, as an indication
for the drug. When this symptom is itself the disease, as in
hidrosis pedum, Hartmann speaks of M. solubilis as not un-
frequently curative. The presence of moisture of the skin,
moreover, in febrile and inflammatory conditions, favours the
choice of Mercurius, as it makes against Aconite and Bella-
donna. The only non-specific skin affections in which we
have any experience with the drug are eczema rubrum and
lepra. In the last-named affection, when not of too long
standing, I have found it very effective; and "psoriasis in
spots over the whole body" (lepra is psoriasis circinata) has
been observed by Kussmaul in the workers.
I should say,
however, in addition, that Hartmann praises it in intertrigo (to
which it is certainly homoeopathic), especially when the ex-
coriation developes not merely in the folds of the skin, but
also at other spots.
S
8. As regards affections of the bones and joints, I have
spoken of the value of Mercury in scrofulous and rheumatic
periostitis. It is recommended by Hartmann in caries de-
veloping itself in strumous subjects after variola, or from
injury to the bone. He also finds it of great service in the
so-called "claudicatio spontanea" of childhood, which he con-
siders dependent upon a greater or less degree of inflamma-
tion of the capsular ligament of the hip-joint and of the
neighbouring glands. If there is much pain, he preludes with
or substitutes Belladonna.
I have yet to speak of certain curative actions of Mercury,
for which I have hitherto found no situation. I refer to its
place in the therapeutics of eye and ear disease, and of the
affections of glands.
9. You will find, if you consult the treatises on diseases of
the eyes given us by Dr. Angell and Drs. Allen and Norton
respectively, that they are in thorough agreement as to the
high place occupied by the mercurial preparations in the treat-
ment of these affections. Of their recommendations as to
corrosive sublimate and other irritant salts of Mercury I will
speak presently; but they concur in praising the ordinary
forms of the drug in blepharitis, where the lids are red, thick,
and swollen; in superficial keratitis; and in episcleritis. They
also give it in preference in all inflammations of the eye
owning a syphilitic origin. Drs. Allen and Norton regard
Mercury as the principal remedy for iritis; though I must say
that I think its homeopathicity here has yet to be established.
1
MERCURIUS.
655
"No case of iritis of any form," says Kussmaul, "has been
noticed among workers in Mercury;" and this though keratitis
and scleritis have not uncommonly been observed. It is
more suitable to retinitis, which is suggested by the symptoms
of both workers and provers, and seems several times to have
been cured by it--the "incipient amaurosis" in which Hart-
mann commends M. solubilis being presumably of this nature.
The symptomatic indications for Mercurius in these dis-
orders are that the discharges are profuse, burning and acrid,
and thin; and that the pains are all worse at night and for
warmth the heat of a light giving more inconvenience than
its luminosity. It is thus especially useful in the affections,
both of the mucous and nervous structures of the eyeball,
which occur in those much exposed to the glare of a fire, as
workers in foundries.
K
10. "In acute as well as chronic suppurations of the middle
ear," writes Dr. Houghton, "Mercurius (vivus or solubilis) is
more frequently indicated than any other remedy." The
pains here too are aggravated at night, especially in the
warmth of bed, abating towards morning. In chronic cases,
the pus may be fœtid and even bloody. A good instance is
related by Rentsch,* in which otorrhoea of this kind, and very
profuse, had existed for a long time (after measles), and a
polypus had formed. M. solubilis, internally and locally,
cured in four weeks.
11. As regards the glands, I have already spoken of the
usefulness of Mercurius in strumous adenitis; and would only
add that Hartmann highly commends it in incipient mastitis
during lactation, when the pain has the characteristic feature
of increasing from evening till midnight, and after this re-
mitting.
III. Very little use has yet been made homoeopathically
of the neurotic effects of chronic mercurialisation. The metal
ought to find place in the treatment of many chronic inflam-
mations of the gray matter of the brain and cord. Bähr re-
lates a case of acute myelitis cured by it. Hartmann
commends it in stammering after apoplexy, and relates the
following curious case, in which it was certainly strongly in-
dicated.
'In a man already advanced in years, there appeared slight tran-
sient vertigo, which afterwards occurred more frequently, and continued
a longer time; in the periods between the attacks, he laboured under
loss of memory, weakness of understanding, and absence of mind,
from which he had never suffered previously. Sometimes cardiac
anxiety, or again ptyalism, which continued for a whole day, at which
* Goullon on Scrofula, p. 204.
656
MERCURIUS.
time his mental powers seemed unimpaired, supplied the place of the
vertiginous attacks. He had used many remedies by the advice of
physicians, but none of them had benefited him; on the contrary, the
morb.d state seemed to increase, and finally complete mania was de-
veloped, which always disappeared entirely on the supervention of
ptyalism. When the cardiac anxiety occurred, it had always been
conjoined with the settled idea that he would lose his reason.
Mercurius solubilis 2, repeated in three days, effected a rapid and
permanent cure."
We may thus be encouraged to follow the indication of the
pathogenetic effects of Mercury, and give it where the pre-
monitory symptoms of cerebral disease exist. When Sir
Thomas Watson says "I have known several obscure but
threatening symptoms of brain disease clear entirely away, when
the gums were made sore by mercury, and kept slightly
tender for some little time," one feels tempted to suppose that
the power of the metal to cause such phenomena had something
to do with the cure, and that the stomatitis induced was at
least unnecessary.-Mercury ought to find place, moreover, in
the therapeutics of paralysis agitans.
The only full analogue of Mercury is lodine. The medicines
resembling it in their action upon special tissues and organs I
have mentioned in their several places.
The range of the dose of Mercury is necessarily extensive.
In syphilitic affections most of us-even those who are other-
wise addicted to high dilutions, as Jahr and Hartmann-give
the low triturations; none however going so far as even to touch
the gums. In most of the other disorders calling for M. vivus
or solubilis the attenuations from the third decimal to the
sixth centesimal will be found suitable; and Hartmann re-
commends us. even when we go as high as the twelfth (which
he thinks far enough), to make our potencies by trituration
rather than solution. This seems to have been Hahnemann's
practice; for in 1822 he recommends M. solubilis to be given
ordinarily in the twelfth trituration.
I proceed now to speak of the more distinctive mercurial
preparations. They are the bichloride, the cyanide, the
iodides, the red oxide, and the sulphide.
Mercurius corrosivus-the bi- or perchloride of chemistry
hitherto, the mercuric chloride of present nomenclature, the
corrosive sublimate of common language-is, as you know
well, a most potent poison, and in our hands is a most valued
medicine. It is prepared by trituration, or solution in recti-
fied spirit. Hahnemann has given a few symptoms as pro-
duced by it, and Dr. Buchner has proved it (in fractional doses)
MERCURIUS.
657
on himself and seven others. To the results thus obtained
Dr. Allen adds numerous effects of poisoning, making a patho-
genesis of upwards of eleven hundred symptoms, which we
may supplement yet further by using the observations made
by Lewin in the treatment (on a large scale) of syphilitic dis-
orders by the hypodermic injection of the drug.
*
Corrosive sublimate is, of course, a mercurial, and therefore
capable of inducing the constitutional effects of the metal; but
these are by no means readily obtained from it, and no mer-
curialist in the past ever used it to cause salivation. We, in
like manner, should be chary of employing it as a remedial
agent in conditions answering to those of pure mercurial in-
fluence, preferring for such purposes the M. solubilis or vivus.
But M. corrosivus has a sphere of its own as a specific irritant
to the living tissue, in which for range and intensity it is
rivalled only by Arsenic. It affects in this way the stomach
and large intestine, the respiratory mucous membrane and the
lungs, the kidneys and external uro-genital organs, and the
peritoneum. I will speak of each action, and of its therapeutic
applications, separately.
1. Upon the alimentary canal the sublimate acts, when swal-
lowed, as a corrosive caustic, chemically destroying the mucous
membrane wherever it comes in contact with it. But obser-
vation and experiment show that, when otherwise introduced
into the system, it still exerts an irritant influence upon
certain parts of the digestive tract, which influence must,
therefore, be of an elective and dynamic character, and suit-
able for homœopathic application. The parts so affected
are the mouth and throat, the stomach, and the large intes-
tine.
The best observations of these actions are those of Dr.
Lewin, as his doses were moderate (to of a grain) and
his experiments extensive. He found mouth affections in
thirty-five per cent. of his cases. They consisted either of
slight stomatitis and moderate ptyalisın, with some tenderness
and swelling of the salivary glands; or of stomatitis ulcerosa,
the ulcers being covered with a dirty yellow coat, which he
compares (hardly justly, I think) to a diphtheritic membrane,
without ptyalism; or of pure increase of the flow of saliva, of
unchanged quality, and without any evidence of inflammation.
If the patients caught cold they had redness and swelling of
the tonsils and neighbouring lymphatic glands, hypertrophy
* The Treatment of Syphilis by subcutaneous sublimate injections.
By Dr. George Lewin. Translated by Drs. Proegler and Gale. Phila-
delphia Lindsay and Blakiston. 1872.
2 U
658
MERCURIUS.
y
of the former being no uncommon effect of a prolonged course
of injections. Gastro-enteric symptoms were observed only
when the maximum dose I have mentioned was overstepped.
"In lighter cases, the intoxication is ushered in by gastric
disturbances, like anorexia, coated tongue, bad taste, some-
times metallic, yet but seldom does the patient complain of
nausea and vomiting. After a little time, pain of a sharp,
burning character is experienced, a symptom which manifests
itself not only spontaneously, but by pressure on the abdo-
men, especially in the region of the stomach and right hypo-
chondrium. A little later, diarrhoea commences, tinged with
blood only when occurring profusely. The patients present
a markedly pale appearance, and complain of great languor.
After the injection of relatively larger doses, the symptoms
were aggravated, patients generally complaining of a vertigin-
ous feeling, and after walking a few steps they would feel
obliged to seize hold of something for support. With the
already painful affections of the abdomen, vomiting occurred,
sometimes with bloody dysenteric stools and tenesmus."
need hardly remind you that similar phenomena are observed
in acute poisoning by the sublimate, and post-mortem investi-
gation, while showing all the signs of inflammation (including
those of dysentery), finds them limited to the stomach and
large intestine, the smaller bowel remaining intact.
Quite in accordance with these facts is the use made of M.
corrosivus in homoeopathic therapeutics. In affections of the
mouth and stomach, indeed, it is not much employed, though
Hartmann recommends it (fifteenth dilution) in "very malig-
nant, obstinate stomacace, arising after debilitating, prostrating
diseases;" and Dr. Pemberton Dudley esteems it highly, in
the second and third decimal triturations, in chronic gastric
catarrh, with distension and soreness of the epigastrium and
of the transverse colon. But when the large intestines are
affected, whether with simple inflammation, with chronic
ulceration, or with dysentery, its effects are amongst the most
brilliant things in medicine. Hahnemann was the first to
recommend it in dysentery, saying (1822) that he had found it
almost specific in the common autumnal invasion of the com-
plaint. He gave the fifteenth dilution in single dose; but Dr.
Ringer reports correspondingly good results with hourly-re-
peated doses of a hundredth of a grain. All homœopathists,
whether high or low dilutionists, concur to praise it here; and
though some would limit its use to a certain variety of the
disease, we have Dr. Espanet saying, “In the numerous cases
of dysentery which I have treated in Algeria, I have never
MERCURIUS.
659
found the least advantage from substituting for M. corrosivus
another remedy which seemed more homoeopathic to the
febrile phenomena or the abdominal symptoms. Dr. Feuille,
of Algiers, has made the same remark.”*
2. Corrosive sublimate inflames the respiratory mucous
membrane of the eyes, nose, and bronchi, and also the lungs.
It is highly esteemed in strumous ophthalmia, as you may see
by referring to the cases reported by Dr. Böcker in the third
and Dr. Kidd in the twenty-second volume of the British
Journal of Homeopathy. Predominance of inflammatory and
ulcerative symptoms call for it here, with great photophobia
and profuse acrid discharges. Drs. Allen and Norton warmly
commend it in syphilitic iritis and choroiditis, and in albumi-
nuric retinitis. Dr. Jousset, and with him Dr. Dekeersmaecker,
treats purulent ophthalmia by instillations of its third decimal
dilution. It should be serviceable in the bronchitis of Bright's
disease, and in syphilitic phthisis (ie., chronic pneumonia in
these subjects).
3. The kidneys are very much affected by this poison.
Suppression of urine is a very common phenomenon, and post-
mortem investigation shows it to be connected with acute con-
gestion or inflammation of the secreting structure of these
organs. The urine is albuminous and bloody during life, in
one case (cited by Allen) " presenting granular, fatty tubuli
in large numbers, showing on their surface epithelial cells of
the tubuli uriniferi also in a state of granular degeneration;
and the patients die with all the symptoms of uræmic poison-
ing. Lower down we have frequent and painful micturition,
and sometimes swelling of the penis and scrotum, with black-
ness of the latter, and intense inflammation-even to sloughing
-of the vulva.
""
-
-
M. corrosivus is considered by Dr. Ludlam the best remedy
for the albuminous nephritis of pregnancy, and is commended
by Bähr in nephritis suppurativa. Dr. Yeldham gives it, in
alternation with Aconite, in the first stage of gonorrhoea. I
have mentioned its usefulness in phagedænic and sloughing
chancre; its homoeopathicity thereto is now manifest.
4. Inflammation of the peritoneum and effusion into its sac
is a frequent feature in poisoning by corrosive sublimate; and
there is reason to suppose that it has a similar influence on
other serous membranes. The cerebral arachnoid has been
found inflamed by it, and Allen's 883d symptom suggests the
spinal arachnoid as in the same state: "Loss of power and
stiffness of the extremities, gradually increasing day by day,
* Bulletin de la Soc. Med. Hom. de France, xix., 179.
660
MERCURIUS.
with excessive pain on any attempt to change the position,
until the patient becomes entirely paralysed."
I have myself the highest esteem for M. corrosivus in peri-
tonitis. I have used it here more frequently than Bryonia,
and with most gratifying results.
Besides these more obvious applications of the peculiar
properties of M. corrosivus, it has been used in homœopathic
practice in several important disorders, as by Dr. Lawrence
Newton in ulceration of the cartilages of the joints,* by Jahr
and Hofrichter in syphilitic exostoses,† and in the eczema
impetiginodes of scrofulous children. The discovery lately
made by Dr. Rutherford, that it alone of the mercurial pre-
parations is a true cholagogue, may possibly lead to further
applications of it as an hepatic remedy. For the present, I
must say no more of it.
Mercurius cyanatus, the bicyanide of the metal, “mercuric
cyanide," we know at present almost entirely from its effects
in a few cases of poisoning by it which have occurred, whose
symptoms are furnished us by Allen. It does not corrode
chemically as the perchloride does, so that its effects on the
mouth and throat are of dynamic origin. Among these we
find, in one case, "buccal mucous membrane red and injected
(third day), a round ulcer, with grayish base and upright
edges, and encircled with bright red, on the inside of the right
cheek (fourth day), the ulcer in the mouth has spread, and is
covered by a large, gray, leathery coating (fifth and sixth
days);"” and again, “a grayish, diphtheritic-looking deposit
around the anus, quite similar to those on the inside of the
cheeks;" and again," a white, opalescent coating on the pillars
of the velum palati and on the tonsils." In another case we
have "the lips, tongue, and inside of the cheeks covered with
a grayish-white pulp (fourth day)." In both instances these
local symptoms were accompanied with great prostration.
It is not surprising that such phenomena should have sug-
gested M. cyanatus as a remedy for diphtheria. Dr. Beck, of
France, was the first to make the application; and Dr. Villers,
of St. Petersburgh, learning it from him, reports that he has
had astonishing success with it. Some of his cases are given
by Dr. Oehme, in his excellent Therapeutics of Diphtheritis.
Dr. Villers has lately reported that in ten years' time he has
treated over a hundred cases of the disease, of all degrees of
severity, without a single death, never giving anything but
* Monthly Hom. Review, xiv., 543.
† Jahr's Venereal Diseases translated by Hempel, p. 412.
MERCURIUS.
661
M. cyanatus. He began with the sixth dilution, but now
prefers the thirtieth. Its effects are very rapid, the exudation
generally clearing away within twenty-four hours, and the
general symptoms improving pari passu.
*
Dr. Villers is not without supporters in this experience of
his. One of them is an old-school physician of the same city,
Erichsen by name, who claims to have been more successful
with the cyanide than with any other remedy, giving from one
forty-eighth to one ninety-sixth of a grain for a dose. Even when
the false membranes extended into the larynx, he found them
clear away under the action of the drug. Of twenty-five cases
thus treated, he lost three only,--one from cardiac paralysis,
one from suppurating parotitis, and one from meningitis; but
even in these cases the local disease was gone. He of course
omits to credit the remedy to his homœopathic colleague. Dr.
Jousset esteems it the best medicine in the putrid form of the
disease; and Dr. Burt, of Chicago, has lately stated that for
the last three years he has been administering it in diphtheria
with such wonderful curative results, that now, as soon as he
is certain that he has a case of diphtheria to treat, he “at
once puts the patient upon the cyanuret of Mercury, with a
feeling of almost absolute certainty of curing him." In two at
least of his cases the membrane had invaded the air-passages.f
The two last-named practitioners have employed the lower
triturations.
Dr. Burt experimented with the poison on a dog, injecting
it under the skin. Great prostration, with feebleness of circu-
lation and respiration, were produced; and on post-mortem
examination the larynx was found inflamed, with its mucous
membrane and that of the posterior nares loaded with mucus,
and the right ventricle contained a white fibrinous clot. In
the Homœopathic Times for October, 1877, Dr. W. A. Allen
writes, "A partial proving of the cyanide gave great prostra-
tion and weakness, a low febrile condition, a whitish-gray
deposit upon the tonsils and mouth, extending along the right
side of the tongue, with slightly swollen tonsils and difficult
deglutition. These symptoms are given as communicated to
me by the prover. The prostration and other symptoms
were so severe that he ceased taking the drug,-the second
potency had been used,—and rapidly recovered by the use of
Baptisia." I think that such facts should encourage us to
a free and trusting use of this remedy when we encounter the
disease in question.
* St. Petersburg Med. Wochenschrift, 1877.
† American Homeopathist, ii., 22.
662
MERCURIUS.
Mercurius iodatus,
Mercurius biniodatus. By these names we designate the
two compounds which Iodine forms with Mercury,--the green
and red iodides (fulvus and ruber) of common language, the
mercurous and mercuric iodides of our present chemical no-
menclature. They are prepared by trituration. I group them
together, as they have much in common, but shall not fail to
indicate their distinctive places.
The mercurial iodides are prepared by trituration. Both
have been proved in the school of Hahnemann, the pro-
tiodide by Drs. Lord and Blakely, on six persons, the biniodide
by the Philadelphia Provers' Union. The pathogenesis ob-
tained by the latter experimenters is given by Hering in his
Materia Medica; both may be read in Allen.
They add little to our knowledge of the physiological action
of the compounds, which had been ascertained to behave
mainly like Mercury, though the double equivalent of the
halogen in the biniodide makes it exceedingly irritant. Their
use in the old school has been mainly in the treatment of
syphilis, and Lugol's experience with Iodine in scrofula made
it supposed that they would be especially suitable to patients
having this diathesis. I do not know that the idea has been
confirmed, and it has not prevailed in the homœopathic school.
Here the compounds (and especially the biniodide) have been
reckoned the best mercurials for secondary syphilides; and
Drs. Yeldham, Clotar Müller and Meyhoffer on the cne side,
Drs. Farrington and MacFarlane on the other, concur to com-
mend them, the former giving the lower triturations, the latter
the highest dilutions.
The other chief sphere of action of the mercurial iodides in
homœopathic practice has been affections of the throat, espe-
cially when its glandular apparatus is involved. Dr. G. W.
Cook, of New York, introduced the protiodide as a remedy for
follicular pharyngitis, giving it in the first trituration;* and
since Dr. Black communicated his favourable experience with
it in 1857-8, it has been the favourite remedy for the disorder
in this country.‡ Dr. Cooper praises it in chronic enlarge-
ment of the tonsils, when an inflammatory tendency is still
present and superficial ulcerations are seen.§ Dr. Blakely, its
chief prover, considers it indicated in affections of the throat
* See Jahr's Manual, ed. Snelling, sub voce.
† Brit. Journ. of Hom., vols. xv. and xvi.
‡ See Ibid, xxxi., 287.
$ Monthly Hom. Review, xi., 580.
MERCURIUS.
663
(and, indeed, of most other parts) where the tongue is coated
bright yellow at the base, but is clean in front. *
A more questionable use of these compounds is their ap-
plication to diphtheria. There is nothing in their pathogenesis
to lead to their employment here, yet there is no question of
Dr. Ludlam,
their being in extensive use and high esteem.
indeed, produces† a formidable array of symptoms as pro-
duced by the iodide, on the authority of Dr. Cook; but if the
original be consulted, it will be seen that the author is
I
describing the morbid conditions he has cured with it.
myself have used them largely, and closely watched their
effects, but I have not been able to satisfy myself of their
exerting any action upon the morbid process. However, one
cannot ignore the favourable results which Drs. Black, Lud-
lam and Helmuth report from the iodide, and Drs. Madden,
Joslin and Dowling from the biniodide. I myself have seen
excellent effects from the latter when the scarlatinal throat has
assumed a diphtheritic character, with much swelling of the
external glands; and Dr. Russell found it curative in the
dangerous parotitis of typhus.‡
Dr. Holcombe praises M. iodatus in chronic catarrh of the
posterior nares, when the patient is annoyed by constant drop-
ping of mucus into the pharynx.
Mercurius oxidatus ruber, the old "red precipitate,” is also
prepared by trituration. Allen gives a short pathogenesis of it,
derived from fourteen observers, one of whom was a prover.
Hartmann Jahr, and also the later homœopathists of Germany
esteem it highly in the severer forms of both primary and se-
condary syphilis, when M. vivus or solubilis seems ineffective.
They all give it in the first trituration, and its modus operandi
may be inferred from what Hartmann says, that in one case he
was compelled to give the sixth of a grain of the pure oxide
three times a day before he could check the disease, and that
no medicinal symptoms appeared, save soreness of the gums
and some loose teeth. It removed a chronic blepharitis in the
prover I have mentioned, and is esteemed by some in strumous
ophthalmia and the other conjunctival affections for which the
mercurials are suitable.
Mercurius sulphuratus, the compound of Mercury with Sul-
phur, appears in Allen's Encyclopædia under its own name of
* United States Med. Investigator, iv., 165.
+ Clinical Lectures on Diphtheria, p. 103.
Clinical Lectures, p. 343.
664
MERCURIUS.
Cinnabar (it is the vermilion of commerce). His pathogenesis
of it is mainly made up of a very thorough proving instituted
by Dr. Neidhard, and carried out on more than twenty persons,
using various potencies of the drug. The record of these ex-
periments may be read in detail in Metcalf's Homeopathic
Provings.
Cinnabar is prepared, like the other insoluble mercurials, by
trituration. Dr. Neidhard was led to prove it by the idea that
"substances found in a naturally compound state are probably
better calculated to eradicate the many complicated chronic
diseases than the simple substances." I hardly think, however,
that the results in this instance have supported his supposition.
The proving yielded little but the disappearance (under the
third trituration) of a chronic sore throat similar to that de-
scribed by Dietrich as caused by Mercury, and the almost
invariable production of sleeplessness by night with sleepiness
by day. Therapeutically, Cinnabar is in repute in the transi-
tion stage between primary and secondary syphilis, when
vegetations and mucous patches are the predominating
lesions. Jahr and many others praise it here, as you may see
from consulting this writer's treatise on venereal diseases. It
is also esteemed in neglected chancres, and in those which
have already been treated with mercury, but without the in-
duction of the constitutional effects of the drug.
•
LECTURE XLIV.
MAGNESIA CARBONICA AND MURIATICA, MANGANUM, MENY-
ANTHES, MEZEREUM, MILLEFOLIUM, MOSCHUS, MUREX,
NATRUM CARBONICUM, MURIATICUM, AND SULPHURICUM,
NUPHAR.
We begin to-day with the magnesian salts, two of which are
used in homoeopathic practice. The carbonate,
Magnesia carbonica,
is prepared by trituration.
A pathogenesis of it appeared in the first edition of the
Chronic Diseases, containing 128 symptoms, probably observed
upon patients taking the twelfth dilution. In the second
edition the list has increased to 890. A few of the additions
are from Schreter and Wahle; but the great bulk of them
are taken from a pathogenesis of 801 symptoms in the second
volume of Hartlaub and Trinks' Arzneimittellehre,-unnamed,
but supposed to proceed from the fertile manufactory of " Ng."
Dr. Allen inserts all these from the original.
Magnesia, in its simple carbonated form, is known only as
an antacid and mild laxative. Trousseau and Pidoux point
out that the evacuations produced by it are, at first, simple
liquid fæces; but that its continued use sets up sub-acute
inflammation of the intestinal mucous membrane. It may
thus find homoeopathic employment in some bowel-affections
of children. Dr. Guernsey says that it is indicated when their
motions are sour-smelling, and resemble the green scum of a
frog-pond the diarrhoea caused by Magnesia is certainly
generally of this colour. But the chief use to which it has
been put in the school of Hahnemann is in the treatment of
scanty and delaying menses, when, on their appearance, they
are of dark colour and pitchy consistence. It may also, it
seems, find place in the treatment of menorrhagia, when the
flow has the characteristic of being worse at night in bed.
Mr.
666
MAGNESIA MURIATICA.
Clifton relates a case of this kind in which, after the compara-
tive failure of other remedies, it effected a speedy cure, and at
the same time removed a greenish diarrhoea to which the
patient was subject, and enabled her to take milk, which for
years she had not been able to do without causing distress at
the stomach and sour risings. He gave the 6th attenuation.
It is recommended by Hahnemann himself for the tooth-
ache of pregnancy, where it has often served me well. The
pain, Dr. Guernsey says, is characteristically insupportable
during repose: the patient must get up and walk about. Dr.
Priel, of Riceys, published some time ago a number of cases
of cataract in which it had been given with effect, 13 out of 22
patients finding improvement more or less marked from its
use.*
He also employed the 6th potency.
The chloride of magnesium,
Magnesia muriatica,
is prepared by aqueous solution.
The first edition of the Chronic Diseases gives 69 symptoms.
to this salt. As the sixth dilution is recommended for
administration, they were possibly obtained from the third.
In the second edition, 749 symptoms are ascribed to it-most
of the additions here also proceeding from Nenning, through
Hartlaub and Trinks.
Hahnemann thought that the virtues of sea-bathing might
be partly due to the large proportion of chloride of magnesium
contained in the water; and considered the salt a powerful
antipsoric. It has hardly, however, fulfilled his anticipations;
though experience has sustained his recommendation of it in
"knotty, hard, difficult, insufficient and delaying stools,"
which sometimes (Dr. Guernsey says) crumble to pieces
directly they pass the anus. Noack and Trinks commend it
in chronic congestion and induration of the liver. Magnesia
muriatica also shares with Magnesia carbonica a uterine
action. Hahnemann indicates its use in "hysterical uterine
and abdominal cramps, which extend even into the thighs
and are followed by leucorrhoea ;" and Dr. Bayes speaks of
finding it very useful here, and in leucorrhoea generally. He
gives the third or sixth dilution.
Here, also, we have some valuable clinical information from
Mr. Clifton. He has communicated to the twenty-first volume
of the Monthly Homoeopathic Review a series of eight cases of
* See Builetin de la Soc. Med. Hom. de France, vols. v. and vi.
MANGANUM.
667
2
congestion and enlargement of the liver in which the drug
was most beneficial. They all occurred in women whose
uterine health, was imperfect; and had been connected for
months or years with recurring attacks of indigestion, "bilious-
ness," constipation, with large round motions like balls, and
inability to lie on the right side (in one case on either side).
He gave the 5th dilution.
Dr. Guernsey says that Magnesia muriatica is one of the
most important remedies in hysterical conditions. Sleepless-
ness, the characteristic constipation mentioned above, and
frequent fainting attacks which seem to start from the stomach,
are his main indications for it.
I have next to speak of the metal Manganesium, or
Manganum.
Triturations, or in the case of the acetate aqueous solutions,
are made for homoeopathic use.
A pathogenesis of Manganese, obtained from the acetate,
appears in the sixth volume of the Materia Medica Pura. It
contains 89 symptoms from Hahnemann, and 242 from ten
fellow-observers. A second pathogenesis was published in the
second edition of the Chronic Diseases, adding to these the 124
symptoms recorded as obtained from the drug in Hartlaub
and Trinks' Arzneimittellehre.
Hahnemann's provings led him to think that Manganese
would prove indispensable in some of the most troublesome
chronic diseases, especially some insupportable pains in the
periosteum and joints, some weaknesses of the senses, and some
affections of the larynx and trachea. The provings of the
native black oxide and the chloride since instituted by Dr.
Lembke, of Riga, on his own person-an account of which is
given by Hempel and Allen-confirm the first and last of
these actions, and show it to affect the head much like Ferrum.
The hoarse cough it causes is characterised by being relieved
on lying down.
From the statements of Noack and Trinks it would seem
that Hahnemann's recommendations of Manganese have been
carried out with some success in inflammations of the bones,
periosteum, and joints; and in chronic laryngeal disease. In
the first named conditions Dr. Guernsey mentions great sensi-
tiveness of the bones as a special indication for it; and Bähr
praises it in a form of laryngo-tracheitis chronica which is
668
MENYANTHES TRIFOLIATA.
very common among persons who use their organs of speech a
good deal. The hoarseness depends upon the presence of
hard and tenacious mucus, so that towards noon, when this
has been cleared away, the voice is tolerably clear. It has also
been used with some benefit in Eustachian deafness and in
chronic cutaneous eruptions. It is a medicine which seems
to deserve more attention than is at present given to it.
From some observations of its pathogenetic effects collected
by Pereira, it appears that in workmen engaged upon it it
produces paralysis of the motor nerves, beginning with para-
plegia. This differs from the paralysis of lead in not being
associated with colic or constipation, and from that of mercury
in first affecting the lower extremities, and in not presenting
tremors of the affected part. The sulphate has a decided
action on the liver. This organ was found inflamed in animals
poisoned by it, and both in these and in the human subject it
acts as a vigorous cholagogue. Dr. Leared has published a
number of cases showing the good effects of Manganese in pain.
after food occurring in weakly females.
Besides these facts, sundry speculations have been
hazarded as to the value of the preparations of Manganese
in chloro-anæmia. I have read them with attention; but am
not much impressed with the theoretical reasoning or with its
practical results.
I can say nothing as to this drug also of analogous medi-
cines or dose.
I have now a few remarks to make on the buck-bean, marsh-
trefoil, or
Menyanthes trifoliata.
The tincture is prepared from the entire plant, dried.
There is a pathogenesis of Menyanthes in the fifth volume of
the Reine Arzneimittellehre, containing 28 symptoms from
Hahnemann, and 267 from nine others.
There is little in the proving which is characteristic, though
pressure as of a weight on the vertex is emphasised by Dr.
Allen's type; and Menyanthes has rarely been employed in
medicine. Hahnemann recommends it in some forms of ague
where the chill predominates. Teste remarks, " According to
to my own experience, Menyanthes is most closely analogous
to Drosera, except that the effects of Drosera are more intense
than those of Menyanthes. Obscuration of sight, which is
MEZEREUM.
669
one of the first symptoms of these drugs, developes itself
alike under the influence of one or the other. It is a sort of
white mist, or vibrations, which are sometimes so violent that
they prevent sight, come on irregularly, of varied duration,
especially in the open air, during a walk, and without any
other sensation. I experienced this symptom from either
drug so violently, while walking on the Boulevard, that I dared
not cross lest I should be crushed by the carriages. The pains
of Drosera and Menyanthes are likewise alike. In their action
on the air-passages they differ only in the degree of intensity.
Menyanthes is little used, and never will be used much. I
have employed it with success in a case of amaurosis; but
there are few diseases where Menyanthes is indicated which
could not be cured much better with Drosera. This opinion,
however, is founded on my own impressions, which I am
always willing to distrust."
We will now speak of the spurge-olive, Daphne
Mezereum.
We make a tincture of the recent, or triturations of the dried
bark.
A proving of Mezereum appeared in the Fragmenta de
viribus, containing 62 symptoms from Hahnemann, and 34
from authors. The drug did not reappear among his medi-
cines till the second edition of the Chronic Diseases was pub-
lished, where it has a pathogenesis of 610 symptoms, the
additions being from ten others. Most of these are taken from
a proving published by Stapf in the fourth volume of the
Archiv, in which eleven persons took part, using the mother-
tincture. Several subsequent provings of like kind have been
made with Mezereum in the homoeopathic school, so that Dr.
Allen can give us a pathogenesis of it drawn from 52 ob-
servers, and containing 1,566 symptoms.
Mezereum was one of the vegetable substances-as guaia-
cum and sarsaparilla-with which it was attempted to replace
Mercury in the treatment of syphilis. It still holds a place in
the compound decoction of sarsaparilla of the British Phar-
macopoeia, but is quite neglected as a specific agent. Ringer
and Wood barely allude to it, and Dr. Phillips (who might
have done better) merely summarises Pereira's article on the
drug. Yet one of its antisyphilitic applications has stood the
test of later practice, and is vouched for by such practitioners
670
MEZEREUM.
as Hufeland and Alexander Russell. I refer to its influence
over nodes and nocturnal bone pains-dolores osteocopi as they
used to be called. Hahnemann's pathogenesis in the Frag-
menta mentions such pains as caused by it in the cranium,
clavicle, and thighs, and several of the later provers report
the same experience; in homoeopathic practice we use it with
much confidence in these affections, and in simple or rheu-
matic periostitis. Whether it acts upon the bones themselves,
I hesitate to say. There is, however, a case on record in which
it seemed to check the necrosis of the jaw produced by
phosphorus; and Noack and Trinks mention several osseous
diseases as benefited by it.
But the homoeopathic method has added another valuable
application of Mezereum, namely, to cutaneous affections.
The plant is a violent acrid, and irritates the skin when ap-
plied externally, as it does the throat, stomach, and intestines
when swallowed. The former, however, unlike the latter, is a
specific action; and is manifested when the drug is otherwise
introduced into the circulation. Hahnemann relates* the case
of a man who took Mezereum for a long time for the cure of
some complaints that he had, and became at length affected
with an intolerable itching over the whole body, which did not
allow him an hour's sleep. This was removed in twenty-four
hours by camphor. Bergius also, cited by him, has observed
an itching vesicular eruption over the whole body, caused by
the internal use of the drug; and several of the provers had
similar symptoms. Mezereum is recommended by Hahne-
mann, and by Noack and Trinks, for several forms of cu-
taneous eruption; but Rückert gives no instance of its use.
Dr. Robert Cooper, however, has communicated to the thir-
teenth volume of the Monthly Homeopathic Review a chronic
case of pityriasis capitis, with loss of hair and great itching, in
which Mezereum in the third decimal dilution effected a very
satisfactory cure. Bähr, moreover, considers Mezereum about
the best medicine for shingles; and not only for the eruption,
but also for the consecutive neuralgia. I have tried it in one
case, occurring in an old man, with the best results.
A valuable study of the action of Mezereum on the skin
was contributed to the World's Convention of 1876 by Dr.
Gerstel, of Vienna: you will find it in the Transactions of the
meeting. He brings together in one view the cutaneous
symptoms of the drug, adding to them a proving on himself,
which resulted in a general itching similar to that experienced
by Hahnemann's patient. He concludes that this is the
* Lesser Writings, p. 381.
MEZÉREUM.
671
mildest form of the Mezereum skin disease, and corresponds
with prurigo; that it especially belongs to parts where the
panniculus adiposus is deficient; and that the itching—which
may pass on into burning-is characteristically worst in the
evening and increased by warmth. He then follows up the
effects of the drug into their higher grades, where they are seen
manifested in exfoliation and vesiculation. As concomitant
symptoms he notes general coldness, which he traces to con-
traction of the superficial blood-vessels, and twitching of the
subcutaneous muscles. The whole action shows the Meze-
reum atoms irritating the dermic tissue, congesting its blood-
vessels, and causing an acrid exudation, while at the same.
time they fret the associated muscular elements to spasm.
He illustrates these facts by citing several interesting cases of
cure-including prurigo senilis, pityriasis versicolor, mentagra,
and the so-called "herpes crustaceus."
Dr. Dunham some time ago contributed to the American
Homœopathic Review a number of symptoms of Mezereum as
given him by a son of the late Dr. Wahle of Rome. No in-
formation is vouchsafed as to their origin, and they read to me
far more like clinical than pathogenetic observations. But
even taking them in the former sense, they extend the action
of the drug to pustulation and ulcers of the skin, and they
have been verified in practice. Dr. Dunham himself wrote:-
"these symptoms suggest at once the applicability of Mezereum
to crusta lactea, to various forms of pure impetigo, and to
some of those mercurial or mercurio-syphilitic ulcers on the
lower extremities which often prove so difficult to cure. I have
frequently had occasion to witness the prompt curative action.
of Mezereum in these affections, in which I have generally
used the 200th potency. This has proved efficacious in cases in
which the lower dilutions have been inert. The characteristics
of the Mezereum skin diseases are well defined in the above
symptoms, viz.: itching occurring in the evening when in bed,
aggravated and changed to burning by touch or by scratching;
sensitiveness to touch; ulcers with an areola, sensitive and
easily bleeding, painful at night; the pus tends to form an
adherent scab, under which a quantity of pus collects." He
also relates an interesting case of deafness cured by the drug,
which was chosen on the ground of the affection having
resulted from the repercussion of an impetigo of the scalp,
closely resembling that described by Wahle. You will find
these facts of his about Mezereum in the first volume of his
collected writings.
Besides the skin, Mezereum specifically irritates the genito-
672
MILLEFOLIUM.
urinary organs. "The urinary organs," says Pereira, “are
sometimes affected by it, an irritation similar to that of can-
tharides being set up;" and Hahnemann found it produce
blennorrhoea of the urethra and vulva. He mentions leucor-
rhoea of some years' standing as having been cured by it; and
in Dr. Cooper's case "terrible irritation of the vagina" was
present, and disappeared under the use of the remedy. There
is also a case narrated by Hempel of poisoning by the external
application of Mezereum, in which symptoms of cerebral
depression supervened like those we have seen produced under
similar circumstances by Anacardium. I may add that it is
recommended in prosopalgia affecting the left infra-orbital
nerve: the pain is apt to extend to the temple.
Altogether, Mezereum is an active and promising medicine;
and from what we have seen as to the nature of its provings
may be used in accordance with them with all confidence.
Its analogues are Anacardium, Guaiacum, Phytolacca, and
Rhus.
With the exception of the experience reported by Dr.
Dunham, the lower potencies have chiefly been used.
I have next to speak of the common yarrow, Achillea
Millefolium.
The tincture is prepared from the entire plant.
Dr. Hering has given us for Millefolium one of his exhaus-
tive collections of observations. It was first published in his
Amerikanische Arzneiprufungen; and has been translated,
with additions, in the ninth volume of the New England
Medical Gazette. It contains symptoms from six provers of
the plant.
The yarrow has long been in popular repute as a vulnerary
and hæmostatic. Its virtues of the latter kind have been
sedulously cultivated by homoeopathists. Hahnemann wrote
of it in 1796: "We should endeavour to find out if the
millefoil cannot itself produce hæmorrhage in large doses, as
it is so efficacious in moderate doses in chronic hæmorrhages."
I cannot discover that it has ever done so when internally
administered, but it is noted by the older writers that if a leaf
of it is put into the nose it causes blood to flow. Hering indeed
cites Hahnemann as stating, in his Apotheker-lexicon (1793-9),
that it causes nose-bleed and hæmaturia, but he gives no
explanations or authorities. However, it is a very good me-
MOSCHUS.
673
-
dicine for hæmorrhages in our small doses, which makes it
probable that its action is of the homoeopathic kind. I have
myself seen it act well in hæmoptysis and recurring epistaxis;
and Dr. Hering cites several instances of its successful use,
among others one of hæmaturia.
This is the only application of Millefolium with which I am
acquainted; but you may possibly discover others from a
study of Dr. Hering's collection, which contains recommenda-
tions of it (from domestic and old-school sources) in numerous
forms of disease. It may be useful in "phthisis florida.
"}
Hamamelis and Ipecacuanha are allied remedies. The
hæmorrhage of Millefolium is not so passive and venous as
that of the former, and less connected with expulsive action—
cough, vomiting, &c.-than that of the latter.
I use the first decimal dilution. In the case of hæmaturia
mentioned, quarter-drop doses of the mother-tincture were
employed. I have seen drop doses of it seriously aggravate
an hæmoptysis, which supports the homoeopathicity of the
action.
We come now to that curious animal secretion, musk—
Moschus,
of which we make a tincture or triturations.
There is a pathogenesis of Moschus in the first volume of
the Materia Medica Pura. It contains 2 symptoms only from
Hahnemann, III from three fellow-observers, and 39 from
authors. The provings seem to have been made with the
pure substance or mother-tincture, and we have others from
Professor Jörg on himself, six pupils, and two females; so that
our knowledge of the physiological action of musk is con-
siderable. Dr. Langheinz, in an article which you will find
translated from the Vierteljahrschrift in the twenty-second
volume of the British Journal of Homœopathy, has shown that
the symptoms cited by Hahnemann from authors are mostly
of doubtful validity. You may read Jörg's experiments in
his pages; and in Dr. Allen's collection you will find some
curious effects observed in those who have made triturations
of the drug.
Musk has long been known as a pretty powerful nervine
stimulant. In this way it affected the provers, exciting the
circulation and sexual organs, and causing headache with
fulness and drowsiness. In this way also it is used in medi-
2 X
674
MUREX PURUPREA,
cine. I know of no distinctive homoeopathic applications of
it, though we utilise the virtues it has more largely than do our
brethren of the old school. I always carry it in my pocket-
case, on account of its great value in two conditions demanding
speedy relief. There are the hysterical paroxysm and nervous
palpitation. I know nothing which so rapidly dissipates an
hysterical attack, even when it has gone as far as unconscious-
ness, as Moschus. It is probably homœopathic to this con-
dition, as it was early noted that in hysterical subjects the
odour of the drug was liable to bring on their attacks. It is
of no less potency in palpitation which has been set off by
some nervous excitement, when there is no organic disease of
the heart; and here also it seems homoeopathic. Moschus
is also occasionally useful in laryngismus stridulus affecting
nervous children; and should be remembered in hysterical
asthma, and in hiccough. Dr. Guernsey considers it indicated
in such conditions by the presence of great coldness. Its use
in ataxic conditions occurring in acute disease seems beyond
the range of our therapeutics.
Moschus is allied with Ambra, Asafoetida, Castoreum, and
Valerian; also with Camphor and Nux moschata.
I use the second and third decimal dilutions of the tincture.
I believe that the odour of this medicine is of importance to
its action, and that pilules and globules of it are useless.
I must now say a few words about the drug we call
Murex purpurea,
which is the colouring matter of the shell-fish so named. It
is triturated for our use, being insoluble in water, alcohol, and
ether. The British Homœopathic Pharmacopoeia directs the
whole mollusc to be used; but this is surely needless.
Dr. Petroz proved Murex, in the fourth trituration, on three
women. His results were published in the third volume of
the Révue de la Matière Médicale spécifique; and are trans-
lated by Dr. C. Dunham, with some additional matter, in the
fourth volume of the American Homeopathic Review.*
Murex evidently acts specifically upon the uterus, rendering
the provers painfully conscious of possessing such an organ.
It produces also in them the well-known sympathetic symp-
toms of sinking in the stomach and pains in the breasts, also
great sadness and despondency: the sexual appetite moreover
* This article may also be found in his collected writings.
NATRUM CARBONICUM.
675
is greatly excited. It has proved curative in several cases of
uterine congestion; and from one of these Dr. Petroz thinks it
likely to be useful in "the inflammatory and fungous en-
gorgements of the neck of the womb, whose degeneration, so
rapid and so dangerous, often produces accidents and irre-
parable disorders." The co-existence of great depression
of spirits may indicate it here.
One of the symptoms induced by Murex was "frequent
need to urinate during the night; urine colourless." Acting
on this hint Dr. Murray Moore gave it* in a case of polyuria,
where the secretion was of this character, with rapidly curative
results.
Murex evidently corresponds both as a medicine and as a
natural product with Sepia. Dr. Dunham points, as a dis-
tinguishing feature, to the deficient catamenia of the latter,
while the Murex patient is generally menorrhagic.
The dilutions from the fourth to the sixth were used in the
cases cured.
I have now to speak of the salts of sodium we use in
homœopathic practice-the carbonate, the chloride, and the
sulphate. It is the old name for sodium-natron or natrum
-which gives it this place in our alphabetical series.
The carbonate of soda,
Natrum carbonicum,
is triturated or dissolved in water for our use.
In the first edition of the Chronic Diseases Hahnemann pub-
lished a pathogenesis of Natrum carbonicum, containing 308
symptoms, which from his preface we may infer to have been
observed in patients taking the third trituration. The salt
was then proved by Nenning and Schreter, and their results
-making 625 in all-appeared in the third volume of the
Arzneimittellehre of Hartlaub and Trinks. No information is
given as to how they were obtained. In the second edition of
the Chronic Diseases Hahnemann incorporated these with his
own, and with some additional observations from three others,
raising the total list to 1,082.
In spite of this extensive pathogenesis, Natrum carbonicum
has found very little employment. Hahnemann says that it
is useful in weakness of the stomach, leading to great dis-
comfort from slight dietetic transgressions. Dr. Bayes has
Monthly Hom. Review, xii., 305.
676
NATRUM MURIATICUM.
found it give relief in subacute inflammatory irritation of the
whole alimentary mucous membrane, from the mouth to the
anus; Dr. Madden thought well of it in deficient menstruation
in adult females; Dr. Lippe commends it in headache from.
exposure to the sun or to gaslight, such as Glonoin benefits;
and Dr. Guernsey in inflammation of the external nose, and
the tendency to the formation of hydatidiform moles.* But
it is hardly mentioned by the systematic writers on homœo-
pathic therapeutics; and to this correspond the conclusions
from recent experimentation that the soda salts, unlike those
of potash, have little specific action upon the system.
I speak of the common preparations of soda, such as the
carbonates and the acetates, which are used as antacids. But
we are transferred into another region when we come to
its combination with hydrochloric acid, the chloride of
sodium, or
Natrum muriaticum.
We prepare this salt in the same way as the carbonate.
Natrum muriaticum has a pathogenesis in the first edition
of the Chronic Diseases, consisting of 897 symptoms. A good
many are supplied by three associates, and of these Hahne-
mann states that they were obtained on healthy persons by
taking globules saturated with the thirtieth dilution. In the
second edition the list has swollen to 1,349; and most of the
additions are from Hahnemann himself, and pretty certainly
(with his earlier contributions) observed on patients taking
the same potency. Natrum muriaticum has also been
thoroughly re-proved by the Austrian Society. Their experi-
ments (in which many persons took part, using both the crude
salt and the attenuations) were published in the fourth volume
of the Esterreichische Zeitschrift, and are amalgamated with
Hahnemann's by Allen.
I wish I could tell you that the results of this exhaustive
re-proving had rewarded the pains of the experimenters.
They are to me rather disappointing. When I have said that
the provers generally became constipated while taking the
* Dr. Jones, commenting on my light esteem of this drug, writes—
"Dr. Hughes may some day get a patient having this symptom-
'Pressing in the abdomen, towards the genitals, as if everything would
protrude, and as if menstruation would appear. Belladonna will miss
fire, Sepia do; and when some good repertory leads him to Natr. carb.,
we trust he will give that remedy in the 200th, and publish the result."
S
NATRUM MURIATICUM.
677
potencies; that the liver was usually somewhat affected, one
prover having much biliary colouring matter in the urine;
that the sexual desire was diminished and (in females) the
menstruation delayed; that a weeping mood was induced in
many; that pains in the thumb and forefinger were common,
and the skin often showed signs of irritation, especially in the
form of herpes labialis-I have summed up the main results
of the proving. It gives us little more than what had been
already elicited as the action of salt from the symptoms ex-
perienced by those who had immoderately used it. These are
a scorbutic degeneration of the blood and tissues; various
eruptions and ulcers upon the skin; polyuria; delay of men-
struation; and in one man genital irritability with its accom-
panying depression.
Nor has physiological experimentation added anything
material to our knowledge. Münch and Plouriez have taken
large quantities of salt for days together, with little effect on
the blood, tissues, or secretions, save that the red corpuscles of
the latter were somewhat increased in number.
Therapeutically, however, Natrum muriaticum holds a very
respectable place in homœopathic practice; though hardly
perhaps answering to Hahnemann's description of it as an
heroic medicine, and one of the most energetic antipsorics.
Like Graphites, the association of constipation and deficient
menstruation are the features which chiefly suggest it; but,
unlike that medicine, there should be much defective nutri-
tion present, showing itself especially in emaciation with dry
and ill-coloured skin. In a case of this kind which came
lately under my care, and where suspicions of organic
abdominal disease were entertained, a few occasional doses
of Natrum muriaticum 30 changed the whole condition, and
initiated a complete recovery. There was much depression
of spirits here; and Dr. Bayes recommends the medicine
strongly in a form of passive hypochondriasis. "There is,”
he writes, "a sort of despairing hopeless feeling about the
future, accompanied by dryness of the mouth, irritable
mucous membrane, often with sore tongue and slight ulcera-
tions, and almost invariably chronic constipation, with hard
stool.'
))*
Save in these chronic morbid conditions, the only use of
Natrum muriaticum which has established itself in homoeo-
pathic practice is in intermittent fever. Wurmb and Caspar
* See Annals, vol. viii., for some cases of constipation reported by
this physician, with irritable mucous membrane, in which the medicine
was strikingly beneficial.
:
678
NATRUM MURIATICUM.
spoke slightingly of it; but Thorer, Neumann, and Hartlaub
found it effective, and an experienced American physician-
Dr. Pearson-writes: "If there be in our Materia Medica
any such thing as a specific for intermittent fever, it is Natrum
muriaticum.”* It is of course in chronic agues especially that
it is so useful, and in the malarial cachexia, when assuming
the features I have already described. But even when the
disease is recent it is reported very effective if the character-
istic symptoms are present. They are thus described by Dr.
Guernsey: "exanthematous spots, looking like large peas, on
the lips; an excessive thirst before and during the chill, no
thirst during the hot stage; in the heat, or at its close, a
headache as though a thousand little hammers were knocking
upon the brain may begin, lasting a long time even after
the perspiration has passed away; the attack comes on in the
fore part of the day; after it passes off, the patient wishes to
retain a recumbent position, does not feel able to get up, or go
about anything." Dr. Mitchell, of the Chicago Homœopathic
College, goes farther still. "The indications for Natrum,"
he writes, "are not always clear. Instead of being a remedy
of feeble power over intermittents, as is asserted by some in
our school, it is one of the most powerful. I formerly re-
garded it as most useful in chronic cases, and after Cinchona,
but more extended experience with it convinces me that it is
equally powerful in recent cases, and those that have not
taken any quinine. Quotidians are most likely to be checked
by it, but it affects tertians favourably in some cases. Pro-
fuse perspiration is a good indication. Thirst during chill is
usually characteristic of Natrum. In this case "-that apropos
of which his remarks were made- "it was not. Time of
chill has not helped me in the selection of Natrum. I have
not been able to verify Bönninghausen's II a.m. indication;
intermittents cured by Natrum have commenced both morn-
ing and evening." Bähr commends it in chronic cases where
the patient has a greyish-yellow look, and the spleen and
liver are very much enlarged.
This reputation of Natrum muriaticum in agues, gained-as
it has been-with the higher dilutions of the drug, is not a
little curious when we remember that salt is one of the febri-
fuges of repute in the old school, of course in substantial
doses. Piorry was a constant advocate of its use; and Dr.
Willemin, in a report to the Board of Trade in Paris of his
experience in the East, says that in Damascus common salt
stopped the fever six times out of every seven; two to four
* United States Med. and Surg. Journal, i., 211.
NATRUM MURIATICUM.
679
doses of half an ounce each being generally sufficient for the
purpose. It was especially useful, he says, in anæmic indi-
viduals.*
Dr. Burnett has recently made a contribution of some value
to our knowledge of Natrum muriaticum in the shape of a
little monograph on the drug, written to illustrate-by its
efficacy-the development of power in substances ordinarily
inert by the Hahnemannian process of trituration. The cases
he relates, while confirming the usefulness of the medicine in
chronic ague, and in conditions of defective nutrition manifest-
ing themselves by ill-coloured skin, constipation, amenorrhoea,
and depression of spirits, add thereto some new spheres of
activity. Such are gouty and rheumatic affections, where
elimination by stool and urine is imperfect; lithiasis and
polyuria, when the other symptoms of the drug are present;
but more especially morbid coldness, either of the whole body
or of its lower half. It is a great thing to have a remedy
which will promote the calorifacient function when depressed;
and this cases 14, 19, 20, 24 and 25 of Dr. Burnett's series
show Natrum muriaticum to be capable of doing.
In his first case he was led to the medicine by the fact
that the neuralgia from which the patient was suffering was
always worse at the seaside. A similar influence of marine
air, but in the direction of amelioration rather than aggrava-
tion, enabled me, not long ago, to cure with Natrum a con-
stipation of some years standing in a little girl. She had
suffered from it since babyhood, her mother told me; and the
only time that improvement had occurred was during a visit to
the sea coast, and for two months afterwards.
The profound influence of Natrum muriaticum on nutrition
and hæmatosis has led Dr. Lilienthal to suggest it as a pro-
mising remedy for such diseases as Addison's, for leucæmia,
and for the cachexia which sometimes accompanies exoph-
thalmic goitre. We have some actual experience with it in
the last-named condition. Dr. Guernsey's symptomatic indi-
cations for it include, besides some of the foregoing pheno-
mena, much headache on waking in the morning, disgust for
bread and longing for salt, contraction of the anus, and sadness
during the menses. Drs. Allen and Norton esteem it highly
in many affections of the eye (Dr. Burnett gives a good case
of strumous ophthalmia cured by it): they especially value it
for the effects of the abuse of caustics. "Sharp pain over the
* See Pereira, fourth edition, in loc.
† Natrum muriaticum; a test of the doctrine of drug dynamiza-
tion.
680
NATRUM SULPHURICUM.
eye on looking down" is said to be characteristic for it; and
in muscular asthenopia they reckon it "one of the most im-
portant remedies we possess, especially if there is a drawing,
stiff sensation in the eyes on moving them."
As analogues of Natrum muriaticum I may mention
Alumina, Graphites, Lycopodium, Plumbum, and Zincum.
((
As regards dose, I may cite the observation of Dr. Watzke,
under whose superintendence the re-proving was carried out:
I am, alas! (I say alas! for I would much rather have
upheld the larger doses which accord with current views)—I
am compelled to declare myself for the higher dilutions. The
physiological experiments made with Natrum muriaticum, as
well as the great majority of the clinical results obtained
therewith, speak decisively and distinctly for these pre-
parations." All subsequent experience points in the same
direction.
Our third preparation of soda is the well-known "Glauber's
salt,"
Natrum sulphuricum.
It is prepared like the others.
Natrum sulphuricum has been proved by Schreter, and by
Nenning. Their results, with all else that is known of the
drug, have been collected by Dr. Hering into one of the
pathogeneses of his Materia Medica. Dr. Allen adds symp-
toms obtained by Lembke.
Dr. Hering's catalogue of symptoms is admirably arranged
for symptomatic prescribing, but is hardly helpful towards
enabling a definite conception to be formed of the special
action of the drug. It seems to cause disturbance of an or-
dinary kind in well-nigh every region of the body. Dr. von
Grauvogl, however, has made a beginning towards defining its
curative sphere. He thinks it one of the most important
remedies for what he calls the "hydrogenoid constitution,"
where the patients are hydræmic, and all their symptoms are
aggravated by damp weather or situations. In such cases a
gonorrhoeal anamnesis is, according to him, nearly always to
be discovered; and he connects the morbid state with the
sycosis of Hahnemann and his contemporaries, and with the
leucemia of Virchow and Bennett. I shall have more to say
on this subject when I come to Thuja, which medicine is
generally used by him in the treatment of such patients. It
NUPHAR LUTEUM.
681
is only given occasionally, however; while Natrum sulphuri-
cum is continued persistently, four or five drops of the third
decimal dilution being taken several times a day.
Dr. von
Grauvogl relates several cases illustrative of this treatment;
and in the twenty-second volume of the British Journal of
Homœopathy you may read a cure of diabetes mellitus by it,
reported by Dr. Ægidi. Here the Natrum was evidently the
efficient agent, as only one dose of Thuja 30-chosen because
of the patient's gonorrhoeal history-was taken.
Previous to von Grauvogl, it had been used in America in
high dilutions for phthisis, chronic diarrhoea, and flatulence
and sciatica, to the last of which its symptoms strikingly point.
It is also said to inflame the lower end of the ileum; and to
have proved curative accordingly in a case of recurrent in-
flammatory colic, where the pain always commenced in the
right groin.
I have nothing further to say of analogous medicines or
dose.
And now a few words in conclusion about a medicine which,
though included by Dr. Hale among his new American reme-
dies, we yet owe to one of our French colleagues. It is the
small-flowered yellow pond-lily-
Nuphar luteum.
The tincture is prepared from the whole plant.
The proving to which I have alluded, by the late Dr. Pitet,
of Paris, is given in Dr. Hale's second edition, with clinical
observations. It was conducted with the medium dilutions.
This proving confirms the ancient reputation of Nuphar as
an anaphrodisiac. It shows also its power to excite a diarrhoea,
which is most troublesome in the early morning. These are
the pathogenetic effects of Nuphar which have led to practical
results. Several cases of morning diarrhea, and of atonic
spermatorrhoea, are reported in Dr. Hale's article in which the
medicine was used with very happy effects.
Agnus castus and Rumex crispus are the two medicines
which, between them, cover the double sphere of action of
Nuphar luteum.
The dilutions from the first to the sixth have been success-
fully used.
1
LECTURE XLV.
NUX VOMICA.
I devote this lecture to a drug whose name will ever be
inseparably associated with homoeopathy,
Nux vomica.
A tincture or triturations are prepared from the seeds of the
fruit of the plant.
We owe the pathogenesis of Nux vomica almost entirely to
Hahnemann himself. Of the 1,300 symptoms ascribed to it
in the third edition of the first volume of the Reine Arznei-
mittellehre, 1,200 are his own; the remainder are chiefly from
authors. Dr. Allen, with numerous cases of poisoning and
other sources of information before him, only gives some 300
more. We have but to add to Hahnemann's observations the
account of the poisonous effects of the drug given by the
ordinary treatises on Materia Medica, of which those of
Pereira and of Trousseau and Pidoux are the best, and we
shall have before us a complete picture of its action on the
healthy. A hardly less complete résumé of its therapeutical
virtues is given by Hartmann, in those Practical Observations
of his to which I have several times referred.
The general physiological action of Nux vomica is on the
spinal cord, or rather on the cranio-spinal axis; for, though
it has no influence on the ideational centres proper, it ob-
viously affects the motor and sensory tracts to their utmost
prolongations. The condition set up by it is one of excite-
ment and excitability. In its first degree it manifests itself
by the patient becoming more susceptible to external impres-
sions, as of light, sound, touch, and variations of temperature.
With this there are tremors and twitchings of the limbs, with
sense of weight and fulness, and some rigidity of the muscles
if attempt is made to put them into action: at this time a
sudden impression on the surface, as a tap on the ham, will
NUX VOMICA.
683
induce a slight convulsive paroxysm. If the action go farther, a
true tetanic condition is induced. The spasms come on from
any exciting cause, however insignificant; or may even arise
spontaneously. In the worst cases they go on to asphyxiate
and kill.
This is in the main Pereira's description. Trousseau and
Pidoux add some important features to the picture. The
spasms, they say, are often preceded by rigors, and sense as of
electric shocks in the sensory nerves. Formication also is
frequently felt, which may go on to intolerable itching, be-
ginning on the head and extending over the whole body.
Vertigo, according to them, is the earliest symptom of the
drug having taken effect.
I have said that these phenomena result from a direct
action of the poison on the cranio-spinal axis. Claude Ber-
nard led us to think that the morbid impression was first
made upon the sensory nerves and carried by them to the
cord, whence it was reflected upon the motor nerves and
muscles. Later experimentation, however, has proved the
primary action to be on the cord; and M. Bernard's facts are
readily explained thereby, without the need of resorting to his
hypothesis. Stimulation of a sentient nerve may give greater
results than occur in health quite as well by increased ex-
citability of the centre as by that of the conducting trunk.
The former will also account for the preternatural acuteness
of the senses noticed in poisoning by this agent, and the
readiness with which the spasms can be excited by any im-
pression on the surface-both which phenomena seemed
strongly to countenance M. Bernard's theory.
The condition set up by Nux vomica in the nervous centres
is described by Todd and Bowman as one of increased
polarity. Drs. Ringer and Murrell,* however, while recognising
its central action, will not allow that this is of an excitant
character. They find similar tetaniform phenomena to occur
in the course of poisoning by substances which are evidently
paralysers of the spinal cord, as Gelsemium and the buxus
sempervirens; and they maintain that they are due to a
diminution or destruction of the resistance of the cord, “so
that an impression conveyed through an afferent nerve can
spread throughout the reflex portion of the central nervous
system and produce tetanus." This is an important thought
in relation to general considerations regarding pharmacodyna-
mics; but it has no practical bearing on our study of the
* See Medico-Chirurgical Transactions for 1876, and Journal of
Anatomy and Physiology, vol. xi.
684
NUX VOMICA.
action of the drug before us. Whatever may be the cause
of such sensory and reflex excitability as culminates in
tetanus, Nux vomica produces it in the healthy and will
remedy it in the sick.
Further, as regards the circulatory disorder induced by Nux
vomica in the nervous centres, it must be said that it is not in
itself inflammatory, as is that of Belladonna; although if the
drug be given when there is a tendency to inflammation, as
when blood has recently been effused, this process may be set
up around the clot. There is, however, decided determina-
tion of blood towards the cord, so that the vessels become
dilated, and even-as van der Kolk has observed-ruptured,
causing effusion here and there. Moreover, probably from
the intense molecular disturbance which is set up, softening of
the nervous centres has been found after death.
I must say a few words about the preternatural acuteness
of the senses caused by Nux vomica. Dr. Anstie, in his
Stimulants and Narcotics, has given some striking instances
of it. It displayed itself in hyperæsthesia of the surface;
photophobia, with flashes of fire before the eyes when looking
towards a bright light, or even in comparative darkness after
each dose of the medicine; and painful sensibility to sound.
Dr. Anstie well shows, however, that there is no increase, but
rather a diminution, of the power of discriminative perception
in these cases,-vision being impaired, and the effects of
sounds being described as deafening.
These toxic phenomena are due to the two alkaloids which
exist in Nux vomica-strychnia and brucia, the latter of
which seems to be a feebler analogue of the former. But the
vomic nut itself has a wider range of action than is mani-
fested here; and this is exhibited by Hahnemann's provings,
to which we will now betake ourselves.
I. Nux has, as I have said, no influence on the ideational
and emotional centres. Illusion, mental aberration, rage, are
unknown in its pathogenesis. The only phenomena of this
kind are of sympathetic character, as anxiety, irascibility,
sullenness, unfitness for mental exertion. But the cerebral
circulation may show decided signs of being affected. In the
first volume of the Annals Dr. Chapman relates the case of
"a chemist who, by way of bravado, took one night three or
four drops of the mother-tincture of Nux vomica. He awoke
early next morning with a feeling as if his head would burst.
He was so giddy that he could neither sit nor stand; he had
rushing sounds in his ears, intolerance of light and sound, and
he could not see. His face was tumid, and he looked be-
NUX VOMICA.
685
sotted, like a man reeling drunk." All these symptoms-the
vertigo, the fulness and headache, and the intoxication-are
reproduced by Hahnemann. The aching occurs most fre-
quently in the occiput. The intoxication has also been ob-
served by Dr. Anstie as a result of the medicinal use of
strychnia. A man who was taking the sixteenth of a grain
three times a day complained that the medicine " made him
drunk;" and, half an hour after his dose, appeared with the
uncertain gait, meaningless smile, and flushed perspiring
cheeks characteristic of intoxication.*
II. Pereira shows that not the voluntary muscles only, but
those also of the alimentary canal, the respiratory organs, and
the urinary system, are affected by Nux vomica. This the
provings entirely confirm. Spasmodic pains and irritable
expulsive actions occur frequently in all these regions. But
there also appear symptoms of irritation of the mucous mem-
branes which are rarely or feebly seen in poisonings, or from
strychnia. The combination of these two actions-in the
moderate degree induced by the doses used for proving-
gives several vivid pictures of dyspepsia and gastralgia. Con-
stipation also is present to a marked degree; and is generally
accompanied with (ineffectual) urging to stool. With this
there is much evidence, alike in liver, in abdomen, and in
rectum, of portal congestion. In the respiratory sphere we
have obstructive nasal catarrh, dry cough, and great constric-
tion of the chest.
III. Trousseau and Pidoux affirm that Nux vomica pro-
duces troublesome erections, and more energetic venereal
desires in both sexes. From Hahnemann it appears that the
catamenia occur too early and too copiously under its use.
IV. His provings also reveal (what is indeed most probable)
that the excitation caused by the drug affects the vascular
nerves and the arteries, causing the febrile phenomena of chill,
heat, and sweat. Modern experimentation has confirmed this
observation, showing that strychnia contracts the arterioles and
greatly increases the blood pressure; and does this by direct
stimulation of the vaso-motor centre at the base of the brain.
I have now to speak of the therapeutical uses of Nux
vomica. Hahnemann found it in use mainly for dysentery
and intermittent fever; and since his time it has been given,.
on antipathic principles, for various forms of paralysis. But
his proving showed that it was in head affections, in dys-
pepsia and other gastric derangements, and in constipation,
that it was to find its chief sphere of usefulness; and in these,
* Stimulants and Narcotics, p. 151.
}
686
and in spasmodic conditions generally, it has played its great
part in homœopathic therapeutics. The knowledge of its
usefulness in dyspepsia and constipation has leaked out into
the other school; and it now constantly finds a place in the
complex prescriptions there dispensed. We shall endeavour
to define its true place and action in these complaints. But
first let us speak of the general characteristics of the cura-
tive operation of Nux.
NUX VOMICA.
These have been plainly put by Hahnemann, and have stood
the test of large experience. It is specially suitable to vigorous
persons, of dry habit, tense fibre, ardent and irascible tem-
perament, and tenacious disposition; to patients addicted to
the use of much wine or coffee and highly seasoned (especially
animal) food, and to those of sedentary habits combined with
considerable mental exertion: lastly, where there is a tendency
to sleep in the evening; to wake from two to four a.m., and to
be kept awake for hours by ideas crowding in upon the mind;
and then to sleep late in the morning. It is an indication for
Nux, moreover, when the symptoms come on or grow worse
at these early hours; also when they are increased by taking
food or by mental exertion. If you desire to follow up still
farther these general characteristics of our drug, you will find
them well put and illustrated in Hartmann's Observations.
English experience has found the city man of business the
typical patient for Nux. His troubles are all nervous and
dyspeptic; and their causes are worry, much mental with too
little bodily exertion, and generally indulgence at his only real
meal, which is a late dinner. Hence headache, sleeplessness,
weight after food with flatulence and heartburn, constipation,
and irritability. Of course Nux will not cure him unless he
studies hygiene more; but it helps him greatly.
M. Teste has called attention to the well-known toxicological
fact, that Nux vomica affects carnivorous animals far more
powerfully than it does the herbivora ; and connects this with
the kind of human constitution on which it manifests its
strongest influence.
We will now discuss the therapeutics of the drug in the
same order in which its pathogenetics have come before us.
I. The striking similarity between the phenomena of
strychnia poisoning and those of tetanus would of course
suggest it on homœopathic principles as a remedy for the dis-
ease. Stillé cites eight instances of traumatic tetanus being
cured by it, all of course of old school origin: the drug was
given in the ordinary fractional doses. We have little re-
corded experience in the treatment of this disease from
NUX VOMICA.
687
homoeopathic sources; but Jahr states that in the insurrection
of 1832 in Paris he treated a case of the traumatic form with
Angustura 30, which soon controlled the convulsions. If he
means the Angustura spuria, this is nothing but Nux vomica
in disguise. However, the facts introduced above are sufficient
to show that the homoeopathic indications deducible from
strychnia poisoning are well warranted. Dr. Bartholow
writes:- "In certain forms of spasm strychnia sometimes
achieves most important results. The evidence which has
been accumulated as to its curative power in tetanus is
certainly very conclusive.”
While thus exquisitely homœopathic to tetanus, Nux would
seem no less perfectly antipathic to paralysis, and upon such
grounds has been largely used in its treatment. There seems
no doubt but that in cases of functional deficiency, whether of
motor or sensory nerves, the local employment of Nux vomica
or strychnia has proved of decided service. Thus in simple
amaurosis, in prolapsus ani, and in the enuresis of the weak
or aged, the hypodermic injection of strychnia in the neigh-
bourhood of the part affected has often been successful. Its
action here may be considered as analogous to that of
galvanism or of will-power, whose exercise has been shown
by Dr. Roth to be so valuable in restoring the tone of para-
lysed parts.* But internal use of the drug as a remedy for
paralysis of central origin has been fraught with disappoint-
ment; and has frequently wrought mischief when the con-
dition of the nervous centres has been one of congestion or
inflammation. Its employment under these circumstances is
therefore now strongly deprecated in the old school: I need
hardly point out that to us the warning becomes an indication,
as far as it goes. Even in the old school they find it bene-
ficial, if only they reduce the dose. Mr. Charles Hunter injects
subcutaneously from one eightieth to one sixtieth of a grain
of strychnia, and states that it removes the sensation of heavi-
ness or weight and the muscular twitchings, spasms, or cramps.
of the paralysed parts. I need hardly remind you how readily
full doses of strychnine excite these spasmodic actions in
palsied limbs. Mr. Barwell objects to its use in cerebral or
spinal paralysis, but we find that he injects from the twentieth
to the twelfth of a grain. So Pereira says that when used
locally for amaurosis it causes sparks to appear before the
eyes, most in the affected one; while Hartmann recommends
it when such sparks trouble the eyes, thinking it a symptom of
cerebral congestion.
See Annals, vol. viii.
688
NUX VOMICA.
II. From what has been said of the action of Nux vomica
on the head, it may be readily conceived that it plays an
important part in affections of this region. I will speak of
three of these-delirium tremens, apoplexy, and headaches.
1. The strong resemblance of the cerebral symptoms of Nux
to the effects of alcohol have led to its use in delirium tremens.
It does not reach this disease when at its height, as Belladonna,
Hyoscyamus, and Stramonium do; but in its forming stage
and during convalescence it is very useful. It is also very
good for the morning vomiting, the trembling hands, and other
nervo-muscular affections of drunkards.
2. The character of the influence of Nux vomica on the
nervous centres, while unfitting it for actual inflammation of
the brain, makes it just the remedy for those congestive states
of the organ which predispose to apoplexy. Even when san-
guineous effusion has taken place, Nux is often the best
medicine to give, unless the state of the local or general cir-
culation is such as to call for Belladonna or Aconite. You will
find these statements well illustrated in the cases of apoplexy
recorded in Dr. Yeldham's Homœopathy in Acute Diseases.
3. Few medicines are more frequently used in headache
than Nux vomica. You will see at once the chief form of the
affection in which it is likely to be advantageous-the head-
ache of strong, plethoric adults, with congestion, giddiness,
flushed face, and constipation, the pain increased by taking
food or by mental exertion. But it is also (in higher dilutions)
curative of such cephalalgiæ as clavus and migraine, where
the constitution suits Nux better than Ignatia. A number of
cases illustrative of its value are collected together in Dr.
Peters' Treatise on Headaches. To the headaches in which we
esteem it Dr. Ringer has added those consisting in heat and
weight at the vertex, whether occurring at the menopausia or
otherwise. Dr. Schrön commends it when the headache
begins with the vertigo spuria of Herz, which Nux causes as
markedly as does Ignatia.
III. I come now to a still more important sphere of the action
of Nux vomica-its influence over the disorders of the ali-
mentary canal. We need here to be discriminating; for the
really great power of Nux in dyspepsia and constipation has
led to its abuse and even discredit. It is no uncommon thing
for homœopathic neophytes to take a pilule of Nux the first
time their evacuations delay, and expect it to act like Aloes
or Colocynth. They fancy, moreover, that it will clean their
coated tongues, and disperse their bilious attacks, and indeed
be a remedy for "indigestion" of all kinds. But the remem-
NUX VOMICA,
689
brance of the physiological action of the drug will save us
from this indiscriminate use. Nux acts here as elsewhere
mainly upon the nerves and muscles. Hence its true place in
gastric disorders. The acute dyspepsia in which it is curative
is that caused by taking indigestible food. There is no par-
ticular mucous disorder; but on the other hand pain, vomit-
ing with much retching, and frequent scanty motions with
colic and urging are present. The chronic dyspepsia of Nux
is essentially the same, but of course presents more variety.
It is one in which the nervous and muscular energy of the
stomach is defective and perverted. The food either causes
pain and less commonly-vomiting, or it lies like a load at
the stomach, oppressing the brain, and soon developing much
flatulence. The tongue is coated at the posterior part_only:
Dr. Bayes thinks this a characteristic sign for Nux. It will
be seen that this is just the dyspepsia of men of business and
intellectual workers, when they perform their tasks with hurry
and worry, and give neither brain nor stomach fair-play. Dr.
Bähr, however, would extend the sphere of Nux to include
chronic gastric catarrh. The taste, both subjective and of
food, is either bitter or sour; and there are eructations of the
same kind. The appetite is gone, yet there is a sensation
of hunger, which even increases to bulimia.
The region
of the stomach is sensitive, especially after a meal, and
generally distended. The pains in the stomach are more
especially a hard pressure, less frequently tearing or crampy
pains." He has here the concurrence of Dr. Ringer, who
esteems the drug highly in those catarrhal states of the
stomach which so often complicate organic disease elsewhere,
and also-from the homoeopathic side-of Dr. Jousset. This
excellent writer, who touches no subject without illuminating
it, has published in his Leçons Cliniques (xvii.) two striking
cases of chronic gastritis cured by the drug in rare doses of a
high dilution. The sub-mucous tissue about the pylorus seems to
have been involved, so that thickening and obstruction occurred
here, leading to dilatation of the stomach and copious vomit-
ing. I have myself great reliance on the drug under such
circumstances. In his comments Dr. Jousset characterises
the three leading affections of the stomach, gastritis, dyspepsia,
and gastralgia; and shows that Nux is the leading remedy
for them all. It is the principal stomach medicine. In
gastralgia I need hardly demonstrate its fitness, when the pain
is spasmodic rather than neuralgic. You will find records of
many cases treated by it in Hempel, and in the eleventh volume
of the British Journal of Homœopathy.
2 Y
690
NUX VOMICA.
This is one of the affections in which our brethren of the
old school are not unwilling to take a leaf out of our book.
Dr. Anstie recommended the hypodermic injection of strychnia
in doses of one hundred-and-twentieth of a grain to relieve
the pain of cardialgia, saying that he knew no such remedy
for it as this.
There are thus very few painful non-organic affections of
the stomach which may not be helped by this precious me-
dicine. The same virtues display themselves in the intestines.
It is quite homoeopathic to spasmodic colic from flatulence;
but other medicines-as Colocynth and Cocculus-are more
frequently used. Constipation is a well-known indication for
Nux vomica in complex cases. As an idiopathic affection,
moreover, it frequently requires this remedy. You may think
that the use of Nux must be antipathic here, as constipation.
means atony of the intestines, and Nux is excitant and not
depressant thereto. The therapeutists of the old school re-
commend it on these grounds. But I must point out that
constipation by no means always depends upon atony of the
intestines. Schroeder van der Kolk states that "long ex-
perience and a great number of post-mortem examinations
have satisfactorily proved to him that chronic constipation is
almost always dependent on constrictions in the descending
colon." And of the Nux constipation Dr. Carroll Dunham
well says,
* "this medicine does not diminish the action of the
intestine. It rather increases it, but at the same time renders
it inharmonious and spasmodic-a hindrance, therefore, and
not a help to evacuation. This is the reason why the consti-
pation characteristic of Nux vomica is accompanied by fre-
quent ineffectual desire for stool-the action of the intestine
being irregular and spasmodic, and the constipation resulting
from the irregularity of action, and not from inaction." It is
probably in a similar way that Nux occasionally relieves ileus,
and incarcerated, or even strangulated hernia. Dr. Imbert-
Gourbeyre has studied the subject in l'Art Médical for 1860;
and numerous illustrations of this property of the drug
exist in homœopathic literature-Trousseau and Pidoux them-
selves admitting that the claim has been substantiated.
Probably also the benefit occasionally obtained from this
medicine in dysentery is due to its control over the tormina
and tenesmus-which are nervo-muscular-rather than from
any action on the mucous membrane. There is a form of
diarrhoea, moreover, in which the undoubted usefulness of
Nux seems explicable in this way. It is where artificial food
* Amer. Hom. Review, vi., 154.
NUX VOMICA.
691
disagrees with infants so far as to cause vomiting and purg-
ing, but without setting up actual gastro-enteritis. Here I
suppose the same irritable state of fibre to be present which
in the adult induces constrictions which impede free evacua-
tion; but in this case it leads to impatience and frequent
emptying of the intestinal canal. Dr. Guernsey regards the
muscular irritability of the rectum of which I have been speak-
ing as a “key-note" for the choice of Nux in affections of its
neighbour, the uterus.
The action of Nux upon the portal circulation has been
largely used in the school of Hahnemann. I cannot go so far
as Bähr, who thinks that the drug has a more specific relation
to the liver than to the stomach; but its hepatic influence is
undoubted. In recent hyperæmia of this organ; in general
abdominal plethora; and in hæmorrhoids, large and blind,
hence resulting--Nux is an excellent remedy. In the two
latter affections it is much aided by Sulphur.
In disorders of the respiratory organs Nux vomica plays
a much less important part than in those of the alimentary
canal. It is very good, however, for dry coryza-the so-called
stuffy cold;" and for violent coughs, with little or no ex-
pectoration, jarring the head, and straining the abdominal
muscles. Nux is obviously homoeopathic to spasmodic asthma;
and frequently plays an important part in its treatment.
There is a brilliant case on record treated by Hahnemann in
his early days, which teaches us that the medicine need not
be used in infinitesimal doses for this malady at any rate.
You may read it in his Lesser Writings. Dr. Kidd, also,
states that he considers Nux our best anti-asthmatic. I
think it best suited to purely spasmodic cases, where there is
no bronchial lesion, but a standing reflex excitability of the
pneumogastric to impressions made from without or through
the stomach. I prefer here the lowest triturations.
((
Still less frequently is Nux vomica required when the
urinary organs are affected. Its only uses here with which I
am acquainted are for the irritable bladder of gout or al-
coholism, and to relieve pain and spasm in the passage of
urinary calculi.
The stimulant action of Nux upon the sexual organs has
naturally led to its being employed in impotence; but the
success seems rarely to have been more than temporary.
With us it is much esteemed in irritable conditions of the
male genital organs, whether primary or left behind by excess
or masturbation, when the other symptoms correspond and
the general characteristics are present. In the female sphere
692
NUX VOMICA.
we find Hahnemann recommending it for the evils caused by
too frequent and too copious periods. Its influence here
reaches even as far as metritis. Hartmann writes: "Nux is a
very admirable remedy in inflammation of the womb, and its
virtues in this complaint are lauded by many experienced
homœopathists, with whom I must join myself. Whether
the metritis has occurred in the unimpregnated uterus, or
during gestation, or after delivery, it matters not; and just
as little influence has the particular part of the womb which
is affected." This would hardly be expected à priori; but I
must say that in two cases of metritis after parturition which
I have had under my care, the effects of Nux were astound-
ing. Dr. Lawrence Newton communicates a similar ex-
perience, and Dr. Guernsey regards the remedy as "very
frequently indicated."
-
*
The ancient repute of Nux vomica in ague has been fairly
sustained in the school of Hahnemann. Its special indi-
cations are of course the accompanying gastro-intestinal
symptoms; though it is said that the paroxysm itself points to
it when the heat precedes or mingles with the chill. Both
Wurmb and Caspar and Dr. Lord place it high among the
remedies required in actual practice; and my own experience
concurs with that of Fleischmann and Russell in thinking
that Nux and Ipecacuanha in alternation most frequently
control the impure intermittents which come under our treat-
ment in non-aguish districts. In his Lesser Writings Hahne-
mann describes such a fever as epidemic in Germany in 1809,
and points to Nux and Arsenic as homoeopathic to and curative
of its only varieties.
There are, of course, numerous other applications of Nux
vomica. You will always think of it when hyperesthesia,
irritability, or spasm is present; when the patient presents
the constitution characteristic of it; and when his troubles
own the causes and experience the aggravations I have men-
tioned. Thus you will often be led to it in hypochondriasis
and spinal irritation; and it will sometimes serve you well in
photophobia, in alcoholic amblyopia, and in the vomiting of
pregnancy. Stillé acknowledges its usefulness in this last
affection "in very minute doses."
-
I will conclude by citing from Hartmann a typical case for
the application of the medicine :-
"Mad. B-, some thirty years old, who had suffered for many years
with a troublesome and distressing cough, lost her cough suddenly with-
* Brit. Journ. of Hom., xxviii., 245.
† p. 628.
+
NUX VOMICA.
693
out any cause; instead of the cough, she was afflicted with a constant
pressure, which sometimes became a griping, in the gastric region,
which was aggravated after every meal, and after drinking coffee be-
came so much exacerbated, that she was obliged to sit completely bent
over. She was at the same time afflicted with constriction and op-
pression of the chest, and could only make a short inspiration, with
which a partial hiccough was always conjoined. Water-brash oc-
curred frequently during the day: inappetence: alvine evacuations
hard, occurring every third or fourth day. She had suffered from this
complaint for full two years. I regulated her diet, and cured her entirely
in four weeks by the administration of two doses of Nux vomica.*
After this she could eat with impunity; she could even occasionally
indulge in coffee, without reproducing her complaint; but she dared
not make it her daily drink."
Ignatia-through its common possession of strychnia—and
Opium through its morphia and thebaia are the only true
spinal analogues of Nux vomica; unless we except Atropia.
The tetanising action of Aconite, of Cicuta, and of Hydro-
cyanic acid is not so connected with increased reflex excita-
bility. Bryonia acts most like Nux on the alimentary and
respiratory organs, though stopping short of its spasmodic
phenomena.
As regards dose, I must express my conviction that the full
virtues of this medicine can only be obtained by a free use of
all degrees of the scale of attenuation, from the mother-tincture
or lowest triturations to the thirtieth dilution. The repute
it has obtained in the old school, Hahnemann's case of
asthma, and those of gastralgia cited by Hempel from Kopp's
Memorabilia, show what it can do in substantial doses. On
the other hand, all the earlier and many of the later homœo-
pathic cures wrought by Nux, which have given it such a
high place among our remedies, which make Hahnemann
speak of it as "a polychrest most cherished and precious,"
were effected by the attenuations from 9 to 30, and mainly
by the latter. My own experience makes me as fond of the
thirtieth dilution as of the first decimal trituration, and I
should not like to be without either in their proper places.
A word in conclusion about the chief alkaloid of Nux
vomica,
Strychnia.-Mr. Henry Robinson has enriched the Materia
Medica with two heroic provings of the liquor strychniæ, the
one prover being a man, the other a woman. Besides the
spasms, or attempts at spasm, which might have been ex-
-
A similar case of chronic dyspepsia and constipation, with hæmor-
rhoids, cured with marvellous rapidity with Nux, is recorded by Dr.
Chepmell (Op. cit., p. 97).
694
pected (these were especially sudden, severe, and painful in
the rectum), several other symptoms were produced. The
male prover became prostrated with a fever, which is compared
to the adynamic intermittents of India; and, as this passed
over, great irritation of the urinary organs set in, culminating
in an attack of inflammation of the left testicle and cord, and
an abscess in the cellular tissue of the scrotum. We note
also continual full and bursting headache, with heat in the
eyes; icy sensation all down the spine; explosive cough;
intense itching of the skin of the whole body, but especially of
the nose; and sharp attacks of toothache, especially in the
upper teeth. You will find the record of these provings in
the twelfth and thirteenth volumes of the Monthly Homœo-
pathic Review. Dr. Allen adds to their symptoms others ob-
tained from cases of poisoning, giving a pathogenesis of 1,235
in all.
NUX VOMICA.
As Strychnia contains, in its most concentrated form, the
spasm-causing property of Nux vomica, it seems obvious to
use it as a homoeopathic remedy for such conditions. I have
done so occasionally in the treatment of spasmodic asthma,
and should adopt the same course in tetanus. Dr. Ringer re-
cords a case of the "athetosis" of Hammond greatly benefited
by minim doses of liquor strychniæ, while aggravated by
hypodermic injections of gr. too of the drug. Liquor
strychniæ contains one part in 120. These are examples of
pure spasm. But in the more complex forms of disease in
which Nux is so beneficial, as in gastro-intestinal disorders,
I think we should suffer loss by substituting strychnia.
15
40
Dr. Walter Tyrrell, of Great Malvern, has published a series
of cases of epilepsy, in which the curative effects of strychnia
were not a little remarkable. He thinks that "its value lies
in the effect it has in deadening that condition of exalted sen-
sibility and activity of the medulla oblongata, which most
recent authors consider to be the predisposing cause of the
disease." If it does this, it must be by homoeopathic action;
and so indeed Dr. Tyrrell admits. His success, as reported by
himself, is something marvellous: and the subject may repay
investigation. His doses are those usual in the old school.
LECTURE XLVI.
NUX MOSCHATA, ENANTHE, OLEANDER, OPIUM.
I have yet another Nux to speak of—the nutmeg, called in
the ordinary pharmacology Myristica, but by us
Nux moschata.
The homœopathic preparation is a tincture made from the
nuts with rectified spirit.
Nux moschata was fully proved about 1833 upon twelve
male and nine female subjects, by Dr. C. J. Helbig, who also
experimented upon himself. The results obtained were pub-
lished in a monograph, entitled "Heraklides," which contained
also a compendium of all that had been said about the drug
in previous literature. In the first volume of the Révue de la
Matière Médicale specifique, Dr. Roth has translated the prov-
ing, arranging the symptoms under the head of their subjects,
and also some of the cases of poisoning. Lastly, in his volume
of Materia Medica (1873), Dr. Hering has made an exhaus-
tive compilation of Helbig's and all later materials for the
knowledge of the effects, pathogenetic and curative, of the
drug. Allen's pathogenesis is based upon Hering's; it con-
tains 571 symptoms.
Nutmegs are classed among the "narcotics;" but their nar-
cosis is of a very distinctive character. Schmidius (1683)
relates the case of a nobleman, aged 36, in whom four nut-
megs seemed completely to overwhelm the nervous system.
He remained in a state of coma vigil for three days, on emerg-
ing from which his memory was entirely lost. Continued
fever supervened, with insomnia and palpitation; and at
length paralysis of all the limbs. Reason and recollection did
not fully return till the expiration of eight days. This is an
extreme case; but Cullen relates a similar one of shorter
duration. In the latter, and in some other instances, delirium
succeeded the sopor. Upon Purkinje the effects were very
like those of Cannabis Indica,-the perception of time and
distance being impaired in the direction of exaggeration.
C
696
ENANTHE CROCATA.
Looking over Hering's collection of symptoms, one is struck
by (besides the foregoing phenomena) loss of memory; great
tendency to laughter; headache with drowsiness, or sense of
looseness in the brain; rush of blood to the head; everything
looking large and red; chalky taste; dryness of mouth and
throat without thirst (Guernsey considers this a key-note of
the drug); sensation as if something grasped the heart; and
pain in the shins as if the bone were smashed. To these I can
add two curious sensations of a patient of my own after eating
one nutmeg. These are objects seem gradually to diminish
in size while looking at them; sense of coldness and empti-
ness under the heart, with distension.
(C
The ordinary modern uses of Nux moschata are contained
in Pereira's words: "Medicinally, nutmegs are used, like other
spices, as stimulants and carminatives." The latter action
seems to be of a specific nature, as the medicine is in increas-
ing repute in the homoeopathic school in the dilutions from
the first centesimal upwards for flatulent dyspepsia. Where
everything turns to wind," as the patients express it; where
there is great bloating of the stomach, oppressing the heart
and lungs, and causing pain behind the sternum; where only
high-seasoned food can be digested; and in hiccough, Nux
moschata is an excellent remedy. It is specially useful in
nervous subjects, as hysterical and pregnant women; and
where unpleasant mental emotions will bring on the flatulence.
The other uses of the medicine have hardly yet been defined;
but since it became a favourite one of Hahnemann's during
his later practice at Paris, it must be borne in mind and con-
sulted as having latent possibilities. Dr. Helbig considers
women and children the most suitable subjects for it: and
that it is indicated where drowsiness or disposition to faint-
ing are present; where the skin is cool and dry, and not
inclined to sweat; and where there is aggravation from cool
moist air, and amelioration from external warmth. Teste
recommends it in retrocession of gout to the stomach.
Allied medicines are Moschus, Asafœtida, and Ambra.
Helbig employed the second dilution mainly. Hahnemann
would probably have given it in higher potency.
I have next to speak of the "hemlock water dropwort,"
Enanthe crocata.
The root is the most active part, and our Pharmacopoeia
directs a tincture to be prepared from it with proof-spirit.
OLEANDER.
697
We know Enanthe only by the poisonings of which it has
been the agent (seventy-two of which are collated by Allen),
and by a few experiments made with it upon animals. It is
one of the group of umbelliferæ to which thusa and Cicuta
belong, and is, as Christison justly says, the most energetic
member of the series. Its special interest to us lies in the
fact that the phenomena of its toxical effects resemble epi-
lepsy more nearly than do those of its fellows. Dr. Bloc, a
pupil of Dr. Imbert-Gourbeyre's, has lately made a study of
the plant from this point of view, an account of which you
will find in the thirty-second volume of the British Journal of
Homœopathy. His experiments on animals entirely confirm
the analogy suggested by the records of poisoning, and show
material changes (inflammation and softening) at the central
seat of the malady, the medulla oblongata and its neighbour-
hood.
We may, therefore, expect to find a place for Enanthe
among our remedies for convulsions of the epileptic type.
Whether it will prove of service in genuine epilepsy, save when
quite recent, is doubtful. Dr. Drysdale has wisely pointed
out that agents curative of this malady are hardly to be looked
for among those which provoke similar paroxysms in acute
poisoning by them; we have to combat the persistent proxi-
mate cause with medicines of firmer grip and longer action.
Dr. Oehme has probably better applied Enanthe for the pur-
pose of checking the epileptiform convulsions of childhood
and pregnancy, in which he has found it very effective.* He
gives the third dilution.
I will now occupy you for a few minutes with the laurel
rose, Nerium
Oleander.
The tincture is prepared from the fresh leaves.
There is a pathogenesis of Oleander in the first volume of
the Reine Arzneimittellehre, containing 342 symptoms from
Hahnemann and five others, and 10 from authors. Allen adds
several fresh observations.
Oleander seems to be a narcotic of moderate intensity, and
also a heart-poison like Digitalis. Hahnemann claims to be
the first to introduce it into medicine, and, if he means in
modern times, he is justified in so doing; but Galen used it.
Hahnemann thinks it likely to be useful "in certain kinds of
*New England Med. Gazette, June, 1877.
698
OPIUM.
mental alienation, as distraction (Zerstreutheit); in some pain-
less paralyses; and in eruptions on the head and other affec-
tions of the hairy scalp." The drug seems certainly to have
an elective affinity for the skin. "The skin of the body is very
sensitive all over it becomes sore, raw, and painful, merely
by the friction of the clothes: for example, the skin of the
neck becomes so from the rubbing of the cravat, that of the
thighs from the rubbing of wide trousers when walking." And
again, "Forty hours after taking the dose, gnawing itching, as
of an eruption over the whole body, while undressing." The
scalp seemed to be a special seat of this sensation. Noack
and Trinks say that Oleander has been found useful in "erup-
tions on the hairy scalp; at times scaly, at times humid,
with burning itching." An excellent illustration of its power
in such affections is related by Dr. A. R. Morgan, of Syracuse,
in the fourth volume of the Transactions of the New York
State Homœopathic Society (p. 332). Symptoms 122 and
123 are: "The power of speech is almost entirely lost, the
breathing being natural. She attempted to answer when
questioned, but she was only able to utter sounds, but no in-
telligible words." They are taken from a narrative of poison-
ing with the plant by Morgagni; and have led to its recom-
mendation for paralysis of the tongue. As I read the original,
however, they merely express the extreme debility of the
patient. From sympt. 189 Hartmann suggests it for lienteria.
If China and Ferrum ever fail you in this disorder, Oleander
might be worth a trial.
I can tell you nothing about allied medicines or doses, save
that Hahnemann recommends the sixth dilution.
C
Our chief subject to-day is a drug which stands at the head
of the list of the medicines of the old school, but occupies
only a second-rate position in ours,
Opium.
A tincture prepared in the usual manner, or triturations, are
recommended by Hahnemann, and used in our practice.
There is a pathogenesis of Opium in the first volume of the
Reine Arzneimittellehre. Of its 662 symptoms, 144 only are
from provings on the healthy; the remaining four-fifths being
taken from authors. The examination which Dr. Langheinz
has instituted into a good many of these last shows them to
be of very dubious purity, either as regards the mode in which
OPIUM.
699
the drug was given or the subjects of its influence; and the
investigations by which I have completed his have led me to
the same results. Hahnemann indeed depreciates them him-
self, saying that they are mostly secondary effects, and there-
fore (according to his view) not available for homoeopathic
application. But to add to his own and his (four) fellow-
observers' symptoms we have two excellent provings of Opium
I in small but substantial doses. The one is by Professor Jörg
and twenty of his pupils; the other by Dr. Eidherr, of Vienna,
in which ten persons besides himself took part. The full
record of the latter is given in the first volume of the Journal
of the Austrian Homoeopathic Society: its schema of results
is translated in the twenty-second volume of the British Jour-
nal of Homœopathy. Dr. Allen, combining the symptoms
from these sources, adds others from numerous fresh ones, so
that his authorities are 350 in number, and his symptoms
nearly 2,300.
Opium is, as you well know, a substance of very complex
constitution. It contains a number of alkaloids-morphia,
narceia, meconia, cryptopia, codeia, thebaia, and others-
each of which has its own distinctive action. The effect of
Opium is the result of the composition of the forces of these
several ingredients. But, being so, it is for us the fact with
which we have to deal. Opium is the form in which its con-
stituents are given us in nature: as a single substance it has
been proved on the healthy and tested on the sick. It thus
becomes a medicine per se. So far as the pathogenetic effects
of any of its ingredients are known, so far they too can be
used therapeutically. But they cannot replace Opium, nor
Opium them. Of one or two of their number I shall have to
speak subsequently; but our concern just now is with Opium
itself as a whole.
Hahnemann says of Opium that its effects are more difficult
to appreciate than those of most other medicines; and so sub-
sequent observers have found. Its action is as complex as its
composition, and it has not been easy to unravel it. Various
theories have been formed to account for the phenomena-as
that the drug is stimulant to some parts of the nervous system,
but depressant to others; that it stimulates at first, but nar-
cotises afterwards; that it is a stimulant in a moderate dose,
but a narcotic in a large one. None of these explanations has
ever satisfied my own mind; and at various times during the
last twenty years* my attention has been directed to the sub-
ject with the hope of penetrating its mystery. I think I am
* See London Medical Review, 1860; Brit. Fourn. of Hom., xxii.
700
OPIUM.
clearer about it now than ever I was before: at any rate, you
shall have my most mature thoughts on the matter. In giving
you them, however, I must beg you to accept them quantum
valeant, and simply as the expression of my own judgment.
That they are not shared by all my colleagues sufficiently
appears from the rather severe criticism they received, when
first published in extenso, in the Monthly Homeopathic Review.
The objections there raised I shall have before me while speak-
ing to you to-day; and you can hardly do better than refer to
them subsequently in aid of your own conclusions. You will
find the criticisms in question in the July and October num-
bers of the volume for 1876.
The facts are these. Taken in a moderate dose, Opium
seems to act as a stimulant. This effect is especially felt in
depressed and chilly conditions of the body, as in hunger and
catarrh as described by Dr. Anstie,* or in the physical and
mental wretchedness which often makes the poor resort to it,
and which—occurring as a secondary result of its intoxication
-drives the habitual opium-eater to "take a hair of the dog
that bit him." There are some, however, who can induce the
apparently stimulant effects of Opium in their ordinary con-
dition of body. But larger doses are here required, and some
approach to narcosis is often seen in the ending of the excite-
ment in a comatose sleep.
B
Again, even when taken in quantities large enough to pro-
duce undoubtedly poisonous effects, Opium seems to excite
some parts of the nervous centres. Hahnemann observes that
it exalts the irritability of the voluntary muscles, and stirs
imagination and courage; and under these two heads the
phenomena of what may be called its poisonous excitation
may be classed. In the first division we have the observa-
tions, multiplying upon us of late, that in the lower animals
and in the young human subject Opium is very apt to cause
convulsions, sometimes of a clonic but quite as often of a true
tetanic character. For the exaltation of the imaginative
powers which it may cause we need not go beyond the "Con-
fessions" of De Quincey; and as to the emotions generally,
it is well known that Orientals use Opium as the Western
nations use alcohol, to spur flagging courage and excite
desire.
On the other hand, it is confessed by all that the full effect
of Opium is pure narcosis-that is, depression and paralysis
of the whole functional activity of the nervous system. The
sensory nerves may first lose their power, and dull aching
*Stimulants and Narcotics.
OPIUM.
701
1
""
pains may accompany the process.
But the brain itself soon
shows it, first-it may be-in a low muttering delirium, but
then in the supervention of that condition which at its height
is called "coma.' Coma is no intensification of natural sleep.
It is not sleep at all, but a stupor; from which the patient
may for a time be readily roused, going off again directly, but
which ultimately deepens into entire unconsciousness. With
these conditions of sensation and ideation, the motor powers
are equally abolished: the respiration also becomes weaker,
and the heart's action slow, until finally death ensues from
the failure of the former function.
The difficulty is to account for the phenomena of stimula-
tion which appear here and there in the action of a drug so
unquestionably narcotic. Now of those which show them-
selves in the motor, imaginative, and emotional spheres, Dr.
Anstie-who in his treatise on Stimulants and Narcotics has
contributed so much thought and observation to this subject
-gives, I think, a satisfactory explanation. He shows (what
Hahnemann had noticed before him) that while the fancies
and desires are aroused, the higher faculties of the mind are
already dulled. He points out that in the normal state of
being we keep down the animal within us; but that in intoxi-
cation—whether with Opium or alcohol-our powers of con-
trol are relaxed, and the lower nature asserts itself loudly ere
it too yields to the narcotic influence. This is confessedly
true as regards alcohol, and it is an easy step to apply it to
Opium. Again, Dr. Anstie argues that it is quite unjustifiable
to assume that convulsion is an evidence of exalted motor
energy. It may mean its irregular distribution and fitful
discharge; it may imply an unbalanced activity from with-
drawal of the control of the higher centres or a diminished
resistance to reflex excitation; but in none of these cases is
any exalted functional vigour present.
But I would now go a step farther than Dr. Anstie, though
in the same direction. The apparent stimulation wrought by
large doses, he maintains, is really paralysis of some parts of
the nervous centres allowing undue manifestation of the rest.
I think that the same explanation will account for the appa-
rent stimulation (as of the mental and muscular powers)
wrought by small doses, which in his eyes is a real one. It is
to me inconceivable that a substance which in moderate quan-
tity excites any function should in a somewhat larger one
depress it.* I know well how this may be when the dose is
an overwhelming one—as in the analogous case of an over-
* See the discussion on this subject in Lecture v.
·
702
OPIUM.
*
strong galvanic current. But the question here is of the
different effect of half a grain of morphia and of two grains.
No sudden shattering destruction of vital energy can be
ascribed to the latter dose; yet we are asked to believe that
its influence is paralysing while that of the former is stimu-
lating. I cannot think it; and as there is no doubt about the
paralysis, I question the stimulation. That is, I question
whether the phenomena of stimulation (whose existence I have
fully admitted) are due to a direct influence of this kind
exerted by Opium on the organs which manifest them.
What part of the nervous system, then, is there whose
depressed activity will account for excitement elsewhere?
answer the sympathetic. There is an apparent antagonism
and contradiction between the nerves of this order and those
of the cerebro-spinal class which accounts for many phenomena
of drug-action and of disease. If we stimulate a sympathetic
ganglion, the nerves animated by it cause the arteries they
supply to contract. Less blood accordingly flows through the
corresponding part of the body: it becomes cold, pale, and
shrunken, and its nervous, muscular, and secretory activity is
diminished. If, on the contrary, we divide the vascular nerves
of any organ, precisely the opposite results occur. Its circula-
tion is increased, and its functional energy for the time
exalted, or, at any rate, more rapidly expended. If, therefore,
a depressing agent makes its influence first felt in the sympa-
thetic system, its earliest phenomena will be those of appa-
rent stimulation, from the increased flow of blood thereby
allowed.
That Opium does depress the sympathetic from the very
beginning of its action I hold to be proved from a number of
consentaneous phenomena, which we have not yet taken
into account. Among these we have that diminished irritability
of the involuntary (non-striated) muscles which Hahnemann
noted as co-existing with excitement of the voluntary set.
Constipation of the torpid kind is the well-known effect of
opiates; and Trousseau and Pidoux have called attention to
the corresponding condition-sluggish and therefore difficult
excretion—as induced in the bladder. Their careful observa-
tions, moreover, confirm the diaphoretic action of the drug,
and show that the perspiring skin is also hot and flushed,
which it would be from vaso-motor depression. The hot skin
of Belladonna, which we have ascribed to tissue-irritation, is
* I mention these quanties because they were those taken by Dr. Anstie
in his experiments on himself. A smaller maximum of dose would
doubtless be safer for any one who sought to repeat them.
OPIUM.
703
dry, as in scarlatina. In the face the same condition is shown
by flushing, in the head by heaviness, giddiness, and somno-
lency, and in the eyes by injection of the conjunctiva and (as
ophthalmoscopic investigation has shown) of the retina. But
in this last region a phenomenon occurs which is yet more
significant, and which alone seems to me a key to the whole
condition.
I refer to the contraction of the pupil, so characteristic of
Opium poisoning. It is, as Dr. Harley says, " in man the most
constant of all the effects of Opium, and comes on in ten or
fifteen minutes after the subcutaneous use of the drug. It
occurs independently of hypnosis." What is its explanation?
Of late years the tendency of opinion has been to regard it as
due to stimulation of the third nerve: this view is maintained
by Harley, Ringer, and Wood. I am, however, quite unable
to assent to it; and must still maintain the position I took up
in 1860, that it is the result of sympathetic depression. The
difficulty which would arise from the continuance of the firm
contraction even after the third nerve must itself have lost its
energy is removed by the later researches into the structure of
the iris, which have shown it to be more an erectile than a
muscular organ. Thus the contraction induced by division or
depression of the sympathetic is due to iridal congestion as
much as to unbalanced activity of its circular fibres, and
answers to the small pupil of plethora or apoplexy. With
this accords the observation of Dr. Anstie, that shortly before
death from Opium-poisoning the pupils dilate. The vessels
are now emptied here as all over the surface, which is pale
instead of flushed as heretofore.
Let us now, with this thought in our minds, read a few
instances and descriptions of the early effects of Opium, and
see if it will not explain them, and harmonise them with the
well known phenomena which follow.
First, let Dr. Harley relate the results of injecting one sixth
of a grain of morphia behind the trochanter of a patient
suffering from sciatica. After ten minutes," he writes,
"there was giddiness and somnolency, and she fell asleep.
On waking an hour after she complained of being very giddy,
and said that everything was running round. The cheeks and
forehead were hot and flushed, the hands hot; she felt hot
all over. The pulse was increased in volume and power. The
pupils had contracted from to of an inch out of the
1/c
light; an hour later they were. The tongue was clean and
6
wet."
Next let us take Dr. Phillips' description of opiate poison-
704
OPIUM.
ing. "When the quantity is very large, and the form such as
to permit rapid absorption of the whole, the course of symptoms
is as follows: the patient, if an adult, quickly becomes con-
scious of a sense of fulness in the head, which seems to
commence in the nape of the neck, and to spread therefrom;
and in the course of a few minutes feels great and increasing
drowsiness, and a sensation of general heat, which increases
to an almost intolerable degree, and is then accompanied by
sweating."
Passing now from health towards disease, we have Dr.
Anstie's graphic description of the effect of a small dose of
Opium upon himself when suffering from hunger or catarrh,
to which I have already referred. In both these cases the
surface is chilly, the arterioles are contracted; and he notices
especially the pleasant feeling of warmth which spread over
his body as the drug began to take effect. Again, let us look
at a patient in the first stage of the paroxysm of ague. The
skin is pale, cold, and dry; the circulation and respiration
quick and feeble; the pupils dilated: everythings shows vaso-
motor excitation. When in this condition, says Sir Thomas
Watson, a full dose of laudanum was given (by Dr. Trotter),
in most cases after a few minutes an exhilaration of spirits
was perceived: the pulse from being weak, quick, and some-
times irregular, became full, less frequent, and equal; an
agreeable warmth was diffused over the whole frame, and
every unpleasant feeling vanished, sometimes in a quarter of
an hour. The patients were themselves surprised at the sudden
change in their sensations." Similar results have since been
obtained (and even more rapidly) by inhalation of nitrite of
amyl, which confessedly acts by relaxing the arterioles.
Lastly, I may mention one of the facts most frequently
brought to light in the experiments conducted under the
superintendence of Dr. Hughes Bennett to inquire into the
antidotal action of meconate of morphia and sulphate of
atropia.* It was that vessels turgid with blood under the
influence of the former contracted considerably when the latter
was administered; and we have already seen that atropia,
which characteristically dilates the pupil, is excitant to the
sympathetic. Experimentation with morphia on animals has
not always yielded consistent results; but from its latest in-
stance that of Picard and Rebatel-I find that similar con-
clusions have been drawn, viz.: that morphia contracts the
pupils and dilates the small vessels by sympathetic paresis.
* See Researches into the Antagonism of Medicines (Churchill),
1875.
OPIUM.
705
I think, then, we may fairly conclude that Opium is through-
out its action a direct paralyser of the nervous system, and
that the apparent stimulation present during its earlier effects.
is due to the removal of the restraint exercised on the
circulation by the vascular nerves. It is a phenomenon
analogous to those observed in the face when the cervical
sympathetic is divided, and to those which occur in the body
generally when the ganglionic centres are depressed by
ice-bags applied to the spine. We thus bring the whole action
of the drug under one uniform and intelligible description,
and this without any "obscuration," "ignoring," or "explain-
ing away" of the facts. I use these terms because they have
been freely applied to what I have written about Opium by
my Monthly Homeopathic reviewer. You will bear me witness
that I have not questioned the fact that the first effect of a
moderate dose of Opium is often cerebral excitement. My
difference with my critic begins when I come to the explana-
tion of this excitement. He assumes that it can only be
produced by a stimulant action of the drug upon the gray
matter of the brain. I have pointed out another way of
accounting for it, viz., by supposing a heightened cerebral
circulation to be present through depression of the inhibitory
influence of the vaso-motor nerves of the organ. I have
argued that all the consentaneous phenomena show such a
condition to exist, and to be so brought about, and that thus
the cerebral excitement produced under some circumstances
by Opium is of a piece with the rest of its operation, and needs
no supposition of a reverse action of large and small doses to
account for it.
Enough has been said on this score, and we have only now
to consider the meaning of the changes in the respiratory and
cardiac movements induced by the drug; and to have brought
before our minds the epiphenomena of its intoxication.
I. Opium kills, as we have seen, by suspending the respira-
tion. The movements of the chest begin to slacken soon after
its poisonous influence is established: breathing then becomes
diaphragmatic only; it is slow, sighing, and irregular, and at
last stops. All this is easily accounted for by the gradual
paralysis induced by the drug, first in the sensory excitants of
respiration, and then in the motor agents of the process; later,
too, the breathing is affected by the congestive coma of the
brain, as it is in apoplexy. The pulse is affected earlier still,
viz., in the so-called stimulant stage of opiate action; it is then
full, somewhat quickened, and stronger. But it falls with the
respiration; and in the second stage of the poisoning is cha-
22
706
OPIUM.
racteristically slow, while remaining full. Experiment appears
to have demonstrated that this retardation of the heart's
action is due to the inhibitory influence of the vagi; and the
congested condition of the brain seems to explain how the
cerebral centres of the nerves may well be excited, as they are,
e.g., in acute hydrocephalus and (again) in apoplexy.
II. The after-effects of Opium, when the sopor has passed
off, are very like those which follow an alcoholic debauch—
nausea, anorexia, headache, chilliness, listlessness, sleepless-
ness, constipation. They are not contraries of the state pre-
viously induced, but merely alternating opposites, oscillations
of the disturbed balance: the chilliness and insomnia imply
the same depressed vitality of the nervous system as did once
the heat and sopor. These epiphenomena are best seen in
the unhappy subjects of opium-eating, whose whole life is
spent in such morbid vicissitude.
We now come to the curative effects of our drug; and must
first inquire how far the induction of its physiological action is
justifiable in disease. This would seem a strange question to
the therapeutists of the old school, especially in these days of
"hypodermic morphia." But, if you have followed me thus
far, you will have seen that the great aim of homœopathic treat-
ment is to avoid such physiological action, to induce it only
up to the point at which it neutralises a similar condition
already present, and then to stay the hand. To use Opium,
therefore, to compel sleep, to allay pain or spasm, and to check
excessive secretion, would with us be only tolerable when we
had no similarly-acting medicines on which we could rely for
the purpose; and even then we should feel it a question for
grave consideration whether remedy or disease constituted the
greater evil.
Hahnemann has some excellent remarks on this subject.
"A short cough," he says, " which has been occasioned by a
cold, a recent trembling caused by fright, a diarrhoea which
has been suddenly occasioned by fear, by a cold or other
slight causes; retching, which has come on in consequence
of a moral emotion, as loathing, &c., may yield to Opium, and
sometimes do yield suddenly, because all that Opium requires
to do in these affections is to suppress them for a short while,
in order to enable the organism to remove in the meanwhile
all disposition to these affections, and to effect its restoration
to health by means of its own inherent recuperative power.'
The same principles would apply to the treatment of recent
and fugitive pains and spasms, and of the chilly and miserable
state of commencing influenzal catarrh. But in morbid con-
"}
OPIUM.
707
ditions of more permanent and recurring character it must
always be a grave question whether we shall resort to the
palliative medication of opiates. We are launching upon a
boundless ocean when we once begin it; and the medical
world teems with recorded cases (and still more unrecorded)
of its pernicious influence.* Morphiomania, it is found, can be
induced as readily as dipsomania; and what sort of nervous
system will its subjects transmit to their offspring? God for-
bid that we should deny to the sufferers from incurable dis-
ease any relief from the pains which agonise them; but
wherever cure is possible, I am sure that we are only diminish-
ing our patients' chances and adding to their distresses by
inducing the narcotism of Opium in their systems.
The abandonment of opiates must be to a new convert to
homoeopathy one of the hardest trials involved in his change
of practice. He need not necessarily do it all at once. Let
him feel his way. Let him see how far the more numerous
and more potent specifics he now possesses will enable him
to do without them. The cough, the diarrhoea, the neuralgia,
which of old he hushed up by poisoning the nerves, now find
in his new armoury their direct remedies. Let him keep his
opiates for cases otherwise irremediable; and their use will
become rarer and rarer. For myself, I can safely say that
during twenty years of homoeopathic practice I have not found
one patient in five hundred who required them.
We turn, then, to the homœopathic applications of Opium,
and find these more limited than might have been expected.
Pereira indeed gives a long list of affections in which it is
contra-indicated and objectionable; and these are of course
the very conditions to which it is applicable according to the
method of similarity. But his statements are too broad and
general; and Hahnemann foresaw truly when he said:
"Opium is one of those drugs the primary effects of which
seldom correspond homeopathically to the symptoms of dis-
ease." He moreover pointed out with great sagacity the two
leading morbid conditions to which it really corresponds.
"Opium is a specific," he wrote, "for certain kinds of the
most obstinate constipation." It holds a high place among
us in the treatment of this disorder, especially when the stools
occur in round, black, hard balls, and the rectum is torpid: it
reaches even to intestinal obstruction when of a paralytic
*“In 15 out of 55 cases of the hypodermic injection of morphia, the
consequences were unpleasant, and in 7 death resulted, in none save
one of which had the ordinary dose been exceeded."
Fourn., Nov. 16, 1878. See also Lancet, April 10, 1880).
(Brit. Med.
708
OPIUM.
nature, and to incarcerated hernia. We also esteem it the
principal remedy for lead-colic, and suppose that it acts here
by removing the constipation. In these latter uses we are at
one with our brethren of the old school; but this because they
are herein unconsciously homoeopathising. Opium is also a
specific, Hahnemann continues, "for acute fevers characterised
by a sopor bordering upon stupor, and by absence of any
complaint, snoring with the mouth open, half-jerking of the
limbs, and burning heat of the perspiring body." That it is
actually homœopathic to the pyrexia may be inferred from
the experiments with morphia on animals communicated by
Dr. Oglesby to the fourth volume of the Practitioner, in which
a rise of two or three degrees of temperature nearly always
followed its adminstration. The cerebral symptoms also of fever
quite as often remind one of the effects of Opium as of those
of Hyoscyamus or Belladonna; and in such cases it will be
found very useful. The drowsiness of which this is the
intensest form is always a special indication for Opium; and
may sometimes present itself as a morbid state per se, when
there is little difficulty about the choice of the medicine.
Thus Dr. Bayes recommends it in passive cerebral congestion,
with somnolence after meals, in patients predisposed to
apoplexy; and Dr. Drury finds it helpful in uræmic coma.
Dr. Guernsey indicates it where the patient is very sleepy, but
cannot go to sleep. Opium should also be occasionally service-
able in headaches like those it causes; and in the atonic
dyspepsia of drunkards. It seems to paralyse the muscular
fibres of the fundus of the bladder rather than those of its
sphincter (herein just the reverse of Belladonna); and is
accordingly remedial in paralytic retention of urine. It is es-
pecially serviceable in these (and perhaps in other) affections
when they have occurred in consequence of a fright.
I have reserved the relation of Opium to two important
cerebral affections, delirium tremens and apoplexy. Resemb-
ling as it does so very closely in its action that of alcohol, it
ought to find a place in the homœopathic treatment of the
drunkard's mania. I cannot, however, claim the ordinary use
of it in this disease as an instance of the operation of the law
of similars, as it is (or rather, was) given in full doses to
compel sleep. There is very little recorded experience of
delirium tremens in our literature. In the cases I have myself
seen, Hyoscyamus or Belladonna was better indicated than
Opium; whose acute delirium, moreover, is without halluci-
nations. When, however, delirium tremens comes on as a
consequence of the drunkard being deprived of his accustomed
OPIUM.
709
stimulus, the analogy of the sufferings of opium-eaters
must be remembered. Stillé, describing from Libermann the
chronic delirium into which they ultimately fall, says-" These
images which, we are assured, are literal copies of the opium-
eaters' phantasms, present a vivid resemblance to the more
familiar spectral illusions of delirium tremens."-In apoplexy,
Opium has been a good deal used in our school. It is, how-
ever, very questionable whether the symptomatic resemblance,
undoubted as it is, warrants its adminstration here. What we
have to treat in apoplexy is not the extravasation, which is
irremediable, but that which has caused the rupture of the
degenerated blood-vessel; and which, if allowed to continue,
threatens to increase the mischief. This cause may be either
an excitement of the general circulation or an active con-
gestion of (i. e., attraction of blood to) the brain. In either
case, is Opium truly homoeopathic to the morbid condition?
Aconite is our substitute for the lancet in the former, and Nux
vomica or Belladonna seems to me the true pathogenetic
analogue to the latter. Where extravasation has not occurred,
but active congestion is the beginning and the ending of the
matter, these medicines seem to me to cover the whole malady.
But I can conceive it possible that where extravasation has
taken place, and the danger arises from oppression of the vital
parts at the base of the brain, a few doses of Opium might be
of service, as the drug would certainly be homoeopathic to this
portion of the disorder. In this connection the remark of Dr.
Ringer must be borne in mind, that "effusion of blood into the
pons Varolii will produce symptoms almost identical with
those of opium poisoning."
Opium has a certain amount of reputation in the treatment
of diabetes. If it does more than palliate symptoms, it must
be, I think, in virtue of its homœopathicity to the disease.
Dr. Coze, of Strasburg, wishing to determine its action on
glycogenesis, injected fifteen grammes of a solution of muriate
of morphia in distilled water into the jugular vein of a rabbit.
The urine was not examined; but the quantity of sugar in
the liver was found more than doubled, and likewise that con-
tained in the arterial blood." Bernard, too, has lately in-
formed us that morphia determines glycosuria after the same
manner as woorara and puncture of the floor of the fourth
ventricle, viz., by increasing the circulation through the liver.†
*
Another homoeopathic use of Opium in the old school is the
employment of it, in the shape of small doses of Dover's
* See Brit. Fourn. of Hom., xxiv., 255.
+ London Medical Record, i., 725.
710
OPIUM.
powder, to check the sweats of phthisis.* This preparation-
compounded of opium, ipecacuanha, and sulphate of potash
-is well known as a diaphoretic in ordinary practice.
Cannabis Indica is the only real analogue I know to
Opium.
Save in intestinal affections, the higher attenuations seem
most in favour.
*See Brit. Journ. of Hom., xxiii., 108; and Practitioner, Sept.
1879.
LECTURE XLVII.
OPIUM ALKALOIDS, ORIGANUM, OSMIUM, PÆONIA, PARIS,
PETROLEUM, PETROSELINUM, PHELLANDRIUM, PHYSO-
STIGMA, PHYTOLACCA.
Before leaving Opium, I must say something as to the dis-
tinctive action of some of its chief constituents.
Morphia, of all these, most nearly represents the full action
of the parent drug, and I have freely used the observations of
its effects when speaking of those of Opium. A full collection
of them has been made by Dr. Allen, who cites from 73
sources. The only remaining ones I care to notice are the
vomiting and the itching of the skin it causes. Of the former I
shall speak under the head of Apomorphia. The latter is a
frequent and marked effect of the alkaloid. It is rarely asso-
ciated with any eruption; and should indicate morphia as a
remedy in pruritus, in which I have several times given it
with advantage.
Codeia very much resembles morphia, but the tendency to
convulsive action is more pronounced under its influence than
that which leads to coma. A pathogenesis of it, derived from
several sources, is given by Dr. Allen in his Encyclopædia; and
in a note thereto two cases are mentioned in which involun-
tary twitchings of the eyelids were removed by it in the at-
tenuations. I have myself had another.
Narceia, on the other hand, is a pure hypnotic; but its
effects of any kind are feeble. Much the same may be said
of Meconia, though it is a little more active; and of Cryptopia,
which Dr. Harley's experiments show to be more potent
still. We could only use these substances in soporose condi-
tions; and nothing seems gained by substituting them for
Opium itself.
Narcotia is moderately convulsive and hypnotic in its action;
but the point of most interest about it is that it has anti-
malarial properties like those of quinine. Thebaia seems to be
the alkaloid in which the tetanising powers chiefly reside.
The spasms resemble those of Aconite, of Cicuta, and of Hy
drocyanic acid rather than those of Strychnia.
The last ingredient of Opium of which I shall speak is
712
ORIGANUM VULGARE.
Apomorphia, which indeed is no natural constituent of the
drug, but a derivative from morphia obtained by heating it
with excess of hydrochloric acid. It has been found to con-
tain in special intensity the emetic properties of morphia
itself. Trousseau and Pidoux had long ago studied these,
and shown them to be most strongly manifested when the
drug was applied externally, and so to be of cerebral rather
than of gastric origin. The same inference was drawn by Dr.
Wood from the fact that the sickness which follows intoxica-
tion by Opium is brought on whenever the patient raises his
head. Apomorphia has been largely tested by Drs. Gee* and
G. Blackley in this country, and by a number of foreign ob-
servers, and has been found to be a prompt and powerful
emetic, acting directly upon the nervous centre of the process.
When Dr. Blackley's paper was read before the British
Homœopathic Society, Dr. Cooper stated that he had suc-
ceeded in removing with Apomorphia the distressing vomiting
connected with a tumour in the brain. Dr. Dyce Brown,
whose prescriptive right it seems to be to turn these new dis-
coveries to homœopathic account, soon followed with a series
of cases of vomiting, in which Apomorphia, in the third dilu-
tion, proved promptly curative. It was most beneficial, as
might be expected, when the vomiting was reflex; but it
helped even the gastric form of the trouble. It is now gain-
ing quite a reputation as a remedy for sea-sickness.
Binz says that "the best preparation of it is the hydro-
chlorate, which forms beautiful crystals, and quickly and com-
pletely dissolves in water. It turns dark green under the
action of light, but does not lose its efficacy in consequence."
Apomorphia itself is probably best prepared by trituration.
G
I now pass to some medicines of lesser interest.
Our information regarding the wild marjoram,
Origanum vulgare,
is derived from a paper by Dr. Gallavardin, of Lyons, pub-
lished in L'Art Médical for 1865,§ and translated in the fifteenth
volume of the North American Journal of Homœopathy.
The oil of marjoram has long been in domestic repute as a
stimulating emmenagogue. M. de Cessoles, who proved it on
* Transactions of the Clinical Society, vol. ii.
† Brit. Fourn. of Hom., xxxi., 497.
‡ Ibid, xxxii., 497.
§ See also his Causeries Cliniques, p. 15.
OSMIUM.
713
himself and two young women, found it produce in the latter
considerable sexual excitement. Dr. Gallavardin has recorded
eight cases of erotomania of various degrees in the female, in
which the action of Origanum, generally in the third dilution,
was most satisfactory. Dr. Bayes tells me that he has several
times obtained excellent effects from Origanum in obscure
nervous disorders in women, in which he suspected irritation
of the sexual system as the exciting or maintaining cause.
The tincture is prepared from the fresh plant.
I have next to mention the rare metal, called
Osmium.
Triturations are prepared for homœopathic use.
Dr. Hering has collected, in one of the pathogeneses of his
volume of Materia Medica, all that was known of Osmium to
that time (1873). In the sixteenth volume of its Bulletin, the
Homœopathic Medical Society of France has, through Dr.
Ozanam, put on record a recent case of poisoning in a worker
with the metal; and has also translated the experiments of
Hoffbauer related in the third volume of the Archiv. This
Hoffbauer, however, was the notorious Fickel, whose endea-
vour to palm spurious provings on Homœopathy makes any-
thing from his pen suspicious. Dr. Hering does not include
him in his list of authorities, among whom, nevertheless, are
five provers of the metal, one of them Dr. Stokes, of Liverpool.
The workman I have mentioned died of the intense broncho-
pneumonia induced by the emanations from Osmium. But
this action on the air-tubes-so far at least as the upper part
is concerned.--is not local only; for the provers had great
hoarseness and cough. Gmelin's experiments on animals.
show the oxide to cause death in convulsions without signs of
inflammation, evidencing an action on the nervous system. In
the provers this is shown by headache, chiefly supra-orbital,
and very marked dimness of vision. Osmium also acts on the
kidneys, the urine being dark and scanty in the provers, and
albuminous in the workman I have mentioned, in whom after
death the so-called second stage of Bright's disease (that is,
the large white kidney) was found established. This man had
also a papular and desquamating eruption of the arms.
There is thus a good deal in the pathogenetic action of
Osmium which, applied upon the homoeopathic principle, pro-
mises good therapeutic result. It is comparable with Man-
ganum, Selenium, and perhaps Arsenicum.
714
PÆONIA OFFICINALIS.
My next medicine is the peony,
Pæonia officinalis,
of which we prepare a tincture from the fresh root. This, it is
said, must be gathered in spring; when August comes, its
power has been lost.
There is a short pathogenesis of Pæonia in the twenty-first
volume of the Hygea, mainly consisting of symptoms observed
by Dr. Geyer on himself and three others, who all took sub-
stantial doses of the mother-tincture. There is little in it
worthy of note, and the plant has scarcely received any medi-
cinal employment. But one of its effects-" painful ulcer at
the anus, with exudation of a fœtid moisture"-led Dr.
Ozanam* to use it in a similar condition occurring idiopathi-
cally; and his success induced him to extend its application to
other ulcers, with rarely failing benefit. Dr. Guérin-Méneville
says that, “according to him, Pæonia would be efficacious in
every ulceration seated below the umbilicus." But Dr. Ozanam
only states that his experience had been limited to this part of
the body; while he ends his paper with a fresh case in which
an ulcer of the breast readily healed under its use. He used
the first three dilutions, either externally alone, or also in-
ternally. Dioscorides and Pliny recommend it for nightmare,
and it caused this affection in Dr. Geyer himself.
And now a few words about the "herb Paris," or true-
love-
Paris quadrifolia.
The entire plant is used for the tincture.
Paris has a good pathogenesis-symptoms from provings of
it by twelve persons (among whom was Hahnemann himself)
being given in Hartlaub and Trinks' third volume, and in the
eighth and thirteenth volumes of the Archiv. It has rarely
received any therapeutic application; but I mention it that
you may know its place in the Materia Medica, though I
cannot tell you how the symptoms were obtained. Dr.
Guernsey gives as characteristics of it-" great sensitiveness
to offensive odours; imaginary foul smells. Cough with ex-
-
* See Bull. de la Soc. Med. Hom. de France, vol. viii.; and Brit.
Fourn. of Hom., xxvi., 53.
PETROLEUM.
715
pectoration in the morning, without expectoration in the even-
ing. Sensation of extension of size, i.e., patient feels very
large. Collection of water in the mouth. Ürine with greasy
cuticle on the surface." Hahnemann says that it removes
cramp in the stomach, and also (in large doses) causes it; and
Allen emphasises (as verified) the symptoms-" it seemed as
though a thread were tightly drawn through the eye to the
middle of the head, which was very painful," and "a sensation
as if a great weight were lying on the nape." No other thera-
peutists mention the drug.
We have now a medicine of more importance—the rock oil,
oleum petræ, or
Petroleum.
We use the white variety, “mineral naphtha," which we dis-
solve in rectified spirit or triturate. Dr. Drysdale suggests
capsules where the pure substance should be given.
We owe the symptomatology of Petroleum almost entirely
to Hahnemann, who gives us 623 symptoms from it in the
first edition of the Chronic Diseases (where he recommends the
18th dilution for use), and 776 in the second. Allen adds
some effects of large quantities and of exposure to it in its
manufacture.
I have little to say of the pathogenesis, except that one of
its symptoms once guided me to the choice of the right medi-
cine for an anomalous but annoying complaint, viz., a feeling
as if there were a cold stone in the heart. I would call atten-
tion, also, to the urinary symptoms, as presenting a pretty
close resemblance to some forms of vesical catarrh. The
workmen get the hair-follicles of their skins inflamed and in-
durated (comedones). The chief reputation of Petroleum in
our school has been as a remedy for sea-sickness. Hempel,
who in his first edition had recommended it, in his second
repudiates it as ineffective. But I must say that both myself
and friends whom I have supplied with it can testify to decided
benefit from its use; and Dr. Bayes confirms this more favour-
able estimate of the remedy. In other forms also of nausea
and vomiting, as in that of pregnancy, it may prove useful :
Dr. Guernsey says that it has the aversion to fat food charac-
teristic of Pulsatilla, and is " particularly applicable in all gastric
troubles of pregnant women." Diarrhoea occurring only in the
day-time is with him a special indication for the drug. Then
716
PHELLANDRIUM AQUATICUM.
y
there are certain uses of Petroleum for which I was indebted
to the experience of my friend Dr. Madden, but which I have
frequently verified for myself. These are to check foetid
sweat in the axillæ; to relieve tenderness of the feet when
these too are bathed in a more or less foul-smelling moisture
(which it removes); and to modify that unhealthiness of skin
which causes a general tendency to fester and ulcerate. Teste,
moreover, recommends it in alternation with Ipecacuanha in
dysentery affecting children. Dr. Drysdale* says that since
he has used it in three-drop doses of the pure substance he has
found it more efficacious than hitherto, getting excellent
results in many chronic catarrhs (urethral, uterine, intestinal,
bronchial), in chilblains and chaps, and in deafness with noises
in the ear.
I commend Petroleum to your study as a medicine whose
virtues have been as yet by no means exhausted.
I have, like Dr. Bayes, found a third decimal alcoholic
attenuation answer every purpose in sea-sickness.
Petroselinum,
the common parsley, a tincture of which is made from the
whole fresh plant, appears from its brief pathogenesis (which
Allen gives from Bethmann) to have a decided action upon
the urethral mucous membrane: and has been used ac-
cordingly in subacute gonorrhoea and gleet. You might be
inclined to doubt the possession of active properties by this
seemingly harmless esculent; but I may remind you that
parsley seeds and their educt, apiol, have been found to affect
the brain like quinine, and have been used with some success
as a substitute for it in intermittent fevers and neuralgiæ.
The water-hemlock,
Phellandrium aquaticum,
of which we use the ripe fruit, has a pathogenesis of 373
symptoms in the second volume of Hartlaub and Trinks'
Arzneimittellehre, mostly furnished by Nenning and obtained
in his usual manner. Phellandrium appears to act as a poison
similarly to its congeners Cicuta and Enanthe. It was in
considerable repute of old time for chronic suppurations
occurring in the lungs, and elsewhere, but it has fallen into
* See Brit. Fourn. of Hom., xxviii., 493.
PHYSOSTIGMA VENENOSUM.
717
disuse in the old school, and has found little place in the
new.* Dr. Dudgeon, however, has published in the twenty-
eighth volume of the British Journal of Homœopathy a case
of severe and long-lasting headache cured by it, after the
failure of more ordinary remedies. He states that he has
given it with success in similar headaches since. The charac-
teristics are "pain like a heavy weight, a stone, a lump of
lead, on the top of the head, with aching and burning in the
temples and above the eyes; pain in the eyes, with congestion
of the conjunctiva; watering of the eyes; intolerance of light
and sound." It caused some stitching pains in the mammæ;
and Gross recommends it for nursing women when such pain
is felt in the nipples on each application of the child.
And now, as we cannot go on to Phosphorus to-day, I will
occupy the rest of this lecture with two other "ph"s-Phy-
sostigma and Phytolacca.
The first is a substance just emerging out of physiological
into therapeutical interest, the ordeal bean of Old Calabar, the
seed of the plant called
Physostigma venenosum.
It is not yet officinal; but triturations of the whole bean seem
the most suitable and active preparation.
A large collection of provings of Physostigma was presented
to the American Institute of Homoeopathy in 1874 by Dr.
Allen, and published in its Transactions for that year. Be-
sides all recorded experiments on the human subject made
in the old school, it contains provings from homœopathic
sources of a very extensive character. Forty-four persons
took part in them, using the triturations from the first to the
thirtieth. The full record of their trials is given here by Dr.
Ailen, and their symptoms in his Encyclopædia; while he pre-
fixes to his collection a very useful catalogue of the bibliogra-
phy of the drug. The experiments which have been made
with it on animals-chiefly by Dr. Fraser, of Edinburgh-are
fully summed up by Wood and Ringer.
The Calabar bean has long been used—as its name imports
-for purposes of justice in the African kingdom in which it
is indigenous. Interest being excited in its properties by the
reports of missionaries, they were investigated by Professor
Christison, and subsequently, more fully, by Dr. Fraser.
See, however, L'Homeopathie Militante, ii., 384.
718
PHYSOSTIGMA VENENOSUM.
Since their results were published (1855-1863) Physostigma
and its active principle-physostigmia or eseria-have been
tested on animals on a large scale, and on the eye in the
human subject. Little clinical application has yet been made.
of the results; but now that we have the more minute homœo-
pathic provings to fill in the outline, we shall be inexcusable
if we do not make that little expand into a great deal. There
are certainly few drugs whose physiological action is so
thoroughly known.
The normal poisonous action of the Calabar bean is to cause
speedy general paralysis, and death from failure of respiration
-consciousness being unaffected to the last. The seat of the
paralysis is the spinal cord itself, the vital properties of the
nerve-trunks and muscles being found intact. Reflex action.
is abolished, and also sensibility so far as pain is concerned;
but tactile impressions are perceived, and the muscular sense
is perfect. The muscles themselves are the seat of tremors
and fibrillary contractions of a very persistent character, which
seem due to a direct action of the drug upon them. In those
of the involuntary class this irritation goes on to active move-
ments, so that the stomach, bowels, and bladder expel their
contents with frequency,-the intestines being often twisted.
up in knots. All the secretions-sweat, tears, saliva, fæces,
urine-are somewhat increased.
Two of the special actions of Physostigma are of peculiar
interest, those which it exerts upon the heart and the eye
respectively.
1. In moderate doses the bean simply retards the heart's
action, not regularly, but by prolonging the diastole, in which
-when poisoning is induced-the organ stops. The retarda-
tion seems due to an exaltation of the inhibitory power of the
terminal extremities (not of the central origin) of the vagi.
It is accompanied by heightened arterial tension, and the
power of the heart is not diminished. But a larger dose
perceptibly weakens the cardiac impulse, and a very large one
may paralyse it at once, leaving it after death flaccid, dis-
tended, and barely responsive to the strongest direct stimu-
lation. General coldness and pallor are always noticed in
poisoning by the bean.
2. Physostigma is almost the only drug besides Opium
which contracts the pupil. It does this whether locally or
internally exhibited. The careful investigations of von
Graefe and Robertson have shown that the ciliary muscle is
contracted as well as-and even before the iris, so that
accommodation is impaired, and myopia induced. There is
G
PHYSOSTIGMA VENENOSUM.
719
set up in the eye a condition precisely opposite to that caused
by atropia, which produces dilatation of the pupil, paralysis
of accommodation, and presbyopia. The rationale of the action
is found by some in sympathetic paralysis; by others in
excitation of the third nerve. I am unable to assent to
either hypothesis; for I find none of the evidences of depressed
sympathetic energy, as we have seen them from the influence
of Opium, nor can I think that a drug which causes general
paralysis can stimulate one of the nerves of the cranio-spinal
axis. I should rather ascribe the condition to the direct action
of the drug on the muscular substance of the iris, answering
to that which we have seen it exerting upon other muscles.
This is also Binz's view. Von Graefe says that on carefully
watching the progress of the myosis, the iris is seen to contract
convulsively with little jerks or twitches, which are so small
and rapid that they easily escape observation. These seem
analogous to the tremors of the voluntary muscles and the
peristaltic agitation of the intestines. The action on accom-
modation (which consists in approximation of both the far
and the near point of vision) progresses by the same spasms
or jerks; and oscillation of the eyeballs has been observed.
A word as to the sensations which accompany these phe-
nomena. In poisoning, they are those of extreme giddiness
and faintness and utter powerlessness, with sluggish articu-
lation. When more moderate doses are taken, severe pressure
at the epigastrium, immediately below the sternum, is com-
plained of; it is accompanied with eructations. It is com-
pared to that which results from bolting large morsels, or
swallowing indigestible food. The provers were mostly over-
powered with drowsiness, and indisposed for mental work.
Many had a severe frontal headache, with a feeling of tension
in the muscles of the forehead. Though contraction of the
pupils is caused by the internal use of the drug in sufficient
quantity, no sensations of any moment are perceived in the
eyes. But when it is locally applied, the myopia of which I
have spoken occurs. Even near objects are not seen distinctly ;
and Mr. Bowman found when experimenting on himself that
astigmatism was produced. Using the eyes for binocular
vision (as in reading) causes pain, blurring, and sense of
straining. Nervous achings may occur in the eyeball affected,
extending along the supra-orbital nerves and over half the
head; and towards the end of the myotic action there is
experienced, even without provocation, a painful tension,
partly in the equator of the ball, and partly in the ciliary
region.
--
720
PHYSOSTIGMA VENENOSUM.
There are of course two possible applications of these facts
-one on the principle contraria contrariis, the other on that
of similia similibus. Upon the former Physostigma has been
used in strychnia poisoning and in tetanus, and with occa-
sional success. But such large doses are required to induce
its physiological effects upon the cord that the heart often
becomes dangerously affected, and even peril from paralytic
asphyxia occurs. These inconveniences are well seen in a case
reported in much detail in the thirteenth volume of the
Practitioner (p. 338); and they were found by Dr. Hughes
Bennett's Committee to render the bean useless as a standing
antidote to strychnia. The excitant action of the drug on
unstriped muscular fibre has led to its use in atony of the
digestive and respiratory tubes (in one case causing "phantom
tumour"); and its power over the eye has been utilised for
the counteraction of the effects of atropia, and for the relief
of mydriasis and weakened accommodation when otherwise
arising. Its homoeopathic application has been indicated by
Dr. Ringer, who has given it with much benefit in general
paralysis of the insane and progressive muscular atrophy. He
administers the thirtieth of a grain of the extract, a whole
grain being the ordinary dose. He has since (Lancet, Dec. 22
and 29, 1877) recorded several cases of paralytic disease in
other forms in which it has proved useful, among them loco-
motor ataxy. That the benefit was generally temporary only
seems inevitable, when we consider the "functional" nature of
the paralysis induced by the drug. Dr. Woodyatt, of Chicago,
has recently put the drug to a very important use, viz., for
acquired myopia resulting from ciliary spasm, which he thinks
a frequent and important factor in the affection. From
Physostigma, given in the third decimal dilution four times a
day, he has obtained "results favourable beyond expectation."*
Dr. Woodyatt is a competent oculist, and his statements come
to us with every recommendation. His pathology has been
called in question by one of his own colleagues, but I think he
has abundantly vindicated the soundness of his position. He
might have quoted the corroborative testimony of Soelberg
Wells, who writes:-" Dombrowsky and others find that rapid
increase of myopia is often due to spasm of the ciliary muscle,
which also causes asthenopia," and again-" Spasm of the cili-
ary muscle (apparent myopia) is not of such unfrequent occur-
rence as is often supposed. We have already seen that it may
accompany myopia and astigmatism; but it is most frequently
observed in youthful hypermetropes who have strained their
* United States Medical Investigator, ii., 375; v., 390; vi., þþ.
PHYTOLACCA.
721
eyes much in reading, sewing, &c., without using convex
glasses; this continued tension of the accommodation produc-
ing a spasmodic contraction of the ciliary muscle, or apparent
myopia. Such patients complain chiefly of two sets of
symptoms, viz.: those of marked asthenopia during reading
and fine work, and also that they are short-sighted."
Drs. Allen and Norton say—“Twitching of the lids should
attract our attention to this drug, especially if combined with
spasm of the ciliary muscle, as in one case in which there was
twitching around the eyes, patient could not read at all without
much pain, frontal headache aggravated by any light, Physo-
stigma gave quick relief.”
Eserine, the active principle of Physostigma, has of late
found a good deal of tentative employment in ocular affec-
tions. Dr. Knapp, of New York, at one time proclaimed it as
useful in acute glaucoma as atropine is in iritis; and he still
makes habitually a corresponding employment of it, though
he admits that it only exceptionally cures. He also says that,
as with atropine, its use in chronic glaucoma may set up an
acute attack; and that, in irritable eyes, its myotic effect is
liable to induce iritis.* Mr. Walker, of Liverpool, has sug-
gested the rationale of the action of eserine in glaucoma to be
as follows. He considers that long-continued over-use of the
ciliary muscle, causing spasm, may and often does cause the
glaucomatous condition; and hence that eserine, which can
induce such spasm, does harm rather than good in most cases
of the disease. After the cyclotomy which he practises, how-
ever, he finds it very useful; and thinks that it acts by open-
ing the discharge-pipes of the anterior chamber.†
I have little doubt but that the study of the provings of the
Calabar bean will lead to further applications of it as time
goes on.
It compares well with Gelsemium, and perhaps with
Baryta acetica. Muscaria, moreover, and the newly-discovered
Jaborandi have many analogies with it in their action on the
pupil and on secretion; and, like Physostigma, are somewhat
antidotal to Atropia.
We will speak next of the poke,
Phytolacca.
The P. decandra of America is the variety commonly used,
* London Medical Record, Feb. 15, 1879.
+ Essays in Ophthalmology, 1879.
1
3 A
722
PHYTOLACCA.
but the P. octandra of Australia seems to have the same
action.* The tincture is commonly prepared from the green
root; but as there is some reason to believe that the berries
act medicinally, especially in rheumatism, it might be better to
employ the whole plant.
The original proving of Phytolacca appeared in the second
volume of the Transactions of the American Institute of
Homœopathy. It is collated with other provings-making
sixteen in all-and several poisonings and experiments on
animals, in an arrangement of the drug which appears in
Dr. Hering's Materia Medica. The article on the drug in
Dr. Hale's New Remedies is also full of information.
regarding it, and Allen adds symptoms from some fresh
?
sources.
The interest of Phytolacca resides in three aspects of its
operation its action on the throat, its power over certain
manifestations of syphilis and rheumatism, and its influence
upon the mammary glands.
I. Phytolacca is undoubtedly a specific irritant of the
throat. All the provers suffered more or less at this part.
The fauces appeared much, sometimes darkly, reddened, and
the tonsils swollen : one prover had thick white and yellow
mucus about the fauces. But it was a startling inference from
such premisses that Phytolacca would prove a valuable remedy
in diphtheria. Nevertheless, this inference Dr. Burt, one of
its provers, did make; and his success and that of the many
American practitioners who have imitated his practice seems
to have justified him in so doing. Dr. Bayes has since intro-
duced Phytolacca into English practice as the principal remedy
for diphtheria; and again most gratifying results were
obtained both by himself and by many of his colleagues.†
The only dissonant note was struck by myself;‡ and I fear I
must here prolong it.
That Phytolacca was curative in the cases recorded I do
not question for a moment. But on going carefully through
them I must say that I do not recognise in them the symp-
toms I have learned to dread in diphtheria. Some, indeed,
were instances of simple inflammatory ulceration of the
tonsils; for when the so-called false membrane came away, it
left "large holes" behind it, which the diphtheritic pellicle
never does. The great majority, however, were undoubtedly
diphtheritic in nature. But they seem to bear to the really
* See Dr. Sherwin's remarks in Monthly Hom. Review, ix., 279.
+ See Monthly Hom. Review, vols. ix. and x.
‡ Ibid, x., 169.
PHYTOLACCA.
723
dangerous form of the disease much the same relation as scar-
ìatina anginosa to scarlatina maligna. In no case among
those recorded in America or in England is fœtor of the breath
mentioned, save in two out of my own three; and both these
died. In nearly all there was high fever, with pains in the
head, back, and limbs-symptoms which are never present,
according to my experience, in bad cases of diphtheria. I
apprehend, indeed, that it is the occurrence of these very
symptoms which constitutes the special indication for Phyto-
lacca. In a paper entitled "An Account of fifty cases of
Diphtheria," which I read before the British Homœopathic
Society in 1870,* I have related how this form of the malady
first came before me in 1865, and how then and subsequently
Phytolacca unmistakeably proved its specific remedy. Equally
good results, I may mention, followed its use after Belladonna
had failed in a case where, with these constitutional symp-
toms, the "large holes in the tonsils" followed the disap-
pearance of the white patches. But then you will read how,
becoming hopeful about the new remedy, I gave it assiduously
in a case of what Dr. Hilbers graphically calls "stinking diph-
theria." The throat certainly cleared under its use; but the
morbid process went on in the nose, invaded the larynx, and
death from exhaustion closed the scene.
I have thus been led to conclude that Phytolacca is specific
in diphtheria where high fever, with aching in head, back,
and limbs, is present; but is incompetent to cope with the
malignant form of the disease. Nevertheless, the other variety
is genuine diphtheria, for it is quite capable of leaving
paralytic symptoms behind it; so that Phytolacca is a real
anti-diphtheritic. If Dr. Burt's urinary symptoms are con-
firmed, moreover, they go to show its essential homoeopathicity
to the disease; for to the inflamed and patchy throat they
add albuminuria. I am glad to find that Dr. Hale, in his
fourth edition, while insisting strongly on this last point,
agrees nevertheless with me as to the form of the malady to
which the use of Phytolacca should be restricted. He states
that in America it often occurs epidemically. Dr. Bayes now
seems to think that the medicine acts as a specific stimulant to
those organs and tissues which are primarily depressed by the
diphtheritic deposit-the throat, the heart, and the stomach."
He lays much stress on its application by wash or gargle
simultaneously with its internal administration.
<<
II. Some of the facts mentioned in Dr. Hale's first account
of Phytolacca indicated that it was a periosteal medicine, like
* Brit. Fourn. of Hom., xxviii., 731.
724
PHYTOLACCA.
#
Mezercum. A recent case of overdosing with it, which is
given at length in the "Symptomatology" of his fourth edition,
shows its power of causing periostitis of the forehead and
face, together with blotches, sore and painful, of the whole
surface of the body, afterwards invading the mouth and the
throat. The suggestion of secondary syphilis is here unmis-
takeable; and we hear from time to time of its curing rupia,
ulcers of the feet, and other manifestations of this diathesis,
but more especially that periosteal affection which is called
syphilitic rheumatism. Extending its action in another direc-
tion, it has been found to act well in true rheumatism affecting
the other fibrous tissues, as the sheaths of nerves and the
fascia; herein resembling Rhus. The tincture prepared from
the berries seems especially serviceable here.
III. To the influence of Phytolacca on the mammary glands
attention was first called by Dr. Hale himself in the twenty-
first volume of the British Journal of Homeopathy. The article
is reproduced in his New Remedies. It appears from this that
the poke root is in constant use in the dairies to remove
"caking," i. e., inflammatory engorgement of the udders.
Hale has used it successfully for this purpose in the human
female, and finds it useful even after suppuration has com-
menced, and when sinuses have formed. I have myself never
wanted any medicine but Bryonia in threatened milk abscess;
but when the mischief outruns the abortive power of that
medicine I habitually rely upon Phytolacca. I have recently
had a chronic case of mastitis in which it proved most bene-
ficial. Dr. Hale commends this medicine also in irritable
mammary tumours, and where the breasts are morbidly
sensitive at the menstrual period or during suckling.
I once had a case where the adminstration of Phytolacca
obviated any injury which might have resulted from a neces-
sarily obscure diagnosis. In a baby of a few months old, a
succession of restless nights occurred simultaneously with the
development of a hard tender swelling about midway between
the nipple and the sternum, but nearer the latter than the
former. Whether the inflammation was affecting some of the
elements of the undeveloped mammary gland, or whether it lay
in the periosteum of a rib, appeared uncertain. In any case,
however, Phytolacca was indicated. I gave it in the sixth
dilution, and the malady rapidly disappeared.
These, I say, are the main spheres of the medicinal action
of Phytolacca. But the breast is not the only gland it affects;
nor is diphtheria the only form of throat disease over which it
exerts control. Several cases are on record proving its power
PHYTOLACCA.
725
to disperse enlarged lymphatic and salivary glands; and the
following one reported by Dr. Allen will show what it can do
in one form of chronic angina faucium.
"The patient, a man aged 45, had had chronic follicular
pharyngitis for several years. No remedies had done him
much good.
((
Symptoms. - Physical: membrane lining fauces and
pharynx, as well as the velum pendulum and the uvula, pale,
puffy, and flabby. Uvula large, almost translucent. Rational:
distressing sense of enlargement of the calibre of the pharynx
and œsophagus from the choanæ to the epigastrium. This
symptom much aggravated by exposure to damp winds. It
then begins at the choanæ, and in twelve hours extends to the
epigastrium. On reaching this point it provokes a cough,
paroxysmal, extremely distressing, and accompanied with very
profuse and exhausting expectoration of thick, starch-like
mucus. The whole chest then feels like a big empty cask,
as if its calibre were enlarged tenfold. Great constitutional
debility along with these attacks, so that the patient, who is
ordinarily intolerant of stimulants, can take whiskey to any
extent, and with great temporary relief.
"Phytolacca decandra 6, a dose every other night for a
month, cured this condition."
The analogues of Phytolacca are Mezereum, Guaiacum,
Kali iodatum and bichromicum, Mercurius and Rhus. Its
curative virtues have hitherto been obtained almost entirely
from the mother tincture.
LECTURE XLVIII.
PHOSPHORUS.
I have to bring before you to-day one of our greatest poly-
chrests—a medicine which will repay the utmost care we may
bestow upon its study,
Phosphorus.
The pharmaceutical preparation of this peculiar substance
is itself a large matter. In the old school, solutions in sul-
phuric ether and olive oil have generally been used. Mr.
Ashburton Thompson has recently shown that the latter
vehicle is very objectionable, as allowing of the free oxidation
of the phosphorus, whereby hypophosphorous acid is pro-
duced, which is far more irritant than its base. He shows
that all the unexpected poisonings which have deterred phy-
sicians from the medicinal use of Phosphorus have arisen from
this preparation. The solution in ether, however, is all that
can be desired. Hahnemann recommended it as an alternative
to trituration; and the British Homœopathic Pharmacopoeia,
in its first edition, did the same, pointing out that the vehicle
takes up almost exactly one per cent., thus making our first at-
tenuation. In its second edition, it directs the primary solution
to be of the 3x strength, making it either with absolute alcohol,
or with equal parts of this and ether. Subsequent potencies
may be prepared with rectified spirit. Mr. Thompson recom-
mends the administration of Phosphorus in glycerine instead.
of water to avoid decomposition. Another excellent prepara-
tion of it, according to this writer, is a solution in cod-liver oil,
which takes it up freely, and does not-like the vegetable oils
allow of its oxidation.
Sa
A pathogenesis of Phosphorus was published by Hahne-
mann in the first edition of the Chronic Diseases. It contains
1,025 symptoms, of which 963 are his own—that is, as we have
seen, observed upon patients taking the drug in infinitesimal
PHOSPHORUS.
727
doses. Soon after, additional provings from themselves and
three others were published-without explanation of their
origin-by Hartlaub and Trinks in their Arzneimittellehre.
These, in the second edition of the Chronic Diseases, were in-
corporated by Hahnemann with his old and some new material,
making a total of 1,915—the longest list in the collection, save
that of Sulphur. 1,169 of these are his own, 662 from nine
collaborateurs, and 84 from authors.
I must leave to your discretion what use you will make of
this pathogenesis. I have already expressed my entire lack of
confidence in the symptoms obtained on the principles avowed
by Hahnemann, and mainly followed by his disciples, in the
Chronic Diseases period. It is otherwise with many later
provings of the school; and in the case of Phosphorus we have
some excellent ones from Dr. Sorge and eleven associates.
He has published these, with a copious collection of poison-
ings, of experiments on men and animals, and of cases cured
by the drug, in his Der Phosphor, ein grosses Heilmittel
(Leipsic, 1862), the prize-essay of the Central Homœopathic
Society of Germany. For materials of later date I may refer
you to a paper by Dr. Holcombe, "Phosphorus; a patho-
genetic study," in the seventh volume of the North American
Journal of Homœopathy; to another, "On the action of Phos-
phorus upon the Liver," by Dr. Madden and myself, in the
twenty-first volume of the British Journal of Homeopathy;
to Wegner's experiments on animals, translated from Virchow's
Archiv in the thirty-first volume of the same journal; and to
the treatise on Free Phosphorus in Medicine, by Mr. Ashburton
Thompson (London, 1874), on whose pharmaceutical portion.
I have already drawn. Dr. Allen, including all pertinent
matter from these sources, adds the symptoms of a number of
fresh cases of poisoning.
The history of Phosphorus as a medicine has been curious
and interesting. The primary stimulant influence which we
shall see that it possesses, and which it exerts especially upon
the nervous system, was for a long time all that was known of
its action; and this property was made use of (often with
success) in typhoid and other adynamic states.
But so many
accidents occurred from the large doses and (as we have seen)
unsuitable preparations employed, that the drug became
branded as dangerous, and, until lately, was seldom employed
in the old school. Dierbach and Trousseau and Pidoux omit
it from their works on Materia Medica; and it did not appear
in Dr. Ringer's until its fourth edition. Its extinguished
flame has recently been rekindled from the homoeopathic
728
PHOSPHORUS.
territory, where its light had long been burning steadily and
brightly; and now it bids fair, in the sphere of the nervous
system at any rate, to resume an important place among
remedies.
Hahnemann, though speaking of Phosphorus as a very im-
portant medicine, was misled by the stimulant properties of
the drug into denying its homoeopathic applicability to states
of depression, which he regarded as only secondary re-
actions. We shall see that they are its real and lasting
pathogenetic effects. This mistake, and the unsatisfactory
nature of his symptom-list, kept the medicine in the back-
ground for some time. But then Fleischmann, Arnold, and
Liedbeck took it up, and showed its power and virtues; and
pari passu with the advance of knowledge as to its poisonous
effects, its use in our hands as a remedial agent has widened
and extended. For old-school therapeutics it is of no advan-
tage to learn that Phosphorus congests the lungs, necroses the
maxillæ, softens the nervous centres, liquefies the blood, and
causes fatty degeneration throughout the body. But to us
such knowledge is fruitful of practical results; and has already
raised the drug into the first rank of our medicines.
I. Before, however, we dwell upon these phenomena, let us
speak of the stimulant properties of Phosphorus. This sub-
stance is one of those which enter into the normal composi-
tion of the body. It exists mainly in the nervous centres, in
the form of a peculiar compound with fatty matter which has
been named “protagon;" just as iron is united with hæmatin
in the blood. It actually forms more than one per cent. of
the human brain, the amount gradually increasing from in-
fancy to adult age, and then again decreasing in old age.
Now the analogy of iron and lime suggests that, up to a
certain point, Phosphorus may be a special stimulant to the
tissue it goes to constitute; and, the stimulation being in
some sort that of a food, it need not be followed by reactive
depression.
That Phosphorus has such an action on the nervous system-
as iron has on the blood and (probably) lime on the bones—is
beyond doubt. "About the second hour," writes Mr. Thomp-
son, "after a dose of the twentieth or the twelfth of a grain,
sensations of exhilaration begin to make themselves felt.
The capacity for exertion, both mental and physical, is in-
creased, and that condition which the French describe as one
of bien-être is experienced. If the subject have taken the
dose while in a state of fatigue, he finds his strength renewed ;
if while in a state of despondency, he takes a more cheerful
PHOSPHORUS.
729
view of things. The pulse becomes firmer and a little more
frequent. These effects pass off gradually in the course of a
With
few hours, and a state of depression does not ensue."
this there is often increase of temperature, perspiration and
diuresis, and sometimes venereal excitement.
It is this action of Phosphorus which made it available,
given in full and frequent doses, in typhoid depression, and
often rallied a patient from an apparently hopeless condition.
It is a property of the drug which we may well employ, under-
standing clearly what it is-that we are giving it as we give
alcoholic stimulants, and not as a medicine. After the same
fashion it may be used, if it is needed, instead of a glass of
wine for temporary nervous exhaustion; remembering, how-
ever, that rest and food-if there is time for them—are far
better remedies. But there is another application of the
stimulant power of Phosphorus which has of late attracted
much attention, viz., the relief and even cure of neuralgia ob-
tained therefrom. Phosphorus causes and cures in minute
doses its own form of neuralgia; but this is rarely met with
in comparison with that which requires Arsenicum, Belladonna,
Aconite, Colocynth and Sulphur. The drug has hence occu-
pied no prominent place in homoeopathic therapeutics as an
anti-neuralgic remedy; but we have known how to use it when
required. A cure of the intercostal form, wrought by one of
us with it after long-continued unsuccessful treatment by an
old-school practitioner, called the attention of the latter to the
remedy; and he and others tested it in various instances of
the affection, and reported favourably of their results. It is
here that Mr. Ashburton Thompson came upon the field. He
treated some fifty cases with the medicine, with a success
which leads him to regard it as an almost infallible remedy
for pure neuralgia, wherever occurring, and as rapid in its
action as it is lasting. But to obtain such result, he says, the
medicine must be given in a full, i.e., a stimulant dose, not
less indeed than a twelfth of a grain every four hours. Thus
its modus operandi seems to be that of food and wine, whose
influence over neuralgic pain is so well known only that its
relation to nervous tissue gives it stimulant and perhaps
nutrient qualities of a special kind. I think that medicine is
much indebted to Mr. Thompson for working out this subject,
as well as for his valuable contributions to the pharmacy and
posology of the drug. We have, in most cases, remedies for
neuralgia of more satisfactory kind; but were we at a non
plus, we might do worse than follow his practice.
But it is with Phosphorus as a neurotic as with iron as an
M
730
PHOSPHORUS.
hæmatic if too long continued, or taken in excess, it acts as
a poison to the very tissues which it stimulates and feeds.
Iron can in this way impoverish the blood, causing anæmia;
and Phosphorus still more surely impairs the vitality of the
nervous centres, and gives rise to paralysis. In acute poison-
ing symptoms of this kind must be received with caution, as
the effect on the nervous centres of an altered blood and a
fattily degenerated heart must be taken into account; and also
the possibility of hæmorrhagic effusion into the membranes
of the cord and the sheaths of the spinal nerves, which in a
case of Bollinger's showing paralysis of the legs was actually
found to be present. But, making all allowance for these
facts, there are cases of acute poisoning by the drug which
seem to exhibit pure paralytic phenomena. Among those
given by Dr. Hempel, in one there was numbness of the
extremities, with formication-the fingers having so little
sensibility that they could not pick up a pin ; and in another
there was amaurosis with widely-dilated pupils, and deafness.
In an excellent study of " Phosphoric Paralysis," by Dr. Galla-
vardin of Lyons, translated from L'Art Médical in the twen-
tieth volume of the British Journal of Homœopathy, two cases
are given, in one of which the left arm, in the other the hands,
became powerless. But the most striking instance of the
kind presented by him is one in which, life being prolonged,
there was progressive paralysis. It is cited from Huss's
Chronic Alcoholism, as follows:-
“A man, æt. 39, who led an ordinary kind of life, occupied
himself for three years in the preparation of phosphoric
matches. He used to work in the room where he lived, and
there he kept the materials and the product of his trade. He
had suffered no inconvenience from it until a year ago, when
a great quantity of Phosphorus and of phosphorated matches
took fire, after a violent explosion. At the time, whilst try-
ing to extinguish the conflagration, he so thoroughly respired
the vapour of Phosphorus, that at last he fainted from suffo-
cation. Immediately after this he experienced a sensation of
weakness in the back, as if he were ready to sink; then weak-
ness in the extremities, and trembling at every effort; creep-
ing under the skin, and a sensation as if something were
starting under the epidermis. At first, great sexual excite-
ment, which afterwards diminished, and for the last six
months gave place to impotence, with absolute impossibility
of erection.
-
"Independent of that, he found himself well, with good
appetite; regular evacuations; good health; normal re-
PHOSPHORUS.
731
spiration. Nothing indicated any affection of the brain.
On his admission to the hospital, the following symptoms
were remarked: his two legs were so weak that he could
only walk a few steps, and even that he did with a tottering
gait, and as if he were not sure of himself; if he tried to
stand upright, his legs trembled and his knees bent; his
hands and arms trembled on making an effort. In the state
of repose, the muscles started out all over the body, especially
in the extremities. They seemed to be twitching to and fro,
though painlessly; different muscles or bundles of muscles
twitched at different periods. At times the twitching stopped,
but it was easily excited by contact. On the left arm, a
constant feeling of formication under the skin; normal sensa-
tion over the general surface of the body. The spine not
sensitive, nor painful, but so weak that the patient cannot
straighten himself, nor remain standing when once straight-
ened. The faculties, both intellectual and moral, the func-
tions of the heart, of the chest, and of the digestive organs,
normal; but the pronunciation embarrassed (? paralysis of
the tongue). The patient lived three or four years in the full
enjoyment of his senses, whilst the paralysis increased and ex-
tended; but all the attempts at treatment were unavailing."
M
Dr. Gallavardin also mentions the experiments on animals
of Mayer. The conclusions of this observer are " Phosphorus
acts specifically on the nerves of voluntary motion, and on the
muscles themselves. It impedes, diminishes, and at last.
entirely destroys the power of movement, or rather it destroys
the irritability of the motor nerves, and the contractility of the
muscular fibres, and at last completely paralyses the powers."
He adds that it also "acts specifically on the nerves of sensa-
tion, destroying sensibility from the periphery to the brain,
the sensorium being in small degree disturbed.'
To all this corresponds the condition of the nervous centres
commonly found in the animals poisoned by it, as you may
read in Sorge's treatise. This is nearly always described as
"pale, soft, and bloodless," and Arnold found its prolonged
use to induce actual softening.
It follows that Phosphorus is truly homœopathic to para-
lytic conditions, when dependent on lowered vitality or even
softening of the centres; and should be a valuable remedy
therein. Dr. Gallavardin cites thirteen cases of the kind,
twelve from old-school and one from homoeopathic sources.
Dr. Trinks has recorded another, described with his wonted
fulness and accuracy, which may be found in the nineteenth
volume of the British Journal; and Sorge and Mr. Thompson
732
PHOSPHORUS.
(C
give some more.* They were nearly all of a functional
nature-from amenorrhoea, seminal losses, exhaustion from
acute disease, and such-like causes. In one case the loss of
power involved only the third, in another only the sixth pair
of cranial nerves. In softening of the brain from exhaustion
Phosphorus seems acquiring quite a reputation in the old
school; but it has long been in use for it among homoeo-
pathists. Jahr praises it also in corresponding cerebral con-
ditions of less advanced degree, as "nervous vertigo" and
hydrocephaloid. The muscular symptoms of the case I have
narrated suggest the "fibrillary contractions" of "wasting
palsy," the "progressive muscular atrophy" of Duchenne.
With Phosphorus, indeed, we should not expect wasting of the
muscles, but simply their fatty degeneration; and a form of
the disease has been described by Duchenne which he calls
pseudo-hypertrophic paralysis," in which this very condition
obtains. In a little treatise, On the various forms of Paralysis,
which I published some years ago, I suggested Phosphorus
for this malady; and Mr. Clifton has obtained striking benefit
from its persevering administration in the third decimal dilu-
tion, in a well-marked instance of it. The girl, who could not
walk six yards when she came to him, could, after a little over
a twelvemonth's treatment, accomplish her four miles without
difficulty.†
(C
در
It is customary in the old school to speak of Phosphorus
as a "tonic" in these cases. I have shown that, like other
tonics, it weakens in health where it strengthens in disease.
It is more plausible to argue that, like iron in anæmia, it acts
as a food. It may do so under some circumstances. But I
think that the evidence of dosage, which favours the hypo-
thesis in the other case, is against it here. Jahr is as laudatory
of his decillionths as Thompson of his hundredths of a grain
in cerebral softening; and even the latter doses would not do
much to feed an organ which naturally contains some three
quarters of an ounce of the substance. So I think we must
conclude that it acts dynamically and homoeopathically here,
and is entitled to our highest consideration.
II. I will take next the symptoms produced by Phosphorus
in the male sexual organs, as these are probably a part of its
influence on the nervous system generally. They are, how-
ever, of sufficient importance to merit special and distinct con-
sideration.
* See another, post-diphtheritic, and with impairment of sensation,
in Hoyne (i., 100).
† See the case in Brit. Journ. of Hom., xxxvì, 127.
PHOSPHORUS.
733
The sexual organs share in the general excitement caused by
moderate doses of Phosphorus; but they manifest its influ-
ence in so marked a manner as to evidence a special action of
the drug upon them, or upon that part of the nervous centre
whence they derive their energy. That Phosphorus is an
aphrodisiac has been known for a long time. It has displayed
this property in a most unmistakeable manner among the
lower animals. Leroy (quoted by Pereira) ascertained that
it was aphrodisiac to drakes. In Dr. Sorge's experiments
cocks, pigeons, dogs, and frogs were affected in the same way;
the latter got those large growths on their fore feet that appear
during their pairing season, and used them accordingly. But
the same prover's experiments on the human subject show
that this excitement is but temporary, and is followed by a
much longer-continued depression, as we see in Dr. Gallavar-
din's case just cited, showing itself in absence of desire, im-
perfect erections, with too rapid ejaculatio seminis, and fre-
quent involuntary emissions.
Phosphorus is thus a thoroughly homoeopathic remedy for
that irritable weakness of the male sexual organs which is left
behind by excesses in venery and by masturbation. Experi-
ence has over and over again confirmed the indications of
theory in this matter. Phosphorus would also (in very small
doses) be homoeopathic to satyriasis, which corresponds to its
primary effects; for this Jahr recommends it from experience.
Might it also be desirable to use it occasionally as a special
stimulant, in full doses, as in impotentia senilis when off-
spring is much desired? The following observation from
Dr. Sorge's collection shows that great caution must be ex-
ercised here :-"An old dog who had long lost his sexual
power, after taking phosphorus rat-poison that was given to
kill him, became sexually excited, and died in the act of
-
coitus."
III. I would now direct your attention to the well-known
action of Phosphorus upon the jaws, as mainly seen in the
workers in lucifer-match manufactories. The fullest researches
instituted on this subject are those of von Bibra and Geist, of
which, if you have not access to the original, you may read a
full account in the eleventh volume of the British Journal of
Homœopathy. The disease usually begins in a carious tooth,
which gnaws and throbs, and sometimes shoots, with itching
and bleeding of the neighbouring gum. Then gum-boils form,
and discharge fœtid pus in which are found granules of bone.
Then the teeth fall out, and the gums recede or melt away, and
the bone appears in a state of caries or necrosis. Inflammation
734
PHOSPHORUS.
of the neighbouring parts and irritative fever are present: and
the case often terminates in death. It is a moot point whether
this effect of Phosphorus is produced by a local and chemical
action on the parts, or whether it is a result of the dynamic
influence of the poison. In favour of the latter being the true
interpretation of at least some part of the morbid process is a
case of poisoning by Phosphorus recorded by Dr. J. O.
Müller, on the fourteenth day of which there came on painful
boring burning pains in the bones, especially in the teeth, the
jaws, and the nose.* They were removed by Mezereum, a
drug which has cured the maxillary caries of the workers in
Phosphorus.
This conclusion has been thought to be impugned by the
recent experiments of Dr. Wegner; but I am unable to draw
such a conclusion from them. He finds that if rabbits are
kept for some time in an atmosphere impregnated with the
fumes of Phosphorus, in a small minority only does there
appear periostitis and necrosis of the jaws, just as the same
thing occurs in but a few of the workers in it. He fairly
argues that there must be some personal causal condition in
each individual case, in addition to the general influence to
which all are exposed alike; but I cannot follow him in his
further assumption that this condition must be a local ex-
posure of the periosteum from dental caries or injury to the
For he admits that in one only of his suffering rabbits
could he find any such lesion ;† and that carious teeth are
not always discoverable in the affected workers. Instead,
therefore, of laying stress on the fewness of those exposed to
the Phosphorus vapours whose jaws are affected without local
access for the irritant, the fact that any are so affected
should indicate that the influence is not local but constitu-
tional.
Still more striking evidence to this effect is derived from
the results obtained by Dr. Wegner from feeding the same.
class of animals with long-continued minute doses of Phos-
phorus-from one to three milligrammes according to one
calculation, from the four-hundredth to the hundreth of a grain
according to another, daily. Here an influence is produced
upon the osteogenetic tissue (of which periosteum is the chief
representative) all over the body, which leads to increased
*North American Fourn. of Hom., vii., 467.
+ Dr. H. Wood's statement is thus quite incorrect that "Wegner
found that when rabbits were kept in an atmosphere full of the fumes of the
poison no necrosis ever occurred, unless, by means of an unsound tooth
or an artificial wound, the atmosphere had access to the bone.'
""
PHOSPHORUS.
735
production of osseous matter, to thickening of the spongy and
greater density of the compact substance of the long and
short bones, and even in some instances to the obliteration
of the medullary cavity by the continuous fresh formation.
Dr. Wegner himself cannot but see the analogy of all this
with the effects on the jaws produced by the fumes. "Phos-
phorus," he sums up, "in minute doses in all probability is
dissolved in the blood, and, circulating with it, operates on the
osteogenetic tissue as a specific plastic irritant. Brought
topically in the form of vapour into contact with denuded
periosteum, in moderate concentration it provokes ossifying
periostitis: while, if the fumes operate very energetically, the
irritation becomes so intense that suppuration is added to the
ossificatory process." I should have said that in the maxillary
disease of the workmen and the rabbits there is always a
combination of new osseous deposits with the necrosis of the
old bone.
The results obtained by these small internal doses thus
throw much light on the nature of the osseous affection in-
duced by exposure to the phosphoric vapours; but they are
also of much importance in themselves. Dr. H. Wood represents
them as if they evidenced merely a stimulant influence on the
nutrition of the tissue. I cannot so read them; nor does Dr.
Wegner really regard them in this light. He connects them
with alterations he finds the drug, when given in the same
way, to produce in the stomach and liver-alterations which,
as we shall see, are essentially of a morbid kind. Older ob-
servations," he writes, "have taught that Phosphorus in large
doses influences certain tissues, particularly the parenchy-
matous elements of the liver, of the kidneys, of the stomach,
and of the muscles, as an extraordinary intense per-acute
irritation, of such a violent nature that in a very short space of
time a fatty degeneration, a necro-biosis of the same, follows.
We have now seen that the same substance, given to the
organism in a smaller quantity, while leaving the first-named
parts perfectly immune, possesses an irritative influence on
totally different kinds of tissue, on the osteogenetic substance,
on the interstitial tissue of the liver and of the stomach; an
irritative influence which has not a degenerative, but essentially
a formative tendency."
From the traditional point of view, the natural application
of this power of Phosphorus would be to further bone-pro-
duction in cases where it was defective, as in osteo-malacia and
rachitis, or where it was needed in temporary excess, as in
fractures, intra-periosteal resections, and transplantations of
(C
736
PHOSPHORUS.
this membrane. In the latter field Dr. Wegner has no doubt
of its beneficial operation; and within certain limits the pro-
cess is a physiological one. In osteo-malacia and rachitis he
can report no decided results; and indeed in both the condition
is too complex for help to be expected from simple increase
in osteogenetic activity. He makes a remark, however, re-
garding the latter disease which is very suggestive to us.
"Under the simultaneous influence," he says, "of feeding with
phosphorus, and of the deprivation of the inorganic substances,
especially of lime, the mode of growth of bones is altered so
as exactly to correspond to what we are accustomed to call
rachitis." He then describes the result of such an experiment,
ending-"The conditions under which this artificial rachitis
arises are a not unwelcome confirmation of the theory which
an exact observation of the process has already set up, viz.,
that rachitis is conditioned by two factors; first, an insufficient
quantity of inorganic salts in the blood, either from insufficient
ingestion of the same, or from their excessive elimination;
secondly, a constitutional irritation influencing the osteogenetic
tissue." For us of course the inference is that we should use
Phosphorus as a medicinal agent here; and indeed Phosphoric
acid already holds a high place in the homoeopathic thera-
peutics of the disease. Other applications in this direction
of the osseous influence of Phosphorus are obvious. It should
be useful in some forms of periostitis and necrosis. Kafka
reports it to be a most efficacious medicine, in conjunction
with Natrum muriaticum, in interstitial disease of the
vertebræ and of the cancellous structure of bones in general.
I have myself been led to its use in cases where the irritation
of a carious tooth is causing frequent gumboils and incipient
disease of the maxilla, and where for some reason or other
we are debarred from extraction of the offending member.
Here I have found it most efficacious. Dr, Bayes, also, praises
it highly in many affections of the teeth and gums. I may
mention that gingivitis, with looseness of the teeth, has been
observed, not only in acute poisoning by Phosphorus, where
it might be secondary to blood changes, but from its medici-
nal use.
IV. I have yet to speak of the action of Phosphorus in other
regions. Let us consider, first, what it does in the alimentary
canal and in the respiratory organs.
1. Phosphorus, in its unaltered state, is not a local irritant.
It does not set up gastro-enteritis as the corrosive poisons do,
unless (as I have said) it becomes oxidised in the stomach,
and hypophosphorous acid is formed. But however it is in-
PHOSPHORUS.
737
troduced into the system, it is liable to set up what Virchow
calls a gastro-adenitis, a swelling and shedding of the epithelial
cells of the mucous membrane like that we have seen occa-
sionally induced by Arsenic, and like that which obtains in
cholera. The same process goes on in the intestines, and is
accompanied there by diarrhea, as in the stomach by vomit-
ing. This is its acute action. But, when gradually ingested
by rabbits, Wegner finds it to set up an irritation of the inter-
stitial connective tissue of the stomach, causing a "chronic
indurative gastritis, with thickening, analogous to cirrhosis of
the liver." From one or other of these processes may occur
the condition described by Taylor:-" chronic poisoning by
the drug is accompanied by cardialgia, frequent vomiting, sense
of heat in the stomach, diarrhoea, tenesmus, pains in the joints,
marasmus, hectic fever, and disease of the stomach, under
which the patient may slowly sink.”
These facts should, I think, receive more homoeopathic
application than has yet been accorded to them. Chronic
degeneration of the mucous membrane of the stomach may
find in Phosphorus a potent remedy; the case recorded by
Dr. Bolle,* and supposed to be of gastric cancer, may well
have been of this kind. Phosphorus has a fair repute in
Germany in chronic dyspepsia characterised by sour risings,
heat at the epigastrium, flatulence, and canine hunger, of which
several instances relieved by it are given by Sorge. Hahne-
mann himself mentions chronic diarrhoea, with soft and thin
stools, as a special indication for it; it is of most service when
this malady affects nervous subjects and delicate children.
Mr. Proctor found it very useful in cholera, to check the drain
of brownish fluid from the bowels which sometimes continued
after the other symptoms had subsided.† But, next to the
stomach, Phosphorus seems to act most powerfully upon the
rectum. A prover, who took five drops of the tincture, ex-
perienced a severe attack of dysentery from his dose.
"The
passages were like the scrapings of the intestines, and almost
constant, attended with tenesmus for upwards of two hours;
involuntary passages occurred on the least motion; eight hours
later, the passages changed to mucus, and mucus mixed with
blood and slime, still involuntary. At the end of twelve
hours, passages began to become periodical at every half-hour,
and then every hour, still involuntary, with tenesmus at least
an hour after each passage, when they became as far apart as
two hours. During the second night," he says, “I was com-
*Brit. Fourn. of Hom., xii., 173.
+ Ibid., xxv., 95.
3 B
738
PHOSPHORUS.
pelled to use the vessel a number of times, making my cal-
culations to have a passage every two hours, as they were
involuntary the moment anything entered the rectum; this con-
dition lasted for two days, and subsequently every time I went
from the warm room into the open air my bowels would
move." I quote from Dr. Allen, who emphasises the involun-
tariness of the discharges as having been clinically confirmed.
I have great confidence in it in chronic disease of the lower
part of the bowel. In one case I had under treatment a dis-
charge of blood and pus, with tenesmus, had been going on
for eighteen months before I saw the patient. Phosphorus 30
effected speedy improvement, and in less than two months
entire disappearance of her symptoms; and she finished by
taking saccharum lactis for another month without any recur-
rence of her troubles. In another patient, the symptoms for
which he consulted me were those of incipient stricture of the
rectum, the fæces having already become flattened. There
was concomitant mucous discharge, and inquiry ascertained
that there had been an attack of acute proctitis about nine
months previously. Phosphorus 30 was curative here also, all
difficulty in defæcation and abnormal shape of fæces soon dis-
appearing, and the discharge ceasing. An old-standing
urethral stricture was simultaneously much improved.
2. On the respiratory organs Phosphorus acts as a pure
irritant. I would not lay too much stress on the bronchitis,
emphysema, pneumonia, and pulmonary phthisis observed in
the workmen and rabbits exposed to its fumes, as these may
be but local effects. They are accompanied, however, with
the weakness, emaciation and hectic which characterise the
gastro-intestinal phenomena of the drug. But Magendie and
others have found hepatization of the lungs in animals poi-
soned by it; and the provers experienced decided symptoms
of laryngo-tracheal and bronchial irritation, and of pulmonary
congestion. For the last I may refer you to Dr. Holcombe's
thorough proving on himself. Its presence was evidenced by
great heat and oppression at the chest, obliging frequent
deep inspiration. Similar feelings were experienced by several
of the subjects of poisoning whose symptoms are given by
Allen, and in two of them the physical signs of pneumonia
were present. In the first "percussion showed slight dul-
ness on the right lower portion posteriorly, with diminished
respiratory murmur and fine vesicular râles; change of pos-
ture caused a change in the area of dulness; vocal fremitus
diminished beneath the line of dulness on the right posterior
portion of the ninth dorsal vertebra; on the fourteenth day,
PHOSPHORUS.
739
1
after a second chill, the dulness extended upward half an
inch, and bronchial breathing was distinct over the area of
dulness." On the seventh day the dulness and râles had
diminished, but the cough, which was at first dry, with scanty
sputa, now became paroxysmal, accompanied by expectoration
of tenacious, purulent mucus. In the other case "percussion
over the lower portion of the thorax was dull on the right
side, with indistinct bronchial respiration and numerous râles;
on the left side vesicular murmurs and some moist bronchial
râles."
Correspondingly, Phosphorus occupies a high place in the
homœopathic therapeutics of respiratory affections. Pneu-
monia was the disease in which it won its spurs. First intro-
duced by Fleischmann, of Vienna, his great success with it
when made known led to its general use by homœopathists in
this country. His own countrymen have hardly concurred so
fully in his choice,-Wurmb and Caspar rejecting it altogether,
Kafka thinking it suitable only to catarrhal (broncho-) pneu-
monia, and Bähr and Clotar Müller inclining to limit its
appropriateness to cases in which the disease threatens to
deviate from its normal course, and where "nervous (i. e.
typhoid) symptoms appear. I must admit that to the typical
croupous" pneumonia, excited in fairly healthy subjects by
exposure to cold, and accompanied by much pain, Phosphorus
is less homœopathic than Bryonia. But I submit that we
comparatively rarely see the disease under such circumstances,
and that it most commonly occurs in delicate persons, with
lowered health, or secondarily to such blood-infections as
typhoid and scarlet fever. The exudation here would be
rather corpuscular than fibrinous. Under such circumstances
Phosphorus is preferable to any other medicine, and the
frequent English use of it in pneumonia is justified accordingly.
It is no less suitable-after Aconite-to acute pulmonary con-
gestion, even when effusion has taken place,—Bähr and Kafka
both praising it in acute cedema pulmonum. I agree also with
the latter author as to its perfect applicability to broncho-pneu-
monia-the catarrhal or lobular pneumonia of the nosologists.
In this malady occurring in children it is the one medicine
which has given me satisfaction; and, in fact, so apt is bron-
chitis in these subjects to run on into pneumonia that I always
employ Phosphorus, after Aconite, in its treatment. Other-
wise, it does not play an important part in the therapeutics of
bronchitis, either acute or chronic, nor in those of respiratory
inflammations higher up, save when they occur in a subacute
and lingering form in delicate, overgrown, or phthisical sub-
((
در
740
PHOSPHORUS.
jects. In these persons, hacking, dry coughs, with sensation
of tickling and perhaps dryness and burning in the larynx,
may often yield to the drug.
Á word here about the use of Phosphorus in pulmonary
phthisis. It is of great service in many ways in this disease.
It keeps down the hyperæmia of the lungs, quiets the cough,
and often moderates the diarrhoea. It may thus be actually
curative in pneumonic phthisis; and I have often seen incipient
symptoms of chronic pulmonary mischief clear away under its
use, in the medium dilutions. I am unable, however, to credit
it with any power of checking the deposit or development of
true tubercle. Neither our small doses of the pure substance,
nor Dr. Churchill's larger quantities of the hypophosphites,
can be relied upon for this purpose.
I must reserve the consideration of the remaining actions of
Phosphorus for our next lecture.
1
LECTURE XLIX.
PHOSPHORUS (continued)—PLUMBUM.
We resume our consideration of the several categories into
which the effects of Phosphorus upon the organism naturally
fall.
V. In nearly all cases of poisoning by this substance which
have been recorded during the last thirty years (mainly from
the ingestion of lucifer-matches), while symptoms of irritation
have not been absent, another and a very different group of
phenomena arrests our attention. The patient appears to be
suffering from what used to be called "malignant jaundice."
The skin and conjunctiva assume a more or less yellow tint,
and the stools are light; but with this there is a general
typhoid prostration which is absent from ordinary icterus.
Petechia and hæmorrhages occur in various parts of the body.
The urine is scanty, high coloured, and loaded with albumen.
Cerebral symptoms-delirium, convulsions, &c., somewhat like
those of uræmia-supervene, and the patient dies in a few days
in a state of coma. At the post-mortem investigation nothing
is discovered in the brain save a little fulness. But the blood
is found in a state of complete fluidity, non-coagulable, and
with very few red corpuscles, while ecchymoses and sanguineous
effusions appear everywhere. The liver, which during life had
been (at any rate at first) enlarged and tender, presents pro-
found alterations of substance. It varies in size; but fatty
degeneration is found to have taken place in its secreting
structure. The acini are sometimes found filled with fat, even
to bursting; but more commonly they are wholly destroyed,
and oil and fat-globules fill their place. The secreting struc-
ture of the kidneys also is found to be undergoing fatty
degeneration, and the ducts are sometimes filled with exuda-
tion matter. When the examination has been carried farther,
this fatty degeneration is found to have involved other parts of
the body, notably the heart and the muscles generally. Nume-
rous experiments on animals have verified these observations,
and have put it beyond doubt that these remarkable changes
742
PHOSPHORUS.
of tissue are really producible by Phosphorus in the space of a
few days, or even sooner.
In the paper by Dr. Madden and myself in the British
Journal, which I have already mentioned, you will find a
detailed account of these remarkable phenomena.*
What is their rationale? I would answer, in the first place,
that the fundamental lesion is an acute fatty degeneration,
which Phosphorus has the power of causing in every part of
the body susceptible thereof. In the second place, I would
refer the neurotic and hæmatic phenomena to the suspension
of the functions of the liver and kidneys, owing to the meta-
morphosis of their secreting cells. I attach most importance
to the affection of the liver. Although the cerebral symp-
toms resemble those of uræmia so far that they suggest the
retention of a similarly hurtful excretion in the blood, they
could hardly be mistaken for them. Combined with the
petechia and hæmorrhages they present a morbid condition
only present elsewhere in what Frerichs calls "acholia," i. e., a
suspension of the functions of the liver, owing to a destruction
of its secreting cells. The most prominent instance of this
lesion is acute atrophy of the liver; but it also occurs occa-
sionally in the course of cirrhosis, obstructive jaundice, and
other chronic hepatic affections. The symptoms are those of
blood-poisoning, to which the nervous phenomena are probably
secondary. I do not want to wander too far into pathology ;
but I must call your attention to the very interesting specu-
lations on the subject of Dr. Austin Flint, of New York.
His theory is that cholesterine is the excrementitious material
of the bile as urea is of the urine, and that the blood-
poisoning of acholia is accordingly a cholesteræmia. But I
must proceed to inquire into the therapeutic bearing of these
curious facts.
1. Phosphorus unquestionably deserves the fullest trial in
malignant jaundice, especially where, as in the great majority of
cases, the pathological condition is acute atrophy of the liver.
All observers, including Frerichs himself, are struck with the
resemblance of phosphoric poisoning to the phenomena which
accompany this lesion. I was myself at first inclined to
question the identity of the two, seeing that in acute atrophy
the fatty change of the secreting cells is by no means a pro-
minent feature. But it is sufficiently marked to lead three
pathologists (Engel, Wedl, and Bamberger) to explain the
1
To the references there given the following are a few additions :
Brit Fourn. of Hom., xxi., 460; xxiii., 128, 280; xxv., 520; United
States Med. and Surg. Journal, ii., 274.
PHOSPHORUS.
743
destruction of the cells by a fatty degeneration arising from an
acute exudation process. And while in acute phosphoric
poisoning the liver is felt to be enlarged (probably from
hyperæmia), Lebert and Wyss have ascertained that in slower
poisoning animals have their livers very much diminished in
size, and in a state which cannot be anatomically distinguished
from that of acute yellow atrophy. A case, moreover, is
recorded as occurring in a London hospital which was
diagnosed during life as acute atrophy, but in which, after
death, "the entire disappearance of the true hepatic secreting
structure and its conversion into oil and fatty matter rendered
it a remarkable case, justifying the term acute fatty degenera-
tion.* I think, therefore, that we may with propriety, if not
with confidence, combat this nearly always fatal disease with
our Phosphorus.
I
2. Dr. Holcombe, who was the first to call our attention to
these pathogenetic effects of Phosphorus, suggested its use
where jaundice complicates toxæmic disorders, and notably in
yellow fever. More recently Dr. Ozanam, of Paris, seeing a
case of this form of phosphoric poisoning in which to the
other symptoms black vomit was added, was forcibly struck by
the resemblance of the phenomena to those of the typhus
icterodes, and wrote accordingly. I feel a difficulty in acced-
ing to these views, because, according to Frerichs, there is not
in yellow fever (or in jaundice accompanying typhus and
pyæmia) any destruction of the hepatic cells, but rather, if
anything, polycholia. I should prefer Crotalus and the serpent
poisons for such jaundice, which seems to me of different
origin, i. e., hæmatic rather than hepatic. In this Dr. Hol-
combe now agrees with me.†
3. In Phosphorus we evidently have a homœopathic remedy
for that important pathological change known as fatty degene-
ration, wherever occurring. I need hardly enlarge upon the
picture thus opened to us of the applicability of our medicine.
It is most obvious when this morbid process attacks the liver
or the heart. Dr. Bayes speaks from experience of its value
in chronic cases of the former malady; and I have seen
undoubted evidence of its power of arresting the progress of
the disease in the cardiac substance. Dr. Lade has recorded a
striking case of the kind, in which, simultaneously with the
cardiac symptoms, an arcus senilis disappeared. Acute fatty
* See Brit. Journ. of Hom., xxiv, 166; and also the case in vol.
xxviii, p. 409.
† See Transactions of Amer. Institute of Homœopathy for 1868.
Hoyne, i., 107.
744
PHOSPHORUS.
degeneration of the heart is apt to occur in typhus; and here
Phosphorus must be remembered. I would also remind you
that the same process is thought by many to constitute athe-
roma of the arteries and mollities ossium; to be an occasional
cause of softening of the brain and cord; and, occurring in
the bronchial tubes, to predispose to emphysema.
4. Before leaving the liver, we must take away the thought
that Phosphorus has a very specific action upon it as an organ,
and may often be found curative in its diseases. The disorder
we have seen set up in it is a diffuse inflammation-as dis-
tinguished from the circumscribed hepatitis of tropical
countries which is so liable to go on to abscess. But
Dr. Wegner finds it capable of causing, when gradually
administered, an interstitial hepatitis also, in which the organ
is hard, enlarged at first but subsequently atrophied, and
then often presenting the typical granular form, the classical
cirrhosis of the liver. With all this there is chronic icterus;
and in the latter event there occur the secondary disturb-
ances so well known in human pathology-ascites and so
forth.
For both these forms of hepatic disease Phosphorus may
prove serviceable in cirrhosis, Dr. Salzer, of Calcutta, speaks
warmly of it. It should also be borne in mind for jaun-
dice, not only when complicating such graver maladies, but
when occurring to all appearance idiopathically. It has been
found capable of setting up the catarrhal inflammation of the
bile-ducts which is so frequently the cause of this disorder.
In jaundice from nervous excitement, moreover, it may be
the best medicine to give, as this is every now and then (espe-
cially in pregnant women) the beginning of an acute atrophy
of the liver.
dat
5. We have yet remaining the renal and hæmatic symptoms
of this form of phosphoric poisoning. It may be thought that
the affection of the kidneys is secondary to that of the liver,
as in two of Frerichs' best-described cases of acute atrophy
fatty degeneration was discovered in their glandular cells. I
must mention, however, that there is one case on record in
which there was no jaundice or cerebral disturbance during
life, although the liver was found (post mortem) enlarged and
fatty. In this case the urine during life was highly coloured
and frothy, its specific gravity increased, and it contained
albumen and exudation cells. After death, the cortical sub-
stance of the kidneys was granular; the Malpighian cor-
puscles resembled red points; and on a microscopical exami-
nation the uriniferous tubuli were found blocked up by exu-
PHOSPHORUS.
745
dation matter. While I agree with Dr. Hempel that this is
not Bright's disease, it is nevertheless a very decided nephritis ;
and warrants the expectation that Phosphorus may find a
place in the treatment of the idiopathic affection. It would be
indicated in chronic tubular nephritis when occurring as a result
of long-continued suppurations, as Bähr suggests. It should
also obviously be given in primary fatty degeneration of the
kidneys. The indication for it here is strengthened by the fact
that in one of Dr. G. Johnson's cases this affection (which
came on in three weeks' time) appeared to be the immediate
result of sexual excess.
↓
/
Yet more difficult is the question whether the dissolution
of the blood induced by Phosphorus is the result of a direct
hæmatic influence, or is secondary to the affection of the liver,
in whose idiopathic form it is a constant phenomenon. The
latter would seem, from physiological evidence, to be the true
alternative, as I can find no record of one set of symptoms
occurring without the other. It has been maintained, how-
ever, that both in acute atrophy and in phosphoric poisoning
the hepatic lesion is secondary to a blood-infection. There
are also therapeutic results which favour the hypothesis of a
primary hæmatic action on the part of the drug. I would not
lay too much stress on its value in purpura, as it is doubtful
whether the hæmorrhages here depend upon changes in the
vessels or in the blood itself. For what it is worth, however,
in relation to the present question, and for its own sake, let
me mention that Arnold, Clotar Müller, and other German
physicians esteem Phosphorus the great remedy for purpura,
and that under it, in Dr. Jousset's hands, a case of hæmor-
rhagic small-pox made a good recovery.† But the symptom
in Hahnemann's pathogenesis, "small wounds bleed freely,"
which has led to the choice of Phosphorus in such cases, has
also conducted to very valuable and unexpected results in no
less a disease than fungus hæmatodes.
The first to report success with it was Dr. Constantine
Hering, his patient being a negro in Surinam. Then the
editor of the United States Medical and Surgical Journal§ pub-
lished a case under the title "What was it?" in which a vascu-
lar bleeding fungus on the thigh, the seat of darting pain, got
rapidly well under Phosphorus 30. This narrative led me to
give the medicine in the following case.
* See United States Med. Investigator, vii., 396.
† See also a case in Amer. Hom. Review, v., 566.
+ See Archiv, Bd. ix.. H. 3, S. 153.
$ See Brit. Fourn. of Hom., xxvi., 658.
*
746
PHOSPHORUS.
Miss W., æt. 26, consulted me on May 23rd, 1870, telling the follow-
ing story. Five years ago she noticed a small lump in the right breast.
She showed it to a physician, but he told her not to be troubled about
it. She thought no more of it till last winter, when it began to enlarge,
and to be the seat of darting pains. Then a hole formed in the skin,
through which matter discharged; and last a flat sore formed at the
seat of the lump.
This was the condition of things when she came to me. I found a
sore, not much depressed and not unhealthy-looking, near the nipple.
The latter was not retracted, and there was no hardness at the base of
the sore.
The health was good; and the only trouble complained of
was the soreness and occasional pain at the seat of ulceration. I pre-
scribed (I hardly know why) Phosphorus 6, a drop night and morning;
and Calendula lotion to the sore.
Miss W. came again on June 3rd, and, on displaying the breast,
showed me, to my horror, a large bleeding fungus, which had sprouted
from the sore during the ten days since I first saw her. It bled freely
when dressed, and was the seat of frequent and severe darting pain.
I now gave a drop of the 30th dilution every alternate night, and
ordered the growth to be dressed with dry lint, and to be kept cool;
pressure also was to be made upon it by means of a bandage.
June 10th.-The fungus has not increased since last week; and there
is little pain now, and less bleeding than before. Continue.
June 18th.-No increase in size; the pain quite gone, and the bleed-
ing only occasional. Continue.
June 25th.-Bleeding quite ceased; and the fungus, which was dark
red at first, is now pale, and is suppurating. Continue.
So matters stood till August 4th; when, the size of the growth re-
maining unaltered, I thought I would try whether Thuja would help,
and prescribed it in the 30th dilution. On August 9th Miss W. came
again, saying that she feared the growth was increasing. It was cer-
tainly looking larger, and I found on one side of it a fresh red mass,
which had evidently sprung from the root of the fungus, and was push-
ing the old and deadened portion up from beneath. There had also
been an outburst of bleeding. As may be supposed, I returned to the
Phosphorus 30, giving a dose every evening.
August 31st.-Miss W. has been taking the Phosphorus until now.
The progress of the disease has again been checked; there is no pain
or bleeding; her general health is excellent; and the axillary glands
are unaffected.
September 24th.-There being still no diminution of size, I now once
more resorted to Thuja 30, this time taking the precaution of giving the
Phosphorus with it on alternate days.
On October 19th my patient exhibited the good effects of this pro-
ceeding. I found the fungus becoming detached at its root, and hang-
ing only by the slenderest of pedicles. I directed her to continue the
medicines, and to give the growth one daily twist upon itself until it
should fall off, when she was to bring it to me. I designed to send it
to some competent microscopist, that the question of its malignancy
might be set at rest.
But I was disappointed; though my patient was not. On November
8th she returned to tell me that about a week after her last visit there
had been a gush of blood from the breast, after which the fungus had
rapidly withered away, and in a few days had disappeared. There was
now nothing to be seen at its site but a small cicatrised sore.
PHOSPHORUS.
747
I continued the medicines for a short time longer, and then left them
I have seen or heard from her several times since; and there has
been no recurrence of the trouble.
off.
That this growth was a "fungus hæmatodes" there can be
no doubt, or there is nothing in the etymology of the phrase,
But whether fungus hæmatodes is always soft cancer is another
question; though, if it be not, I know not what it is. I had
hoped to have had an undoubted instance of that disease to
report, as cured by Phosphorus. The growth sprang from the
caruncula lachrymalis, and had completely covered and closed
the eye. It was not very painful, but bled profusely. Under
Phosphorus 30, a dose every other day, it diminished to less
than half its size, and made vision again possible on that side.
But the patient, a woman over sixty, showed coincident symp-
toms of break-up of constitution, and finally died hemiplegic
and dropsical. I would not therefore lay too much stress.
upon the action of the medicine here; but in the case cited it
was unquestionable. The help rendered by the Thuja also
seems palpable.
Dr. Broadbent published, some time since, a case of essen-
tial anæmia cured by our medicine, but its subsequent em-
ployment in this disease has not yielded satisfactory results.
There is one curious use of Phosphorus which does not fall
within any of the above categories. It is its power of curing
chronic mastitis, where sinuses have been left in the gland
after extensive suppuration. There are several cases on record
illustrating this power of the medicine. Bryonia has the same
exceptional action on the mammæ. Has local affinity, I
wonder, anything to do with it, both being such important
chest medicines?
I must also say a few words upon the use of Phosphorus in
diseases of the eyes. Its symptoms point to choroidal con-
gestion and retinal depression; and in affections of the fundus
having these characters, especially when photopsies or chro-
mopsies are present, Dr. Allen and Norton (and also Dr. Vilas)
have found it very useful. Dr. Goullon has recorded a cure
of amaurosis following cerebro-spinal meningitis wrought by
it,* and it should be useful for this affection when brought on
by excess in venery and perhaps in tobacco.† But its most im-
portant use in this sphere is its application to glaucoma. It
is when this morbid change begins with recurrent neuralgic
attacks, and seemingly depends upon the same nervous lesion
as that which causes the pain, that it is suitable and effective.
* See Brit. Fourn. of Hom., xxxvi, 93.
† Dr. Usher has reported a case of this kind cured by it (Hoyne, i., 99).
748
PLUMBUM.
Several cases of apparent cure with it have been recorded,*
and in my own hands it has proved of no little efficacy in
diminishing pain and checking the progress of degeneration
in glaucomatous eyes.
I may mention, in conclusion, some of Dr. Guernsey's
symptomatic indications for the drug. It is most suitable, he
thinks, for tall, slender women (he is speaking only of that
sex), who are liable to sensation of great weakness and
emptiness in the abdomen, and of heat running up the back,
with coldness of the feet and legs. They are generally costive,
passing long, narrow, dry hard stools, difficult to evacuate.
Upon the first of these characteristics Dr. Allen remarks that
it by no means holds good universally, as in diseases of the
nervous system requiring Phosphorus the patients are often
fat; as also in the fatty degenerations so obviously calling for
it.f The "face like polished ivory," which Dr. Hoyne
mentions as indicative of the drug, points to this morbid pro-
cess in the system.
Phosphorus is so unique a drug that I cannot name a single
genuine analogue to it.
As for dose: in the acute affections of the respiratory
organs for which Phosphorus is so frequently required, I find
the second and third dilutions answer every purpose.
The
first has been most used in paralysis and neuralgia, and I
should not be disposed to go higher in malignant jaundice.
The higher potencies have acted well in sexual irritability,
and in chronic affections of the respiratory organs, alimentary
canal, and mammæ.
I shall occupy the remainder of your time to-day with the
important metal, lead, Latiné
Plumbum.
Either the precipitated metal itself, the carbonate or the
acetate may be used to obtain the specific action of lead.
They are all triturated for homœopathic use.
A pathogenesis of Plumbum was published by Hartlaub and
Trinks in the first volume of their Arzneimittellehre. It con-
tains 1,024 symptoms, of which 565 are cited from authors,
being observations of the noxious effects of the medicinal or
operative employment of lead. The remainder are the result,
* See Brit. Fourn. of Hom. xxxii., 6-11.
† Hahn. Monthly, xiii., 486.
PLUMBUM.
749
as is stated, of "a careful proving on the healthy by means of
moderate doses of the acetate," in which five persons took part.
The best pathogenesis of the drug, however, which we have
hitherto had has been the well-known account given by
Tanquerel des Planches of the phenomena occurring in workers
with the metal.* A schema of the symptoms he enumer-
ates was given by Dr. Black, in the appendix to the
first volume of the British Journal of Homœopathy; and has
been of great use. We have now, however, in Dr. Allen's
Encyclopædia an amalgamation of the symptoms obtained
from these two sources with those of upwards of four hundred
additional observations of the same kind, making a total
pathogenesis of 4,163 symptoms. An excellent account of the
latest observations and studies of chronic lead-poisoning is
given by Naunyn, in the seventeenth volume of Ziemssen's work.
I need hardly remind you that the earliest symptoms of
saturnine intoxication are the well-known "lead colic," and
the "wrist-drop" which results from paralysis of the extensor
muscles of the fore-arm, accompanied by wasting of their sub-
stance. More profound poisoning of the system induces a
kind of degeneration of all the tissues. The nervous centres
are found indurated or softened; and headache, amaurosis,
neuralgia, palsy, anæsthesia, epilepsy, occur during life. The
muscular tissue throughout the body is wasted or contracted.
The kidneys are small and granular. There is complete
decay of the bodily and mental powers, with profound
melancholia; and the impairment of nutrition shows itself in
the anæmic and cachectic appearance of the subject, who pre-
sents commonly a yellowish hue of skin (icterus saturninus).
Let us consider separately each of these effects, or groups.
of effects, in connexion with the use of Plumbum as a medicine.
The division made by Tanquerel des Planches is that com-
monly adopted in describing lead poisoning, and we cannot
do better than follow it. He classifies the phenomena as
those of colic, of paralysis, of arthralgia, and of encephalopathy.
M
I. The colic of lead is a severe pain, consisting of occasional
intense paroxysms, generally of shooting character, the in-
tervals being filled up with a continued sense of griping and
cramp. It is as a rule worse in the evening and night. It
may occupy all parts or any part of the abdomen. It is
always relieved by pressure, and the more the firmer this is
made. It is accompanied by obstinate constipation, by re-
traction of the abdominal walls, frequently by vomiting and
slight icterus, and by a slow, full, and hard pulse.
* Traité des maladies de Plomb, Paris, 1839.
750
PLUMBUM.
Pathologically, this affection seems compounded of neuralgia
and spasm. Naunyn and Eulenberg describe it as a neurosis of
the intestinal plexus (iliac and coeliac), the peculiar pulse
being due to reflex excitation of the cardiac nerves through
the splanchnics. Stillé, describing the pain as "darting in
every direction, to the back, loins, uterus, scrotum, and groins,
or occupying the thighs and legs, or the muscles of the chest
and of the upper limbs," says "in a word, it has all the
characters of a severe neuralgia whose greatest severity is ex-
pended upon the digestive organs." Spasm shows itself in
retraction of the abdomen (and often of the testes); and
Tanquerel "succeeded in feeling very energetic contraction of
the rectum during an attack of colic, by digital examination."
A similar condition is shown in the bladder by tenesmus or
retention of urine, and by great hindrance to the passage of a
catheter.
These abdominal phonomena of lead-poisoning at once
suggest the metal as a remedy for colic and constipation,
whether occurring separately or together. And indeed I
know of no better instance of the truth of the law of similars
than the beautiful action of Plumbum in such conditions. For
obstinate habitual constipation, when the stools are dry and
lumpy, and the intestines half-paralytic and half-crampy, I
have the utmost confidence in it. It is no less valuable in
what Dr. Copeman calls "obstipation "-that is, in impaction.
of fæces. Of this you may read a good instance by Dr.
Lohrbacher in the twenty-ninth volume of the British Journal
of Homœopathy. This use of lead, inexplicable save upon the
homœopathic hypothesis, has been recently imported into
ordinary practice by Dr. Thorowgood, as usual without
acknowledgment of its source.* We carry it still farther,
relying upon the medicine in any form of obstruction of the
bowels that has not a mechanical cause, and in incarcerated
and even strangulated hernia. You will do well to read the
remarks of Drs. Baumann and Mayländer on this subject in
the thirty-first volume of the British Journal. The latter
generally succeeds in strangulated hernia with Belladonna and
Nux vomica; but, if these fail, he resorts to the knife. Dr.
Baumann considers that, before this extreme remedy is sought,
we have a resource in Plumbum, and adduces good evidence
for his belief, of which indeed there is no lack elsewhere.
Nor less when colic is the prominent point of similarity to
the effects of lead is its medicinal power displayed. Of this
Dr. Holland has put a striking case on record. The patient
* See Brit. Fourn. of Hom., xxxi., 376.
PLUMBUM.
751
had been suffering from most agonising abdominal spasms for
two days, with vomiting, and suppression of stool and urine.
A grain of Plumbum aceticum, third decimal, was given; and
in less than ten minutes the patient fell asleep, waking after
many hours free from pain, and able to relieve his bowels of a
Most of us have
mass of scybala. The next day he was well. *
probably seen similar good effects from the medicine, though
under less striking circumstances.
·
The association of colic with constipation, and of constipa-
tion with colic, always forms the special indication for Plum-
bum as a remedy for either. But such association is not
essential. The habitual costiveness in which the medicine is
so efficacious may be quite painless; and on the other hand
Bähr has related one case, and I myself another,† of what may
fairly be called neuralgic enterodynia cured by it, where the
bowels were regular enough. In such cases the sense of re-
traction in the abdomen mentioned as characteristic by Dr.
Guernsey, or the actual hard and tense condition observed by
Bähr, may guide to its choice. The latter author justly main-
tains that it is in neuralgic colic rather than that brought on
by cold (in which Colocynth is so valuable) that Plumbum finds
its place. On the other hand, I think he errs in discouraging
the use of the drug in ileus, because the abdomen herein is
distended instead of as in lead-poisoning-retracted. Naunyn
says of the latter condition :— “În not a few cases, however, it
is entirely wanting, and in its place there is swelling of the
abdomen."
2. Of the paralysis of saturnine intoxication I have already
spoken in its most familiar form of "wrist-drop," ie, loss of
power of the extensors of the hands, which are affected more
than the flexors. Manouvriez has shown that this may some-
times be a local effect of handling the metal (see S. 3089 of
Allen). But, while much more frequently occurring in the
upper than in the lower extremities, yet lead paralysis every
now and then invades the latter. It is rarely accompanied
with anesthesia, though lead anæsthesia as an independent
affection is common enough. The paralysis is preceded often
by a trembling (tremblottement saturnine) of the affected
muscles, sometimes by spasms and shooting or tearing pains.
It is partial rather than general; and Tanquerel des Planches
states that he was frequently astonished to find that muscles
were paralysed whose nerve supplied others also that were not
paralysed. There is always marked atrophy of the affected
muscles; and sometimes this condition becomes general, so
* Brit. Journ. of Hom.,xxxii., 79. † Ibid, xxii., 239.
752
PLUMBUM.
that the patient resembles a walking skeleton. The muscles,
when examined post mortem, are found wasted and very pale,
and have sometimes the appearance of white fibrous tissue.
(C
It is impossible not to be reminded here, even more than
with Phosphorus, of the disease known as progressive mus-
cular atrophy or wasting palsy. The local selection, the pre-
dominant atrophy, the presence of trembling (fibrillary con-
tractions) and absence of anesthesia correspond in the two.
Trousseau admits that the differential diagnosis is attended
with difficulty; and can only adduce by way of distinction
the different behaviour of the muscles when submitted to the
electric stimulus, and the history of the evolution of the symp
toms. The former is a mere matter of degree, and as to the
latter, M. Trousseau is inconsistent with himself. In the
lead-disease," he says, "palsy precedes atrophy,” leaving it to
be understood that in wasting palsy atrophy precedes loss of
power. But he himself had already made the following remark
on the case of the latter malady which gave rise to his clinical
lecture. "You may remember that Dr. Duchenne himself,
who honoured us with his presence during our round, had
shown that most of the muscles of the arm and fore-arm still
contracted under the influence of electricity, whilst the patient
could not voluntarily move his hands or his fore-arms. One
could not but suppose, therefore, that previous to any ana-
tomical change, which seemed not to exist then, the peripheral
extremities of the nerves had undergone a modification, in
consequence of which they had lost the power of rousing mus-
cular contraction. A loss of excitability of the peripheral ex-
tremities of the nerves would therefore precede the degeneration
of the muscular fibres, a fact perfectly in accordance with
pathological physiology."
Consider, then, the experiments on rabbits which are related
in the seventeenth volume of the North American Journal of
Homeopathy, and which point strongly to the same analogy.
Read, moreover, the series of cases of muscular atrophy given
in the first volume of the Practitioner to illustrate the effects
of electricity in its treatment. In several of these it remained
doubtful to the last whether the poison of lead was not the
exciting cause of the disease. I think that, in the face of this
cvidence, you will warrant me in recommending from the
homœopathic point of view the persistent trial of Plumbum in
the first instance of wasting palsy which comes under notice.
I may mention, for your encouragement, two cases in which
this recommendation of mine (first made in 1869*) has been
* On the various forms of Paralysis, p. 43.
PLUMBUM.
753
acted upon with advantage. One was treated by myself. The
muscular wasting, which had been going on for two years, was
completely checked by the use of Plumbum, in varying dilu-
tions, during a space of three or four months; though I have
been disappointed in my expectations of a restoration of
power. The second is reported to me by Dr. Reginald Jones,
of Birkenhead. The patient "presented the appearance of a
living skeleton." The presence of fibrillary contractions in
the paralysed muscles led him to the use of Plumbum, which
he gave in the sixth attenuation. "The results," he writes,
“have been most gratifying."
But I have already reminded you, when speaking of Bella-
donna, that wasting palsy is a member of a group of paralytic
diseases dependent upon the same pathological alteration in
the nervous centres, and differing only in the seat of its occur-
rence. Accordingly, a further study of plumbic paralysis brings
features to light which correspond with the symptoms of other
spinal paralyses. I will content myself for the present with
referring you to the remarks of Erb, in commenting on the
wrist-drop of lead under the title of "musculo-spiral paralysis"
in Ziemssen's Cyclopædia (vol. xiii.). It cannot be doubted, he
says, that the seat of paralysis should not be looked for in the
muscles and we have here a primary lesion of the nervous
system. He then discusses the question whether the lead-
paralysis is peripheral or central; and concludes―" The spinal
origin of the paralysis thus appears to be a possibility; and I
am at present inclined, on various grounds, to regard it as more
probable than the peripheral origin, partly on account of its
obvious analogy with the spinal paralysis of children, with
regard to distributive atrophy of muscles and electrical rela-
tions, partly on account of the regular symmetrical affection
of the same nerve-regions, partly on account of the merely
partial paralysis of definite fibres of the same nerve-trunk (the
supinator longus remaining free), and, lastly, on account of the
sensibility remaining unaffected." Naunyn concurs in the same
conclusion.
The paralytic conditions in which Plumbum has hitherto
been used in the school of Hahnemann are principally those
resembling its wrist-drop. Drs. Dudgeon,* Sharp,† and Chal-
mers‡ have each recorded a cure of a case of this kind; and
Dr. Bayes speaks of having seen others. But Dr. Jousset has
made the commencement of an application of Plumbum to the
* Brit. Journ. of Hom., xxix., 612.
+ Essays on Medicine, pp. 388, 456.
Monthly Hom. Review, xiii., 145.
3 C
754
PLUMBUM.
inflammations of the cord by curing a case of acute spinal
paralysis with it. You will find the narrative at p. 465 of his
Leçons de Clinique Medicale. He gave the 30th dilution.
That paralysis may occur as early as the third day after the
first exposure to lead (Tanquerel) shows it to be perfectly
suitable to such cases. But I should expect to find it still
more useful in chronic inflammations of the brain and cord,
whether seated in the nervous substance itself or in the neur-
oglia. Some of the symptoms of multiple cerebral sclerosis
are very obvious in its pathogenesis, and in one case observed
by Renaut (occurring in a worker) the ataxy characteristic of
posterior spinal sclerosis was present. Mr. Thorold Wood
lately communicated to the British Homœopathic Society* a
case regarded by him as of this kind, occurring in a child, in
which Plumbum 6 was curative. I cannot quite agree with
his diagnosis, but unquestionably spinal paresis was present.
3. The neuralgic and spasmodic pains of lead-poisoning,
which we have already seen in its colic, are also manifested in
the limbs. They occur even in acute poisoning by the acetate;
and among the workers are the symptoms most frequently
seen after those of the abdomen. They are the arthralgies of
Tanquerel, who explains that he uses ȧpopov in the sense of
limb, not of joint. He describes the pains as sharp in
character (Naunyn says burning and tearing); not precisely
following the track of the nervous cords (Dr. Bartholow thinks
that the intra-muscular sensory nerves are their seat); con-
stant, but becoming acute by paroxysms; diminished by
pressure and increased by motion; and accompanied by
cramps, which are always a very marked feature of the pains
of lead. They are sometimes felt in the thorax also, but
very rarely in the face-in one only of all the observations
collated by Allen. They have once at least been described as
"lightning-like" (S. 3,300 of Allen), suggesting the douleurs
fulgurantes of locomotor ataxy.
The neuralgic pains of Plumbum have hardly found their
application to practice; but it plays an active part in our
hands in the treatment of local spasms. Dr. Stokes has put
on record a case of cramps of the calves of long standing
rapidly cured by it.† Drs. Chapmant and Cooper have
illustrated its value in spasmodic conditions of the rectum and
anus, and Teste has removed with it painful retraction of the
testicles. Dr. Dyce Brown has called our attention to the im-
* See its Annals, viii., 375.
† Brit. Fourn. of Hom., xxvi., 128.
† Ibid, iii., 170.
-
PLUMBUM,
755
portant observation that vaginismus has been observed as an
effect of lead-poisoning,*-a fact which may yet be turned
to practical service, though I found the medicine inoperative
in a case in which I gave it. In an incurable paralysis which
I once treated with it, it almost entirely removed the cramps
which constituted the most distressing element of the case.
4. The "encephalopathy" of lead-poisoning embraces its
cerebral symptoms, which, though of diverse kinds, always
appear as a connected group. They are doubtless sometimes
uræmic, from the renal mischief of which I shall presently
speak; but more commonly they are primary. Violent head-
ache and amaurosis are the usual prodromata; then maniacal
or melancholic conditions may supervene, but most frequently
eclampsia. The convulsions are quite epileptiform in cha-
racter, and coma or delirium may fill up their intervals.
This epilepsy of lead-poisoning has hardly received suffi-
cient attention hitherto. Occurring, as it generally does, in
the "secondary saturnine intoxication," it implies the existence
of some amount of degeneration of the nervous centres, thus
rendering Plumbum as truly homoeopathic to chronic as
Hydrocyanic acid to recent epilepsy. I agree with Bähr in
ranking it with Cuprum as the remedy from which most is to
be expected in confirmed cases of the disease. Dr. Burnett
has recorded† a striking cure of epilepsy of 13 years' standing
by it: the patient's general condition Was one to which
the medicine was exquisitely homœopathic. He gave the
30th dilution.
Besides these recognised forms of lead-poisoning, I must
speak of certain other manifestations of its influence.
5. The first of these is its action upon the urinary organs.
In the first place, we have Dr. Ringer's statement that after
the administration of its salts there is an increased amount of
mucus in the urine, with signs of irritation of the lining mem-
brane of the bladder, even to the extent of inducing a catarrhal
condition. Correspondingly, Teste claims to have cured with
Plumbum several chronic affections of the urinary organs.
But of still greater interest is the action of the poison on the
kidneys. These are found, as I have said, small and granular :
there is present the contracted kidney which constitutes the
most serious form of Bright's disease. So frequently does
this lesion occur in the subjects of plumbism, that Dr.
Dickinson states that it was found in twenty-six out of forty-
two workers in lead who died from various causes in St.
* Monthly Hom. Review, xiii., 574.
† Ibid, Jan., 1878.
-
756
PLUMBUM.
George's Hospital. During life, albuminuria is an evidence
of the mischief being set up; and it has been thought that
the saturnine epilepsy and amaurosis may sometimes be due
to it.
Another effect of the renal degeneration induced by lead
is that the separation of urates from the blood is checked, so
that the uric acid of the urine is diminished while that of the
blood is increased. This is the pathological condition which,
according to Dr. Garrod, excites gouty inflammation; and he
and Dr. Ringer agree in stating, from experience, that if to a
gouty person, free at the time from the special manifestation
of the disease, a salt of lead is administered, it developes an
acute attack of gout, with its usual symptoms of severe pain
and high fever. Dr. Garrod accounts in this way for the
frequency with which gout appears among workers in lead as
compared with those following other occupations. Of all this
there need be no question. But it is another thing to suppose
that lead causes its renal degeneration through the inter-
mediary development of gout. That its kidney is the "gouty
kidney" is unquestionable; but only, I think, because both
it and the gouty poison have the same renal action. It is
admitted that in many instances the granular kidney is the
only gouty manifestation present in the subjects of lead-
poisoning; and Dr. George Moore has entered into a thorough
examination of the evidence in a paper contributed to the
twenty-fourth volume of the British Journal of Homœopathy,
the result of which is entirely adverse to the causation of true
gout or rheumatism-by lead.
K
We conclude, then, that lead causes granular degeneration
of the kidneys by a direct and specific action; and should be
a hopeful remedy for the disease, whether of gouty or other
origin. No medicine, moreover, so closely corresponds to the
general phenomena of the malady-as the atheroma, the
cachexia, and the depression of spirits: the amaurosis also of
the two is precisely similar. The only recorded (old-school)
experience of the use of lead in renal disease is that of Lewald,
as given by Dr. Ringer. He found it constantly diminish the
albumen in the urine, though only by nine or ten grains in the
twenty-four hours. The diminution appeared to hold no
constant relation to the quantity of lead administered. At the
same time, and with the same absence of quantitative relation
to the drug, the amount of urine was increased in the same
period by 200 cubic centimétres. The form of the renal mis-
chief here is not stated, but Dr. Ringer thinks with reason that
the large white kidney existed. I have myself tried the treat-
PLUMBUM.
757
ment in two well-characterised cases of granular degenera-
tion. In one the effect was nil, save to relieve an accompany-
ing constipation. In the other great improvement in general
health ensued for a time; but a chill caused pericarditis and
death. Dr. Samuel Jones has recorded an apparent cure in
the twelfth volume of the American Observer.
6. The other affection I have now in my mind is the
amaurosis of lead-poisoning. It is sometimes (as I have said)
secondary to renal mischief, when it is either a temporary anæmia
of the retina, or a more lasting retinitis albuminurica. It may,
however, occur as a substantive change, and then appears to
consist in an optic neuritis, with its central scotoma. This
action of the metal has not yet been, but ought to be, applied
in practice.
In these six categories I have included the main effects and
uses of Plumbum. But other conditions of body every now
and then come across us in practice which remind us of lead-
poisoning, and in which we may expect benefit from its use.
Such is the melancholia religiosa of which two cures by it are
recorded by Dr. Chapman,* and with which great constipation
is generally, as there, associated. Dr. Sharp also speaks of
using it beneficially here. Dr. Winter points out its homœo-
pathicity to chlorosis, and gives instances of its successful
use.† Bähr suggests its employment in chronic encephalitis,
and I have seen good results from it in chronic dull headaches,
with depressed spirits and constipation. Again, the effects of
drinking water contaminated with the metal must be taken
into account as homoeopathic indications for the use of the
drug. An interesting series of such cases has lately been
communicated to the British Journal by Dr. von Tunzelmann.‡
In one amblyopia with double vision occurred; in another
icterus and (nocturnal) vomiting; a third had renal congestion,
a fourth anasarca and paralysis; in another pulmonary con-
solidation with wasting occurred; and in yet another hæmop-
tysis and epistaxis-all these troubles passing off as the
noxious influence was removed. It is also worth noting that
in a case related in Frank's Magazin a quarter of a grain of
the acetate three times a day caused swelling, pain, and great
weight in the testicles; and Dr. Rutherford has lately ascer-
tained that it is a direct depressant (ie., not through the
medium of purgation) to the secretion of bile.§ Plumbum is
* Brit. Fourn. of Hom., iii., 170.
† Ibid, p. 218.
Vol. xxxii., P. 17.
$ Brit. Med. Fourn., Dec. 28, 1878.
G
758
PLUMBUM.
another medicine whose remedial effects seem to me far from
having been exhausted.
Alumina, Opium, Platina and Zinc are more or less closely
allied medicines.
LECTURE L.
PLATINA, PODOPHYLLUM, PULSATILLA.
I have to speak to-day of three medicines,-two of the
second or even a lower rank, but the third of primary im-
portance. They are Platina, Podophyllum, and Pulsatilla.
First, of
Platina.
Our preparation is made by triturating the precipitated metal.
It would more correctly be called Platinum.
There is a pathogenesis of Platina in the second edition of
the Chronic Diseases. It contains 527 symptoms, most of
which are credited to Gross. They are taken from a proving
instituted by this physician, chiefly on "a damsel, both bodily
and mentally healthy and blooming, though somewhat excit-
able," who took doses of the first trituration equivalent in all
to between two and three grains of the metal. This proving
(or rather the symptoms thereof) is recorded in the first volume
of the Archiv. An admirable study of Hahnemann's patho-
genesis, and of the clinical uses of the metal, by Dr. Veith
Meyer, was translated in the second volume of the Phila-
delphia Journal of Homœopathy by Dr. Dunham, and will be
found in the first volume of his collected writings.
this study mainly my remarks will be based.
Upon
The chief action of Platina appears to be upon the nervous
centres-the symptoms, when allowance is made for the tem-
perament of their chief source, being generally characterised
by depression. There is a strong tendency to paralysis and
anæsthesia, localised numbness being a frequent sensation;
and in the emotional sphere there is anxiety and apprehen-
sion, even to the fear of death. With this-perhaps through
an action upon the abdominal and pelvic plexuses-there is
torpor of the intestinal canal, shown in flatulence and consti-
pation; and also premature menstruation. As is usually the
760
PLATINA.
case, many spasmodic and neuralgic phenomena are mixed up
with those of paralysis and anæsthesia; the pains arc
mostly crampy, and associated with numbness and coldness.
In accordance with these pathogenetic indications, Platina
has hitherto been used mainly for hysteria and melancholia
in females, connected with deranged uterine health. It has
cured even religious melancholy in these subjects; and alto-
gether may be said to be to women what Aurum is to men.
In corroboration of this remark, it may be observed that
Platina holds the same place in the treatment of chronic
ovarian disease as Aurum in the corresponding affections of
the testicle. Hering recommends it for induration of the
ovaries (Hahnemann had already mentioned a similar condi-
tion in the uterus as indicating it); and Mr. Harmar Smith
has published a case of chronic ovarian irritation with sterility
in which it was curative." The distinguishing feature between
Platina and Pulsatilla in these cases is that with the former
there is menorrhagia, with the latter the reverse. Menorrha-
gia itself is often helped by Platina, especially, Dr. Guernsey
says, when a black and thick condition of the menstrual flow
is present. Sexual excitement, both psychical and physical,
is apt to accompany such phenomena; and Platina is much
esteemed for this, even when it reaches to nymphomania. Jt
is also useful in such a condition in the opposite sex, while
below puberty; I mean to subdue the morbid excitement
which keeps up the habit of masturbation in young boys who
have been inducted into it. For this purpose Dr. von Grau-
vogl commends it highly. Dr. Meyer thought much of it in
the treatment of hysteria, when the patients are depressed;
herein contrasting with Ignatia, whose subjects are keenly
impressionable and capricious. He notes the "hysterical
asthma" and the clavus as frequent among its symptoms.
Dr. Guernsey lays more stress, among the mental symp-
toms of Platina, on the sense of exaltation of self and con-
tempt for others as characteristic of it. He also frequently
reports "horrifying thoughts" among its key-notes.
Platina has also some points of usefulness which remind us
of those of Plumbum, to whose effects it has been suggested
as an antidote. It is useful in some superficial neuralgia,
accompanied with torpor and numbness. Hahnemann men-
tions "constipation while travelling" as indicating it; and in
this trouble when occurring in women whose uterine health is
imperfect, it is often helpful. Dr. Guernsey describes its stools
as putty-like, so hindering their own expulsion.
* Brit. Journ. of Hom., xxv., 157.
*
Bang
PODOPHYLLUM.
761
The chloride of platinum has been used successfully in the
old school in the treatment of chronic syphilis and of condy-
lomata, acting very much like the chloride of gold.* Höfer,
who has introduced it here, found six grains to produce in
himself a violent but short-lasting headache, chiefly occipital.
A very severe and obstinate syphilitic headache in a woman,
which iodide of potassium alone seemed unable to cure, went
on rapidly to recovery when I gave the chloride of platinum
(five drops of the third decimal dilution twice daily) as an
alternating remedy. I was led to its selection by the profound
depression which was present. As to condylomata, Teste long
ago classed Platina with Thuja as an anti-sycotic.
The analogues of Platina are the Aurum, Pulsatilla, Ignatia,
and Plumbum I have already named. You will find their
points of resemblance and difference well pointed out (together
with those also of Asafoetida and Crocus) in Dr. Meyer's
article.
Platina has generally been used in the higher potencies,
from the sixth to the thirtieth; but Dr. Meyer professes him-
self quite satisfied with the second and third triturations, in
which I agree with him.
My second medicine is one which we homoeopathists took
many years ago from the so-called "eclectic" practitioners of
America, and of which ordinary medicine has since made the
acquisition from the same source-the mandrake, or May-
apple,
Podophyllum.
We use a tincture prepared from the root of the P. peltatum.
Podophyllin, which is now so much used as a cholagogue, is
a resinoid derived from the plant, and seems to contain its
active virtues. It is triturated, or dissolved in rectified spirit,
for our purposes.
Podophyllum was proved, in the 1st, 3rd, and 15th dilutions,
by Dr. Williamson in 1844; and his results published, with a
few symptoms from five others, in the Materia Medica of
American Provings. But the knowledge of the action of the
drug is best learned from its toxical and curative powers, as
Dr. Hale records them in his New Remedies; and from the
numerous experiments on animals which have been made
with it during the last twenty years. Allen's Encyclopædia
* Like this metal, it appears able to excite some salivation.
762
PODOPHYLLUM.
gives symptoms from twenty human subjects, obtained in
various ways.
=0
Podophyllum came to us with the reputation of a chola-
gogue purgative, resembling calomel. The three sets of ex-
periments which have been made with it on the lower animals
-those of Dr. Anstie,* Dr. Hughes Bennett,† and Dr. Ruther-
fordt-bear especially on this question.
Dr. Anstie found an
increased quantity of bile in the evacuations a comparatively
rare phenomenon; but the liver in most of his autopsies is
stated to have been somewhat congested. Dr. Hughes Bennett
found purgation by the drug, as by other agents, diminish the
flow of bile through a biliary fistula; but even when the dose
fell short of producing this effect, the solid elements of the
secretion were reduced in quantity, though its fluid portion
was somewhat increased. Both observers seem to infer that
Podophyllum has no action on the liver; but I cannot think
that such a conclusion is fairly deducible from their facts. On
the contrary, they seem to be such as to invite further experi-
mentation, especially upon human subjects, with the view of
following up their hints. My own expectation is that Podo-
phyllum will be found to act here as we have seen Mercury
doing in the mouth, i.e., that its irritant influence on the
duodenum (which will presently come before us) leads to a
copious flow of bile from the gall-bladder and liver; but that
it may also act on the liver itself, congesting it, and so impair-
ing its function. The former part of this hypothesis seems
confirmed by the recent experiments of Dr. Rutherford, who,
on introducing Podophyllin into the duodenum of fasting dogs
found it increase the amount both of the solid and fluid ele-
ments of the bile.
However this may be, there is--as with Mercury-a con-
sensus of opinion as to its therapeutical virtues which no
physiological evidence can set aside. Doses much too small
to induce purgation-from the fourth to the hundredth of a
grain or even less-have been shown by practitioners of both
schools to act with the best effect in relieving hepatic torpor
and partial stagnation, to the great benefit of the patient. I
would refer you especially to the observations of Dr. John
Moore in the thirty-first volume of the British Journal of
Homoeopathy, and to those of Dr. W. A. Allen in the fourth
volume of the (American) Homeopathic Times. The latter
believes it the great remedy for rectifying the hepatic dis-
orders occurring under malarious influences; and it cannot
* Med. Times and Gazette, 1863, i., 326.
† Brit. Med. Fourn., 1869, i.,418. ‡ Ibid, 1875, ii.
PODOPHYLLUM.
763
act as a "cholagogue” in his hands, as he gives it in doses which
could only avail for a truly homoeopathic operation, viz: the
second and third attenuation where constipation is present,
the thirtieth and higher where there is diarrhoea. Whatever
may be its modus operandi here, it seems evident that, so long
as we stop short of its purgative effects, no harm is done.
We get on clearer ground when we come to the intestinal
influence of the drug. That it readily caused vomiting and
purging was well known; but the experiments of Dr. Anstie
have enabled us to define this action with great precision. He
found, in numerous experiments on dogs and cats, that an
alcoholic solution of Podophyllin, when introduced into the
peritoneal cavity, caused no inflammation there, but set up in
the small intestines an intense hyperæmia. The duodenum
was chiefly affected, and actual ulceration was more than once
developed there. The lining membrane of the whole small
gut was generally found covered with bloody mucus. The
inflammation usually ceased at the ileo-cæcal valve, but occa-
sionally invaded the large intestine. The frequent stools
consisted of glairy mucus, sometimes stained with bile, but
more commonly with blood.
These are very important results. They give us in Podo-
phyllum another medicine to add to Arsenic, Kali bichromicum
and Uranium nitricum as acting specifically on the duodenum,
and capable of controlling ulceration therein.
And more,
they give us a remedy truly homoeopathic to enteritis affecting
the jejunum and ileum, which neither these nor Mercurius cor-
rosivus are. The first enabled me once to cure a duodenitis,
which was resisting Arsenic. The latter shows a local affinity
for the diarrhoea of typhoid, in which, and in simple enteritis
affecting the same parts, the drug may do good service.
No action on the rectum was manifested in the animals
poisoned by Dr. Anstie; but in the human subject—especially
in children-this part is readily affected by the drug, as shown
by tenesmus and prolapsus recti complicating the diarrhoea.
The feeble affinity of Podophyllum for the colon makes it
unsuitable for ordinary dysentery, which has its seat there.
But when dysenteric diarrhoea appears to depend on inflam-
matory irritation of the rectum, it will give rapid relief. Such
a malady is not uncommon in children, and is generally ac-
companied by painful prolapse of the rectum at each stool.
Dr. Hale speaks of having seen two such cases caused by the
over-use of the drug; and I have recorded one, and Mr.
Harmar Smith another,* of speedy cure by it. In simple pro-
* Brit. Fourn. of Hom., xxiv., 673; xxix., 399.
764
PODOPHYLLUM.
lapsus ani from debility, moreover, when occurring in child-
hood, beautiful results are almost always attainable from
minute doses of the drug.
Besides enteritis of the small intestine, and dysentery of the
rectum, Podophyllum is useful in several forms of diarrhoea,
both acute and chronic.* Drs. Ringer and Phillips concur
with us in praising it here, adding the necessary caution that
it must be administered in very small doses. The former,
moreover, confirms what homoeopathists have always regarded
as a main indication for the medicine in chronic diarrhœa,
viz., its recurrence especially in the early morning. It is often
serviceable in cholera nostras and cholera infantum; but its
place in their therapeutics is hardly yet defined. It is very
useful when the stools are too frequent, and yet natural-a
not uncommon complaint in children, and generally associated
with some amount of wasting.
St
A good deal of evidence has accumulated of late, showing
a power on the part of Podophyllum of benefiting prolapse
of the uterus as well as of the rectum. I know not whether
it is by a direct action that it accomplishes this. Dr. Guernsey
speaks of a sense of falling in the abdomen as especially
indicating it.
In the fourth edition of his New Remedies, Dr. Hale gives
two interesting communications on Podophyllum, one from
Dr. Scudder, an "eclectic" practitioner, evidently "almost
persuaded to be a" homoeopathist; the other from a prominent
writer of our own school, Dr. Searle, of Brooklyn. The former
gives, from his experience, certain peculiar symptoms as in-
dicating the choice of the drug. They are, fulness of the
superficial veins; dull, unpleasant pain, or weight, in the hypo-
gastric region; a sharply defined ache in the sacro-ischiatic
foramina, with tenderness on pressure; and pain in the course
of the ulnar nerve. He also mentions a peculiar stool as
characteristic of it,-the first part being large and hard, but
then fluid and wind following. Dr. Searle compares the
morning diarrhoea of Podophyllum with that of some other
medicines. "In the morning aggravations of the bowel symp-
toms," he writes, "Podophyllum resembles Aloes and Sulphur,
but may easily be differentiated from these. The stool of
Aloes is a windy spurt of watery or slimy yellow fæcal matter,
the desire for which can hardly for an instant be controlled
from a seeming if not real weakness of the internal sphincter.
Sulphur demands equal haste from tenesmus. It has a brown
stool, not especially flatulent, and neither so scanty as that
* See Brit. Fourn. of Hom., xxvi., 654.
PULSATILLA.
765
Podo-
of Aloes, nor so profuse as that of Podophyllum.
phyllum gets its victim up early, but not in so great haste as
the others; and has a very profuse, yellowish or greenish,
stool-so profuse, indeed, that one wonders whence so much
can come. It often contains undigested food, and is very
offensive to the smell, having sometimes the odour of carrion."
Dr. Searle might have mentioned Apis, Nuphar and Rumex
as additional analogues to Podophyllum in respect of morning
diarrhoea. In its general action it resembles Colchicum, Iris,
Leptandra, and Mercurius.
The third attenuation of Podophyllin seems to give us all
its strictly homœopathic applications.
My last medicine is the meadow anemone, pasque flower,
or wind flower-
Pulsatilla.
It was the P. nigricans which was introduced into medicine.
by Stoerck, and proved by Hahnemann; and which accord-
ingly is used in homœopathic practice. The American species
has been found, as we shall see, to possess similar properties;
but though chemical research has discovered that the P.
pratensis also contains the alkaloid anemonin, it is not proved
that this is its active principle, and as a fact the English in-
digenous species has little medicinal power. The Pharma-
copœial tincture is made from the entire plant.
The pathogenesis of Pulsatilla is in the second volume of
the Reine Arzneimittellehre. It contains 1,153 symptoms, all
except about a hundred of which are Hahnemann's own, the
remainder being supplied by five provers and a few authors.
Hahnemann states that his own symptoms were obtained from
very moderate doses, and are therefore primary effects of the
drug. He has bestowed great attention upon the pathogenesis,
annotating it freely, and pointing out the connection of the
various symptoms. For an excellent commentary on these I
may refer you to Dr. Carroll Dunham's remarks on Pulsatilla
in the second volume of his lectures. Dr. Allen adds provings,
with the mother tincture, by Lembke and Wenzel, and, with
the dilutions, by Robinson. The American species-Pulsatilla
Nuttalliana-has been proved by Drs. Burt and C. Wesselhoft.
You may read the experiments of the former in the second
edition of the New Remedies, of the latter in the Transactions
of the American Institute for 1868. They include observations
on several women. Dr. Allen, of course, presents them all.
766
PULSATILLA.
Pulsatilla was one of the plants introduced into medicine
by the celebrated Baron Störck. He found it very useful in
chronic affections of the eyes, as cataract, spots on the cornea,
and amaurosis; in secondary syphilis; and in cutaneous dis-
eases. It has fallen into entire disuse in the old school; and
though homoeopathy has preserved it in full employment, its
provings and small doses have not led to these applications of
the drug. But an American (old-school) physician, Dr. W. H.
Miller, of S. Paul's, Minnesota, using the native variety in full
doses, has obtained the same results. It will be for us to con-
sider how far we can follow his practice with advantage.
Little was known of the physiological action of Pulsatilla
until Hahnemann proved it. Some German therapeutists
(quoted by Dr. Hale) speak of its causing, in over-doses,
nausea and vomiting, slimy diarrhoea, profuse and offensive
sweats, vesicular and pustular eruptions, coryza and cough,
increased urinary flow, and peculiar pains and dimness of the
eyes. But the homoeopathic provings show that, besides these
affections of the mucous membranes and the eyes, Pulsatilla
exerts much influence on the synovial membranes, the veins,
the ears, and the generative organs of both sexes.
1. In the mucous membranes Pulsatilla sets up the catarrhal
process. The dry stage is short and little marked (except
sometimes in the respiratory tract); and much mucous secre-
tion is the rule. As symptoms of this condition the patho-
genesis gives us-in the alimentary canal, raw throat, coated
tongue, furred mouth, foetid smell of the breath, taste deadened
or variously altered (bitter, sour, salt, even putrid), foul or
acid eructations, nausea and inclination to vomit, sensation as
if the stomach were spoiled, weight and pressure in the
stomach, and mucous diarrhoea; in the respiratory tract green
or yellow discharge from the nose, and cough with much
expectoration* (often tasting salt or bitter); in the urinary
mucous membrane frequent micturition with tenesmus, and
jelly-like sediment in the urine.
2. Pulsatilla seems to fall just short of the true serous mem-
branes, but compensates itself by acting powerfully upon
their near relatives, the synovial membranes. The joints
chiefly affected are the knees, the ankles, and the small joints
of the hands and (most especially) the feet. The rheumatico-
gouty action thus displayed is also manifested in pains of
divers kinds in the nape of the neck and the extremities.
3. The veins seem to lose their vital resistance under the
* The dry cough of Pulsatilla I am disposed, from clinical experience,
to set down as sympathetic, i.e. as a stomach cough."
(C
PULSATILLA.
767
action of Pulsatilla; so that varicosis readily occurs, especially
in the rectum.
4. Pulsatilla manifests its affinity for the eyes mainly by
affecting the lids, which it inflames greatly, causing them to
be agglutinated in the morning, and to pour out quantities of
mucus. It causes also, however, considerable aching pain in
ob-
the eyeballs, and many disturbances of vision. Temporary
scurations of sight often occur; fiery circles or haloes are seen ;
and after sleep there is a feeling as if something were hanging
The sensation
over the cornea which could be wiped away.
is only subjective, and disappears spontaneously.
5. The ears suffer from the action of Pulsatilla even more
than do the eyes. In some provers the concha and external
meatus were inflamed, with purulent discharge. In others
deafness, generally with noises of various kinds, was present.
The seat of the latter symptoms is indicated by Dr. Burt,
who suffered from "snapping noises in the ear,” and “draw-
ing pains along the right Eustachian tube." Others yet
suffered from mere pain in the ear, generally of a jerking
character.
6. The action of Pulsatilla upon the generative organs of
both sexes is very marked, but is not easy to define. The
pathogenetic symptoms of its action in this sphere are, in the
female, contractive pains of the uterus, leucorrhoea of various
The
kinds, and scanty, delayed, and often painful menses.
abdominal pains are too vaguely described to enable us to
discern any irritation of the ovaries; but their analogues in
the male, the testes, swell up and become painful,-the sper-
matic cord also being involved.
The febrile condition which accompanies most of these
ailments is marked by predominant chilliness.
This is the best outline I can give you of the physiological
action of Pulsatilla. It has little interest in itself, being
hardly capable of a rational exposition; but it is amply avail-
able for therapeutic applications. Before, however, I turn to
these, let me cite some of Hahnemann's remarks upon the
symptoms of the drug. Of certain of the pains caused by
Pulsatilla, he says that they are "a short-lasting drawing
tension, which always terminates in a darting analogous to
tearing, somewhat as if a nerve were put upon the stretch, and
then let loose again suddenly, causing a painful jerk. Of
others he says that they feel as if there were an internal ulcer
present. Of all save these he notes that they are relieved by
pressure. He points out, moreover, that its symptoms are
generally worst when at rest and in a warm room, while they
768
PULSATILLA.
are relieved by motion in the open air; and that they tend
to appear on one side only of the body.
Hahnemann has also done much to fix for us the character
and temperament to which Pulsatilla best corresponds. "The
medicinal employment of the drug," he says, " will be the morc
salutary when, in the maladies to which this plant corresponds
as regards bodily evils, there is at the same time a timorous
tearful state of mind, and tendency to inward depression and
quiet grief, or at least to passiveness and resignation, especially
if in health the patient was kindly and pleasant (or even of
light and changeable disposition). It therefore especially suits
the lymphatic constitution, and is consequently but little
appropriate to men quick at their course of action and energetic
in their movements, even though they appear kindly disposed."
He gives, moreover, as indications for it-frequent chilliness,
absence of thirst, retarded menstruation, long delay in getting
to sleep, and the aggravation of the symptoms towards even-
ing. Teste adds, as regards constitution, that it is "particu-
larly suitable to persons who, by the relative predominance of
the adipose tissue in their composition, by the whiteness of
their flesh, the roundness of their forms, the mildness of their
disposition, and their fitful moods, exhibit all the marked
features of the female sex."
I see no reason for supposing that Pulsatilla has any gene-
ral influence upon the nervous system or upon the blood. I
shall arrange its therapeutic virtues under the headings already
adopted for the physiological outline.
1. Pulsatilla plays an important part in gastric disorders.
In dyspepsia, whether acute or chronic, the prominence of
mucous derangement-i.e., white tongue, nausea with little
vomiting, and absence of much pain-indicates this medicine
in preference to others, such as Nux vomica.* The tongue
calling for Pulsatilla is thickly coated with a white roughish
fur, very different from the milky white of Antimonium cru-
dum, or the yellowish brown of Kali bichromicum. The acute
dyspepsia in which Pulsatilla is curative generally arises from
the ingestion of fat or other rich food, as the pork specified
by Hahnemann. In chronic gastric disorder it does better
when heart-burn than when water-brash is present, in which
it again contrasts with Nux. Dr. Marston, however, says
*There is a good case illustrating its action here by Dr. Marston in
the twelfth volume of the Monthly Homœopathic Review, following
upon a differential diagnosis between this medicine and Nux. You may
also refer to that one which Hahnemann himself has recorded in the
preface to the second volume of the Materia Medica Pura.
PULSATILLA.
769
that when the fluid of water-brash is sour or foul tasted
Pulsatilla is quite equal to its removal. Indeed, bad taste,
whether subjective, of the ingesta, or of eructations, is a special
indication for our remedy. Dr. Bayes considers it indicated
in dyspepsia by a great feeling of tightness after a meal, so
that the clothes must be removed or loosened. The diarrhoea
for which Pulsatilla is suitable is a passive mucous flux, with
little pain, occurring chiefly at night. The stools, Dr. Guernsey
says, often vary in character from one to the other. These
gastro-intestinal symptoms are frequently present in the febrile
affections of childhood, as in mumps and varicella; and a few
doses of Pulsatilla are useful accordingly. In two of these
diseases our medicine is indispensable, viz., measles and re-
mittent fever. Having no control over the fever itself—which
requires in the former case Aconite, in the latter Gelsemium—
it aids powerfully to recovery by cleaning the tongue and (in
measles) checking the diarrhoea and moderating the catarrh.
Pulsatilla has less influence when the respiratory mucous
membrane is affected. Nevertheless, it is of considerable
utility in chronic nasal catarrh, with thick aud bland dis-
charge.* It is often a valuable palliative in nocturnal loose
coughs, as of phthisis; and is sometimes the best medicine in
subacute and chronic bronchitis occurring in delicate persons,
and accompanied with much mucous expectoration. Dr.
Hirschel says that it is also specific for a cough which is loose
by day, but becomes dry and tickling on lying down at night.
So in disorders of the urinary tract Pulsatilla is far less fre-
quently indicated than Cantharis, Cannabis, and Belladonna;
yet is sometimes useful for the dysuria of pregnancy, and for
chronic catarrh of the bladder.
Dr. John Brunton, an old school practitioner, recently (1876)
made a communication to the Medical Society of London,†
recalling their attention to this neglected remedy. He related
a series of acute nasal, bronchial, vaginal, vesical, and conjunc-
tival catarrhs "so rapidly and successfully cured by it as to
be, so to say, cut short," and mentioned that he had also used
it with benefit in some chronic affections of the mucous mem-
branes (as dyspepsia) and in amenorrhoea. Dr. Routh con-
curred with him in esteeming it in the last-named malady.
2. The action of Pulsatilla upon the joints has led to its use
in suitable forms of gout and rheumatism. The disorder of
digestion, which lies at the foundation of gout, is just that to
which Pulsatilla corresponds. Hence it is well calculated to
* See cases in Brit. Fourn. of Hom., xxxi., 370; and Hoyne, i., 295.
+ Proceedings of the Med. Soc. of London, iii., 67.
:
3 D
770
PULSATILLA.
effect radical benefit in recent cases of this malady. In the
paroxysm itself it is generally superseded by Colchicum ;
though I know of one case in which the timely administration
of Pulsatilla has several times seemed to blight an incipient
attack. It is said to be indicated especially when the pains
fly from place to place. In subacute rheumatism with little or
no fever occurring in delicate persons it is extremely useful,
especially when the knees, ankles, or small joints of the hands
and feet are affected. In idiopathic inflammations of these
joints, moreover, Pulsatilla is the best remedy while the mis-
chief is yet recent. But perhaps the form of arthritis to which
Pulsatilla most closely corresponds is rheumatic gout, using
this term to signify the independent malady so named. Dr.
Fuller has pointed out the much preponderating frequency
with which the female sex is invaded by this disorder, and its
intimate relations with menstrual derangements. Pulsatilla is
almost specific in its acute form; and even in chronic cases
may sometimes be given with advantage. Jahr recommends
it in the analogous gonorrheal rheumatism.
3. In affections of the veins Pulsatilla occupies much the
same ground as Hamamelis. It is superior to that medicine
in crural phlebitis following parturition, but yields to it in
venous hæmorrhages. In piles and other varicoses-as of the
spermatic cord or the lower extremity-Pulsatilla will act
well when the general condition of the patient seems to call
for its use.
4. It was for diseases of the eyes, as I have said, that Pul-
satilla was first brought prominently forward by Störck. The
more modest claims to service here warranted by our experi-
ments can be amply sustained. Pulsatilla is most useful in
affections of the lids. In recent blepharophthalmia, with
profuse lachrymation and meibomian secretion, it is the best
medicine. It will blight a stye almost as effectually as Bella-
donna will a boil: but I have not found it prevent their ten-
dency to recur. For the twitching of the eyelids, with dazzling
of sight, with which some persons are annoyed, I know no
remedy so useful as Pulsatilla. The aching of the eyeballs
produced by it is rather such as occurs in some forms of head-
ache than an idiopathic affection. For a further presentation
of what Pulsatilla can do in diseases of the eye I may refer
you to the article on the drug of Drs. Allen and Norton. They
commend it in ophthalmia neonatorum, and even in strumous
ophthalmia where the discharge is profuse and bland, and
there is not much photophobia; also in superficial ulcers of
the conjunctiva corneæ.
PULSATILLA.
771
>
5. Few medicines are used in our practice in affections of
the ears more frequently than Pulsatilla. Its curative virtues
are most evident in the ear-ache which so often troubles chil-
dren, and which is generally a subacute inflammation of the
middle ear; and in recent catarrhal deafness, with noises in
the ears.
But it has also been used with good results in acute
inflammation of the auricle and meatus, in neuralgia of the
nerves of the ear, and in non-scrofulous otorrhoea with deaf-
ness when the discharge is thick. Drs. Houghton and Cooper,
moreover, concur in giving it the highest place among the
remedies for acute inflammation of the middle ear.
6. I now come to what is perhaps the most important sphere
of the operation of Pulsatilla,-the generative organs of both
sexes. In the male subject you will find it invaluable in acute
orchitis, however caused (this property of the drug has lately
been vouched for by two practitioners of the old school,* who
admit that they got the remedy from us); and in prostatitis
(with Thuja). It is one of the medicines (with Graphites and
Rhododendron) which have cured hydrocele. But its fullest
powers are displayed in the female organism. When in girls
of mild disposition puberty is unduly delayed, or the menstrual
function is defectively and irregularly performed; when they
grow pale and languid, and complain of headache, chilliness,
and lassitude, Pulsatilla (with or without Ferrum) is a most.
excellent remedy. Dr. Guernsey recommends it for the pain-
ful lumps which sometimes form in the breasts of these sub-
jects, the pain extending to the corresponding arm. When
the menses have been suppressed by a chill, if the time for
Aconite has gone by, Pulsatilla will generally restore the dis-
charge. This property of the drug Störck had indicated. I
believe it to be as good a remedy for ovaritis as it is for
orchitis; and far superior to most of those ordinarily recom-
mended. In simple mucous leucorrhoea it is often curative ;
and in dysmenorrhoea when the little blood which flows is
black and coagulated, and when diarrhoea is wont to occur at
the periods. It presides in a most beneficial manner over the
function of parturition. Given daily for a month or so pre-
viously, it greatly facilitates the process in women whose
labours are tedious and difficult. In labour itself, when the
pains are irregular, tardy, and defective, yet ergot is hardly
called for, Pulsatilla will often do good service; as also when
from the same cause the placenta is unduly retained. There
are several cases recorded which leave little doubt but that in
false presentations Pulsatilla favours spontaneous version,
* See Hom. Times, May, 1878.
772
PULSATILLA.
After labour, it is very useful in promoting the secretion of
milk, when this is deficient, or in improving the quality. Alto-
gether, the weaker sex has much for which to thank homoeo.
pathy in its gift of Pulsatilla.
You may smile at one of these properties I have ascribed
to our remedy, namely, that of rectifying false presentations.
But you must remember that in these cases spontaneous
version is not so very uncommon an occurrence, which shows
that nature has means of effecting the change, and may well
be helped thereto by an appropriate drug-stimulus. The
evidence that Pulsatilla does render such aid comes from
several practitioners, both in France and in America.* And
if you suggest that the cures they report may have been
instances of the spontaneous version of which I have spoken,
I will adduce the testimony of Dr. Mercy Jackson, (late) of
Boston. In a communication made by this experienced lady
to the American Institute of Homœopathy in 1875, she relates
fifteen successive cases of false presentation, being all that
had occurred in her practice from a certain time onwards. In
every one she administered Pulsatilla, and in every one the
body underwent rotation and the head came to the fore. It is
beyond all probability that these fifteen cases should have
been a series of coincidences; so that they seem to establish
the power of the drug in question.
Dr. Bayes, whose article on Pulsatilla is one of the best in
his book, speaks of its predominating action on the left side
of the body, and recommends it accordingly in clavus, hemi-
crania, and infra-mammary pain having this seat. He also
advises it in constitutional disturbance in children associated
with copious excretion of urate of ammonia in the urine, an
experience which I have often confirmed.
Pulsatilla is also one of the leading remedies for chronic
intermittents. It is indicated where its temperament, gastro-
intestinal symptoms, and circumstances of aggravation and
amelioration obtain; and also where a condition of hydræmia
and chlorosis has been set up.
Pulsatilla, like the polychrests generally, has no true
analogue. The medicines which most frequently come up
for comparison with it in practice are Actaea, Antimonium
crudum, Caulophyllum, Conium, Cyclamen, Hamamelis and
Sepia.
Again like the polychrests generally, Pulsatilla requires to
be given in various potencies to obtain all its virtues.~ I have
little experience with the mother-tincture or first dilutions,
* See Bull. de la Soc. Med. Hom. de France, xviii., 544.
PULSATILLA.
773
though with the former Dr. Phillips seems to get all the good
effects of the medicine, and our old-school colleagues of whom
I have spoken cured their cases of orchitis. In dysmenorrhoea
only, I have myself gone as low as the 1st decimal. But I
can recommend to you the 3rd decimal in gastric disorders and
inflammations of the testicle or ovary, the 3rd centesimal in
affections of the eyes and ears, and in rheumatism; while the
6th and 12th I believe to be best suited for gout, for affections
of the veins, and for ovario-uterine disturbances.
•
LECTURE LI.
RANUNCULUS, RATANHIA, RHEUM, RHODODENDRON, RHUS,
RUMEX, RUTA.
We shall be able to dispose of all the drugs beginning
with the letter R to-day. They are a succession of vegetable
medicines of various degrees of importance.
The first will be the several varieties of Ranunculus. Two
of these, Ranunculus bulbosus and sceleratus, have received
a very fair proving. As I see no essential difference between
their properties, I shall treat of them indiscriminately here
under the title of
Ranunculus.
The tincture of either variety is prepared from the whole
plant.
The provings appear in Stapf's Additions. That of
Ranunculus bulbosus was undertaken by Dr. Franz and two
others (one being a woman), all using full doses of the pure
tincture. Ranunculus sceleratus was proved on himself, in
the same form, by an anonymous physician. Dr. Allen adds
a proving of the former (on a woman) by Stapf, and of the
latter by Schreter.
The Ranunculi are intensely irritant when applied locally,
causing inflammation and vesication, with burning itching.
It is not evident from the provings whether this effect-so
much resembling that of Rhus-is, as with that medicine,
dynamic and specific in nature. But this may be inferred from
Franz's experiment, in which contact with the juice produced
not only an immediate eruption of bullæ, but a subsequent
development (a fortnight after these had healed) of a series of
herpetic patches, the vesicles being dark blue, and itching and
burning intolerably. No eruptions were developed by the
internal use of the plant, though there was a good deal of
subjective cutaneous irritation. The most characteristic and
RANUNCULUS.
775
lasting effects of both were exerted upon the walls of the chest.
The symptoms from the 175th to the 212th of Ranunculus
bulbosus, and from the 117th to the 138th of Ranunculus
sceleratus, are composed almost entirely of the various kinds
of pain and soreness experienced by the provers in the sternum,
ribs, intercostal spaces, and hypochondria.
Correspondingly, the Ranunculi have been used with the
utmost success in pleurodynia, whether rheumatic,* neuralgic,†
or myalgic. I cannot à priori diagnose for you their place
in these maladies as compared with that of Actæa racemosa
and of Arnica: you must be guided by the accompanying
symptoms, ie., by the absence of the nervous or uterine
disorder of the former, and by the greater acuteness of the pain
than in the cases suitable to the latter. I know of no other
standing uses of Ranunculus. I once treated a case of chronic
dysentery in a domestic servant accompanied by infra-mam-
mary pain on both sides. After a fruitless trial of Mercurius
corrosivus and Kali bichromicum, I was led by the pains to
give Ranunculus bulbosus in the third dilution. Under its use
the intestinal symptoms rapidly subsided, and the pain dis-
appeared from the left side, but persisted in the right, from
which it was at length dislodged by Nux vomica. Two or
three returns of the malady have been rapidly checked by
the same drug.
In conclusion, Ranunculus should be borne in mind in some
cases of sciatica, and other rheumatic neuralgia: also in herpes
and eczema. It ought to be a very efficient medicine for
shingles, covering as it does the intercostal neuralgia as well
as the eruption. Dr. Markwick says he finds it very useful
here;§ and Drs. Allen and Norton mention a case involving
the supra-orbital region, in which the success consequent on
the use of this drug was "exceedingly brilliant." Dr. Bayes
praises it in pleurisy and hydrothorax of the right side, and
Dr. Guernsey in leucorrhoea at first mild, but afterwards acrid
and corrosive.
Rhus, Clematis, Euphorbium, Croton, Mezereum, Sabadilla
and Staphisagria are the analogues of Ranunculus.
The dilutions from 1 to 3 seem to have been generally
used.
And now a few words about a medicine which is ordinarily
* Brit. Fourn. of Hom., xxiv., 160; ii., 274.
† Ibid, ii., 274.
+ Monthly Hom. Review, x., 752; Bayes, sub voce.
§ Ibid, xv., 64.
776
RATANHIA.
known only as an astringent, and not often used even in that
capacity at the present day, the Krameria root,
Ratanhia.*
The tincture is prepared from the dried root.
There is a pathogenesis of Ratanhia in the third volume
of Hartlaub and Trinks' Arzneimittellehre. Some additional
symptoms are furnished by Teste, in his article on the drug,
and by Allen.
I can give no general account of the symptoms ascribed
to Ratanhia. One of them only, so far as I know, had (until
lately) led to practical results," sensation as of a skin before
the eyes." Acting on this very slight hint, Dr Madden tried
it in a case of pterygium, and with success. I have myself
used it with curative results in three cases of this disease-
one in the human subject, and two in the lower animals (a
dog and a cat respectively). Several other cases of success
with it have appeared in the Monthly Homœopathic Review
during the last few years.
Another symptom of Ratanhia, “dry heat at the anus, with
sudden stitches which the patient compares to stabs with a
penknife,"† makes it possible that it is somewhat homœopathic
to the fissure of the anus which the French physicians pro-
fess to cure with it. Dr. Allen has confirmed this supposition
by the cure of a bad case with the third dilution. He thinks
it indicated in preference to Graphites when the pain is cutting
and lancinating rather than a sensation of smarting and
soreness, and to Nitric acid when such pain is felt more after
than during the passage of the motion. Teste recommends it
in uterine pains following retrocession of an eruption situated
on the lumbar region.
I can say nothing about medicines allied to Ratanhia.
For dose I have always used the second dilution; but the
first decimal has been employed with benefit.
And now we come to an old enemy of the childhood of
* In his paper subsequently referred to, Dr. Allen says that this
name should be spelt "Ratania," but in his Encyclopædia he prints
it as above.
+ This is given by Teste, as observed by himself; but omitted by
Allen.
‡ North American Fourn. of Hom., May, 1878.
·
RHODODENDRON CHRYSANTHUM.
777
most of us-happily unknown, as a drug, to our own children
-Rhubarb, Latiné Rhabarbarum, or
Rheum.
Our tincture is made, like the common one, from the dry
root.
The pathogenesis of Rheum is in the second volume of the
Reine Arzneimittellehre. It contains 194 symptoms from
Hahnemann and five others, and 14 from authors. It was
also one of the medicines tested by the Vienna Provers'
Society; whose results you may read in the sixth volume of
the British Journal of Homœopathy, or in Hempel.
None of these provings add anything of import to the
knowledge previously existing of the action of Rhubarb on
the alimentary canal. Of this Hahnemann writes:-"It is
not an easy, liquid, and copious stool, or a painless diarrhoea,
which is the primary action of Rhubarb on the bowels, but
rather a colicky and sometimes ineffectual urging to altered
evacuations, which are nevertheless always fæcal." To the
same effect is the testimony of all therapeutists. Rhubarb
is considered to stimulate the muscular fibre of the whole
length of the intestine, purging without causing serous
effusion, and never-however far its action may go-inflaming
the mucous membrane. Dr. Rutherford has ascertained that,
like Podophyllum, it increases both the liquid and the solid
elements of the bile. The constipation which often follows
the purgation of Rhubarb seems due to an after action of the
tannin it contains.
A corresponding form of diarrhoea is occasionally met with,
especially in children: a sour smell has been found character-
istic of it, and was noticed by Gross in the course of his prov-
ing. When this morbid condition occurs, Rheum-from the
second to the sixth dilution-will give you every satisfaction;
and you will feel glad that you can use it to remove children's
troubles instead of to cause them.
Dr. Allen emphasises repulsiveness of food as characteristic
of this remedy.
My next medicine is the beautiful Siberian rose,
Rhododendron chrysanthum.
The dried leaves and flower-buds are the officinal portion of
the plant.
778
RHODODENDRON CHRYSANTHUM.
A proving of Rhododendron, conducted by Dr. Seidel on
himself and several others with moderate doses of the mother-
tincture, is given in Stapf's Additions. Dr. Allen adds some
symptoms by Lembke.
The most characteristic effects of Rhododendron are the
pains which it excites in the muscular and fibrous tissues,
and the swelling and tenderness of the testes and epididymis.
In practice it has been found useful accordingly. It has a
high native reputation for gout and rheumatism; and homœo-
pathic experience shows it to be specifically curative in many
forms of these maladies. It seems especially serviceable in
rheumatism of the cervical and thoracic muscles, and in rheu-
matic neuralgia of the extremities. The pains are worse at
rest, and at the approach of stormy weather. I have myself
used Rhododendron with much benefit, acting on a hint from
German experience, in rheumatic face-ache.* Relief of pain
during and after eating seems characteristic of it here. Drs.
Allen and Norton mention a case, apparently of incipient
glaucoma, in which the aggravation of the (recurring) pains
before a storm led to the choice of Rhododendron, which not
only relieved these, but checked the disease, and materially
improved the vision. Chronic affections of the testes-as
orchitis and hydrocele-have also been frequently cured by
Rhododendron.
The stools characteristic of this drug are loose, but require
much pressure for their expulsion.
Rhus and Clematis, and perhaps Ranunculus, are analogues
of Rhododendron. The diagnostic marks between it and
Rhus are fully given in the second volume of the American
Journal of Homœopathic Materia Medica (p. 247). Briefly,
they are that, with Rhododendron, the pains do not admit of
the limbs being at rest, and moving relieves at once; while,
with Rhus, the first movement aggravates the pains, and con-
tinued motion only relieves. Again, the pains of Rhodo-
dendron are aggravated in the night indeed, but more towards
morning; those of Rhus more towards evening and night.
Once more-Rhus corresponds to rheumatism in the cold
season, Rhododendron in the hot; and the symptoms of the
former are worse after, the latter before rain.
The dilutions from 12 to 30 were given in the cases which
Dr. Seidel prefixes to his pathogenesis; but in rheumatic
prosopalgia my experience is that of the German physicians,
who prefer the 1st and 2nd decimal.
* See Brit. Fourn. of Hom,, xxvii., 149.
RHUS.
779
I have now to introduce you to the medicine, which, what-
ever the species of the plant we use, is known as
Rhus.
Under this name we include the Rhus toxicodendron, the
sumach, or poison oak; Rhus radicans, the poison ivy or
vine; and Rhus venenata, the poison wood or ash. The last,
by the way, must not be confounded (as it sometimes is) with
the Rhus vernix of Linnæus, which grows in Japan. The
leaves of the two former species, and the juice which exudes
from incisions in the bark of the Rhus venenata, are used to
make their tinctures.
a
Rhus toxicodendron was proved by Hahnemann. The
second volume of the Reine Arzneimittellehre contains
pathogenesis of 976 symptoms, of which more than half are
his own, the remainder being supplied by nine fellow-provers
and some authors. Rhus radicans was proved by Dr. Joslin
and ten others: the record of his experiments is contained
in the first volume of the American Homeopathic Review.
Dr. Allen unites the symptoms of R. radicans with those of
R. toxicodendron, and adds numerous observations of the
effects of handling the plant. The effects of Rhus venenata
have been very fully ascertained by Drs. Burt, Hoyt, and
Oehme, both by taking the drug internally and by exposing
themselves to contact with its juice or emanations; as you
may read in Dr. Hale's pages. Here too Dr. Allen adds
much fresh matter in his Encyclopædia.
The poisonous influence of the juice of all the sumachs has
been found to reside in a volatile acid which it contains.
Hence exposure to the emanations has almost as potent an
effect as actual contact with the juice. I will describe the
results of either in the words of a late Lecturer on Materia
Medica at the Medical School of the Westminster Hospital:-
"The effects produced by Rhus are redness and swelling of
the affected parts, which, if the exhalations be the exciting
cause, are more particularly the face and eyes. Subsequently
there is pain, and often a considerable increase of tempera-
ture, and the inflamed surface is generally studded with
vesicles. Combined with these symptoms, there is an almost
unbearable amount of itching, which is not confined to the
patches of inflammation, but diffuses itself, more or less, over
the entire surface of the body, the hairy portions appearing
to be very specially affected. The condition induced thus
780
RHUS.
appears to be of an erythematous or erysipelatous type. It
is superficial, but spreads rapidly over the surface, and speedily
involves large areas of the body; eventually extending to the
mucous membranes, as indicated by redness and swelling of
the throat and mouth, with, ordinarily, great thirst, irritable
cough, nausea, vomiting, vertigo, dulness and stupefaction of
head, and colicky pains throughout the abdomen. These last
are chiefly experienced during the night, and are aggravated
by eating or drinking. Diarrhoea frequently ensues, accom-
panied by tenesmus, and the stools are often bloody. There
is often retention of the urine, or else diuresis, and the water is
frequently accompanied by blood.
"Rhus also induces pains, apparently of a rheumatic kind,
and which are felt not only in the limbs but in the body,
though most especially about the joints. Pain and stiffness
in the lumbar region are often induced, and to these affections.
is often added a sense of numbness in the lower extremities.
The structures most powerfully affected appear to be the
fibrous ones. The pains in question are accompanied by a
very slight amount of swelling; and, singular to say, they
become intensified by rest and warmth. Sleep is greatly
disturbed, the patient becoming restless, constantly turning
about, and often suffering from great nervous depression.
T
"The fever which sometimes accompanies the effects of
Rhus, though by no means an universal symptom, usually
occurs, when present, in the later stages, and generally partakes
of a typhoid character. It is often attended by delirium;
the lips are apt to become dry and parched, and to be covered
with a brownish crust. Sometimes it assumes an intermittent
character, and is then usually marked by profuse perspiration.
"The above-described effects of Rhus, though so distress-
ing to whoever may have to endure them, appear, however, to
be very seldom fatal; and it is remarkable that a certain
constitutional predisposition appears requisite to their occur-
rence, so that it is only individuals who are in danger.
Were it otherwise, a plant so common in its native country
as the present would be a perpetual source of trouble to the
persons dwelling near. I have myself witnessed several
instances of the poisonous influence, and can personally vouch
for the manifestation of nearly all the phenomena that have
been indicated."*
Buy
I have thought it well to cite this account from an author
not partial to the homœopathic doctrine, as I shall have to
* Materia Medica and Therapeutics. Vegetable Kingdom. By
Charles Phillips, M.D., &c.
RHUS.
781
show that the efficacy of Rhus as a medicine is displayed in the
very regions in which it is so active as a poison. We shall
see it as a remedy for many cutaneous affections, for rheu-
matism, and for typhoid conditions of several kinds.
I. The action of Rhus on the skin is obviously of a very
acute and specific kind. Teste well describes it as that of "a
corrosive caustic, which, from its extreme subtilty, has a ten-
dency to invade large surfaces, rather than to penetrate deeply
into tissues." He compares it with Arnica, which dips deeper
down; and with Ledurn, whose influence is more localised.
Severe boils followed the primary symptoms in two of the
provers of Rhus venenata. An additional value for homœo-
pathic purposes is given to these effects by the fact mentioned
by Dr. Phillips, that they only occur in a certain number of
those who are exposed to the influence of the plant, i.e., they
are contingent upon special susceptibility. Dufresnoy, more-
over, states that persons, not constitutionally susceptible to
the disorders induced by Rhus as a poisonous agent, are not
so likely to receive benefit from it if used as a medicine. It
points in the same direction when we hear from Trousseau
and Pidoux of the symptoms first appearing twenty-five days
after inoculation with the juice, and from Fontana of their
recurrence at intervals subsequently.
Correspondingly, in cutaneous affections, especially when
acute, Rhus naturally takes high rank as a remedy. The
members of the order vesicula-herpes (especially h. zoster),
eczema, and pemphigus-are the forms of eruption to which
it is most suitable. I have frequently cured these affections
with Rhus, and indeed rarely require any other remedy for
them. Dr. Hedges, physician to the Half-Orphan Asylum of
Chicago, says that 75 per cent. of all the cases of eczema occur-
ring therein have been cured by this remedy. Itching with burn-
ing is a characteristic indication for it here, and also (accord-
ing to Dr. Guernsey) the presence of an inflamed margin
around the spots of eruption. Dr. Dunham recommends it
in eczema impetiginodes, and Dr. Wesselhoft has communi-
cated cases of prurigo senilis and vulvæ cured by it.* Still
more closely do the effects of Rhus correspond with erythema
and erysipelas. When this latter malady goes on to the
formation of vesicles and bullæ (vesicular erysipelas), Rhus is
the standard remedy among homœopathists; and I have often
seen it act here in the most beautiful manner. Teste seems
justified in recommending it as the best medicine to be given
in extensive but superficial burns.
See Brit. Fourn. of Hom., xxiii., 563.
782
RHUS.
It was the accidental cure of an old herpetic eruption by
the development of the cutaneous symptoms of Rhus poison-
ing that led to its first introduction into medicine, by Dufresnoy
of Valenciennes. His memoir on the subject (of which you
may read a full account in the twenty-eighth volume of the
British Journal of Homœopathy) relates several cases of a
similar kind in which he gave the drug internally with
distinguished success. Like so many other valuable pieces of
practice, however, this use of Rhus had perished in the old
school, but has been maintained in homœopathy, to which it
legitimately belongs.
II. The rheumatoid pains described by Dr. Phillips as
occurring in Rhus poisoning are seen in an especial degree in
the provers of the drug. From Rhus venenata the joints, as
well as the fibrous tissues, were affected-especially the knees,
ankles, feet, and hands; but there was no genuine synovial
swelling, as with Bryonia and Pulsatilla. It is chiefly to
these rheumatoid pains that Hahnemann's well-known ob-
servation belongs, that, unlike those of Bryony, they are most
violent when the part affected is in a state of perfect rest.
He extends the statement, indeed, to the symptoms produced
by the drug generally; and the recent provings of Rhus
venenata support his statement.
Rhus has thus come to occupy a high place in homœopathic
therapeutics amongst the remedies for rheumatism. It is not
often indicated in rheumatic fever. It would be so where, as
in a case mentioned by Dr. Bayes, restlessness and constant
desire to change the position were present. Dr. Phillips also
says that “in the after stage of acute rheumatic fever, when
aconite may have been employed, and when the temperature
has fallen to 100º, or below it, and where the patient still
suffers from wearing stiffness, and aching in the neighbour-
hood of the joints, rhus is positively invaluable." But in
various subacute and chronic rheumatic affections it is a
most precious remedy, especially when they can be traced to
a wetting. Herein it resembles Dulcamara, and differs from
Aconite and Bryonia, whose local rheumatic symptoms are
rather such as dry cold produces.* Its action is mainly, if not
entirely, upon the fibrous tissues-tendons, fasciæ, sheaths of
nerves, &c.—and perhaps the muscles. I do not think that it
controls the rheumatic affections of the synovial membranes,
but only those of the ligaments external to the capsules of the
joints. Nor do I think that it acts upon the nerves them-
* See a case of rheumatic pleurodynia in Hoyne (i., 128) illustrat-
ing this point.
RHUS.
783
selves. Its undoubted value in rheumatic sciatica* depends, I
take it, upon its influence on the fibrous sheath of the nerve,
which is so often the seat of the pain. It is powerless in pure
neuralgia here or elsewhere. It is certainly the best remedy
in most cases of lumbago, at any rate after Aconite :—I sus-
pect that here the lumbar fascia is the part affected rather
than the actual muscles. It is thus especially indicated
when lumbago and sciatica are present together. In rheu-
matic lameness of the lower extremities, depending largely
upon the state of the fascia lata, Rhus has made brilliant
cures.t-In all these maladies the characteristic features,
<<
worse at rest, relieved by motion," are of immense weight
in determining our choice of Rhus. Dr. Neidhard has added
the important observation that on first moving after rest the
pains are increased. It is not until the parts have been moved
for some little time that relief ensues. With Bryony, on the
other hand, the longer the movement continues, the worse the
pains become; and with Rhododendron, as we have seen,
movement relieves from the first. Dr. Carroll Dunham has
drawn out these characteristics of the pains of Rhus in a
very interesting manner, in some observations on the drug
which you will find in the first volume of his Lectures. "The
rheumatic symptoms of the drug," he says, come on with
severity during repose, and they increase as long as the patient
remains quiet, until, at length, their severity compels him to
move. Now, on first attempting to move, he finds himself
very stiff, and the very first movement is exceedingly painful.
But as he continues to move, however, the stiffness is relieved
and the pains decidedly decrease, the patient feeling much
better." He goes on to point out that this improvement does
not continue indefinitely; for weariness readily comes on in
such patients, and then rest is at first grateful, only after a
while to be disturbed by a recurrence of the aching pain. As
chronic rheumatisms of muscles, ligaments, and fascia are
generally of this character, Rhus is by far the most frequently
indicated remedy for them, and in my own hands has made
many a cure.
(C
The action of Rhus on the white fibrous tissues has led to
its being used in the treatment of sprains. Hahnemann says,
"I have recognised in these latter years that Rhus is the
best specific against the consequences of muscular strains and
contusions." He does not say what relation it bears to Arnica
* See case in Brit. Journ. of Hom., xi., 146; and another in Hoyne,
i., 136.
+ Ibid, xxv.,
661.
784
RHUS.
here; nor do I know that general experience has found it
superior or even equal to that medicine, save when its own pecu-
liar symptoms of aggravation and amelioration are present. In
so-called "rheumatisms," however, having these features, and
where severe or continued strain seems to have been the
originating cause, Rhus is of undoubted value.
III. The fever of Rhus poisoning is at first sympathetic
with the dermatitis that is set up. But later here, as pointed
out by Dr. Phillips, and perhaps primarily (as suggested by
the provings) from the internal use of the drug, a febrile con-
dition of low and nervous type is set up, with diarrhoea and
prostration. Hahnemann was led hereby to use Rhus as a
principal remedy for the epidemic fever which ravaged Ger-
many in 1813. Whether it was true typhus, or (as Dr. Russell
thinks) relapsing fever, is doubtful; but this at least is certain,
that while the mortality under the ordinary treatment was
considerable, Hahnemann treated 183 patients without a single
death.* He also recommended it, in alternation with Bryonia,
in the consecutive fever of cholera.t
Rhus has accordingly taken rank as an important anti-
typhoid remedy in homoeopathic practice. Drs. Wurmb and
Caspar, from their experience in the Leopoldstadt Hospital at
Vienna, define its place in typhus and enteric fever. It cor-
responds, they say, to an erethistic type of the malady, such
as, when more severe, requires Arsenic. Dr. Dunham points
out that a corresponding condition is apt to supervene in the
course of measles‡ and scarlatina; and that here Rhus is no
less indicated and beneficial. In the latter disease, he says,
it is still more strongly called for “if there be an oedematous
condition of the fauces, soft palate, and uvula, with vesicles
upon these parts, and a singularly annoying itching, smarting,
and burning." Epidemics of influenza sometimes present this
condition of the throat, with great debility; and here also
Rhus is remedial. A red triangle at the tip of the tongue is
said to indicate it in typhoid states.
Another variety of scarlatina in which I have much confi-
dence in Rhus is that in which rheumatic symptoms appear.
I speak of the "scarlatina rheumatica" of this country; but
I should think the remedy equally applicable to the epidemic
disease which sometimes bears this name-the "dengue" of
America and the Indies: I would suggest the Rhus venenata
here, on account of the implication of the mucous membrane
* Lesser Writings, p. 712; see also p. 328 of this Manual.
† Ibid, p. 847.
See case in Brit. Fourn. of Hom., xxx., 587.
RHUS.
785
of the mouth and throat, which is seen most prominently in
the pathogenesis of this variety. On this account I gave it
once, and with much success, in a relapse of Ceylon fever in a
patient lately returned from that island.
These cutaneous, rheumatic, and febrile disorders form the
main sphere of action of Rhus in homœopathic practice. Of
its anti-paralytic virtues we have not, perhaps, sufficiently
availed ourselves. Dufresnoy first brought these to light by
accident. Giving the medicine for a hemiplegia, under the
supposition that it was caused by a repelled eruption, he cured
his patient, though mistaken as to the origin of the malady.
He therefore gave it in other paralytic affections, often with
benefit; and his practice was followed with the same results
by Alderson in England. Improvement, as with Collin's use
of Arnica, was generally preceded by pains and other sensa-
tions in the affected parts. It is doubtful whether Rhus acts.
homœopathically here. The paralytic symptoms of its patho-
genesis are rather those of general prostration than of special
depression of the motor centres; and the only recorded.
experience of its value in the school of Hahnemann is that
of Trinks, who gave it in increasing doses of the mother-
tincture. The paralysis in all these cases is described as
painless. But there is a paralytic condition which is far from
being painless, viz., the rheumatic form; and in the minute.
doses commonly used by homœopathists it is here that Rhus
has been chiefly used. It will often result from exposure of the
back or seat to damp cold. Dr. Dunham suggests that para-
plegia occurring in young children is generally thus caused;
and states that it readily yields to Rhus, and an occasional
dose of Sulphur.* Of the same kind is the paresis of one or
more of the muscles of the eyeball which sometimes results
from damp cold; and here Rhus vies with Causticum.
Rhus is, moreover, thoroughly homoeopathic to affections of
the mucous membrane resembling those which it causes on
the cutaneous surface. The late Sir James Simpson has well
shown that conditions answering to erythema and eczema of
the skin are not uncommon on the lining membrane of the
bowels and other parts, especially in women. Rhus is also
beneficial in diarrhoea and dysentery associated with low
general conditions, as typhus † and scorbutus. Dr. Guernsey
says that it is "almost, if not quite, a specific in dysentery when
the pain runs in streaks down the limbs with every evacua-
tion." This is in children. The mucous membrane it in-
* See case in Brit. Journ. of Hom., xxviii., 793-
† Monthly Hom. Review, xvi., 733.
3 E
786
RHUS.
fluences most powerfully is the conjunctiva. In the sixth
volume of the British Journal of Homœopathy Dr. Dudgeon
has collected numerous testimonies, from both old and new
schools, to its value in strumous ophthalmia. Perhaps the
phlyctenular character of the affection has something to do
with its usefulness here; and it is noteworthy that there is
often an association of general eczema of the face. When this
occurs, Rhus is doubly indicated.
Drs. Allen and Norton have considerably extended the
sphere of action of this medicine in ocular disorders. They
account it "a remedy of the first importance," "the remedy,"
in orbital cellulitis, saying that some alarming cases of this
disease occurring in their own experience have been promptly
arrested by it. They praise it in ophthalmia neonatorum and
suppuration of the cornea, and say that "the grandest sphere
of its action is to be found in suppurative iritis, or in the still
more severe cases in which the inflammatory process has
involved the remainder of the uveal tract, especially if of
traumatic origin, as after cataract extraction." It is thus in
suppurative inflammation of the eye, especially of its deeper
parts, that it plays such an important part in their hands.
Great oedema of the eyelids is said to be symptomatic of such
morbid processes, and to be a special indication for the remedy.
They recommend the employment of the higher dilutions at
first, as we cannot afford to produce an aggravation in a
sensitive subject;" but that "if most prompt results are not
obtained in a few hours," we should resort to the lowest.
((
I
In favour of this power of Rhus over acute suppurative
processes is a case of poisoning with the "radicans" variety
observed by Dr. Helmuth,* in which " the symptoms were all
those belonging to septicemia. Suppuration had taken place
in the ankle, which was affected with severe synovitis. Besides
the symptoms above-mentioned, the patient had vesicles in the
mouth and throat,. . large and purple bullæ over the leg,
which was immensely tumefied and red, together with
a toxæmic expression, which was remarkable in every re-
spect."
Several other facts about Rhus, and applications of it as a
medicine, may be gleaned from Dr. Dunham's study of the
drug, which I cannot too warmly commend to your notice.
His observation as to the acridity communicated by it to all the
fluids and secretions of the body is especially worthy of notice.
I was led by this symptom to give it in a case of gouty oph-
thalmia, to the very great relief and improvement of the
System of Surgery (4th ed.), p. 67.
RUMEX CRISPUS.
787
patient. Dr. Guernsey's chief indication for it, in addition to
the characteristic rheumatic pain I have already described, is
bodily restlessness, so that the patient cannot remain long in
any one position, and finds momentary relief from any change.
It has been recommended in intermittents when a tearing
cough occurs during the chill.
The medicines most allied to Rhus are Croton, Ranunculus,
Ledum, Rhododendron and Bryonia.
In recent cutaneous affections I recommend the 6th dilu-
tion: in chronic, from the 1st to the 3rd decimal, as also in
shingles and erysipelas. In chronic rheumatism the higher
dilutions seem to have made the best cures; while in paralysis
and strumous ophthalmia the material doses of Old Medicine
have given the drug its reputation. Hahnemann says that
the action of Rhus is slow; and that improvement is rarely
perceived (I hope he means in chronic cases) until thirty-six
hours after the administration of the dose.
Once again we turn to America, as she sends us the yellow
dock,
Rumex crispus.
The fresh root is used in the preparation of the tincture.
The original proving of Rumex, by Dr. Joslin, is in the
second volume of the American Homœopathic Review. Several
persons took part in it, using both the tincture and the dilu-
tions. The pathogenesis is given, with numerous clinical
cases, in the second edition of Dr. Hale's New Remedies; and
by Allen, who adds symptoms from three other provers.
Rumex has some influence on the skin and alimentary
mucous membrane, causing in the former an itching which is
increased by exposure to cool air, and relieved by warmth
(herein contrasting with that of Sulphur and Mercury), and
in the latter a sense of weight at the stomach, and a morning
diarrhoea. Its main action, however, is exerted upon the
respiratory mucous membrane, and especially that of the
larynx; where it diminishes secretion while exalting sensi-
bility. Hence changes in voice, and dry titillating cough.
The action hardly goes on to inflammation.
Rumex has cured some cases of gastric and intestinal
derangement characterised as above, especially morning diar-
rhoea. It should be thought of in prurigo, where the itching
has the unusual characteristic of that excited by the drug.
788
RUTA GRAVEOLENS.
Dr. Searle communicated to the third volume of the United
States Medical and Surgical Journal an account of the con-
tagious prurigo, or "army itch," so frequently observed during
the American civil war. After trying several ordinary reme-
dies in vain, he found Rumex crispus its specific. He gave
several drops of the first decimal dilution for a dose.
But the chief use of Rumex is in laryngo-tracheal cough, of
which quite an array of cases may be read in Dr. Hale's article.
The symptoms are those of catarrh, with excessive irrita-
bility of the laryngo-tracheal mucous membrane, causing a
violent, incessant, and fatiguing cough, with little expectora-
tion. Pressure, talking, and especially inspiration of cool air,
cause aggravation. There is often a sense of excoriation be-
hind the sternum. I have several times prescribed _Rumex
with success in this kind of cough, but quite as often with
entire failure, though it seemed thoroughly indicated. When
it cures, it does so with almost magical rapidity.
The analogues of Rumex in the respiratory sphere are stated
by Dr. Carroll Dunham to be Lachesis, Belladonna, Causticum
and Phosphorus. His sketch of the laryngeal symptoms of
the five medicines respectively (given by Dr. Hale)* is a model
of delicate application and discriminative comparison. I would
add to his four analogues a fifth, Spongia. In its relation
to morning diarrhoea, Rumex corresponds to Apis, Nuphar,
Podophyllum and Sulphur.
Nearly all the recorded cures have been made with the
dilutions from the 6th to the 30th.
My last medicine to-day is the common rue,
Ruta graveolens.
The tincture is prepared from the whole plant, which should
be quite fresh.
The proving of Ruta is in the fourth volume of the Reine
Arzneimittellehre. It contains 26 symptoms from Hahnemann,
259 from eight others, and 3 from authors. Dr. Allen adds
some further provings, and some poisonings.
"Hardly any medicine," writes Stillé, "was more frequently
employed of old, or with greater confidence in its virtues,
than this now neglected plant." Its poisonous action shows
it to be an acro-narcotic, with a special action upon the uterus.
This last has lately been studied by Dr. Hélie, of Nantes,
who finds it cause both active determination of blood to the
* See also Homeopathy the Science of Therapeutics, p. 417.
RUTA GRAVEOLENS.
789
Rue is thus
organ, and contraction of its muscular walls.
emmenagogue and abortifacient, which properties of the plant
have long been known and utilised in domestic, and to some
extent in professional, practice. We of course turn them to
account by giving Ruta, not in amenorrhoea, but in meno- and
metrorrhagia; and not to cause miscarriage, but to avert it.
In the former use of it we have the countenance of an old-
school celebrity, M. Beau of La Charité, who appears quite
unconscious of the homoeopathicity of his practice.
In Hahnemann's proving the chief symptoms elicited were
pains in the bones, joints, and cartilages, especially of a
"bruised" character. "Ruta seems," he remarks, "to excite
many pains in the bones or the periosteum." It has accord-
ingly been used in the treatment of rheumatism, especially_of
the wrist and ankle; and in bruises of the periosteum. Dr.
Henriques has published an interesting case in which an un-
united fracture in a cachectic patient rapidly took on healing
action under its influence.† The tenesmus which the provings
show it to cause in the rectum and bladder-even to prolapse
of the former-well corresponds to its action on the uterus,
and should receive homœopathic application. Dr. Guernsey
recommends it in constipation with prolapse of the rectum
before or during the stool.
Yet another virtue of rue is its undoubted power in dimness
of vision caused by over-exertion of the eyes. Hahnemann
mentions it as commended by Rosenstein, Swedjaur, and
Chomel in this trouble, and points to S. 38 and 39 in his
"Observations of Others," as showing that the drug causes
what it cures. A Hungarian physician, Dr. Elgâjaki, has
lately drawn attention to the same double series of facts.
Ophthalmology has not yet ascertained for us what is the
precise pathological condition induced by Ruta or removed
by it (Drs. Allen and Norton consider it to be asthenopia);
and meanwhile we must content ourselves with phenomenal
indications. You will remember that it was "with euphrasy
and rue" that Milton's angel purged Adam's visual nerve,
that he might see.
All parts of the body upon which he lies, even in bed,
are painful, as if bruised (after 17 hours)" is a symptom of
Hartmann's emphasised by Allen's type, and worth bearing
in mind.
Crocus and Sabina in the uterine sphere, Mezereum and
Phytolacca in the locomotive organs, and perhaps Euphrasia
* See Brit. Journ. of Hom., xxi., 343.
† Ibid., X., 445·
790
RUTA GRAVEOLENS.
in the eyes, correspond to Ruta. M. Beau says that rue is to
savin what Ipecacuanha is to Tartar emetic.
The second dilution is recommended by Hahnemann. In
Dr. Henriques' case the twelfth was given.
LECTURE LII.
SABADILLA, SABINA, SAMBUCUS, SANGUINARIA, SARRACENIA,
SARSAPARILLA, SCILLA, SECALE, SELENIUM, SENECIO,
SENEGA.
The medicines beginning with the letter S, on which we
now enter, will occupy us a much longer time than those
which have R for their initial.
We will commence with the Indian barley,
Sabadilla.
A tincture and triturations are prepared from the dried cap-
suled seeds as imported.
It
The proving of Sabadilla is in Stapf's Additions.
appears to have been a thorough one, having been conducted
with the mother-tincture on upwards of eleven healthy
persons.
Sabadilla contains veratria, of which we shall speak when
we come to Veratrum album; and besides the virtues of that
alkaloid, it has acrid properties of its own. Its proving ex-
hibits many well-characterised symptoms, but it has been very
little employed in disease. Stapf writes:-" among the many
important and characteristic symptoms of Sabadilla which
every observing physician will easily recognise, the Sabadilla
fever is especially remarkable. Sabadilla is not only a specific
for a certain kind of very bad angina, and to a rare kind of
pleurisy (where no inflammatory fever or thirst is present,
and the patient complains of coldness mingled with isolated
flushes of heat), but also for some forms of ague where the
chilliness sets in with nausea and inclination to vomit, recurs
frequently, and sometimes alternates with flushes of heat; and
where the heat is more perceptible in the face and on the
hands than on the rest of the body. There is absence of thirst
both in the cold and in the hot stage." Dr. Bayes communi-
792
SABINA.
cates some unique experience with it in hay-fever, in which he
regards it as of the greatest possible use. "The method," he
writes, "I have found most serviceable for its administration
has been to order the olfaction of the third decimal tincture
several times a day, and the taking of one drop two or three
times a day in water. By this means I have cured a number
of severe cases, and have made many firm converts to our
system of medicine." He has also used it in other cases of
coryza, with severe frontal pains and redness of the eyelids,
with great benefit; and I have had good results from it in two
cases of chronic nasal catarrh.
Sabadilla is a medicine to which you will more frequently
be led by a repertory than by à priori knowledge of its action.
When, however, you are directed to it by its homoeopathicity
to the morbid condition before you, you may employ it with
confidence.
Staphisagria and Veratrum album seem somewhat analogous
medicines.
We come next to a better known medicine in the shape of
savin, the Juniperus
Sabina.
The tincture is prepared from the fresh leaves and green tops;
or from the oil distilled from the same, dissolved in ether, it
is not satisfactorily soluble in alcohol. Sometimes the oil is
triturated with sugar of milk.
The proving of this drug also is in Stapf's Additions. Ten
experimenters are mentioned; but nothing is said about the
doses they took. Dr. Allen adds some symptoms from poison-
ings and over-dosings.
Savin is a general irritant, stimulating the circulation and
congesting the brain and lungs, and also inflaming the kidneys
by which it is eliminated, so that the urine becomes bloody
and albuminous. It further manifests a specific influence over
the pelvic organs, causing strangury in front, bloody stools
behind, and between the two metritis with hæmorrhage, and
(in pregnant women) abortion. This uterine action of the
drug has given it its chief therapeutic application. It is, of
course, used in the old school as an emmenagogue, and enjoys
some little repute in that capacity. Dr. Madden has shown
that it may occasionally be used without harm in this way.*
* See case in Brit. Journ. of Hom., xxiv, 301.
SAMBUCUS NIGRA.
793
But it must be remembered that it acts here as a purgative
opens the bowels; and its use in our hands must be corres-
pondingly exceptional. On the other hand, it is a most
valuable homœopathically acting remedy for ovario-uterine ex-
citement; as in menorrhagia where the blood is bright red, in
metrorrhagia, in threatened miscarriage from irritation, and in
metritis-in a case of which disease in an acute form I have
seen it effect a most satisfactory cure. The presence of con-
sentaneous rectal and vesical irritation adds weight to the
indications for the choice of Sabina in these disorders. M. Beau,
whom I have already quoted as a witness to the value of
Ruta in uterine hæmorrhage, extols savin as its chief remedy.
He will have it exactly homoeopathic, moreover; for it is in
"hæmorrhagic metritis," "metritis accompanied by flooding,'
that he gives it. One grain of the powder is given for a dose,
and very often needs no repetition.* Pain going through from
the sacrum to the pubes, and discharge of blood half fluid and
half clotted, are Dr. Guernsey's chief indications for it. He
also praises it in thick, corrosive leucorrhoea, which probably
connotes a similar state of the uterus (see Allen, S. 267).
""
Sabina caused in the provers an unusual number of symp-
toms relating to the joints, even so far as to set up heat,
redness, and swelling. It has been used in both schools for
what are vaguely called "arthritic affections." The connec-
tion which has been traced between rheumatic gout and the
uterine functions makes it probable that this is the malady in
which, especially when recent, Sabina would be curative. I
have used it once or twice upon these indications with very
satisfactory results. It has occasionally relieved the paroxysm
of true gout.
As allied medicines to Sabina I may name Belladonna,
Crocus, Pulsatilla, Ruta and Trillium.
All dilutions, from the 1st to the 24th, and even the crude
oil or powder, have in various hands proved efficacious. I
myself am very well satisfied with the 2nd and 3rd decimal.
The next name on my list is the common elder,
Sambucus nigra.
The fresh inner bark of the young branches is used for the
tincture.
* See Brit. Journ. of Hom., xxi., 342. Aran had recommended it
before him (vol. iii., p. 416). Recent therapeutists attempt to make
out that it is in atonic menorrhagia that Sabina is curative; but M.
Beau is against them.
794
SAMBUCUS NIGRA.
There is a pathogenesis of Sambucus in the fifth volume of
the Materia Medica Pura, containing 20 symptoms from
Hahnemann, and 99 from five others.* The articles in
Hempel and Teste also should be consulted, and the additions
made by Allen to the symptomatology.
The only facts about the physiological action of Sambucus
to which I can assign importance are that it is a powerful
sudorific; and that it has caused asthmatic phenomena.† Its
therapeutic use accordingly has been to moderate excessive
sweating, and to relieve asthma, laryngismus stridulus, and
the obstructive coryza of infants. I have myself found it of
great use in checking those debilitating perspirations which
often retard convalescence after delivery. I think, too, that
I have seen some benefit from it in asthma: Dr. Jousset
praises it in the paroxysm. Dr. Bayes writes:-" in the
suffocating cough of children, waking them up in the middle
of the night, and accompanied by rough sibilant wheezing,
and great dyspnoea, but without croup, I have found small
doses of Sambucus of the most rapid service." It has some
repute among us in laryngismus stridulus, similarly occurring.
Dr. Searle, who contributes an excellent paper on this dis-
ease to the ninth volume of the Transactions of the New
York State Homœopathic Society, gives the determining
symptoms for this remedy as-" burning, red, hot face, hot
body, with cold hands and feet, during sleep. On waking, the
face breaks out into a profuse perspiration, which extends
over the body, and continues, more or less, during the waking
hours; then, on going to sleep again, the dry heat returns.'
When these peculiarities are encountered, he says, Sambucus
is pretty sure to cure, and almost as certain to fail if they
are absent. I may remark that such symptoms, as well as
those described by Dr. Bayes, often depend (in children) upon
nasal obstruction; and that for this trouble, when the nostrils
are dry, Sambucus is (as I have said) much esteemed among us.
Teste describes some neuralgic pains in the forearms which
it cures.
)"
Aconite and Ipecacuanha are allied remedies.
The 1st decimal is the dilution I have used in diaphoresis
and asthma, and Hahnemann himself recommends the pure
juice to be given.
* As Dr. Allen did not receive my notes on Hahnemann's cited
symptoms in time for this medicine, I would mention here that the
"dropsical swellings " of his S. 94 should be “œdematous state of the
parts to which it is applied.'
""
† See Hahnemann's sixth symptom.
SANGUINARIA CANADENSIS.
795
America again comes forward to furnish us with our next
medicine, the blood-root,
Sanguinaria Canadensis.
The tincture is prepared from the rhizoma.
Sanguinaria has been proved principally in the old school,
as you will see from Allen's pathogenesis of it. Some homœo-
pathic experiments, however, are given in the Materia Medica
of American Provings. Dr. Hale's article in his New Remedies
should be consulted.
The physiological effects of Sanguinaria are not very dis-
tinctly known. It seems to be an emetic, a general irritant
of mucous membrane, and a depressant of the circulation. It
comes to us from the eclectic practitioners of America with
a high reputation in the treatment of affections of the respira-
tory organs; in which it excited in the provers many symptoms
of irritation. It is said to have proved curative in homoeo-
pathic practice in membranous croup and oedematous laryngitis,
in chronic cough with hectic, and even incipient phthisis.
Dr. Hale recommends it in the third stage of pneumonia.
(grey hepatisation); and Dr. Drysdale also in pulmonary
abscess.*
But a more frequent application of the drug which has been
made in the school of Hahnemann is to migraine. Dr. C.
Hering was the first to indicate its suitableness thereto, but
many others have followed in his wake. Among them is Dr.
Jousset, who in the new edition of his Elements de Médecine
Pratique styles Sanguinaria the principal remedy for this
malady. It corresponds, he says, to violent hemicrania, re-
lieved by lying down and by sleep, accompanied by bilious
vomitings, toothache, earache, pains in the limbs, electric
shootings in the head, and shiverings. Migraines connected
with the catamenial period, especially in women whose menses
are profuse, are peculiarly appropriate for Sanguinaria. He
gives the dilutions from the 12th to the 30th. One of our
latest homœopathic journals, the American Homeopathist,
has in its third number two good cases of sick headache re-
ported by Dr. Mills, of Chicago, in which Sanguinaria was
very effective. He describes the form of migraine indicating it
(as Hering does) as a "sun-headache," ie., increasing in violence
with the ascent of that luminary, and decreasing as it de-
clines. It is generally, he adds, preceded by scanty urine
* Monthly Hom. Review, x., 349.
796
SARRACENIA PURPUREA.
and passes off with profuse aqueous diuresis,-which last he
regards as a "key note" for the drug. He thinks it specially
suitable to women at the climacteric age, for whose flushings
indeed Dr. Gray, of New York, had already recommended it.
Dr. Lucius Morse, of Memphis, in his excellent treatise on
Nasal Catarrh, speaks well of Sanguinaria in chronic affections.
of the mucous membranes of the nose and throat, when there
is present "a sensation of stinging and tickling, accompanied
by irritative swelling of the parts, with or without free dis-
charge." He gives the third trituration. A patient of my
own, in whom these symptoms have co-existed with frequent
attacks of migraine, has been much benefited in respect of
both her troubles by the remedy.
Dr. Guernsey commends Sanguinaria in catamenial or
other headaches when the pain ascends from the nucha into
the head.
Dr. Hale compares Sanguinaria with Phosphorus and Lyco-
podium: to me Scilla seems its closest analogue.
Both high and very low dilutions seem to have been used
with advantage.
I would now say a few words upon the pitcher-plant,
Sarracenia purpurea.
A tincture of the root, or triturations of the whole dry plant,
seem the best preparations.
Provings of Sarracenia, instituted by three persons, with
substantial doses, are contained in the second edition of Dr.
Hale's New Remedies, and in the therapeutic portion of the
fourth edition you may read its clinical history.
Sarracenia came into medical practice some fifteen years
ago with a high repute among the American Indians as a
remedy for smallpox. Several English and American
practitioners reported most favourably of its virtues: it
seemed to promote eruption at first, but to check maturation
afterwards, so that unvaccinated subjects recovered as if they
had only had varioloid. Mr. Marston's trial of it at the London
Smallpox Hospital, however, proved unsuccessful; and it has
fallen out of use in the old school. Its homoeopathic
provings showed a power of developing feverishness, with
pains in the bones and soreness of the limbs, not unlike
that with which variola sets in; and Dr. Miracas in Spain, Dr.
Cigliano in Italy,* and Dr. Mouremans in Belgium have
* This physician has also proved it, as may be seen in Allen's En-
cyclopædia.
SARSAPARILLA.
797
published reports of its use which seem to show it possessed
of no little efficacy. We need further experimentation to
fix its place in the treatment of this disease.
The dilutions from the Ist decimal to the 3rd centesimal
have been those in which Sarracenia has been used.
Next, of
Sarsaparilla,
of which also triturations, or a tincture of the root, are pie-
pared in homœopathic pharmacy.
There is a pathogenesis of Sarsaparilla in the fourth volume
of the Reine Arzneimittellehre, containing 34 symptoms from
Hahnemann, and III from four others. Nenning then proved
it for Hartlaub and Trinks' Arzneimittellehre, the second
volume of which contains 347 symptoms from him. In the
Chronic Diseases all these are incorporated, together with
some new symptoms from Schreter, making 561 in all. An
arrangement of these materials, with clinical observations
interspersed, appears in Dr. Hering's Materia Medica.
It has long been said in the old school that while surgeons
swear by this medicine, physicians despise it. Dr. Clifford
Allbutt has lately proved an exception to his class in this
respect; for he has come forward to show the benefits of the
practice followed in the Leeds Infirmary of giving Sarsaparilla
in large doses-from twelve ounces to a pint of the compound
decoction daily.* In this way he is able to benefit old
syphilitic patients whose condition would otherwise seem
hopeless-" patients," he says, "whose constitutions have been
undermined by want of nourishment or by excesses, who have
gone through many courses of mercury, whose irritable mucous
membranes will not bear any more iodide of potassium, and
who are so sallow, so worn, so broken down, so eaten up by
disease as to seem fit only for the grave." The large quantities
required, and the fact that the compound decoction (which
seems always the preparation employed) contains also`meze-
reum, guaiacum, and sassafras, show that, whatever use we
may make of such practice, we are not thereby turning to
account any specific properties of the drug.
The proving shows considerable irritation of the urinary
organs, and Dr. Hering gives many testimonies to the power
of Sarsaparilla to relieve the sufferings attendant on gravel.
* Practitioner, iv., 257.
B
798
SCILLA MARITIMA.
3
It seems also to have some relation to asthma-the association
of this trouble with gravel, and their mutual dependence on
gout, must be remembered. In another direction, we find it
acting well in gonorrhoeal rheumatism. Dr. Guernsey gives
as its "key-note"-"much pain at the conclusion of passing
water, especially in women." Schreter found a gravedo of
six months' standing lessen, so that his head became free, from
the first day of his proving.
Dr. H. C. Allen has related a case in which, a mother hav-
ing given her four children teaspoonful doses of a preparation
of Sarsaparilla, daily, for some time, they all became affected
with herpes.
,
Teste makes a curious statement about this drug, which I
give you for what it is worth. "When a child with red hair
takes Sarsaparilla for three months (three teaspoonsful a day
of a solution in four ounces of distilled water of three drops
of tincture at the eighteenth), his hair absolutely changes
colour. From red it becomes a light flaxen. It is to be
remarked that Sarsaparilla in such a case causes no appreci-
able organic trouble: the health of the child is in no way
affected."
The higher potencies only have been used.
We will now speak of squills, under the name of
Scilla maritima.
A tincture is prepared for our use from the recent bulb.
There is a pathogenesis of Scilla in the third volume of the
Reine Arzneimittellehre, containing 86 symptoms from Hahne-
mann, 172 from seven associates, and 30 from authors.
The acrid properties of squill, which are manifest enough on
the skin or in the stomach from its local application, remain in
it when absorbed, and manifest themselves more or less every-
where it sets up irritation in the nervous system, in the
respiratory and urinary organs, and on the cutaneous surface.
It is in the second and third of these regions that its influence
is most felt; so that it is ranked in old-school therapeutics
as expectorant and diuretic, in either action being qualified as
"stimulating." Studied physiologically, we find that in its
mildest operation it excites (as Hahnemann says) the muci-
parous glands of the trachea and bronchi, and the urinary
secretion so far as its aqueous portion is concerned. When
it acts more powerfully, inflammatory symptoms are mani-
SECALE CORNUTUM.
799
fested in both regions, going on to bronchitis and pleuro-
pneumonia in one, and to nephritis, strangury, and suppressed
-or scanty, bloody, and albuminous-urine in the other.
Squill being thus expectorant and diuretic in ordinary prac-
tice, it has been used by homoeopathists mainly for coughs
with excessive secretion, and for diabetes insipidus. In both
these conditions I can commend it highly. But there is no
reason why it should not be used, on the principle of similarity,
in those higher degrees of irritation which it causes. The
presence of inflammatory action is always held to contra-
indicate it in ordinary practice; and, as I have often said,
their contra corresponds to our pro. Hahnemann justly
characterises as merely palliative its action in chronic dropsies
with scanty urine. But in an earlier treatise* he had pointed
out that it was quite homœopathic to rapid acute dropsical
swellings with suppression of urine. He also says that in and
before his time it was much used in pneumonia and pleurisy,
and that its good effects are only explicable upon the same
principle. It has received some employment in his school as
a remedy for the latter malady; and Professors Wood and
Chapman from the other camp recommend it very strongly in
cases of serous effusion into the pleura dependent upon chronic
inflammation of the membrane.
The narcotic, emetic, and cutaneous action of Scilla, and
the power of retarding the heart's action which it shares with
Digitalis, must be taken into account in our selection of the
drug; but have not themselves been utilised in our practice.
I know of no other medicine which has the same charac-
teristic range of action as that of Scilla.
I have myself used the first dilution for coughs, the second
and third for diuresis.
Our next medicine is the ergot of rye, which we (incorrectly)
call
Secale cornutum.
Incorrectly, I say; for it is not the rye which we use in medi-
cine, but the fungus which has developed at its expense. Of
this "ergot," freshly gathered, we prepare a tincture. We
also use ergotin, which is not an alkaloid, but a "concentrated
preparation" analogous to macrotin and leptandrin. It is
usually triturated.
* See Lesser Writings, p. 348.
800
SECALE CORNUTUM.
No proving has been made of Secale in the homœopathic
school; but the numerous observations extant as to the effects
of eating the spurred rye-" ergotism "-have been collected
by Trinks (in his and Hartlaub's Annalen) and by Buchner:
the latter's collection of symptoms was translated in the
appendix to the fourth volume of the British Journal of
Homeopathy. Dr. Allen has enriched the pathogenesis of
Secale from numerous other sources, giving it over 1,000
symptoms. A full account of later experimentation, physio-
logical and clinical, is given by Dr. Horatio Wood.
It has long been known that when rye in which ergot has
been developed is taken for some time as food, a train of
poisonous symptoms is developed. These appear in two forms
-the "gangrenous" and the "convulsive." In the former the
first symptoms are "deep, heavy, aching pains in the limbs,
an intense feeling of cold with real coldness of the surface,
deep apathy, and a sense of utter weariness. Then a dark-
red spot appears on the nose or on one of the extremities;
all sensation is lost in the affected part; the skin, perhaps
over a large surface, assumes a livid red hue, and in the foci of
local changes bullæ filled with serum appear.
The
gangrene is generally dry, the parts withering and mummi-
fying; but sometimes it is moist.
The toes are
most generally the portions destroyed, but it may be any
one or all of the extremities; and the nose, lips, ears, and
even the buttocks sometimes bear the brunt of the disorder."
The rationale of these remarkable effects was very obscure
until it was discovered that Ergot exerts a specific influence
upon unstriped muscular fibre throughout the body, exciting
a persistent and long-lasting contraction. Hence its well-
known effect upon the uterus, of which I shall speak pre-
sently. But, finding as it does this kind of muscular fibre in
great abundance in the coats of the arteries, it has the same
influence upon them, diminishing their calibre and so reducing
their current of blood. It is in this way it seems to cause
gangrene: the mortification induced by it is like that which
appears in senile gangrene, or which results from embolism
or from frost-bite. The general coldness which is noted points
in this direction; and also the fact that when suckling women
are ergotised the milk is dried up, and young women get
amenorrhoea.
It seems to be an open question whether this action of ergot
on unstriped muscular fibre is exercised directly, or through
the ganglionic nerves; but I myself incline strongly to the
former hypothesis. Division of the sympathetic does not
SECALE CORNUTUM.
801
materially affect the vascular contraction, according to Brown-
Sequard. The drug would be thus the precise opposite of
Amyl nitrite.
The arterial spasm caused is more persistent
than that which results from cold, and there is less tendency
to reactive dilatation. In acute poisoning, however, the latter
may be seen, as in a case cited by Dr. Wood, where the face
became intensely congested and purplish red, and pain in the
head was felt.
The other form of ergotism is the convulsive or spasmodic.
The symptoms here are those of the nervous system. Formi-
cation and numbness, going on to complete anæsthesia, com-
mence the morbid history. Then follow violent and painful
tonic contractions all over the body, but especially in the
flexors of the extremities. More or less paralysis mingles
with the spasms, and the same condition is manifest in the
cerebral and optic centres, where disturbance of vision often
goes as far as amaurosis, and giddiness, epileptic paroxysms,
delirium and idiocy reveal the low estate of the brain.
These phenomena, I say, belong to the nervous centres.
The voluntary muscles and the nerve-trunks are found after
death in their wonted integrity. But it is another question
whether they arise from any direct action of the poison upon
the nervous substance. It seems to me more probable that
they are the result of the profound anæmia induced in the
brain and cord by the arterial contraction caused by the drug.
Gaspard's experiments on frogs, indeed, cited by Buchner,
showed much congestion and softening of both centres; but
this condition is so unlike that induced in warm-blooded
animals, and which Dr. Brown-Sequard has experimentally
demonstrated in the spinal cord under the influence of ergot,
that I cannot lay any stress upon them.
These gangrenous and spasmodic phenomena constitute the
chief effects of ergot on the healthy body. They are some-
what intermingled in chronic poisoning by it, and still more
in acute. In the former, moreover, they are both accompanied
by gastro-intestinal symptoms, of which the most characteristic
is a ravenous hunger, which may persist even till death. The
frequency of abortion in pregnant women suffering from
ergotism directed attention to the action of the drug upon
the uterus. It was found to be powerfully stimulant to its
muscular fibres, having therefore little effect upon it in the
unimpregnated state or in early pregnancy, where these are
but little developed, but acting as an abortifacient in the
later months, and as an ecbolic during parturition. There is
some reason, moreover, to believe that it is capable of causing
3 F
802
SECALE CORNUTUM.
an inflammatory state of the organ, when given for such con-
ditions as leucorrhoea; it certainly does so in experiments on
animals, and has several times produced such effects when
given to menstruating or pregnant women, as Allen shows.
This power of ergot to contract unstriped muscular fibre as
it is found in the arteries and in the uterus has led to its
extensive therapeutic use in ordinary practice. It is employed
to arrest hæmorrhage, to occlude aneurisms and varices, to
starve fibrous tumours, and to diminish congestion of the brain
and cord. You know, also, its value to the accoucheur, who
with it aids the expulsion of the foetus or the placenta, and
prevents post-partum hæmorrhage by inducing immediate con-
traction of the uterine walls and vessels. There is nothing to
prevent your use of it for these purposes, under the usual
rules and with the obvious precautions. It is a potent agent
you are handling; and you must take care not to asphyxiate
the child you would deliver by making the pains too continuous,
or (as an American colleague of ours has lately done*) irre-
mediably destroy the whole nutrition of your patient while you
are aiming at her morbid growth. You will also do well, here
as elsewhere, to consider whether you cannot cure by the more
excellent way of homoeopathy ere you avail yourself of a
purely antipathic agent.
Not much, however, has been done with Secale as a homoeo-
pathically-acting remedy. Persistent arterial contraction is
not a common idiopathic morbid state. It is certainly present
in Asiatic cholera, and here Secale has some reputation,-Dr.
Russell expressing great faith in it in some of the worst
varieties of the disease, especially when occurring in women.
It is not unlikely, moreover, that the anæmic condition which
is now regarded as the basis of "spinal irritation" is thus
caused. The cramps and dysæsthesia which accompany this
affection are very like those of Secale, and are often amenable
to its use.† Senile gangrene, frost-bite, and other forms of
sphacelus are phenomenally at least like the effects of ergot;
and it should be borne in mind in their treatment. Dr. Jousset
speaks of having cured a case of senile gangrene with it.
But the chief use of Secale in the school of Hahnemann
has been derived from its action on the uterus. To check the
tendency to miscarriage it is generally the best remedy in the
later months of pregnancy, when the muscular tissue of the
womb is largely developed. Frequent labour-like pains,
without discharge, indicate it here. It will also relieve after-
* See Brit. Journ. of Hom., xxxiv., 391,
† See Ibid, xxvi, 218.
-
SELENIUM.
803
pains, when these are continuous and unintermitting. Its
tendency to inflame the uterus shows that it may be homoeo-
pathic to hyperæmic and even hæmorrhagic conditions of the
organ. There is a general agreement among those who use
the medium and higher dilutions that it will, thus given,
check many a menorrhagia when the other symptoms of the
patient suggest it. Bähr and Kafka, moreover (and also
Guernsey), recommend it in inflammations of the uterus when
symptoms of putrescence appear. It has also proved useful
in prolapsus uteri.* In a woman three months pregnant, who
took a large quantity, "the uterus, that had previously been
in a normal condition, descended so that it almost protruded
from the labia" (Allen, S. 538). It is said to be used in the
Leopoldstadt Hospital with much benefit to relieve the pain
of uterine cancer.
More difficult of belief are the statements of the practitioners
I have mentioned as to the efficacy of high potencies of the
drug to restore labour-pains, when these are flagging from
general or uterine exhaustion. Experienced accoucheurs like
Leadam, Croserio, and Guernsey, however, seem to have no
doubt on the subject; and experience must always outweigh
theory. I can only leave you to test the question for your-
selves. Dr. Guernsey thinks the remedy best suited to thin
"scrawny " women, in a weak, cachectic state. In such sub-
jects he commends it in several forms of disease, especially
excessive discharges of dark colour and bad character. In
acute affections he considers it much indicated when the
patient, through cold, cannot bear to be covered. One of the
observations collated by Allen exhibited this symptom in its
subject,—one affected by ergotism.
Secale has also some repute in paralysis of the bladder
(which it has caused), when there exists a continuous sensa-
tion as if the organ were imperfectly relieved of its contents.
Caulophyllum probably acts on the uterus in a manner
similar to that of Secale. Its myotic influence is unique.
I have mentioned the affections in which the higher dilu-
tions have been found useful. Otherwise, Secale has usually
been given in the lower potencies.
I have but little to say about my next medicine, which is
another of the rare metals,
Selenium.
It is of course prepared by trituration.
* Brit. Fourn. of Hom., i., 407.
804
SENECIO AUREUS.
There is a short pathogenesis of Selenium in the twelfth
volume of the Archiv, purporting to have been obtained by
Dr. Hering on himself, but without explanation as to the
manner of his experimenting. He has revised and augmented
it for Allen's Encyclopædia; and some experiments by Schreter
and others are added there.
Selenium appears from this pathogenesis to have some
influence upon the larynx and the male genital organs. A
similar concatenation appears in the pathogenesis of Spongia :
it is interesting, from the physiological connection between
the two parts, as seen in the changes which occur at puberty.
Dr. Meyhoffer writes of it :-“ few as are the laryngeal
symptoms of the proving of this mineral, the raising of small
lumps of blood and mucus, and the tendency to hoarseness,
are sufficiently characteristic to show its specific affinity for
the vocal organ. Moreover, Selenium, when combined with
alkalies, appears to possess a powerful energy, according to
the experiments of Rabuteau, and an almost exclusive affinity
for the breathing apparatus. Rabuteau operated on seven
middle-sized dogs : he introduced from 10 to 50 centigrammes
of selenite or seleniate of potash or soda diluted in water or
milk, either directly by injection into a vein, or by causing it
to be absorbed from the stomach. The animals died; but
whether death occurred within half an hour of the introduc-
tion of the poison into the system, or some days later, they
all expired with the symptoms of asphyxia. The lungs were
found extensively and intensely congested, the air-tubes
injected, the trachea choked with froth, and the blood in the
arteries dark-coloured." He esteems the medicine highly in
the milder forms of follicular and the incipient stage of
tubercular laryngitis, preferring the seleniate of soda, from
the third to the sixth decimal, to any potencies of the pure
metal.
Selenium has also been found useful, in higher attenua-
tions, in impotence.
I must now say a few words upon the
Senecio aureus,
of which we make a tincture from the entire plant.
There are provings of this plant by three persons, in sub-
stantial doses of the mother-tincture, in the second edition of
Dr. Hale's New Remedies; and the therapeutic part of his
SENEGA.
805
fourth edition tells us all that is known of its curative
virtues.
These provings evidence a good deal of action upon the
kidneys, as shown by pain in the loins and bloody urine.
Senecio has occasionally proved curative in renal dropsy, and
in congestion and even inflammation of the kidneys; also in
one case of chronic inflammation of the neck of the bladder.
It is popularly known as "female regulator" and "false
valerian,” names which indicate its kind of action. It has
not been proved upon a woman, but appears likely to be bene-
ficial in some forms of amenorrhoea. It also seems to act upon
the respiratory organs somewhat like Sanguinaria. Its exact
place in practice has yet to be defined.
Helonias, Pulsatilla and Sanguinaria seem its closest
analogues.
The clinical results mentioned above have been mainly
obtained from the mother-tincture.
My last medicine to-day is the snake-root, Polygala
Senega.
We make a tincture from the dried root.
Stapf's Additions to the Materia Medica contain an ex-
haustive monograph on Senega by Dr. Seidel, which includes
provings by eight persons, carried out with the powdered root
and the mother-tincture. Dr. Allen adds symptoms from
Lembke and from eight experimenters of the old school.
Senega is commonly known and used as a "stimulating
expectorant." The drugs so-called are generally, if not always,
specific irritants of the respiratory mucous membrane. Such
is Senega. The proving reveals that it has a special affinity
for this tissue, causing a great deal of cough, mostly dry, and
pains of all kinds about the chest; while Schroff found senegin
to produce irritative cough and secretion of mucus, lasting
several hours. You will find prefixed to the pathogenesis
some good cases of chronic bronchitis, thus characterised, in
which Senega proved curative. I myself have often prescribed
it with the utmost benefit in the bronchitis of old people,
when the cough is irritating and shaking. One patient to
whom I gave it compared its effects to that of an opiate.
That in such cases it acts homeopathically we have the testi-
mony of one of the old school, Dr. H. Dobell.* "Senega,"
* On Winter-cough.
*
806
SENEGA.
he says, "irritates the cough. If it already is frequent, it does
harm.' I have seen it cause this aggravation even in the
first dilution. Dr. Meyhoffer commends it when the phlegm
is very adhesive.
This is the main sphere of the action of Senega. But it
undoubtedly has something to say also to the eyes. In the
provers, the lids were much inflamed, and there were aching
pains and sense of tension in the balls. From Dr. Seidel's
citations, it seems that Senega was in high repute of old
among the German oculists for various affections of the eyes,
on which they regarded it as exerting a specific action. Dr.
Emery has mentioned its value in hypopyon ;* and Dr. Seidel
gives some cases of iritis and specks upon the cornea treated
by it. Dr. Allen cured with it a paralysis of the third nerve,
affecting especially the superior rectus muscle, so that the
patient could only see clearly by bending the head back-
wards.†
در
In one of his interesting Causeries clinicales Dr. Gallavardin
has illustrated the value of Senega in pleuritic effusion and
hydrothorax ; and in the twenty seventh volume of the
British Journal of Homœopathy you will find some cases of
pneumonia and of vesical catarrh in which it proved efficacious.
To the last-named affection symptoms 274-278 of the proving
plainly point.
Bryonia and Hepar sulphuris are the medicines which most
resemble Senega in their influence upon the respiratory
organs.
I have always used the second dilution where the drug was
perfectly homoeopathic; but higher potencies seem to have
acted well.
* See Brit. Fourn. of Hom., xxiii., 341.
+ See New York State Society's Transactions, X., 194.
- See l'Art Médical, xxvii., 127, 290; and Brit. Journ. of Hom.,
vi., 338.
LECTURE LIII.
SEPIA-SILICA.
The subjects of my lecture to-day are two of those medi-
cines whose extensive use is so marked a differentia of homœo-
pathic practice.
The first is
Sepia,
or, more fully, Sepiæ succus. It is the blackish-brown fluid
contained in the pouch of the mollusc so named, which in its
dried state is so largely used by artists. In this condition we
triturate it with milk-sugar for medicinal use.
Hahnemann published a pathogenesis of Sepia in the first
edition of the Chronic Diseases. It contained 1,242 symptoms,
obtained (of course) from patients taking it in the attenuations
from the third upwards. In the second edition 413 additional
symptoms are given, of which about 160 were from five fellow-
provers: the remainder were his own. Sepia was the medicine
selected for re-proving by the American Institute of Homœo-
pathy in 1874; and the report of the experiments made with it
is contained in the Transactions of that body for 1875. Thirty
persons took part in them, all of whom tested the drug on
their own (healthy) bodies. Ten of these were women. The
experiments were superintended, and their faithfulness and
accuracy are vouched for, by the lecturers on Materia Medica
in the homoeopathic colleges of New York, Cincinnati, Phila-
delphia, and Boston. The attenuations from the third to the
two-hundredth were employed. Uterine examinations and
urinary analyses were made when required. Out of the thirty
persons twenty-six experienced effects, more or less decided,
from the drug; and the total register shows 517 symptoms to
have been elicited. These have, of course, been incorporated
with Hahnemann's by Dr. Allen.*
*
*See also a single but interesting experiment with the drug in Brit.
Fourn. of Hom., xxxvi., 397.
808
SEPIA.
The objections which have hindered me from drawing any
conclusions from the pathogeneses of the Chronic Diseases
exist in fullest force in the case of Sepia. When, therefore, I
refer you to the study of its symptoms by Dr. Veith Meyer,
which is translated from the Vierteljahrschrift in the thirteenth
and fourteenth volumes of the British Journal of Homœopathy,
it is with this reservation. Nevertheless, it is an instructive
paper. He attempts to give unity to his subject by assuming
that the primary and essential action of Sepia is to cause
venous congestion, first in the portal system, and then through-
out the body; and that its local effects are to be ascribed to
this general condition. The hypothesis corresponds well
with the curative action of the drug, and may be used with
advantage as a tentative clue to its pathogenetic phenomena.
It does not appear what led Hahnemann to introduce the
juice of the cuttle-fish into medicine. He rightly says that he
was the first so to employ it. But it is a curious fact that
broths and other preparations made from the mollusc itself
were (as Teste points out) used by the ancients in many of
the affections of the generative organs, of the urine, and of
the skin, in which Homoeopathy now finds the juice so bene-
ficial. I need hardly say that for many centuries its use has
been quite unknown. Here, as in so many other instances,
that holds good which our laureate says—
"Is it so true that second thoughts are best?
Not first, and third, which are a riper first?"
I. Ever since its introduction into the list of medicaments
Sepia has been reputed a valuable remedy in disorders of the
female sexual system. Since now we have for the first time
an undoubted proving upon healthy women, we look with
great interest to see what symptoms are manifested in this
sphere. They are of much importance.
1. The catamenia were always diminished in quantity, and
either dark or pale in colour. The one exception to this rule
was a woman whose menses for some time past had been
scanty and dark; in her case, under the influence of the drug
they flowed freely, and were brighter in colour. The period
was often, but not always, delayed; sometimes, indeed, it
anticipated.
2. Considerable pain was experienced by several of the
female provers in both ovaries and uterus. In the former the
pain was sometimes a dull and heavy ache, sometimes a series
of sharp shootings. The uterine pains are commonly described
as a general sense of distress within the pelvis, with bearing
SEPIA.
809
downwards; they were relieved by pressure from without or by
crossing the thighs. One prover had severe uterine cramps
before each of the two periods which occurred while taking
the drug.
3. With three of the female provers the effect on the uterus
seems to have been very intense. The first was a widow, æt.
41, who took doses of the 200th dilution, at intervals, between
January 5th and 24th. She was examined by Dr. Emma
Scott, an intelligent young "lady-doctor" of New York, whose
acquaintance I had the pleasure of making during my stay
there, and whose competence I can attest. She was perfectly
healthy at the commencement of the proving; but at its close,
after experiencing a great deal of dull pelvic pain, with pres-
sure to pass water, a yellowish leucorrhoea appeared. Dr.
Scott examined her, and reports, "uterus congested, and a
yellowish leucorrhoea pouring from it; beginning to prolapse;
slightly displaced." The second case was that of a married
woman, who took six doses of the third trituration on three
successive days. The only effects at that time seemed to be
a sense of prostration and "goneness," especially referred to
the stomach. After an interval of nearly four weeks, of which
no account is given, she again took a powder, with the same
results, and also much aching in the pelvis. The uterus was
then (it would seem) examined, and found prolapsed, with
inclination of the fundus to the left side: there was also ten-
derness of the os. This report is too scanty; but as it is
presented by Dr. Conrad Wesselhoft, there can be no doubt
of its validity. The third case, though given on the same
authority, is less satisfactory. Dr. Wesselhoft notes,-" This
patient (Miss H-) has suffered from enlargement of the
womb, 'a tumour cured by galvanism,' at our hospital." He
does not say when, or in what state the uterus was left after
the disappearance of the tumour. We must therefore take
the proving provisionally for the present. Its subject took
four doses of the third trituration on as many successive morn-
ings. Flushing of the head and face, with frontal headache,
followed each dose; and there gradually supervened weight
and bearing down in the pelvis, which lasted some days after
the proving ended. It was resumed a fortnight later, and a
dose of the same potency taken every morning for thirteen
days. The pelvic symptoms reappeared, but more severely,
and on the eighth day leucorrhoea set in, at first yellowish,
then creamy, then glairy and offensive-with the last two
kinds blood also being intermingled.
These effects of Sepia show its power of congesting the
810
SEPIA.
uterus even to inflammation, and hence of favouring its pro-
lapse or displacement. The provers in whom they appeared
report many of such sympathetic sufferings as would be ex-
pected to occur in these conditions. But they are best marked
in the case of the first in order of the female provers, who took
Sepia 200 for three days together. Pelvic distress, of an out-
pressing character, speedily set in, and with it came vesical
irritability, feverishness (temp. 999 at noon), thirst, tenderness
of the mammæ, and sensitiveness at the epigastrium. The
urine was strongly acid, and of sp. gr. 1,030 nearly throughout
the proving.
Such facts confirm the appropriateness of Sepia to affec-
tions of the female sexual system which is so generally recog-
nised in the school of Hahnemann. It has indeed found its
chief employment in homoeopathic practice in chronic diseases
affecting the female sex during the period of ovario-uterine
activity. It is considered especially suitable to women of
dark complexion, of fine delicate skin with red or yellow tint-
ing here and there, and of great sensitiveness to all impres-
sions. In such subjects it renders eminent service in many
derangements of the sexual apparatus. Pelvic congestion, of
passive venous type, is the pathological condition specially
calling for it; and from this source spring most of the symp-
toms which indicate its employment. No medicine is more
frequently beneficial in leucorrhoea owning such origin: the
discharge is either greenish and thick, or profuse, watery, and
offensive. It will often remedy uterine displacements con-
nected with congestion of the organ. Dr. Bayes strongly
recommends it in dysmenorrhoea with insufficient loss. I
myself find it the best medicine for gonorrhoea in the female,
after the acute symptoms have subsided; and it is praised for
follicular vulvitis. In pregnancy it is often useful to relieve
constipation, and to remove such sympathetic troubles as
vomiting and toothache. At the climacteric age it is very
helpful in reducing the congestions which are incident to the
failure of the monthly relief of the system. Altogether, no
medicine save Pulsatilla is so useful to the weaker sex as
Sepia.
The venous congestion which characterises all these Sepia-
affections of the uterus may be primary. But it is very often,
I think, secondary to abdominal plethora. The uterine veins,
indeed, open into the vena cava, and are consequently not
directly affected by portal obstruction.
But the womb may
be indirectly influenced by such cause through the rectum.
When in this way constipation, prolapsus ani and hæmorrhoi-
SEPIA.
811
dal fulness are induced in women, and then the uterine health
becomes impaired, Sepia is indicated for the whole group of
symptoms; and will do much towards removing them.
Some observations on the drug appended to the American
proving would seem to extend its virtues beyond those com-
monly ascribed to it, at any rate in this country. They are
from the pen of the late Dr. Mercy B. Jackson, of Boston.
I had the opportunity of a good deal of conversation with
this lady during my visit to America, and can quite corro-
borate the high estimation in which she was held by her
colleagues of the other sex. She was advanced in life, and
had had large experience in the maladies of women and chil-
dren. Her remarks are so brief and to the point that I will
read them to you in full.
G
"For more than twenty years," she writes, "I have found Sepia in-
dispensable in the treatment of uterine diseases. There has been no
other medicine used by me that has been beneficial in so many cases.
(
"The symptoms and conditions which most surely call for Sepia, in
my opinion, are misplacements, whether by prolapse, or ante-version,
or flexion on itself forward and backward; Sepia will in most cases re-
store the uterus to its normal position, if given in the 30th or higher
potencies, daily or every second day, and persisted in for sufficient time,
without manual interposition, and the cure is generally permanent.
"But in order for it to be useful in any case the subjective symptoms
must correspond to its pathogenetic symptoms.
"Those most characteristic are turns of prostration and sinking
weakness running suddenly over the patient, resembling fainting, but
not going so far as to destroy consciousness. I have rarely, if ever,
found a case of uterine disease in which these turns were frequent, in
which the other symptoms of Sepia were not found, and when it did not
do a great deal for the sufferer.
"Another characteristic symptom is a burning pain in the small of
the back, accompanied by a dragging sensation there, continuous or
often recurring.
""
Bearing down in the pelvis is another symptom that calls for Sepia,
and when this and the first-mentioned symptom are wanting, it will
rarely or never be useful.
"Yellowness of the skin and brown spots on it corroborate the other
symptoms and make the choice more easy.
"Profuse leucorrhoea, rather watery and offensive, is almost always
improved by Sepia, and if to these indications are added a brownish
colour, and acrid character of the discharge, it is still more sure to be
successful.
"I have felt it in procidentia restore the uterus so rapidly that its
movement was plainly felt returning to its place, as if raised by a power
within the pelvis, and have often seen cases restored by it in a few
minutes, in my practice, and so great is my confidence in its power to
do this, that in recent cases of prolapsus I never resort to manipulation,
but prepare some in water and give one teaspoonful every few minutes
till the sufferer is relieved, and then continue it at longer intervals, until
it is given only once a day to complete the cure.
812
SEPIA.
"Of course the patient is placed in a favourable position, on the
back with the knees elevated and the feet resting on the soles.* In
many cases of recent origin, Sepia will entirely cure, but in cases brought
on by lifting, Calc. carb. is often needed to aid the Sepia.
"I have found in many cases of chronic disease in women, where
the symptom first mentioned of sudden prostration with sinking faint-
ness was often experienced, that Sepia was a very important remedy,
and I think that symptom is the most characteristic of any in its patho-
genesis."
Professor Henderson mentions such an attack as occurring
in a gentleman to whom the medicine was given (in the 30th
dilution) for a cutaneous eruption.† Dr. Guernsey adds
several other symptoms as indicating Sepia. As belonging
to the pelvis he mentions-a sensation of bearing down so
considerable that the patient feels she must cross her legs and
"sit close" to keep something from coming out of the vagina;
pains shooting upwards in the os uteri; a feeling as of a weight
or heavy lump in the anus (this, he says, is very characteristic);
and fœtid urine, so offensive sometimes that it cannot be
suffered to remain in the room, "depositing a reddish, clay-
coloured sediment, which adheres to the bottom and sides of
the vessel as if it had been burnt on, like burnt clay." Else-
where he notes that the Sepia patient has very cold hands and
feet, and complains of a great sense of emptiness at the pit of
the stomach. You may remember this symptom in connexion
also with Ignatia and Phosphorus; but with those medicines
it is of nervous origin, here it is uterine.
II. The influence of Sepia upon the portal system has
always been recognised, as Meyer's generalisation of its action
shows. It has not hitherto been much employed in sub-
stantive hepatic affections, save when connected with uterine
derangement. But Bähr recommends it in lithic acid dys-
pepsia and hepatic engorgement occurring in females, even
without such complication; and the American proving makes
it promise much usefulness in this sphere. You are aware of
the close connexion between hepatic disorder and lithiasis, as
so well described in the late Dr. Murchison's Croonian Lec-
tures on Functional Derangements of the Liver. Now among
the re-provers, besides many symptoms referable to the liver
and digestive organs, marked alterations in the urine were
observed. This point was specially studied by Dr. Allen, who
made the six provers of his class examine their urine daily.
* It is no less "of course "open to question whether the posture
adopted had not as much to do as the Sepia with the restoration
effected in these recent cases.-R. H.
† Homeopathy fairly represented, 2nd ed., p. 240.
SEPIA.
813
All noticed a great increase of the urates in the secretion, which
was very acid, deeply-coloured, and of high specific gravity.
An amorphous sediment, either of brick-dust or whitish
colour, was deposited; and examination proved it to consist
of urates. The significance of this symptom (already
noticed in the instance of Lycopodium) was at once appre-
ciated. The last practical contribution to our literature of the
lamented Carroll Dunham was on the subject ;* and he relates
two excellent cases of sub-acute hepatic congestion, with
lithiasis, in which the action of Sepia (30th trituration) was
very rapid.
III. Sepia has always had some repute in cutaneous affec-
tions. The re-proving displayed a considerable action of the
drug on the skin. Perspiration was increased in one person,
having an unpleasant odour; abrasions were slow in healing in
two; and in five a rash appeared. It was generally vesicular,
but a tendency to pustulation showed itself: itching accom-
panied the vesicles, and the pustules in one case were painful.†
It has been mainly when the skin has been discoloured in
connexion with derangement of the general health that Sepia
has been employed, as when "liver-spots" and other maculæ
have appeared, or a yellow saddle has formed across the bridge
of the nose; and the presence of such phenomena is always
considered an indication for it. In Professor Henderson's
case, however, a "scaly eruption on the legs, on a dark
dusky redness of the skin," of fifteen years' standing, disap-
peared in a few weeks after the single dose whose effects I
have mentioned; and Dr. Drury, who has had much experi-
ence in diseases of children, expresses great confidence in it in
recent ringworm.
<<
IV. The most important action of Sepia, however, beyond
that which it exerts on the abdominal and pelvic organs, is its
power over migraine. There is a general agreement among
the German writers as to its great value here; among others
Trinks states that he has made several radical cures by it.
It is in patients of the sex and characteristics already men-
tioned, and of venous and bilious constitution, that it proves
most useful. The pain is generally very severe, of rending
character, and increased by any excitement. You will find
several statements and illustrations relative to this matter in
Peters' Treatise on Headaches. Tietze points out the "sudor
hystericus," a peculiar odorous perspiration in the axillæ and
* See Transactions of N. York State Hom. Society for 1876-7, p. 87.
† Cutaneous symptoms were also experienced by the prover referred
to in the note to p. 807.
814
SILICA.
soles of the feet, as an unerring guide to its selection here;
and Dr. Clotar Müller says* that he has given Sepia with
happy results in other maladies when this symptom was
present.
The following are Dr. Meyer's conclusions:-
"1. Sepia has its sphere of action in the portal system, in
which it causes obstructions.
"2. Most of its symptoms indicate a high degree of venous
congestion.
((
3. It is characterised by torpidity and depression, often
ending in perfect exhaustion of the vital powers.
"4. Hence it is suitable in mild and easy dispositions, and
therefore especially for women.
"5. The affections arise and increase in severity, mostly in
the evening and at night, during and immediately after a
meal.
"6. The affections either disappear during, or are alleviated
by, active exercise, and by pressure of the painful part.
"7. The affections are often accompanied with chilliness.
"8. There is great sensitiveness of the skin to cold air.”
I may add that the re-provers experienced much dulness
of the intellectual powers and diminution of energy; and that
amelioration of most of their subjective symptoms was
usually observed (contrary to Dr. Meyer's canons) from eating
and after repose.
Dr. Hoyne says that he has cured more cases of chronic nasal
catarrh with Sepia than with any other remedy; and Drs.
Guernsey and C. Wesselhoeft warrant it in enuresis nocturna,
when the wetting of the bed always occurs during the first
sleep.
The only real analogue of Sepia with which I am acquainted
is Pulsatilla. Lycopodium, Lilium and Murex have points of
contact with it.
Sepia is a medicine which has been almost exclusively used
in the higher dilutions. I know of no records showing it
to possess much activity from the third downwards. I myself
nearly always employ the twelfth.
My second medicine is one of equally strange origin, and of
no less therapeutic virtue. It is common flint,
Silica.
Thus, and not Silicea, it should be styled: "silicea" is an
* See Brit. Fourn. of Hom., xxi., 16.
SILICA.
815
adjective, whose substantive is "terra," the two being con-
joined in the Chronic Diseases. Chemically, it is of course
silicic acid, an oxide of silicon. In the Pharmacopoeia you
will find Hahnemann's directions for obtaining the pure
Silica in powder; but I suppose that any other approved
process, or even that of Berzelius which makes the flint
soluble, would give us what we want. The ordinary form is
triturated for our use.
The original pathogenesis of Silica appeared in the first
edition of the Chronic Diseases. 567 symptoms are ascribed
to it there, which seem to have been observed on patients
taking the attenuations from 6 to 12. In the second edition
the list has swelled to 1,193, about 150 of the additions being
contributed by seven others. A short proving of the soluble
Silica, in a preparation of strength about equivalent to our
second dilution, is translated in the twenty-eighth volume of
the British Journal of Homoeopathy. Dr. Allen adds symp-
toms from provings made with the dilutions, instituted by
Ruoff and Robinson, raising the total of his pathogenesis to
1,903.
It seems that flint was first used as a medicine by Para-
celsus, and praised by him and his followers in renal and
vesical calculus, in suppression of milk and of urine, and in
some nervous disorders. But its employment had become
quite unknown when Hahnemann, encouraged by the
success of triturating the otherwise inert metals, applied the
process to it also; and thereby gave us a most valuable
remedy.
The genuine physiological action of Silica is quite unknown.
No Meyer has sought to define its central point, and no asso-
ciation has selected the drug for re-proving. Dr. Becker's
experiments with silicated water were slight, and, owing to
his imperfect health, gave curative rather than pathogenetic
results. We will turn at once, therefore, to therapeutics,
where Silica plays a well-understood and very important
part.
Silica influences the nutrition rather than the functional
activity of the tissues which come within its range of action :
it is hence suited to organic changes rather than to functional
disorders. Its deep and slow action, moreover, makes it
appropriate to chronic rather than acute diseases; though
we shall see some of the latter in which it acts rapidly enough.
Teste says it is especially suited to fat people, of a lymphatico-
sanguine temperament. Such is its general character; and
now to descend to particulars.
+
816
SILICA.
I. The first great property of Silica is its power over sup-
puration. It does not act like Mercury in averting this pro-
cess when threatening; and it is inferior to Hepar sulphuris for
promoting it when inevitable. But when it is once established,
and by its excess or long duration is causing mischief, the effect
of small internal doses of Silica in checking it is something
magical. You cannot do better than read in illustration the
two cases related by Dr. Noack, jun., as translated from L'Art
Médical for 1865 in the twenty-third volume of the British
Journal of Homœopathy. Both were severe and extensive
(one caused by dissecting wound), and purulent infection was
threatening; but Silica 30, internally and externally, changed
the whole aspect of affairs, and effected a speedy cure. I
have seen it no less efficacious in purulent infiltration of the
tissues of the neck, following carbuncle: here the sixth dilu-
tion internally was all that was given. In carbuncle itself,
when the inflammatory stage is past, and matter has already
begun to form, Silica will often stay all further progress: and
many an abscess will become absorbed under its use. So also
with whitlows, which it will often blight if given early
enough, and whose tendency to recurrence it will check.*
The same property makes it curative (according to Teste) in
impetigo capitis and (according to Bähr also) in chronic
purulent bronchorrhoea, such as the "stone-cutters' phthisis."t
Dr. Vilas recommends it in purulent otorrhœa.
It is probably in virtue of a property of the same kind that
Silica promotes the healing of some ulcers, as in the leg and
on the cervix uteri. It is the "simple ulcer" alone which it
benefits; and its local use is generally necessary, though this
need not be in greater strength than that in which it is pre-
scribed constitutionally.‡
G
II. From these forms of perverted nutrition we rise to
those of more general character; and find Silica one of the
chief medicines in the two great dyscrasia of childhood-
rachitis and scrofula. In Sir William Jenner's graphic account
of the phenomena of rickets, you will find two symptoms
which are very characteristic of Silica, viz., the perspirations
about the head only, and the tenderness of the general sur-
face. The tendency which obtains, moreover, to defective
formation of bone and increased growth of cartilage in this
disease calls loudly for Silica. Dr. von Grauvogl pointed out
* A case of this disease cured with it (by Dr. Stens) is given by
Hoyne (i., 493).
† See Hoyne, i., 507.
See Goullon on Scrofula, sub voce.
SILICA.
817
that the only chemical difference between cartilage and bone
is that flint is present in the latter but not in the former; and
he has given a good case of enchondroma of the fingers in
which, acting upon this suggestion, he administered Silica 3
with most satisfactory results. I have already expounded to
you his theory about "tissue remedies," of which this bit of
treatment is an instance. I can speak no less confidently of
the power of the drug when, as in rachitis, the enchon-
dromatous tendency is general. I am accustomed to prescribe
it in the earliest manifestations of the diathesis, which are
generally unhealthy evacuations, sweats of the head, and ten-
derness of the surface; and with the best results. In scrofula
we have so eminent a therapeutist as Dr. Jousset proclaiming
it the chief of remedies. I should myself have placed it below
Sulphur and Calcarea; but in Dr. Goullon's treatise on the
disease you will find quite an array of instances of it in which
Silica has proved curative.
It is chiefly when scrofula manifests itself in the bones and
joints that Silica proves its remedy. There is abundant testi-
mony to its value in periostitis, when non-syphilitic in origin;
and it is no less valuable when the bone itself is affected, as
shown by caries or necrosis. In the scrofulous joints—the
"white swelling" of the old authors, where all commend it, it
is probably most useful when the mischief has begun in the
bones or cartilages, rather than in the synovial membrane.
If in any of these cases matter is already discharging, do not
neglect the local use of the remedy.
III. Another very important influence of Silica is that
which it exerts upon the nervous system. It is probably the
nutrition of the centres which it affects; but, whatever be its
modus operandi, its remedial powers are unmistakeable. The
first (so far as I know) to direct attention to this property was
Dr. Black, in the second and fifth volumes of the British
Journal of Homœopathy. He there states that Silica exercises a
powerful action on the brain and spinal cord, especially the
latter; indicates nervous exhaustion, as from over-study, as
the condition specifically calling for it; describes two forms of
headache characteristic of it; and relates three cases of spinal
paresis in which it proved curative. The first was an instance
of Pott's disease of the vertebræ; the other two of long-
delayed ability to stand or walk in strumous children. We
have next a valuable contribution on the subject from Dr.
Dunham, which you will find in the Transactions of the New
York State Homoeopathic Society for 1871. His chief point
here is that "with evidence of exhaustion furnished by the
3 G
818
SILICA.
sensation of weakness, paralysis, &c., there is," with Silica,
"an exalted condition of susceptibility to nervous stimuli.
The special senses are morbidly keen, the brain cannot bear
even moderate concussion, nor the spine either concussion or
pressure, and the whole surface is unnaturally tender and
sensitive. Cold aggravates and warmth relieves." This
"erethism conjoined with exhaustion" may, as he further
shows, go on to spasm; and he relates a case of epileptiform
spasms, with great nervous irritability, cured by it. It had
been caused by a fall on the supra-orbital region, whose feel
suggested that some fracture had occurred there; pain was
felt at the spot on stooping, or when the upper spine (which
was tender) was pressed upon. All these symptoms, after
lasting some months, and resisting other medicines, yielded
rapidly to Silica.
Dr. Dunham subsequently recorded two cases of chronic
headache cured by the drug, in both of which great sensitive-
ness to pressure, noise, motion, and light were present, and
relief was obtained from warmth, as from wrapping the head
in a shawl. He has further described the Silica patient as
one who “feels as if he could not possibly do this or that, but,
when urged to the doing, goes off in a paroxysm of over-
doing." Dr. Samuel Jones, who reports this last observation,
has put on record a striking cure of chronic headache, with
nervousness and loss of memory, resulting from overwork, in
which the patient (himself a medical man) was led to the
remedy by it. The description of his headache given by this
sufferer is typical of that to which Silica corresponds. It
"commenced low in the back of the neck, with a feeling as
though the muscles could not support the head, gradually
increasing until there was a sensation as if the neck had been
severely bruised (as struck with a club), but it was not sore to
the touch. Gradually the pain would work up over the head,
leaving in the vertex a sensation of heat, as though one had
caught cold in the scalp; finally settling in the forepart of the
head, and at times involving the eyeballs and making them
sore."
I think you will now see that there are (as Dr. Jones says)
many neurolytic conditions which Silica promises to benefit.
The headaches of spinal patients, of students and governesses,
of the subjects of masturbation and indeed of any whose
nervous centres are debilitated and at the same time hyper-
æsthetic, find in it one of their best remedies; and it will
* See Hoyne, i., 487.
† See Brit. Fourn. of Hom., xxxvi., 196.
SILICA.
819
prove" tonic" as well as " sedative" to them. To its virtues of
this kind I can testify from my own experience. Whether it
will reach to the profounder effects of such causes, as paralysis
and epilepsy, one cannot yet say. It will have been observed
that in the two chief cases of this nature which I have men-
tioned, the lesion lay in the osseous surroundings of the brain
and cord rather than in their substance itself.
I should add Teste's observation, that in the nervous dis-
orders calling for Silica there is often present a sense of great
prostration, causing a craving for food to remove it, and that
the symptoms are always the worse for abstinence.
IV. In suppuration, in scrofula and rickets, and in neuro-
lytic conditions, we have the more general sphere of action of
Silica; but it has several miscellaneous properties, which I
must now detail to you.
1. Dr. Dudgeon has put on record a striking case in which
Silica arrested the progress of inflammation of the lachrymal
sac*, and I have myself had another precisely similar. It is
said, also, to have caused the healing of lachrymal fistula.†
Drs. Allen and Norton confirm these virtues of the drug,
but add that to check dacryo-cystitis it must be given before
suppuration has occurred, and that a lachrymal fistula to be
healed by it must be a recent one.
2. In the lower extremities Silica finds frequent employment
in "housemaid's knee," where the testimony to its usefulness
is very general. Another use of it in this region has regard
to perspiration of the feet, which is an affection of no uncom-
mon occurrence, and, from the tenderness it causes, and the
offensive odour it often exhales, is a cause of considerable
distress. If, moreover, it be violently suppressed, not only
are the feet left cold, but various constitutional affections are
apt to supervene. Of these one of the most frequent is weak-
ness of sight, and the cause of such weakness has more than
once been found to be opacity of the lens. Now Silica con-
trols this entire series of occurrences. We have already seen
its influence over the constitutional condition which manifests
itself in perspiration about the head; and Dr. Guernsey notes,
as one mark of difference between it and Calcarea here, that
the sweat is apt to be offensive. No less power does it display
in checking similar perspirations of the feet. But—and this
is the important point-when the exhalation has been sup-
pressed from without, and systemic troubles have hence arisen,
Silica will make the feet warm and moist again, and will
* Brit. Fourn. of Hom., xiii., 135.
† Hoyne, i., 488.
820
SILICA.
cause the morbid symptoms to disappear. Some of Dr.
Becker's cases treated by silicated water illustrate these state-
ments. But their best evidence is a series of instances
recorded by Dr. Gallavardin in L'Art Médical for 1866.* The
local use of atropia, as introduced by Dr. Ringer, to check
these perspirations is becoming so general, that we shall
probably have frequent occasion to resort to our Silica as a
remedy for the consequences.
3. Dr. Hering has found Silica of frequent value against
bad effects resulting from vaccination.
It is of course
cspecially suitable when these are of a suppurative character,
as porrigo capitis; and in such conditions I have found it
most serviceable. But Dr. Hering extends its use, as in some
cases he has mentioned, to convulsions thus arising. †
4. Dr. Cooper recommends it in cutaneous eruptions
itching only in the daytime and evening, not at night. It
has been little used, however, in affections of the skin, save
when suppuration has been their leading feature.
5. Dr. Guernsey lays much stress on a form of constipation,
as not only itself curable by Silica, but as indicating the
remedy when present among other symptoms. It is where
the fæces form in hard lumps, which remain long in the
rectum, and are difficult of expulsion; while sometimes, after
long straining, the protruding part suddenly recedes again.
He sets this down to deficient power on the part of the rectum,
but Dr. Dunham seems to ascribe it to spasm of the sphincter
ani. Besides this "key-note" for the drug, Dr. Guernsey
mentions-in women-paroxysms of icy coldness during the
menses, and—in children-frequent grasping at the gums
during dentition.
6. The great sensitiveness of the surface characteristic of
Silica led Dr. Ludlam to give it, with success, in a distressing
cough occurring during convalescence from spinal meningitis,
where the slightest current of air set going in the room pro-
voked the paroxysms. In the same category is probably to
be placed a cure of vaginismus wrought with it, as reported
by Dr. Skinner.§
So far speaks Homeopathy; and I think you will admit
that, if these statements can be substantiated, it possesses in
Silica a most precious remedy. But there is something more
to be said about the drug.
Silica is a constituent of several mineral waters, among
* See also his Causeries clinicales homœopathiques, nos. iv. and xix.
† See Hoyne, i., 502. ‡ Ibid, p. 492.
& See The Organon, i., 76.
SILICA.
821
others those of Teplitz and Gastein, where it exists in the
proportion of from three-fifths to three-tenths of a grain in
the pound. But it forms a much larger percentage of the
Missisquoi and Bethesda springs of America, the former of
which contains 016000 parts in a thousand. Now these
waters have a great reputation in their own country for
cancer, tumours, diabetes, and albuminuria. Dr. Tuthill
Massy called our attention to them in the Monthly Homeo-
pathic Review for 1870; and, as they are largely impregnated
with lime, their action was supposed to be due to this in-
gredient, and to be of a picce with the experience of Drs.
Hood and Spencer Wells with pulverised oyster-shells, of
which I have spoken under Calcarea. But Dr. Fowler Battye
has recently communicated to the Edinburgh Medical Journal*
a series of cases of chronic discase which he has treated with
finely powdered Silica. He does not explain how he was
led to employ it; but the fact that his cases consist entirely of
those in which the Missisquoi waters have gained their repute
speaks for itself. A side-wind of the high estimation of the
medicine in homoeopathic practice may also have influenced
him; but this would not account for his choice of cases, as
they are quite outside the range of our employment of the
drug. Dr. Battye's results are very important. The pains of
cancer abate greatly or cease within ten days of commencing
the drug, and sometimes a withering of the growth occurs.
Fibroid tumours of the pelvis greatly diminish; and both sugar
and albumen disappear from the urine, with corresponding
improvement in the general health. These last effects seem
certainly due to the dynamic action of the drug; and Dr.
Battye's grain doses night and morning point in no other
direction.
As allied medicines to Silica we have Fluoric, Phosphoric
and Picric acid, Calcarea, Hepar sulphuris, Mercurius and
Phosphorus.
The dilutions from the sixth to the thirtieth have been those
most commonly employed by homœopathists. It may be
that to get Dr. Battye's results we most employ his more
material doses. I have verified his experience with Silica as
an anodyne to the pains of cancer, giving the 1x and 2x tri-
turations.
* Vol. xx., P. 420.
1
LECTURE LIV.
SPIGELIA, SPONGIA, STANNUM, STAPHISAGRIA, STRAMONIUM.
My first subject to-day is a very interesting, and-beyond
the homœopathic range-little-known medicine, the pink-
root,
Spigelia.
The tincture is prepared by maceration from the dried root of
the Spigelia anthelmia, the Demerara pink-root, which was
that proved by Hahnemann. The Carolina pink-root-S.
Marylandica—seems to have the same properties, and Hahne-
mann has admitted symptoms produced by it into his list,
though Allen isolates them.
The proving of Spigelia is in the fifth volume of the Materia
Medica Pura. Thirteen persons co-operated with Hahnemann
therein, and added 525 symptoms to his own 130, and to 17
which he cites from authors. Large doses seem to have been
used, as in his preface he speaks of having observed the effects
of 60, 80, and 100 drops of the tincture; and the symptoms
are very full and pronounced.
Spigelia was introduced from America as a medicine for
destroying lumbrici, and is in use there for such purposes to
the present day, though it is little known elsewhere. Struck,
probably, by the narcotic effects observed from over-doses,
Hahnemann thought well to prove it; and in view of the
"varied and great powers" it presented predicted that it was
destined to accomplish results much more important than the
destruction of worms. His prophecy has been fulfilled, but
only among his own disciples: the common practice is content
to know this valuable remedy only as a vermicide.
The effects of over-dosing with Spigelia are somewhat like
those of the mydriatics. There are dilated pupils; flushed
and swollen face; quickened pulse; heat and dryness of skin :
spasms of the facial muscles, especially of the eyelids; and
SPIGELIA.
823
subsultus tendinum, which may even go on to convulsions and
death. The irritation of the nervous centres here displayed
is in the provings shown especially in their sensory portion.
Pain, usually of a shooting character, is stirred up in many
parts of the body, but especially in the head, face, and chest;
and in all very predominantly on the left side.
Spigelia has hence taken a high place in homœopathic
practice in the treatment of neuralgia, especially of the tri-
geminus. When headaches take the form of supra-orbital
neuralgia, especially on the left side; when the pain recurs at
regular intervals, tends to spread to the face or neck and to
involve the eyes, is aggravated by the least concussion or
motion, but especially by stooping, and is associated with pale
face, restlessness, and palpitation-in such circumstances
Spigelia, in almost any dilution, will prove strikingly curative.
Thirteen cases of the kind are cited in Peters' Treatise on
Headaches; and others are scattered throughout our journals.
It is no less effectual when the pain is seated in the infra-
orbital and maxillary branches of the nerve; so that Bähr
gives it the first place among the remedies for prosopalgia,
and Hoyne has collected several cases of cure by it. The
pain is relieved, according to Dr. Guernsey, by firm pressure.
It must be observed that the supra-orbital neuralgia I have
described here is not true migraine: in this disease Spigelia
has accomplished little.
The most marked actions of the drug, however, which
Hahnemann's provings display are those which it exerts upon
the eyes and the heart. The first of the two had been observed
by several of the authors whom he cites. Pain in and over
the eyes, redness and injection of the whites, sparks before the
sight and distortion and irregular movements of the balls are
symptoms taken from Linning, Chalmers, Wright and Browne.
His own provers confirm them; and add still more decided
evidences of inflammation, the severe pain accompanying
which indicates the sclerotica and iris as the tissues chiefly
affected. The symptoms of the heart are those of great pres-
sure on the chest, shooting pains through it and down the
left arm, and violent palpitations.
All this reminds us of Aconite; and has led to the use of
Spigelia as an auxiliary to that great medicine in several
affections of the eyes and heart. It is especially when these
organs are attacked by acute rheumatism that its powers are
called into play. When "rheumatic ophthalmia" is very
painful, Spigelia will act most satisfactorily in the process of
its cure. Still more important is its control over the cardiac
824
SPIGELIA.
inflammation of rheumatic fever. Decisive testimony is given
on this score by Fleischmann. He treated, he says, in the
Gumpendorf Hospital at Vienna fifty-seven cases of rheumatic
"carditis" (evidently including under that name all forms of
inflammation of the heart) with but one death, and Spigelia
was the only medicine employed.* Dr. Russell writes--"In
the few cases of pericarditis I have treated it has done all
that medicine could do, and I have the utmost confidence in
it." Dr. Bayes expresses (and substantiates)‡ equal satisfac-
tion in its power over endocarditis. Thus Spigelia becomes a
most useful addition to our armamentarium in combating
acute rheumatism. Dr. Phillips even commends it for the
joint affection itself, when it shifts rapidly: the drug seems,
he says, to centre and steady it.
But you must not suppose that it is only in true rheumatic
affections of the eyes and heart that Spigelia is beneficial. It
is much praised in the primary, neuralgic stage of the "arthritic
ophthalmia" of the old ophthalmologists, which is probably
acute glaucoma. Dr. Angell commends it in several inflam-
matory conditions of the eyes in scrofulous children, where,
with photophobia, there is severe ciliary neuralgia. It is the
presence of this last trouble, whether alone or in association
with inflammatory affections of the eye, which chiefly indicates
Spigelia, and which leads to its best results.
The pains
radiate from a point, and are increased by movement of the
eyes and at night. As regards the heart, Dr. Bayes relates
one case and Dr. Kendall§ another of angina pectoris, in
which it proved curative,-Dr. Jousset also speaking of fre-
quent success with it; and Dr. Yeldham has shown what great
benefit a heart chronically damaged by rheumatism can receive
from the free and persistent administration of the drug. In
all these affections it is the darting, shooting, stabbing, or
lacerating pain which indicates Spigelia, and which is relieved
by it.
I think that Teste is well borne out in saying that Spigelia
—at any rate in infinitesimal doses-acts best in anæmic and
debilitated subjects.
Aconite is the medicine most nearly allied to Spigelia. Like
Cina it has numerous symptoms in its pathogenesis which
resemble those of helminthiasis; and it may possibly act in
* Brit. Fourn. of Hom., xiv., 23.
† Ibid, xii. 569.
‡ Monthly Hom. Review, June, 1867.
$ Brit. Fourn. of Hom., xxvi., 157.
|| Annals, iii., 539.
SPONGIA.
825
this condition with the same inexplicably beneficial results
which we have already recognised in Cina itself. Like that
medicine, moreover, it will prove as beneficial in disordered
states simulating helminthiasis as if worms were actually
present. Stillé writes:-" there is a state of intestinal de-
rangement presenting all the symptoms of lumbricoid ascarides,
and which is most frequently observed among strumous,
feeble, and precocious children. They have fever, a dry hot
skin, furred tongue, tumid and confined bowels, capricious
appetite, and nervous irritability. These symptoms are often
dissipated by the influence of spigelia, and without causing the
discharge of any worms, to the presence of which they are
most commonly attributed." You will remember Dr. Chep-
mell's similar testimony to the usefulness of Cina. Dr.
Guernsey commends it here when the child refers to the
navel as the most painful part, and where palpitation is a
coincident symptom.
The higher dilutions in neuralgia, the lowest in cardiac
affections, have been those generally given. Hahnemann,
who recommends the thirtieth, says that even a small dose
acts for four weeks, and that its effects go on progressively
increasing for the first week or ten days. This observation,
which of course belongs only to chronic disease, needs con-
firmation
-
Our next medicine is the Spongia marina tosta, or, more
briefly,
Spongia.
You will observe that it is Spongia tosta, not usta. Hahne-
mann justly directs that it shall only be roasted brown, and
not burnt black, so that its natural constituents shall not be
too greatly altered. In this condition it is treated with alcohol
to make a tincture. Triturations would seem a better pre-
paration, considering the many mineral ingredients of sponge;
but they have not been used, and all I shall have to say of
the homoeopathic employment of the medicine belongs to it as
made into tincture.
The proving of Spongia is in the sixth volume of the
Reine Arzneimittellehre. It contains 156 symptoms from
Hahnemann, and 235 from ten others. Dr. Hering's volume
of Materia Medica contains an arrangement of the drug
embodying much of the clinical experience gained with it.
826
SPONGIA.
I.
Burnt sponge has been used, ever since Arnold of
Villanova introduced it in the fourteenth century, as a remedy
for goitre. Hufeland and all the authorities of his time
express the utmost confidence in it; and Joseph Frank says
that it is as sure as Cinchona in intermittent fever. Since
the discovery that it contained Iodine, and that this agent by
itself displayed marvellous anti-goitrous properties, sponge has
fallen into disuse in ordinary practice,-Vogt alone among
modern therapeutists protesting that it will often cure when
Iodine fails. In homoeopathic practice it has not undergone
this neglect. Hahnemann says that the endemic bronchocele
of the inhabitants of valleys, being always essentially the same
affection, ought to be curable by the same specific; and this
he considers Spongia to be. He states that one or two doses
of the attenuated tincture (he does not specify how far attenu-
ated) suffice for the purpose. If this is spoken from experi-
ence, it ought to be tested more widely than it has been. Dr.
Hering can only find three cases of cure by it in infinitesimal
doses, and Dr. Hoyne reports but one more; and of these one
alone answers to Hahnemann's description. I know, how-
ever, of another; and probably many testimonies could be
borne to it.
As to the rationale of this action, all that I have said while
upon Iodine holds good. Spongia itself has caused swelling,
pain and tenderness in existing goitres; and one of Hahne-
mann's provers reports-"The region of the thyroid gland is
as if hardened." These symptoms, and the cures of the dis-
ease-however occasional-wrought by infinitesimal doses,
show that Spongia is sometimes at least homoeopathic to it.
When it is preferable to Iodine in its treatment we have not
yet learnt to predict beforehand.
2. Hahnemann proved Spongia in order to learn its relation
to goitre; but he thereby brought to light a much more
important action of the drug, viz., that which it exerts upon
the larynx. Hoarseness, tenderness, dry and painful cough,
and obstruction of respiration as if a plug were there-these
were the symptoms produced; and Hahnemann at once in-
ferred the applicability of the medicine to croup. By the time
the second edition of his Materia Medica Pura was published,
he could speak of this as the most remarkable curative applica-
tion of Spongia which homœopathy had made. You may first
lessen the local inflammation, he says, by a dose of Aconite;
and you will sometimes, but rarely, need the aid of Hepar to
complete the cure. Such has been the experience of homœo-
pathists generally, as you may see from the series of cases
SPONGIA.
827
given by Dr. Hering, or those collected in the fifth volume of
the British Journal of Homœopathy. Bönninghausen's cele-
brated "powders for croup" consisted of two of Aconite, one
of Spongia, and two of Hepar,—a powder to be taken every
two hours. Dr. Hale in his excellent Lectures on Diseases of
the Chest has recently taught the same practice; and I can
myself recommend you nothing better. The same process
has indeed been gone through with croup as with goitre.
Koch, in 1841, suggested that Iodine was the active ingre-
dient of sponge in the former as in the latter case; and I have
already told you, on the authority of Elb and Meyhoffer, how
actively Iodine can influence this disease. But so also, as we
have seen, can Bromine; and Spongia contains them both in
a state of natural combination which may be superior to our
artificial preparations of either. It may be that, as with goitre,
Iodine will cure some cases of croup, Bromine others, and
Spongia others again; and that we may yet learn how to
distinguish them à priori. At present we must be content to
hold the remaining members of the group in reserve in case
of the failure of the first chosen; and that, from its traditional
claims, may well be Spongia. Dr. Guernsey says as to its
indications," the cough is dry and sibilant, or it sounds like
a saw driven through a pine board, each cough corresponding
to a thrust of a saw. Spongia is particularly indicated when
there is no mucous rattle. The cough is dry and hoarse, and
causes pain in the throat, but no mucous rattle."
But whatever may be thought about membranous croup,
there can be no question as to the eminent value of Spongia
in simple inflammations of the larynx, from the lightest
catarrh to the severest laryngitis, with all their manifesta-
tions of hoarseness, aphonia, and barking cough. It is in the
dry form or stage of these affections that Spongia finds its
place; and it rapidly promotes resolution. I have seen it so
prompt in removing laryngeal symptoms in a phthisical
patient that I can well believe the reports of its value in
laryngeal phthisis. Indeed, Spongia bears to phthisis pul-
monalis itself the same relation as Iodine-both Neumann
and Hufeland warning that its incautious use is liable to set
up
this affection, in which Dr. Hering esteems it highly as a
remedy. The cough of Spongia is said to have the charac-
teristic of being relieved by eating and drinking.
3. Hahnemann observed from Spongia aching swelling of
the testes and a similar condition of the spermatic cord. Dr.
Hering gives several cases of chronic orchitis and epididymitis
in which the drug proved highly efficacious.
828
STANNUM.
4. But perhaps the most important action of Spongia after
that which it exerts on the larynx is displayed in the cardiac
sphere. This was first brought to light by Dr. P. P. Wells, of
Brooklyn. A sufferer from organic affection of the heart ate
and swallowed a piece of newly roasted sponge. It produced
a frightful attack of pain, palpitation, and dyspnoea, with
livid lips and fear of approaching death. On recovering from
this a remarkable relief of her wonted cardiac distress ensued,
and lasted for several weeks. Dr. Wells was thus led to give
it, in minuter doses, in several cases of heart-disease. He is
led to think it the most valuable medicine we have where
there is fibrinous deposit upon the valves. He states that he
has repeatedly found the bellows-murmur disappear, as well
as the subjective symptoms become relieved, under its use.
Sudden waking in the night, with a sense of suffocation, is the
symptom which especially leads him to its choice; and others
have noted orthopnoea as indicating it. In another case it
greatly relieved the cough and other concomitants of an
aneurism of the descending aorta. I must say that, for remov-
ing the valvular lesions of endocarditis, I have found Spongia
very inferior to Naja.
5. Teste's recommendation of Spongia in all serous inflam-
mations-pleurisy, pericarditis, peritonitis, &c.—with or without
effusion has not been confirmed.
Allied medicines are Iodine and Bromine (of course), Hepar
sulphuris, Kali bichromicum and Selenium.
In croup and laryngeal affections Spongia seems to act well
in all dilutions: I myself find the first and second decimal to
answer every purpose. In cardiac disease the higher attenua-
tions alone have yet been used.
We will speak now of metallic tin,
Stannum.
We use the purest tin-foil; and, having reduced it to powder,
triturate it with milk-sugar for medicinal use.
The proving of Stannum appears in the sixth volume of the
Materia Medica Pura. It contains 204 symptoms from Hahnc-
mann, 5 from authors, and 451 from seven fellow-observers.
The pathogenesis in the Chronic Diseases is but a reproduction
of this, with the preface abridged and the notes omitted; so
that it would be better if translators would give us the original
draught. Dr. Allen adds some effects of the bichloride, and
STANNUM.
829
an observation of poisoning from food cooked in a new tin
pan.
Stannum is one of the few Hahnemannian medicines re-
garding which we have any information as to the doses used in
the proving. In a note to Gross's first communication, we are
told that his symptoms were obtained from a male and a
female prover, taking increasing doses of a trituration of five
grains of tin to a hundred grains of milk-sugar till the man
had consumed three and the woman two grains of the metal.
The inference that the rest of the proving was conducted with
similar quantities is supported from another source. In the
case of Stannum alone among medicines does Hahnemann
recommend a lower potency than before to be used. Writing
so late as 1827, he says that he has hitherto used the sixth
attenuation; but now finds it unnecessary to go above the
third.
Tin is known to modern medicine only as a vermifuge. It
is generally supposed to act mechanically; but Hahnemann
showed that such an hypothesis was untenable upon the facts
known in his day, and it has since been affirmed that water in
which tin has been boiled (or cooled after heating) is anthel-
mintic, and that several compounds of the metal have the
same property. Hahnemann thinks that tin acts in tapeworm
by stupefying the parasite, and so enabling purgatives to dis-
lodge it: he asserts that even in the third trituration it pro-
duces this effect. Teste says that both lumbrici and ascarides
come away often in large quantities after the use of the
dynamized metal.
The frequent causation of nervous disorders-as epilepsy
and chorea-by worms led to the use of tin in instances of the
kind where such origin was suspected. But it not unfrequently
happened that no worms were brought away, and yet epileptic
fits were much alleviated. Thus the medicine grew in favour
for a time as directly influencing the disease; and Hahnemann
can justly cite Fothergill (though not Monro) as commending
it, and Quincy as saying that we possess no more potent anti-
epileptic than this metal. Hahnemann's 409th symptom
among the "Observations of Others," if taken (as it is in some
translations and compilations) without its bracket and note,
would seem to show that tin was capable of producing actual
epilepsy in the healthy. The observation he cites is one of a
boy, who suffered frequently from convulsive attacks, espe-
cially in the morning fasting. Tin was given to destroy the
worms which were supposed to be present; and thereupon the
fits increased and multiplied to perfect epilepsy. More satis-
830
STANNUM.
factory is the evidence of the neurotic influence of tin derived
from the observed effects of the chloride. Pereira's account of
this salt is naively homoeopathic. "When taken as a poison,”
he writes, "it causes convulsive movements of the muscles of
the extremities and of the face, and sometimes paralysis. It
has been used
as an anti-spasmodic in epilepsy,
chorea, and other convulsive diseases, and as a stimulant to
paralysed muscles in paraplegia." Orfila, who is Pereira's
authority for the physiological part of this statement, relates
one instance in which a cataleptic state was induced in a dog
by the introduction of this salt.
In homœopathic practice, the neurotic properties of Stannum
have been turned to effect mainly in certain neuralgiæ.
It
produced a good deal of nerve-pain among its provers. Hahne-
mann says that this is usually of a "drawing pressing or
pressive drawing" character; and Gross notes as a general
condition of such pains that "they commence lightly, increase
gradually and to a very high degree, and decrease again as
slowly." From these indications Stannum has often been
given with success in neuralgia (chiefly supra-orbital) and
headache. You will find some interesting cases of the kind
by one of our Russian colleagues, Dr. Villers, in the seven-
teenth volume of the British Journal of Homœopathy, and
another by Dr. Dudgeon in the twenty-ninth volume. I have
myself found it very beneficial in migraine having this cres-
cendo decrescendo character, the vomiting supervening at the
acme. Another nervous disorder in whose treatment Stannum
has found a place is hypochondriasis. Albrecht and Geisch-
läger found it useful here, says Hahnemann; and he points to
some of his provers' symptoms as very like the abdominal
spasms and diaphragmatic pains of these subjects. He also
says that it is indicated by intolerable uneasiness, so that the
patient knows not what to do with himself. Hartmann, in
harmony with this, urgently recommends Stannum in hypo-
chondriasis where the abdominal pains are relieved by walking
about, while on the other hand the sufferer is so weak that he
is fain to rest, whereupon his distress returns. Apropos of
abdominal pains, I should mention that Dr. Guernsey strongly
commends Stannum in the colic of young children (whether
from worms or not) when firm pressure affords relief.
Before the anthelmintic and neurotic properties of tin were
known, it was in some repute as an anti-hectic, and as a
remedy for what Hahnemann calls "ulcerous phthisis." (A
preparation of it constituted the "anti-hecticum Poterii," and
is much commended by Muraltus, Hoffmann, Vogel, and
STAPHISAGRIA.
831
others.) He means chronic bronchial and pulmonary condi-
tions characterised by profuse muco-purulent discharges and
general colliquative symptoms. He quotes Stahl's statement
that tin "
causes marasmus and phthisis," and points to several
of the symptoms observed by himself as suggesting the same
action. Thus the use of the metal in such conditions has sur-
vived in the homœopathic school, while it has become unknown
elsewhere. We regard it as indicated by great abundance of
the sputa, especially if they have also a greenish colour and
sweetish taste; and also by a sense of great weakness and
emptiness of the chest, so that a slight exertion of voice causes
much fatigue. This last Dr. Guernsey considers a general
"key-note" of the drug. Dr. Meyhoffer has found much
benefit from it in dilatation of the bronchi. Even in phthisical
cases where it cannot cure, Stannum will often do a good deal
to moderate the exhausting sweats and expectoration.
While homœopathy has preserved this use of the drug, it
has initiated another. The sensations experienced by a female
prover have suggested its use in relieving the sensation of
"bearing down" so often complained of by women, and even
in benefiting prolapsus uteri. I have hardly ever known it
fail to effect the former purpose; and I have been quite
astonished at its power over prolapsus. It seems to strengthen
the uterine ligaments.
*
Sepia in the two latter spheres of action, and Argentum,
Cuprum and Zincum as neurotics, are analogues of Stannum.
While Hahnemann's experience seems to show that there is
no advantage in going beyond the third, I must say that,
like Drs. Bayes and Drury, I have seen higher dilutions act
well.
We have as our next medicine one which we have turned to
more noble purposes than that of destroying lice, the "staves-
acre," Delphinium
Staphisagria.
The tincture is prepared by maceration from the seeds.
The proving is in the fifth volume of the Materia Medica
Pura. It contains 283 symptoms from Hahnemann, and 438
from twelve others.
Up to Hahnemann's time Staphisagria was little known save
* This observation, however, I find not to be new. Hoffmann
quotes Muraltus as saying that tin "uterum corroborat."
832
STAPHISAGRIA.
as an external application for phthiriasis—a use of it which, in
the form of the oil of the seeds (ascertained by Mr. Squire to
be the active element), still survives. Dioscorides, however,
had praised it as a masticatory for toothache; and Schulze
had experienced a frightful aggravation of the pain when so
employing it. Hahnemann was thus, perhaps, led to prove it;
and he found it so powerfully to affect the healthy body that
he thought it likely to prove a great medicine. His patho-
genetic results have been substantiated by the active properties
found to belong to the two alkaloids of stavesacre-delphinine
and staphisagrine; but his therapeutic expectations have
hardly been realised as yet. Staphisagria, in fact, is one of
those drugs which one hardly ever thinks of in connection with
the treatment of the ordinary forms of disease. Every now
and then, however, the consultation of a repertory leads us to
choose it as the similimum to the group of symptoms, and in
time, perhaps, it will attain a forward place in therapeutics;
for its provings evidence its possession of a very extensive
range of influence. In the meantime I would call attention to
its effects upon the genito-urinary organs. Putting them all
together, they present a perfect picture of that form of
spermatorrhæa so well described by Lallemand, in which the
prostatic portion of the urethral mucous membrane is the seat
of chronic inflammatory irritation, which sometimes extends
into the ejaculatory canals and seminal ducts. I have used it
several times in this malady with great benefit, and Bonjean
commends it highly. The provings, moreover, confirm the
suggestion of the experience of Dioscorides and Schulze as to
the specific influence of the drug on the teeth and gums. The
teeth ache and decay, get loose, and even show black streaks
in their substance under its use: the gums become retracted
and white. Odontalgia in persons so affected readily yields to
Staphisagria; and the tendency to such decay of the teeth
may in other maladies be an indication for its use. It here
resembles Kreosote
The writer who seems to know most of the curative virtues
of Staphisagria is M. Teste. He gives a long list-like those
of Hahnemann for his antipsorics-of morbid conditions in
which it has proved beneficial. Of these I may especially men-
tion nausea from vertigo, as in sea-sickness. From experiencing
this combination of symptoms in himself he was led to try
the medicine in the mal de mer. Of twenty persons whom he
supplied with a single dose of three drops of the sixth dilution
when starting on a voyage, and from whom he received a
report of the result, five only derived no benefit. In seven the
STRAMONIUM.
833
trouble was absolutely avoided, and the remaining eight
expressed themselves as greatly relieved. The medicine must
be taken, he says, before vomiting has set in, at the moment
when the dizziness and nausea commence. He also speaks of
it as the best remedy for another form of sympathetic nausea
and vomiting, viz., that of pregnancy. Dr. Phillips, who gives
the drug in doses of from five to twenty drops of the tincture,
confirms these recommendations, of Teste's, and also those
which he makes of it in regard to ophthalmia tarsi, chronic
amenorrhœa, periostitis, and shifting pains in the long bones.
Bähr has much confidence in it in chronic blepharitis, and to
prevent the recurrence of styes, in which last recommendation
he is joined by several other writers.
Mr. Clifton has lately given us one of his practical com-
munications as to Staphisagria, in which—among other things
-he speaks of its usefulness in chronic gout in atonic subjects,
in caries, neuralgia, and chronic tonsillitis and prostatitis.
Dr. Guernsey considers the subjects best suited for it to be
those who are extremely sensitive alike to mental and physical
impressions. It was ranked by the older homeopathists as
one of the antidotes to the after effects of Mercury, and also
to those of indignation and chagrin.
Dr. Turnbull found delphinia, when taken internally, to
cause heat and tingling in various parts of the body; and used
it with benefit in some forms of neuralgia. Dr. Bayes praises
Staphisagria itself in this malady, having once obtained
striking relief from it in tic-douloureux itself. All this reminds
us of Aconite; and it is like Aconite that (according to Böhm)
delphinia affects the heart. It has been given as a "sedative "
to the circulation in acute rheumatism.
Teste classes Staphisagria with Causticum, Coffea, and
Cocculus; to which I would add Kreosote, and Dr. Hering
Colocynth.
The dilutions from the sixth to the thirtieth have given
most satisfaction.
We will conclude to-day's lecture with a few words upon
the thorn-apple, Datura
Stramonium.
The tincture is prepared from the entire herb in the usual
manner.
There is a pathogenesis of Stramonium in the third volume
Monthly Hom. Review, xxi., 469.
3 H
834
STRAMONIUM.
of the Reine Arzneimittellehre. It contains 96 symptoms from
Hahnemann, 90 from two others, and 383 from authors.
Among these last I must caution against any dependence on
citations from Stoerck and Greding, as they were taken, in
the same wholesale way which we have heretofore seen, from
patients treated by them. Dr. Hering has given us a very
full arrangement of the symptomatology of Stramonium in
his Materia Medica, incorporating many fresh cases of poison-
ing. The English materials of this nature which he has used
may be read at length in Dr. Berridge's "Pathogenetic Record,"
now publishing as a supplement to the British Journal of
Homeopathy. Dr. Allen adds symptoms from some 150
more observations of the kind.
W
To the therapeutists of the old school Stramonium must
be a greater puzzle than even Hyoscyamus. Pereira's article
on the drug might have been written by an avowed homœo-
pathist. It is "used to produce intoxication for licentious
purposes," ie., as an aphrodisiac; and-"Wendt used it to
lessen venereal excitement, as in nymphomania." In fatal
doses "the leading symptoms are
delirium (usually
maniacal);" and "the diseases in which Stramonium has
been principally used are mania and epilepsy." "In some
cases of spasmodic asthma smoking the herb has given at
least temporary relief," but "the practice requires great
caution, as it has proved highly injurious.
Aggra-
vation of the dyspnoea
is one of the evils said to
have been induced." We may fairly look under these cir-
cumstances to the systematic account of the drug which
Homœopathy enables us to give.
Stramonium acts chiefly on the brain, and in a manner
closely resembling that of Belladonna and Hyoscyamus. The
delirium it causes is more furious than that of either; but
the determination of blood to the head, while greater than
that of Hyoscyamus, is less than and not so inflammatory as
that of Belladonna. With the delirium are hallucinations;
dilated pupil; amaurosis; diminished general sensibility;
extreme mobility of the muscular system, with loss of
voluntary control; sexual excitement; spasmodic dysphonia
and dysphagia; great dryness of throat; and frequently a
bright red eruption over the body. If the poisoning goes on,
congestive sopor and general palsy set in. I have already
discussed the rationale of these phenomena, when speaking
of Belladonna. Stramonium is evidently an almost pure
neurotic. The only parts besides the brain which show any
signs of tissue-irritation are the throat and the skin.
STRAMONIUM.
835
Correspondingly, the use of Stramonium as a therapeutic
agent has been nearly exclusively confined to affections of the
brain and nervous system. The only exception is scarlatina;
in some forms of which Stramonium may be preferable to
Belladonna. The distinguishing characteristics of the two
drugs in relation to this malady are well given by Dr. P. P.
Wells, in the fifth volume of the American Homeopathic
Review. He lays most stress on the presence of an extreme
degree of nervous erethism-convulsions, trembling, restless-
ness, &c.—as indicating Stramonium.
There are few neuroses in which Stramonium is not more
or less useful. It is our chief remedy in acute mania, to
which it is more homoeopathic than the inflammatory Bella-
donna; and is hardly less valuable in delirium tremens, when
assuming the active form described as "mania-à-potu" by
the older writers. Numerous cases of these maladies in which
it proved curative are recorded by Dr. Hoyne. The constant
association of hallucinations with its delirium makes it very
appropriate here, and wherever else they occur. You will
not be surprised that a homoeopathist should speak thus; but
it is curious to hear the same practice advocated, and on the
same grounds, by an eminent alienist of the old school—I
refer to Dr. Moreau.* Stramonium is sometimes indi-
cated for the cerebral manifestations of typhus and typhoid,
but less often than the other mydriatics and Opium. But in
nymphomania and in puerperal mania it stands highest among
remedies, owing to its special action on the sexual functions.
In epilepsy brought on by a fright, and yet recent, it may
prove very useful. It is, as Hahnemann points out, exquisitely
homoeopathic to hydrophobia, even more so than Belladonna.
In a child of Dr. Duffin's poisoned by the seeds,† not only
were the symptoms during life strikingly analogous to those
of this disease, but after death "a slight unusual blush pervaded
the pharynx and oesophagus to about one third of their
extent; the larynx was similarly injected, and the rima
glottidis thickened and very turgid." It appears that in
China the different species of Datura, and among them the
D. Stramonium, are in popular use as prophylactics against
hydrophobia. Extracts from reports of missionaries on this
subject are given by Dr. Ozanam in the eighteenth volume of
the Bulletin de la Societé Medicale Homœopathique de France.
It is stated to be necessary that enough of the plant should
be taken to provoke an attack of "rage," the patient is then
* See Trousseau and Pidoux, sub voce.
† See Berridge, Case 2.
836
STRAMONIUM.
safe. We have no certain experience with Stramonium when
hydrophobia has actually set in, for in the case recorded by
Dr. Ozanam the symptoms (which came on the day after the
bite) might have been the effect of fright. But I should be dis-
posed to trust to it rather than any other medicine when, as it
generally is, the tendency to death arises mainly from the ex-
haustion produced by the incessant delirium and restlessness.
<
Nor is Stramonium less beneficial when the nervous
erethism, just stopping short of inflammation, which these
maladies imply within the cranium, manifests itself in the
spinal cord. In chorea it is one of the best vegetable medi-
cines; though it rarely cures cases of any standing without the
aid of the minerals Arsenic, Cuprum, Zinc, &c. Stammering
is a kind of local chorea; and in this affection great good may
often be obtained by the persevering use of Stramonium.
The recommendation is Teste's; and it is sustained by many
published cases.* Dr. Cooper has found the drug curative of
a similar morbid state in the bladder; though the vesical con-
dition which best indicates it is, according to Dr. Guernsey,
one in which the urine dribbles away slowly and feebly,
though without pain. It is, like Ignatia, frequently indicated
in spinal convulsions: you may read a good case of the kind
by Trinks, where they originated from concussion of the spine,
in the nineteenth volume of the British Journal of Homœo-
pathy. But it goes beyond Ignatia in reaching also to true
eclampsia, as infantile and puerperal convulsions. In the
latter Dr. Guernsey gives the
Guernsey gives the following indication :-
"parturient women show such signs of fear as to cause them
to look frightened and to shrink back from the first objects
they see after opening their eyes. If they have had no
spasms, they soon will have after betraying such symptoms,
unless Stramonium be immediately administered." This
symptom is, according to him, very characteristic of Stra-
monium in many disorders. The other mental symptoms
which he assigns to it are great loquacity, expressing (it may
be) wild and absurd fancies; desire for light and society;
and an imploring and beseeching mood.
You will find abundant evidence of these and other cura-
tive powers of Stramonium in Dr. Hering's arrangement.
As allied medicines, besides its blood-sisters Hyoscyamus
and Belladonna, Stramonium has Agaricus, Chamomilla,
Cannabis Indica and Ignatia.
For dose, I am very well satisfied with the dilutions from
3 to 6.
* Brit. Fourn. of Hom., xv., 399.
-
LECTURE LV.
SULPHUR.
I shall occupy your time to-day with a medicine which, if
not the most important, is perhaps the most frequently used
of all we have-
Sulphur.
The washed "flowers of sulphur " of commerce, again washed
in distilled water, are used in our pharmacy; and are of course
prepared by trituration. A " tincture of Sulphur" is also in
use; it is made with absolute alcohol, which (at a temperature
of 60°) retains nearly one per cent. in solution. If this form
is desired, it must be prescribed as such. Its strength is
uncertain when exposed to lower temperatures. It is now
only used in its primary preparation, which is designated as
the "tinctura fortissima;" but at one time Hahnemann em-
ployed it for making the subsequent attenuations.
The pathogenesis of Sulphur appeared first in the fourth
volume of the Materia Medica Pura. In the second edition
of that work (1825) it contains 755 symptoms from Hahnemann
himself, and 60 from his son Friedrich and some authors. As
the medicine is recommended to be given in the second tritu-
ration, it is probable that the symptoms were obtained from
this or lower potencies; though their subjects are doubtful.
In the first edition of the Chronic Diseases (1830) another
pathogenesis is presented, to which Hahnemann adds upwards
of 300 symptoms; and in the second edition (1839) the list
has swollen to 1,969, a few only of the additions being taken
from a proving by Nenning which had appeared in the third
volume of the Arzneimittellehre of Hartlaub and Trinks. The
source of these later materials is obvious, as Sulphur was in
constant use at the time in the treatment of chronic affections.
Much more satisfactory information is supplied by the splendid
re-proving undertaken by the Austrian Society, and reported
by Dr. Wurmb in the first volume of the Zeitschrift des Ver.
838
SULPHUR.
Hom. Aerzte Oest. It is translated in the fifteenth and six-
teenth volumes of the British Journal of Homœopathy.
Twenty-four persons took part in the experiments, which
were conducted with full doses of the crude substance and of
the tincture, as well as with the attenuations. Dr. Allen in-
corporates their symptoms with Hahnemann's, adding a few
from later observations. Dr. Casanova has also enriched the
pathogenesis of the drug by some observations of the effects
of the sulphureous waters of Harrogate.*
Sulphur has long been reputed as a stimulant to the capil-
lary circulation of the skin and mucous membranes, and to
the venous system of the pelvis. Dr. Wurmb's proving con-
firms and illustrates the ancient opinion. The drug excited a
peculiar itching of the whole surface, giving an agreeable sen-
sation on rubbing or scratching, and increased notably by the
warmth of bed. With this were various eruptions, mostly
papular, but sometimes vesicular, and occasionally closely re-
sembling that of scabies. Boils, too, frequently result from
the use of Sulphur. I know of a lady who accompanied her
husband to Harrogate; and, although herself in good health,
joined him in drinking the waters. When she returned home,
she came under treatment covered with boils. After the skin,
the mucous membranes feel most severely the influence of
Sulphur, especially those of the eyes (conjunctiva oculi et
palpebrarum), bronchi, urethra, and rectum. Burning with
itching, and mucous discharge, are the characteristic symptoms
here.
Besides these more general effects, the use of Sulphur pro-
duces other pretty constant phenomena, as follows:-
1. There is a decided determination of blood to the head.
Fulness with aching was experienced by nearly all the provers:
vertigo by some. The Harrogate waters, if drunk largely and
incautiously, appear to be capable of bringing on apoplexy.
Part and parcel of the above is the erysipelatoid inflammation
of the nose so frequent among the provers, and mentioned
also by Dr. Casanova.
2. The sexual organs are always excited by Sulphur, even
to swelling of the external parts. The catamenia in one prover
came on profusely; and were black, clotted, and gluey, as
with Crocus.
3. Although Sulphur in massive doses is a mild aperient,
its dynamic action is manifested by constipation, from which
nearly all the provers suffered. The alternative, diarrhœa, is
very rare.
* Brit. Fourn. of Hom., xxi., 353.
SULPHUR.
839
4. Rheumatoid pains were very common among the
provers; most of whom were troubled also by awaking
early in the morning, and finding it impossible to go to
sleep again.
5. In two provers there was painful swelling of the tongue.
Unless we add to these the countless symptoms of the
pathogenesis in the Chronic Diseases, we seem to have but a
narrow basis on which to rest the vast fabric of the therapeutic
applications of Sulphur. But this drug has attained a unique
place among homœopathic medicines, of which the relation
of Mercury to syphilis affords the only-and that a faint-
resemblance. This is owing to the famous "psora theory"
of Hahnemann, of which I must here take notice.
-
The first volume of Hahnemann's Chronic Diseases is de-
voted to an exposition of this theory of his. He begins by
assigning one eighth of these maladies to syphilis and its
ally sycosis. He points out that each of these diseases
depends upon a specific and contagious "miasm." This,
being received into the organism, after a period of incubation
developes an external sign-the chancre and the condyloma
respectively. If these are left alone, or cured from within by
small quantities of their appropriate specific (Mercury in the
one case, Thuja or Nitric acid in the other), no general
evils result. On the other hand, the suppression of the ex-
ternal sign is followed by the well-known constitutional
symptoms. The maladies thus set up are far more difficult to
cure, and are only curable at all by the same or similar
specifics-selected not merely on the ground of their homœo-
pathicity to the existing symptoms, but also because of their
relation to the primary taint, in like manner ascertained.
Thus (the illustration is my own) it would be useless to attempt
to cure a syphilitic angina with Belladonna, or a syphilitic
psoriasis with Arsenic.
In the remaining seven-eighths of chronic diseases, Hahne-
mann says that he found the same impossibility of effecting a
permanent cure with the common homoeopathic specifics. He
sought therefore for some constitutional miasm or miasms.
which should explain the protean changes and inveterate
duration of these maladies, as the syphilitic poison explained
the character of the disorders resulting therefrom. In the
common itch (psora or scabies) he thought he had found what
he sought. Numerous authors testified to the evils resulting
from repercussion of the itch eruption-these evils including
nearly every ill to which flesh is heir. Again, many of his
chronic patients confessed to having had the itch, and in many
840
SULPHUR.
others he ascertained the same fact by inquiry of parents and
nurses. The itch was a specific disease, very contagious, hav-
ing a period of incubation after infection, and then manifest-
ing itself by one or more vesicles at the point of contact,—in
all these features resembling syphilis and sycosis. Unable to
discover any other chronic miasm but this to account for
the host of chronic diseases which were neither syphilitic nor
sycosic, Hahnemann propounded the theory that they were all
psoric. Hence followed the treatment. Recent itch could
nearly always be cured in a reasonably short time, by one or
more infinitesimal doses of Sulphur; and the same medicine
was curative of many of the consequences of the suppression
of the eruption. But these were too multifarious to be homoeo-
pathically covered by any one remedy. Hence a number of
other medicines were, on various grounds,* classed with it as
"antipsorics;" and with these, selected according to the law
of similars, all chronic non-venereal diseases were to be com-
bated.
I think that the above is a fair presentation of Hahnemann's
theory. For a fuller account of it, and of the criticisms it has
provoked, I may refer you to Dr. Dudgeon's Lectures on
Homœopathy. But I would strongly recommend you to read
Hahnemann's own exposition of his doctrine. It is a marvel
of erudition, of thought and of reasoning,—if only the pre-
misses were sound.
But here is the fatal flaw. Hahnemann lived at a time
when the parasitic nature of scabies had been forgotten. His
contemporaries Rayer and Biett regarded it as questionable;
and Hoffmann, Juncker, Wenzel and Autenrieth had gone
before him in tracing numerous diseases to the repercussion of
the eruption. Now, however, no reasonable doubt can exist
but that the reception of the acarus is the proximate cause of
the whole phenomena of scabies. The disease is invariably
treated by external applications, chiefly Sulphur ointment;
and the extensive experience of such men as Hebra and
Erasmus Wilson may be taken as conclusive when they say
that they have never seen any ill effects from the practice,
which, I may add, is as freely used by homoeopathists as by
others.
Is there then no truth in Hahnemann's theory? Just the
reverse; as I have already pointed out in one of my introduc-
tory lectures to this course, and as I shall now further attempt
to show.
Although Hahnemann undoubtedly based the logical super-
* See Chronic Diseases (Hempel's transl.), I., 185.
SULPHUR.
841
structure of his theory upon the distinct entity, scabies,* yet
ever and anon he includes other cutaneous affections under its
name. Thus he considers the ancient leprosy to hold the
same relation as scabies to chronic diseases; and in another
place he speaks of “tinea capitis, crusta lactea, herpes, &c.,"
as "varieties" of itch. He is thus standing upon the truth
which is every day becoming more generally recognised, that
many cutaneous diseases are external manifestations of a con-
stitutional taint. To say nothing of the syphilitic exanthe-
mata, who does not know how frequently the gouty, rheumatic,
or scrofulous diathesis comes before us represented solely by
an eruption on the skin? Nor would it be denied that the
suppression of such eruptions from without would greatly
favour the development of internal disease. The same thing
would happen, though more slowly and mildly, as that which
follows the retrocession or even the non-development of the
rash in the acute exanthemata. Again, there is no doubt but
that the repulsion by external applications of any cutaneous
eruption is liable to cause disorder of the internal organs in
its immediate neighbourhood. Lallemand reports cases of
spermatorrhoea thus induced,† Beer of amaurosis, and
Weitenweber of aphonia§-in the two latter the itch itself
being the exanthem in question.
A still more important point is made if we accept the
doctrine of many French pathologists—among whom, be-
sides our own Tessier, I may name Bazin, Chomel, and
Gueneau de Mussy-as to the existence of a “dartrous,” or
"herpetic," diathesis, distinct from the ordinarily recognised
constitutional vices which manifest themselves on the skin.
To this "herpetism" Bazin would refer all cutaneous dis-
orders not purely local (as those of parasitic origin), and
which cannot be traced to scrofula, syphilis, or gout. An
interesting account of these views is given by Dr. Jousset, in
the first volume of his Elements de Médecine Pratique.
"Dartre," he says, is characterised by cutaneous and visceral
affections which alternate or coincide. The cutaneous affec-
tions, under the title of "dartre séche" and "dartre humide,"
embrace all the ordinary diseases of the skin; they are super-
ficial, mobile, and of variable type; they are accompanied
* This has been denied; but I think it cannot be doubted by any one
who studies his argument as a whole. It was this that led him to reject
an hereditary origin for his psora, which would banish scrofula from the
category of its representatives.
+ On Spermatorrhea (Engl. tr.), p. 83.
+ Brit. Journ. of Hom., iii., 255.
§ Ibid, vi., 314.
842
SULPHUR.
>>
with intense itching. The visceral affections of herpetism are
chronic catarrhs of the mucous membrane, whose discharges
-whether serous or purulent-are also provocative of great
itching; ophthalmiæ, neuralgiæ, migraines, and asthmas. In
severe cases of long standing, the visceral mischief may be-
come cancerous. There are "anomalous" and "larvaceous
forms, in which the cutaneous affections are slight or absent;
and in which the character of the visceral disorders, the ab-
sence of other causes for their development, and the family
history of the patient (for “dartre" is hereditary) are our only
guides to its recognition. This is evidently "psora" under
another name, and with a more limited range; and one must
regret to see that the French pathologists give no credit to
Hahnemann for his exposition of the subject.
Now the point of main interest to us here is, that for all
these disorders alternating with skin eruptions or resulting
from their suppression, Sulphur is confessedly the principal
remedy. Dr. Jousset of course esteems it (with Arsenic) the
great remedy for the dartrous diathesis. But the same prac-
tice prevails in the old school. Beer's amaurosis was removed
by it-the eruption returning. Dr. de Mussy recommends
the Eaux-Bonnes (which are sulphur springs) as the best
treatment for the chronic throat affections which (especially
when assuming the form of follicular pharyngitis) he traces to
herpetism. Lallemand cures his cases by sulphuretted
baths. Dr. Casanova maintains that the reason why Har-
rogate waters cure some cases, and utterly fail in others
apparently similar, is that in the former the symptoms may be
traced back to the suppression of some eruption, while in the
latter they have originated from other causes. He gives two
pairs of cases strikingly illustrative and confirmatory of his
doctrine. And in chronic gout and scrofula-diatheses in
which the skin is so frequently involved-Sulphur stands at
the head of our remedies; while in other constitutional
maladies, such as rachitis, which have no cutaneous determina-
tion, it plays no useful part.
This is the "antipsoric" action of Sulphur. You will see
that it is not peculiar to the homoeopathic school, though it is
there that it has received its fullest development, both theo-
retical and practical. Of the theory of it I have spoken at
sufficient length: let me now turn to the practice.
There are very few chronic diseases in which the treat-
ment may not be advantageously commenced by a few doses
or a short course of Sulphur. This is well illustrated by the
facts mentioned in Jahr's Therapeutic Guide, the result of his
SULPHUR.
843
forty years' practice. You will continually find in that work
the first and earliest place given to Sulphur in the treatment
of chronic disease, and will hear of some even of the most
unlikely character yielding to it. Of these I may specify the
nocturnal enuresis of childhood, in which I have several times
verified Jahr's praise of it. Still more obviously appropriate
is the practice when diathetic disorders are present. I shall
speak of rheumatism presently; but as regards gout, Dr.
Acworth, who made this malady a special study, said that he
knew of no better medicines for the diathesis than Sulphur
and Calcarea. In scrofula in all its manifestations (except in
the bones) the occasional exhibition of Sulphur is most useful.
And besides such definite maladies, we frequently meet with
cases presenting numerous symptoms of ill-health, which
rapidly clear up under the influence of the drug. I suppose
that in these patients there is or has been some tendency to
cutaneous eruption; in a word, that they are "dartrous."
Many observers, moreover, testify to the striking results of
giving a dose or two of a high dilution of Sulphur in the course
of such diseases as inflammation of the brain and lungs, and
in almost any disorder where improvement flags or relapses
occur. In all these instances the drug seems itself to effect a
certain amount of improvement, while it renders subsequent
medicines more efficacious. Curiously enough, however, it
rarely cures alone. If it be continued, in chronic disease, above
a week or two, the progress made towards cure is generally
arrested, and even becomes retrograde. Hahnemann says-
"Sulphur, when administered in a small dose, seldom fails in
effecting an incipient cure of the chronic non-venereal diseases.
I know a physician in Saxony who obtained a great reputation
for curing such maladies by adding, without knowing why,
flowers of Sulphur to every one of his prescriptions. In the
beginning they produced a good effect, but only in the
beginning, for, in a little while, the good effects ceased."
There is one of the diseases now under consideration, how-
ever, in which Sulphur plays a more permanently curative part.
This is rheumatism. Here the medicine has the highest
reputation-alike in the domestic practice which carries it in
the pocket, or takes it as "brimstone and whisky" or the
"Chelsea Pensioner"; in its local application in the old school
to muscular and tendinous rheumatism and sciatica; and in
the internal use of homoeopathic therapeutics. "I almost
always," writes Dr. Russell, "commence the treatment of
chronic rheumatism by the administration of Sulphur in some
form; and sometimes I find it useful to persevere with this
844
SULPHUR.
one remedy for months. I believe that in this I merely act
in accordance with the general practice of all experienced
homœopathists." Dr. Bayes says that he has found it very
beneficial in chronic lumbago and sciatica in patients of venous
constitution. Sulphur seems to act here rather in virtue of
its immediate homoeopathicity than by any relation it bears
to the rheumatic diathesis at large. It caused much rheuma-
toid pain in its provers; one of whom, being sceptical as to
its influence, tested it by alternately omitting and resuming
the drug, when he found his pains invariably showing a corre-
sponding decline or increase. The cutaneous manifestations
of rheumatism-of which erythema nodosum may be taken as
a type-are hardly those for which Sulphur is suitable. It
lends force to this view that it is in the lower potencies that
Sulphur has done most for rheumatism, while the higher best
bring out its virtues as an antipsoric.
In passing now to the local actions of Sulphur, I would
note that the "venosity" of which Dr. Bayes speaks is a
recognised character of the subjects and maladies in which it
displays most decided influence. Hempel says that it is to
the venous radicles what Aconite is to the arterioles, with equal
force dissipating their engorgements. We may with advan-
tage take this thought with us as we proceed.
1. For many cutaneous diseases Sulphur is the best medicine
we have. It readily cures recent prurigo, when the itching
has the characteristic of that induced by the drug. It clears
the skin of the anomalous eruptions which infest it in unhealthy
children. It is good for acne, where also its local application
in some form is useful; and in the closely allied "molluscum
Dr. C. Wesselhæft has found it curative. Teste commends it
for favus, Chepmell for eczema, and Hempel for crusta
serpiginosa. It is almost an unfailing preventive of the re-
currence of boils; and only less so of that of styes and whitlows.
In scabies we of course use Sulphur in the usual manner to
destroy the acarus. But since the eruption often spreads far
beyond the burrows of the parasite, and endures after its
destruction, we need an internal remedy homœopathic to it;
and this our provings show that we possess in Sulphur. I
would add that dry porrigo capitis and psoriasis discolor dis-
appeared during the Austrian provings; and that Dr. Clotar
Müller (as also Jahr) esteems Sulphur the principal remedy
for old ulceration of the legs.
2. Sulphur is very useful in many affections of the eyes.
It acts most upon the conjunctiva, and is of course best indi-
* See Hoyne, i., 169.
W
SULPHUR.
845
cated when inflammations of this membrane take place in
unhealthy subjects. Its chief place is accordingly in strumous
ophthalmia, for which at some time in the treatment it is
indispensable, which it will indeed at times cure single-handed.*
But it also, says Dr. Dudgeon, possesses in acute catarrhal
ophthalmia an efficacy almost magical; and has been used
with more or less success in inflammation of nearly every
texture of the visual organs. I refer you to his able series of
papers in the sixth and seventh volumes of the British Journal
of Homœopathy, for cases illustrative of its value. Drs. Allen
and Norton rather minimise its efficacy in affections of the
deeper parts of the eye; but their experience has been mainly
gained with the higher dilutions, while the older observers.
who have reported its power in "arthritic ophthalmia" have
given it in the lower triturations. Our authors bear high
testimony, however, to its value in every form of strumous
ophthalmia, whether affecting the lids, the conjunctiva, or the
cornea; and also in acute and chronic ophthalmia catarrhalis.
Sharp pain, as if pins were sticking into the eye, and dislike to
the use of water, which aggravates all the symptoms, are their
chief subjective indications for it. It has removed, to their
knowledge, pterygium, pannus, hypopion, "ground-glass"
cornea, the adhesions of iritis, and opacities of the vitreous.
3. Another chief seat of the influence of Sulphur is the
rectum. It is very good for itching and burning of the anus;
and for piles, especially when dependent upon abdominal
plethora (with Nux vomica). I can recommend you nearly
always to begin the treatment of chronic constipation with
Sulphur, especially when piles are present. But here, also,
you will generally have to go to some other medicine to com-
plete the cure. Often, delighted by the wonderful improve-
ment effected in these cases by a week's course of Sulphur, I
have continued its administration; and as often have seen the
benefit gained steadily disappearing until I changed the
medicine. Dr. Brown, as you have probably learnt, finds it
very effective to give a pilule of the tinctura fortissima every
night to patients who, while being treated for other affections,
think they "need an aperient." There are also cases of chronic
diarrhoea, the evacuations occurring chiefly if not entirely in
the early morning, and being very urgent, in which Sulphur is
curative. It must be remembered that, as Dr. R. Bell has
lately pointed out,f this morning diarrhoea is frequently a
* See a lecture on Sulphur, by Dr. Dyce Brown, in the Monthly Hom.
Review, vol. xx., p. 552.
† Lancet, Feb. 14, 1880.
846
SULPHUR.
▼
symptom of chronic retention of fæces; and hence, possibly,
the efficacy of Sulphur in its treatment. The laxative effect
of this drug does not present urgency of evacuation among its
features. Hahnemann, in the Materia Medica Pura (and
therefore when he was using the second trituration), recom-
mends it in autumnal dysentery with fatiguing tenesmus,
worse at night. Here its action on the rectum comes in.
4. Not less specific is the influence of Sulphur on affections of
the respiratory organs. I cannot better exhibit its homœopathi-
city here than by bringing before you the experience obtained
with the sulphurous springs of Eaux-Bonnes. Pidoux, who had
great opportunities of observing their effects, writes:-" It is
rare that after three or four weeks' use at the most of these
waters, patients do not experience sharp heat in the larynx
and isthmus faucium, a peculiar dry, stifling, or choking
(etranglée) cough, with a constrictive irritation at the entrance
of the respiratory passages, some dyspnoea, mingled with a
feeling of weight and contraction of the thorax, vague pains in
the walls of that cavity, principally under the clavicles, and so
forth." A further account of these effects of the Eaux-Bonnes
is given in a communication made by Dr. Leudet to the
eleventh volume of the Practitioner. He describes the effect
of the medication in a case of chronic bronchitis, characterising
it as "a kind of congestive poussée towards the respiratory
organs, with nervous and circulatory stimulation throughout
the whole of the system. It seems as if the bronchial disease
resumes an acute character under the exciting impression of
the sulphurous water, and that in order to heal and disappear
it requires this ephemeral revivification." In another place he
says—“There is no doubt that the Eaux-Bonnes may bring on
spitting of blood in phthisical subjects, since they are capable
of producing the same result in individuals whose air-passages
are quite unimpaired.' And again-"The Eaux-Bonnes
stimulate the muscular coating of the bronchi, excite its
contractions, and may go so far as to create artificial asthma."
To these actions of the drug (which are fully substantiated
by our pathogeneses) its use in homœopathic practice precisely
corresponds. At the Leopoldstadt Hospital in Vienna Sulphur
has for many years held a very high place among the reme-
dies for pleurisy and pneumonia. In pleurisy it is given (after
Aconite) in the acute plastic form, where it is said rapidly to
disperse the effusion. Nor has it less power, according to the
able physicians who first conducted the Hospital-Drs. Wurmb
""*
* Dr. Bayes has seen Sulphur produce this effect more than once in
the 30th dilution; and Dr. Madden related to me a similar experience.
I
SULPHUR.
847
and Caspar-, in promoting the resolution of pneumonic
hepatisations. It is at the end of the second stage of pneu-
monia that it is indicated;-that " period," as Bähr well says,
"of anxious expectation to the physician, because he cannot
decide whether re-absorption or a purulent dissolution of the
exudation will take place.
Now is the period for
the exhibition of Sulphur, and it is astonishing with what
magical rapidity the organic reaction is sometimes kindled
by this agent.” Dr. Russell considers Sulphur a most impor-
tant remedy for asthma; and points out the frequent alterna-
tion of paroxysms of this disease with fits of gout and attacks
of lepra and psoriasis. I know indeed of no remedy so fre-
quently beneficial in chronic asthma. Dr. Meyhoffer, in his
classical treatise on Diseases of the Respiratory Organs, gives
several illustrations of the value of Sulphur in chronic bron-
chitis, especially in gouty, rheumatic, or otherwise unhealthy
subjects. Dr. Bayes praises it in phthisis when the skin is
eruptive. As regards this disease I would again refer you to
Dr. Leudet's interesting paper. While showing that the good
effects of the sulphurous waters are primarily due to their local
affinity and substitutive action, he goes on to say that the
forms and varieties of phthisis in which they are most bene-
ficial are those in which" the patient is not only phthisical, but
something else besides-rheumatic, gouty, or herpetic." These
old "organic habitudes," he says, "are stirred up and brought
to life by the sulphurous medication. They had been van-
quished by the more destructive and fatal tubercular diathesis;
but now, revived, they in turn prove antagonistic to it, and
suspend its course." This is just the "antipsoric
"" use of
Sulphur in other words.
It is worth remembering that of the diseases most fre-
quently ascribed to the repercussion of itch by Autenrieth
and his fellows asthma and phthisis occupy the highest
place.
5. A neurotic action has only lately come to be ascribed to
Sulphur. Dr. Robert Cooper, one of our most industrious
therapeutic workers, has been labouring at this subject for
some years past. In a pamphlet published in 1869,* he
endeavoured to establish the specific power of the drug over
" an intermittent periodical neuralgia, in which an aggrava-
tion takes place every twenty-four hours, generally at 12 or I
o'clock, either in the middle of the day or at midnight,
gradually increasing up to this point, and then as gradually
diminishing.” In subsequent communications, mainly to the
* Sulphur as a remedy for Neuralgia and Intermittent Fever.
848
SULPHUR.
British Journal of Homeopathy, he shows that he has been
led to extend the use of Sulphur to almost every form of
neuralgia, and with rarely failing benefit. It is in his hands
what we have seen Phosphorus to be in those of Mr. Ashburton
Thompson; and, like that, has hardly proved so successful
elsewhere. Several cures by it, however, have already been
published by other practitioners; † and further experience will
doubtless enable us to fix its place in the therapeutics of the
disease, and so to have another useful agent at our command
in its treatment. It is possibly when neuralgia is of “ dartrous”
origin that Sulphur is its remedy.
Dr. Cooper would extend the neurotic action of Sulphur to
intermittent fever, and considers that we have in it an "anti-
periodic" of the first order. I can hardly think that the evi-
dence yet adduced is sufficient to warrant this conclusion.
But some of the cases he has related ‡ do show that we have
in it a valuable remedy for the malarial cachexia, as we often
meet with it in those who have returned from tropical
climates; and as this, too, is a new use of the drug, Dr.
Cooper merits our best thanks for having added to our know-
ledge of its virtues and put new means at our disposal for the
aid of our patients. He considers the subjects best suited for
it as those whose complexion is dark, muscular system flabby,
hair long and lank, and skin moist.
6. Lastly, I would speak of the use of Sulphur in the form
of sulphurous acid, as obtained by burning it in the atmo-
sphere the patient breathes, or spraying a solution into the
air-passages. This medication has been brought before the
profession by Dr. Dewar, of Kirkcaldy,§ and Mr. Pairman, of
Biggar. In affections of the respiratory organs they obtain
the same benefits which we have seen as resulting from the
internal use of the drug; and find that Sulphur can thus
cause asthma as well as cure it, just as the Eaux-Bonnes do.
But their most important result is to show-what was indeed
partially known previously-that the fumes of Sulphur
constitute one of the most potent disinfectants known; and
in this capacity operate most beneficially in the management
of all infectious diseases. In those of animals such a mode
of treatment seems to promise great things; and there is
no reason why, especially in the form of spray, sulphurous acid
* See vol. xxix., 664; xxx., 274.
† As in Monthly Hom. Review, xvi., 93.
Brit. Journ. of Hom., xxviii., 192; xxxiii., 698.
$ On the Application of Sulphurous Acid. 1868.
|| The Great Sulphur Cure brought to the test. 1868.
SULPHUR.
849
should not be helpful in destroying the germs of contagious
maladies in the human subject.
It is curious to find Dr. Dewar and his friend as enthusi-
astic about Sulphur, as being almost a panacea for all
diseases, as if they were complete adherents of the psora-
doctrine.
There may yet be forms of disease—especially old con-
gestions, as of the brain and liver-in whose treatment Sulphur
finds a place; but I think that from what I have said you will
have gained a fair idea of most of its properties. I would
only add Dr. Guernsey's suggestions for the use of the drug.
"The indications for this remedy," he writes, "are to be found
rather in general characteristics than in local symptoms."
These "general characteristics" he specifies thus :-"heat on
the top of the head, general flushes of heat, weak, fainting
feeling; very hungry and faint about II o'clock a.m.; awakens
frequently at night, and feels very weak and faint in the morn-
ing; very cold feet, sometimes burning in the soles of the feet
at night in bed." In another place he says that the sleep of
the Sulphur patient may, instead of being broken, be heavy
and exhausting. The itching and eruptive state of the skin
and the muco-cutaneous outlets are also given due weight by
him as indications for the medicine. The flushings of which
he speaks suggest those of the menopause, and I am informed
that for these the drug is in constant use in America.
As an "anti-psoric," Sulphur is a unique drug. Otherwise,
it best compares with Arsenic and with Sepia.
All dilutions seem to act well; but in rheumatism and
asthma the lowest triturations seem most in favour. Dr.
Cooper's cases were all treated with the tinctura fortissima.
3 I
LECTURE LVI.
TABACUM, TARAXACUM, TELLURIUM, TEREBINTHINA,
TEUCRIUM, THUJA, URANIUM.
WE are now beginning to see the end of our journey.
Sulphur is the last medicine which will require any lengthened
treatment; and in two or three more lectures I hope to com-
plete all I have to say about the Materia Medica Homœo-
pathica.
My first topic to-day will be the "weed" dear to smokers,
Nicotiana
Tabacum.
We make a tincture from the leaves of the Virginian plant.
There is a proving of tobacco in the third volume of the
Arzneimittellehre of Hartlaub and Trinks, contributed by
Schreter and Nenning, and seemingly obtained from substantial
quantities on the healthy subject. To this Dr. Allen adds
numerous effects of poisoning with or excessive use of the
plant.
Most of those who listen to me are, probably, smokers. I
need not therefore remind you of the ordinary effects of
tobacco on unsophisticated frames. They form the group of
symptoms-pale face, cold and perspiring skin, salivation,
faintness, sinking at the stomach, small, frequent, and irregular
pulse-which, with the distressing sensation of sickness itself,
constitute the condition called "nausea," as we have seen it
induced by Tartar emetic and Lobelia. With it-and more.
from tobacco than from the others-is general muscular relaxa-
tion throughout the body. I have already said that physiology
has not yet explained the rationale of this condition, save by
referring it to the emetic centres at the base of the brain; and
that pharmacology accordingly can only deal with it pheno-
menally. It is important, however, to know that the ordinary
depressant and relaxant effects of tobacco-whether as smoked
TABACUM.
851
by a novice or as injected in infusion into the rectum-belong
to the state of nausea. For its actual direct effect upon the
heart, muscles, and nervous centres is of a somewhat different
character, as experiment has ascertained and poisoning by it
occasionally shown. It is in the form of its alkaloid nicotine
-a tetaniser to both voluntary and involuntary muscles,
including the heart, intestines, and uterus; and it contracts the
pupil. In large poisonous doses it affects the cerebral func-
tions, causing a semi-apoplectic condition and (post mortem)
much congestion of the brain, especially about the pons Varolii
and medulla oblongata.
Beside these effects of tobacco, we have those of its long-
continued use in excess. Palpitation and intermittent action.
of the heart are among the most common of these; and in
extreme instances even angina pectoris may be induced, as
observed by M. Beau.* Amaurosis, from white atrophy of
the retina (without preceding neuritis), was for some time
among its more dubious effects: but the observations of Mr.
Hutchinson seem to have established the reality of the con-
nexion between the two. In Le Progrés Medical for June
2nd, 1877, M. Guelliot has defined the characters of the tobacco
amaurosis, as observed by him. It always commences in one
eye, generally the right; at first the patients see as through a
mist, with a central scotoma, then from time to time they see
objects yellow: there is no confusion of colours: the patients
see worse in the evening: the pupils are contracted and im-
moveable. Alcoholic amaurosis, on the other hand, com-
mences in both eyes at once: there is confusion of colours,
sometimes pain, and the patients see better in the evening.
In a case recorded by Lallemand, spermatorrhoea with all its
attendant evils seems to have been induced by continued
exposure to the emanations of tobacco. Then we have
observations upon the state of health of workmen in cigar
manufactories, some of which you will find in a paper by M.
Teste translated in the seventeenth volume of the British
Journal of Homeopathy. It produces in these subjects a
peculiar dull grey complexion (evidently of hæmatic origin, as
it is removable by the preparations of iron), loss of flesh, and
dyspnoea probably asthmatic. Last, we get such effects as
those described in the Edinburgh Medical Journal of August,
1864, where long-continued tobacco-eating (!) caused complete
marasmus, paralysis, and death.
* See Phillips, sub voce.
† See Medical Times and Gazette, Sept. 28, 1867.
‡ On Spermatorrhea, p. 233.
852
TABACUM.
Shall I add to these unquestionable symptoms any deriv-
able from what is called the "moderate" use of tobacco? As
I am no smoker myself, I must be careful to preserve impar-
tiality here. I believe that the use of tobacco stands on the
same footing as that of tea and coffee.* They are all medi-
cinal agents; all produce violent symptoms of poisoning when
taken in large quantities; and all, when habitually used in
excess, disorder the functions, especially those of the heart
and nervous system. But the experience of all of us goes to
prove that tea and coffee may be taken daily without any
appreciably disturbing effect on the health. This is the
moderate" use. Its figure can only be ascertained by ex-
perience, and probably differs with different persons. So also
with tobacco. Only I suspect that the quantum allowed them-
selves by most smokers is beyond the safety-point of modera-
tion. Teste says:-" all smokers of long-standing, or almost
all-for I admit exceptions-have their slight or severe ail-
ments which would immediately cease were they to leave off
smoking." It is easy for any one who suffers, but does not as
yet mistrust his pipe, to try the experiment for himself.
think that any one who will read M. Teste's cases (including
his own experience) as related in the paper I have mentioned
will feel inclined to do so. Dr. Dyce Brown's recent advo-
cacy of moderate smoking† in no way conflicts with these
views. I cannot, however, agree with him in supposing that
to the healthy body tobacco is ever a "stimulant," however
small the dose. His own experiences of its action of this kind
are entirely taken from morbid conditions; and he himself
admits that if he smokes when not fatigued or depressed his
usual allowance will make him "seedy."
SC
-
I can say little at present about therapeutical uses of
Tabacum. To poison people with it for the sake of obtaining
muscular relaxation is of course no part of our practice; and
even in the old school has been rendered unnecessary since
chloroform has become known. Its employment in tetanus
may rest upon another foundation. If the drug is given to
cause relaxation through nausea, it is of course used anti-
pathically, and is sufficiently perilous. But, as we have seen,
it is in another mode of its action perfectly homoeopathic to
the tetanic condition; and some of the success claimed for it
* I do not mean, as my Monthly Homœopathic reviewer supposes,
that their action is similar. Tea and coffee are stimulants, and the
effect of large doses of either is morbid excitement; while tobacco I
apprehend to be a sedative throughout.
+ See Brit. Fourn. of Hom., xxxiii., 496.
TARAXACUM.
853
here (in the form of nicotine) may be due to this modus
operandi. It ought to be an occasional remedy for sea-sick-
ness; my trials of it, however, have hitherto yielded only
negative results. Teste's observations would show its homoeo-
Dr.
pathicity to some forms of gastralgia and enteralgia.
Edward Blake commends it in the insomnia of dilated
heart,* and Dr. Jousset in what he calls "essential vertigo"
In the
-the "vertigo a stomacho læso" of the old authors.
very interesting little brochure he has lately published, entitled
"On Deafness, Giddiness, and Noises in the Head," Dr. Woakes
has shown cause for believing that it is through the laby-
rinthine circulation that any gastric disturbance causes vertigo
in patients thus affected; and he cites the effects of smoking
tobacco as another instance of the same morbid state. He
adds, from his own observation, to the features of mild
tobacco-poisoning "feeling of tightness in the head, as though
a band were stretched around it," and " aching and feeble-
ness of the arms."
As allied medicines we have Antimonium tartaricum, Digi-
talis and Lobelia.
We next come to the dandelion, Leontodon
-
Taraxacum.
Our tincture is prepared from the expressed juice of the recent
plant.
Hahnemann obtained five provers for Taraxacum, though
he did not experiment with it himself. Their results, making
264 symptoms, appear in the fifth volume of the Reine Arznei-
mittellehre.
This pathogenesis presents little that is characteristic. The
coating of the tongue with a white skin, which peels off in
patches, leaving a raw surface; diuresis; and profuse perspi-
ration throughout the night, are the only symptoms which
strike me. A case of over-dosing with the drug, cited by
Hempel from the Lancet, shows its power of causing an exan-
them like a mixture of lichen and urticaria, with fierce itching
and constitutional irritation.
We have no experience of Taraxacum confirmatory of the
hepatic action ordinarily ascribed to it, but which the experi-
ments of Dr. Hughes Bennett, and also those of Dr. Ruther-
ford, render very questionable. Dr. Phillips thinks its medi-
Monthly Hom. Review, xix., 94.
854
TELLURIUM.
cinal efficacy is due, not to any action on the liver, but to a
"tonic influence which it exerts on the stomach and duode-
num. This may well be, as Pereira says that "where the
digestive organs are weak, and readily disordered, Taraxacum
is very apt to occasion dyspepsia, flatulency, pain, and diar-
rhoea." It ought to be serviceable in such dyspepsia, when
accompanied with patchy tongue. It might be useful, more-
over, in some cases of diuresis, of night-sweats, and of recent
cutaneous disorder. Dr. Frédault finds it useful in the affec-
tion he calls "tympanite hysteralgique.
"*
For dose Hahnemann advises a drop of the pure juice, i.e.,
two drops of his mother-tincture.
در
Another of the rarer metals now comes before us in the
shape of
Tellurium.
The precipitated metal is triturated for our use.
A monograph on Tellurium, containing provings on twelve
persons mainly instituted with the lower triturations, is con-
tributed by Dr. Hering to the fifth volume of the American
Homeopathic Review. Dr. Allen incorporates with these a
few later observations.
Dr. Hering tells us that he proved Tellurium on the same
day in the morning of which, for the first time in his life,
he saw the metal and took it into his hands. "Everything
of the kind," he says, "must, with me, pass as soon as possible
over the mucous membrane of the tongue, mouth, and
pharynx; and I then listen with a more attentive spiritual
ear than if a symphony of Beethoven were being performed.
I listen eagerly to hear what kind of an answer may be forth-
coming from the unknown depths of the human body and
life." He did not hear much that was significant in his ex-
periments on his own person; but two of his fellow-provers
Drs. Metcalf and Carroll Dunham-got very striking results.
Several provers had prickling itching of the skin, with papular
eruption; but Dr. Metcalf had besides two or three well-
marked patches of herpes circinatus. Dr. Carroll Dunham
found, after some days, his left ear beginning to itch, burn,
and swell. "There were aching and throbbing pains in the
external meatus, and, in the course of three or four days, a
copious watery discharge from the ear, smelling like fish pickle.
* L'Art Médical, vol. xlvii.
TEREBINTHINA.
855
The discharge was acrid, and caused a vesicular eruption on
the lower lappet of the ear and on the neck, wherever it touched
the skin. The inflammation of the ear generally was not vesi-
cular. The colour was a bluish red, and the ear had the
appearance of being infiltrated with water." This affection
lasted nearly three months; and left the prover with his hear-
ing permanently (though but slightly) affected.
Both Dr. Metcalf and Dr. Dunham report much success
from using the drug in accordance with these indications. I
can myself confirm the experience of the former as to its value
in herpes circinatus; and Dr. Houghton, of New York, who
is giving much attention to aural disease, tells us that Tellu-
rium is as specific for otitis media with thin acrid discharge as
Pulsatilla when it is thick and bland.*
Another effect of the drug on Dr. Dunham was great super-
ficial tenderness of the spine, from the last cervical to about
the fifth dorsal vertebra, with an irritation radiating therefrom
upwards, outwards, and forwards. This lasted for some two
months; and should cause the metal to be remembered in
spinal irritation.
As Tellurium was proved mainly in the third and fourth
triturations, it would seem that it should not be given lower
in disease. Dr. Metcalf used the third potency in his cases,
Dr. Dunham the thirtieth.
I must next direct your attention to the place occupied in
homœopathic practice by the oil of turpentine,
Terebinthina.
We make a solution of the oil in rectified spirit.
Terebinthina has received hardly any proving; but observa-
tions of over-dosing with it are so numerous that Dr. Allen
can give it, from these, a pathogenesis of 326 symptoms.
The rubefacient effects of turpentine when applied to the
skin suggest its local action on the stomach and bowels when
swallowed, though it is commonly hurried too quickly through
the alimentary canal to set up inflammation. Given in condi-
tions of passive inflammation and ulceration of the digestive
mucous membrane, the same local influence, acting substitu-
tively, becomes curative. Hence its repute in typhoid fever,
when the ulceration of the bowels becomes active (as shown
mainly by the dry and glazed tongue), or lingers too long into
the stage of convalescence, provoking recurring diarrhoea,
* See Brit. Fourn. of Hom., xxxiv., 356.
856
TEREBINTHINA.
When absorbed into the blood, turpentine acts as a general
stimulant, causing intoxication and a febrile condition, and
setting up inflammatory irritation at the seats of its elimina-
tion, which are the urinary and respiratory organs and the
skin. I will speak of these seriatim.
1. By far the most important sphere of the action of Tere-
binthina lies in the region of the kidneys and urinary mucous
membrane generally. It is an irritant throughout the tract.
Acting on the kidneys, in very small doses it is diuretic: in
larger quantities, it sets up congestion going on to inflamma-
tion of these organs, with hæmaturia, albuminuria, and some-
times complete suppression of urine. Dr. Goodfellow* records
a case in which its inhalation seems to have induced renal
dropsy. It inflames also the bladder and urethra, and often
causes strangury. All this is so well known, that any appli-
cation of turpentine to urinary inflammations must be admitted
to be homoeopathic. So Pereira says, "In blennorrhoea of the
urinary apparatus, it seems to set up a new kind of irritation
in the affected membrane, which supersedes the previously
existing disease." It is indeed our chief remedy in hyperæmiæ
of the urinary organs. In simple renal congestion, which is
almost as common as the corresponding affection of the liver,
it is well nigh infallible. When this condition goes on to
complete suppression of urine, turpentine will often restore
the secretion; as in a case of Dr. Yeldham's in the first volume
of the Annals (p. 386). When it manifests itself by hæma-
turia, you will generally find turpentine the best styptic. But
the relation of the drug to true inflammation of the kid-
neys requires more detailed consideration.
C
Q
There is a typical case of its pathogenetic effects in the
eleventh chapter of Dr. George Johnson's book on Kidney
Diseases. Besides the evidences of inflammation of the urinary
passages, there was considerable hæmorrhage, which the pre-
sence of blood-casts of the renal tubes proved to have come
from the kidneys themselves. But it should be observed that
albumen was found only when blood was present, and that no
desquamation of renal epithelium could be discovered. These
are, as I have satisfied myself, the usual effects of turpentine
upon the kidney. They signify, I take it, that its main in-
fluence is expended upon the Malpighian bodies, causing
their congestion, and hence (as we have seen) hæmaturia or
ischuria. In nephritis, accordingly, it would be preferable
where the congestion predominated over the desquamation.
This obtains, according to Dr. Dickinson, in the nephritis
Diseases of the Kidneys, p. 44. See also Allen's S. 172.
TEREBINTHINA.
857
Our
from cold as distinguished from that of scarlatina.
experience with the drug fairly corresponds with these patho-
genetic indications. A paper of Dr. Kidd's on Bright's
disease, published in 1855,* first brought it prominently for-
ward as a remedy. The first case in which he gave it was one
of albuminuria of some months' standing, with great anasarca,
from cold. The urine was scanty and smoky, sp. gr. 1018;
under the microscope blood-globules only were observed.
Complete recovery took place under four-drop doses of the
The other case was ap-
pure spirit three times a day.
parently one of granular degeneration. But it had begun
with hematuria from mechanical violence; there was much
anasarca, with hydrothorax; and the urine contained fibr-
inous casts and blood-discs. Terebinthina, gtt. j ter die,
removed the anasarca and hydrothorax, and the general health
improved; but the urine remained slightly albuminous and of
sp. gr. 1012 only.† Nor do the cases of post-scarlatinal
nephritis adduced by Drs. Henderson and Yeldham‡ lead
to any different conclusion. In all the immediate effect of
the turpentine is to make the urine freer and clearer;-i.e., it
liberates the Malpighian capillaries from their congestive
torpor, so that the aqueous portion of the urine is freely
secreted, and the loaded tubes flushed of débris and cleared
for action. I myself, however, prefer Arsenicum and Can-
tharis in this form of the disease.
Two excellent cases illustrating the sphere of Terebinthina
and Cantharis respectively in the post-scarlatinal renal affec-
tion were contributed to the Transactions of the British
Homœopathic Society in 1878 by Dr. Wolston, of Edinburgh,
and appear in the eighth volume of the Annals. They entirely
conform to the canons I have just laid down. The action of
Terebinthina in acute nephritis, from cold, has also found
another recorded example in the Comptes rendus of the Paris
Congress of 1878 (p. 91). Dr. Cartier, of Lyons, was its em-
ployer; and he gave it in doses similar to those of Dr. Kidd.
In other affections of the urinary mucous surface Terebin-
thina is homœopathic enough, but is hardly used so frequently
as its analogues in our practice.
2. That turpentine is exhaled by the breath is evident to
* See Brit. Fourn. of Hom., xiii., 560.
† In his recently published Laws of Therapeutics, Dr. Kidd writes—
"The cure in this case was not permanent. Some months after-
wards he took cold, with symptoms of pleurisy. The country doctor
bled him, and in a few days he died" (p. 144).
‡ Brit. Journ. of Hom., xiv., 1; Annals, i., 386.
858
TEREBINTHINA.
the senses; and it is allowed by all that where the bronchial
mucous membrane is the seat of chronic catarrh, the medicine
in passing through it exercises a modifying influence for the
better. But it is not clearly recognised that this influence is
of the same character as that which we have seen in the
urinary sphere—that it is a true instance of "substitution," i.e.,
of homœopathy. Trousseau and Pidoux, however, make this
plain. "The mucous membranes," they say of those under its
influence, "are dry, as if in the first stage of catarrh: they are
injected, turgid, and hot. There is frequently herpes labialis,
heavy sub-sternal pain and tickling in the trachea, as at the
commencement of bronchitis: the subjects have been seen to
bring up phlegm streaked with blood."
3. Turpentine, as it is eliminated by the skin, causes redness
and even scarlatiniform eruption there. No use, however, has
yet been made of its cutaneous action.
There are three other properties of turpentine which re-
quire consideration, and which do not obviously spring from
its physiological action.
The first is its anti-hæmorrhagic virtue, which is unquestion-
able. Whether it is homoeopathic or no, I cannot say. We
have certainly seen it causing hæmaturia and hæmoptysis, and
Stillé says that females inhaling the oil suffer from menor-
rhagia and dysmenorrhoea. To such bleedings, then, it is a
simile; but I cannot yet affirm that this is its modus operandi
when curative of the hæmorrhage of gastric and intestinal
ulceration, or of purpura, as it is said to be.
Secondly, turpentine is well-nigh specific for tympanites, as
it occurs in typhoid fever and in puerperal disorders. Here
the evidence of homoeopathicity is stronger; for Trousseau
and Pidoux specify meteorism among the effects of swallowing
a drachm of the oil, as observed by them.
These writers also show that the same account is to be
given of another singular property of turpentine, viz., its
power over sciatica. "In certain cases," they say, "it causes
an exquisite sensibility, especially in the lower extremities-
a general painfulness of the parts, but existing especially
along the track of the great nerves." I suspect that its value
in rheumatic ophthalmia, as established by Carmichael and
others, rests on the same foundation; though this has not yet
been demonstrated. Dr. Henderson has suggested that, to
ascertain this point, the drug ought to be proved on a rheu-
matic subject. He mentions a case of a gentleman who had
taken a quantity of turpentine for rheumatic sciatica, and
who thereupon became affected with iritis; but whether post
TEUCRIUM MARUM VERUM.
859
or propter hoc cannot be asserted. Dr. Liebold esteems it
highly in this complaint; and Dr. Norton has communicated
several cases to the American Observer, in which, given because
of the urinary symptoms present, it removed ophthalmic
troubles.
Cantharis and Copaiba are the chief analogues of Terebin-
thina, though many others might be named.
The lower dilutions only have (to my knowledge) been
employed. I use from the third to the first of the decimal
scale according as the case is acute or chronic.
I have now a few words to say about the cat-thyme-
Teucrium Marum verum.
The tincture is prepared from the whole plant.
The pathogenesis of Teucrium is in Stapf's Additions. The
proving was conducted by four persons, but their manner of
proceeding is not stated. In Allen's Encyclopædia this medi-
cine appears under the name of Marum verum.
There is little that is distinctive in the list of symptoms
produced by Teucrium. It was reputed of old in polypus
narium, used locally in the form of snuff; and homoeopathy,
discerning some specific action on the Schneiderian mem-
brane, has preserved the tradition, giving the drug as an
internal remedy. But its chief value is as a remedy for as-
carides, against which it operates in the same curious manner
as we have seen Cina do. I prefer it to the latter when these
parasites cause much irritation of the rectum. It rarely fails,
when given in small doses of the mother-tincture or one of
the lower dilutions, to neutralise their effects and promote
their expulsion.
I have next to bring before you a medicine of some import-
ance, which is quite strange to ordinary practice. It is the
product of the evergreen known as "arbor vitæ," the
Thuja occidentalis
of Linnæus. Our tincture is prepared from the young shoots.
The pathogenesis of Thuja was published by Hahnemann
in the fifth volume of the Reine Arzneimittellehre. It contains.
334 symptoms of his own, and 300 from ten fellow-observers.
For this drug also we have the advantage of one of the admir-
860
THUJA OCCIDENTALIS.
able re-provings of the Austrian Society. It was carried out
upon twenty-six persons, of whom eighteen were men, five
women, and three children. The doses were pushed even to
as much as 1000 drops of the tincture. The full record of the
proving was published by Dr. Mayerhofer in the second volume
of the Austrian Journal, accompanied with a complete account
of its clinical history. This valuable monograph may be read
in English in Metcalf's Homeopathic Provings. Dr. Allen
adds some few other observations; but I regret that he includes
among these the report of the enthusiastic Wolf, who took a
single globule of Jenichen's 1000th potency, and then recorded
every deviation which occurred in his health for the next
two years as the result of this violent dose. All symptoms in
Allen's pathogenesis marked 12 only must be regarded as
dubious until otherwise confirmed. A number of them (as
S. 2819-2825) are quite beyond the range of the drug's action,
and S. 2990 is obviously an attack of variola.
The Austrian provings, which are entirely confirmatory of
Hahnemann's, show that the main action of Thuja is on
the genito-urinary organs, with the anus, and on the skin. It
causes copious and frequent urination; burning in several parts
of the mucous tract; pains of various kinds in the penis;
inflammation of the prepuce and glans; ulcers, tubercles, and
other excrescences on the sexual organs, with itching and pro-
fuse sweating; and-in the female-leucorrhoea. The sexual
appetite was depressed, and the catamenia retarded. Burning,
itching, swelling, and mucous discharge occurred at the anus;
and on the skin generally, but especially in the ano-genital
region, tubercles and warts were developed. In the neighbour-
ing mucous membranes similar phenomena appeared, but
naturally of moister character.
Hahnemann found Thuja almost unused in practice; and
the few recommendations of it contained in the older writers
were of the vaguest character.* The symptoms he observed it
to produce in the generative organs led him to recommend it
as the most appropriate—because most homoeopathic-remedy
for the non-syphilitic form of venereal disease, which he called
"sycosis." I do not think that his doctrine on this subject is
generally understood: I can certainly say for myself that only
lately I have come rightly to apprehend it. In those days
gonorrhoea and chancre were generally regarded as products of
the same poison; and in his treatise On Venereal Diseases,
published in 1788, Hahnemann adopted the same opinion.
But in later times he saw reason to modify his views in favour
* See ch. ii. of Mayerhofer's monograph.
THUJA OCCIDENTALIS.
861
of the now received doctrine of their essential distinctness,
which had already been maintained by Bell, Autenrieth, and
others. His attention was also drawn to the condylomatous
excrescences or fig-warts which-perhaps more frequently then
than now-were apt to accompany the contagious blennorrhoea
of the urethra. He formed the opinion that these were the
chancre of the non-syphilitic venereal miasm; and, like that,
constituted the vicarious local manifestation of the internal
evil. If cauterised or otherwise destroyed, they either returned
in the same spot; or "similar excrescences broke out in other
parts of the body-whitish, fungous, sensitive, flat elevations
in the cavity of the mouth, on the tongue, palate, and lips, or
large, elevated, brown, dry tubercles in the axillæ, external
neck, scalp, &c. ;" or other bodily sufferings came on, which,
with the exception of contraction of the flexor tendons, especi-
ally of the fingers, he does not specify.
The pathology of this subject, so far as condylomata are
concerned, still remains obscure. Jahr, who was a devoted
follower of Hahnemann, differs from him about it, holding
the common view that condylomata, with the mucous patches
in the mouth described as connected with it, are products of
syphilis; while Drs. Skae, Wallace and Rose Cormack agree
with Hahnemann. The first,* who from his experience at the
Edinburgh Lock Hospital spoke with some authority, states
that the condylomatous form of venereal disease is known in
some parts of Scotland under the distinctive name of “sibbens.”
There seems no doubt that a true chancre not uncommonly
sprouts into condylomatous vegetations before disappearing, or
becomes transformed in situ into a mucous patch; and that
both fig-warts themselves and mucous tubercles like them
may occur as manifestations of syphilis. But it is also certain
that condylomata are frequently met with in connection with.
gonorrhoea, and even without any other venereal sign what-
Dr. Skae relates that, when so occurring, they may be
communicated by contagion; and that secondary symptoms
accompany them in the shape of whitish elevations on the
mucous membrane of the mouth and fauces, a husky tone of
voice, and perhaps some cutaneous eruptions. He evidently,
with Hahnemann, considers that condylomata, with or without
gonorrhoea, are themselves the primary phenomenon of a
specific venereal taint. His successor, Dr. Gillespie, has
observed the same secondary phenomena, though he thinks.
the condyloma the result of local irritation and non-contagious.
I have taken the above facts from his interesting communica-
* Northern Journal of Medicine, vol. i., 1844.
ever.
862
THUJA OCCIDENTALIS.
tion on the subject in the second volume of the Edinburgh
Medical Journal.
However this may be, the point of interest to us here is
that Thuja is the great remedy for all sycosic manifestations.
When indeed these occur in connexion with syphilis, the
mercurial preparations,* or Nitric acid, which seems to occupy
a sort of middle ground between the two diseases, will
generally answer every purpose. But even here, when the
condylomata are acuminated and dry; and invariably when
they come alone, or in connexion with gonorrhoea, Thuja has
proved of striking efficacy. Dr. Mayerhofer has shown by
numerous citations how large has been its success both in
allopathic and in homœopathic hands, and in all dilutions.
The local use of the drug seems generally helpful-Hahne-
mann himself recommending that in old cases the larger
excrescences be touched once a day with the mother-tincture.
This treatment has been forgotten of late years, and was per-
haps never known in this country. But since Dr. Phillips has
recommended it in his treatise of course as an original pro-
duct of his own experience-it is likely to gain ground in
British practice, to the saving of much cauterisation and
snipping.
These fig-warts being hypertrophies of the cutaneous papillæ,
Dr. Petroz has argued that other growths of like nature—as
warts and polypi-are also products of the sycosic virus.†
While this is doubtful enough, I think he is justified, both
from theory and from practice, in claiming for Thuja a like
efficacy in their treatment. He gives cases of polypus of the
uterus and larynx which came away spontaneously under its
action; and both he and Mayerhofer relate numerous instances
of its cure of warts. One of these is especially interesting, as
showing how the drug acts in the same direction as the
disease. A woman had four horny and painful warts on her
hands, of three years' standing. After taking from six to ten
drops of the mother-tincture of Thuja daily for a month, first
one and then another crop of new but painless warts appeared
on the hands. After leaving off the drug, these soon dis-
appeared, and the old ones vanished simultaneously, leaving
her hands quite free. I have myself had most successful
results from Thuja in warts. If one or two only are present,
they should be painted with the mother-tincture daily. But
when they come in crops, the internal administration of the
* Dr. Gillespie says that he has "seen the effects of Mercury on the
lips and tongue very closely resemble the milky patches of condyloma."
† Mémoire sur la Sycose, in his collected works (ed. Cretin).
THUJA OCCIDENTALIS.
863
the drug is the proper treatment. I have more than once seen
large collections of these excrescences, of long standing, dis-
appear in a few weeks under infinitesimal doses of the medi-
cine.*
I have also obtained the detachment of an aural
polypus from its use,† and the rapid withering of an elevated
and enlarging nævus on the thigh in a child of five months
old. Dr. Drysdale removed with it a vascular tumour of the
cornea.‡ Nor does it fail us when the morbid growth is of
the serious character known as " epithelioma." This is-histo-
logically at least-identical with warts and polypi, and feels
similarly the action of Thuja. Dr. Quin has recorded a case
of cauliflower excrescence of the os uteri, in which the medi-
cine was strikingly beneficial ;§ and it served me equally well
to complete the cure of a bleeding fungus of the breast, after
Phosphorus had brought its activity to a standstill.|| You will
also consider the celebrated case of Radetsky, in which a fungous
tumour in the orbit seemed to disappear under its use. But
I must not further multiply instances. Suffice it to say that,
whatever you may be led to think of the sycosic theory (which,
I should mention, Dr. Jousset also holds, calling the condition
a diathése epithéliale") the presence of excrescences on skin
or mucous membrane may always suggest to you the use of
Thuja.
Dr. von Grauvogl would extend the range of sycosis farther
still. He thinks that the leucemia of Virchow, with its enlarged
spleen and lymphatic glands, is an effect of the poison; and
that many complex cases of chronic disease can be traced
back to an initial gonorrhoea. Acting upon this view, he
treats them with Thuja and—as its ally-Natrum sulphuri-
cum; and reports excellent results, even such forms of disease
as locomotor ataxy and diabetes recovering hereby. You
may read a further exposition of his views in the prize essay
on Thuja, lately written by Dr. H. Goullon, which has been
translated in the twenty-fifth volume of the North American
Journal of Homoeopathy. You will see that an additional
connection is established here with the so-called "hydrogenoid"
constitution described by von Grauvogl, in which the patient
is morbidly hygroscopic, so that damp air and the neighbour-
* See also a case in Brit. Journ. of Hom., xxvi., 491. In this a con-
comitant enuresis of long standing disappeared while the medicine was
being taken.
† Monthly Hom. Review, xiii., 536.
Brit. Fourn. of Hom., vii. 244.
§ Annals, vol. i.
|| See p. 746.
¶ See Brit. Journ. of Hom., vol. i.
864
THUJA OCCIDENTALIS.
hood or use of water are highly inimical to him. The Natrum
sulphuricum is the agent to which he mainly trusts in com-
bating this diathesis; while the Thuja antidotes the specific
infection of sycosis.
But I have been carried away from my primary subject,
which was to establish the specific relation of Thuja to
gonorrhoea and its condyloma. I have shown this as regards
condyloma; but it is no less true in respect of gonorrhoea
itself. Dr. Dudgeon shall tell us what the drug can do in
causing the phenomena of the discase.
"On the 10th of July last, when taking a walk, I happened
to pass a Thuja tree laden with green cones. I plucked one,
chewed it a little, and thought no more about it.
That same
evening I observed a very disagreeable scalding on making
water, which continued all next day, and I was horrified to
observe on undressing that my shirt was spotted all over in a
manner extremely repugnant to one's notions of respectability.
I found a considerable gleety discharge from the urethra,
which was evidently swollen and inflamed, as the stream of
urine was small and split, and the burning had increased. I
had quite forgotten the circumstance of having chewed the
Thuja cone the previous day, and I could not imagine what
could have produced in me, a decent paterfamilias, such a
very incongruous complaint. The following day the discharge
had become yellow, while the other symptoms remained as
before. I now remembered the cone-chewing on the 10th,
and regarded the malady with more composure. I resolved
to take no medicine to interfere with its course. The discharge
still continued, though in a diminished degree, until the 15th,
but the scalding and interrupted stream of urine were by that
time gone, and on the 16th I was again quite well.”
This is a more decisive picture of acute gonorrhoea than the
provings present, and warrants the use of the medicine even
in this condition. Hitherto it has rather been reserved for
lingering and chronic cases, especially when the prostate is
involved. Dr. Böhm writes that an extensive experience has
taught him that the prostate is more or less affected in all
gonorrhoeas which have lasted longer than six or eight weeks,
and that this condition of the gland is itself the cause of a good
half of all chronic cases of the disease. In such conditions he
has the utmost confidence in Thuja. He says that he could
produce more than twenty cases from his own practice, which,
though of long standing, and treated with the most varied
remedies, have yet yielded rapidly and perfectly to Thuja
alone. My own experience is quite in favour of the specific
THUJA OCCIDENTALIS.
865
influence of Thuja on the prostate. I have derived unequivocal
benefit from it in several cases of acute and chronic inflamma-
tion of the gland: It should be useful, also, for balanitis, and
for some affections of the pudenda feminæ, for which indeed
Dr. Guernsey commends it. I have recently obtained a pretty
cure with Thuja, to which-had it not been for its relation
to gonorrhoea-I should not have been led. The patient
consulted me about his voice, which, being an amateur of no
mean pretensions, he desired to have in good order. For a
twelvemonth it had become thick, and reedy in its high tones.
Every morning he had to clear away (by coughing) a large
quantity of dense blackish mucus. Further enquiry ascer-
tained that he had frequently incurred gonorrhoea, and was
liable, on the slightest chill, to a return of urethral discharge.
His health was otherwise good. Under Thuja 30 and 12
improvement soon set in, and in a few weeks the mucus had
almost entirely disappeared, and the voice had become satis-
factorily clear. He has continued well since: a cold brings
back some slight laryngeal catarrh for a time, but the urethra
is no longer liable to irritation.
Drs. Allen and Norton consider that Thuja has a special
action on the sclerotic coat of the eye, and is of great use in its
diseases. They also call it " a grand remedy" in syphilitic iritis.
Bönninghausen and others have thought that Thuja has
some specific action in small-pox, even so as to prove prophy-
lactic against it, as Belladonna against scarlatina. More evi-
dence seems required here; though I should mention that Dr.
Drury in this country esteems it highly. But there is no
doubt that the medicine has proved curative of "grease" in
horses, which many think of the same nature as vaccinia and
variola. I take this opportunity of saying that Thuja has
often been of eminent service in veterinary practice, as in the
treatment of farcy and of the warty vegetations of the surface
so common in the lower animals.
In the thirteenth volume of the Monthly Homeopathic Review
Dr. Gibbs Blake narrates one case, and refers to four others,
of ranula, in which Thuja was curative. Dr. Guernsey con-
siders that the drug has a special influence on the left ovary,
and is indicated when this is chronically inflamed, or is the
seat of dysmenorrhoeic pain. The suffering in it is aggravated
by walking or riding, and often becomes so severe as to
compel the patient to lie down.
در
-
Cannabis, Cantharis, Copaiba, Mercurius, Petroselinum and
Pulsatilla resemble Thuja in its influence on the genito-urinary
organs. Nitric acid is its only ally as an "anti-sycosic.'
3 K
866
URANIUM.
All dilutions seem to have acted well: perhaps on the
whole the balance is in favour of the higher.
My next medicine is as novel as the last. It is yet another
of the rare metals,
Uranium.
The nitrate is the salt generally used, and is best prepared
for use by aqueous solution, or (less suitably) by trituration.
Dr. Edward Blake has carried out an excellent proving of
Uranium nitricum, three human subjects and nineteen animals
having been the subjects of experiment, and full doses being
taken. His results, first published in the twenty-sixth
volume of the British Journal of Homœopathy, have been
wrought by him into a monograph upon the drug which
constitutes the second part of the Hahnemann Materia Medica.
Our attention was first called to Uranium as a medicine by
a statement in the British and Foreign Medico-Chirurgical
Review for 1851 that "Leconte always found sugar in the
urine of dogs slowly poisoned by small doses of nitrate of
uranium" (vol. xix, p. 44). This fact, curious only in the
eyes of an ordinary reader, was to a homoeopathist pregnant
with suggestiveness. Its import was first pointed out by Dr.
F. S. Bradford, in the eighth volume of the North American
Journal of Homœopathy. He gave no cases; but stated
generally that, in diabetes, "two or three grains of the third
trituration, administered morning and night, will, in a short
time, reduce the quantity of urine passed to nearly a normal
standard, and, after a continued use, the proportion of sugar
is materially lessened." He also commended it in simple
diuresis, especially when the urine was apt at times to become
acrid. In the tenth volume of the same journal, Dr. E. M.
Hale-ever to the fore when new remedies are concerned
-published three cases of supposed diabetes in which he gave
Uranium nitricum, in one with great amelioration, in the other
two with cure. Unfortunately, the urine was not tested for
sugar, nor was even its specific gravity taken; so that the
cases are open to question, and Dr. Blake maintains that the
two which were cured resemble Bright's disease rather than
glycosuria. Of this you will form your own opinion. But in
the twenty-fourth volume of the British Journal of Homœo-
pathy you will find three cases of my own of undoubted dia-
betes mellitus, in which the beneficial effects of the drug were
>>)
URANIUM.
867
unquestionable,-all dietetic influences being eliminated. From
this time onward numerous communications appeared testify-
ing to the value of the remedy. Dr. Blake's monograph con-
tains those from Drs. Lowder, Curie, Jousset, Bähr, Drysdale,
and John Blake, which had appeared up to the time of its
publication. I have myself published two additional cases;*
and Dr. Cornell, of America, another.† Drs. Zwingenberg
and Fischer have spoken of successful results with it; and
Dr. Magdeburg has related two severe cases in which the
muriate proved most beneficial.§ Another cure has since been
reported by Dr. Koeck, of Munich. The practice has even
been adopted in the old school; and in the Lancet of June
13th, 1874, Mr. Carey narrates an instance of its success. He
ended his paper with a frank acknowledgement of the source
of his prescription; but this the Lancet, with characteristic
dishonesty, omitted.
Such evidence appears highly satisfactory, both as to the
positive value of the remedy and as to the homoeopathicity of
its action. Dr. Blake's experiments, indeed, seemed to cast a
doubt on the latter point; as in none of his subjects, human
or brute, was sugar eliminated in the urine. But he was
rather hasty in assuming therefrom that "glycosuria was quite
put out of court, as a condition theoretically calling for the
use of nitrate of uranium." He might have remembered
that it was in dogs that Leconte obtained his results; while
he himself employed in seventeen out of nineteen experiments
cats and rabbits. The non-appearance of sugar in two pup-
pies and three human subjects is no warrant that it might not
be found in the next instance of either kind. In the latter,
this warning against rash conclusions from negative results
has already received an illustration. Dr. Magdeburg says—
"I have satisfied myself by my own experiments that after
several weeks' ingestion of small doses of Uranium muriati-
cum or nitricum by healthy persons sugar can be found in
their urine." On the other hand, I think that Dr. Blake
may be right in suggesting that the marked action on the
stomach which (as we shall see) he found Uranium to possess
may account for its usefulness in the treatment of diabetes.
My own experience leads me to believe that it is best suited
to cases originating in dyspepsia or assimilative derangement;
* Brit. Fourn. of Hom., xxxi., 369. Blake, Case 21.
† Ibid., xxvi., 661.
‡ Ibid., xxxiii., 544.
§ Ibid., xxxiv., 67.
|| Ibid., xxxvi., 86.—See also vol. xxxvii., pp. 356, 360.
Dr. Curie, also, states that he has verified Leconte's experiments.
868
URANIUM.
while Phosphoric acid excels it where the starting-point of the
disease was in the nervous system.
The whole question, both as to the physiological and the
therapeutic action of the metal, seems likely soon to be tested
on a wider field. Among the subjects of experimentation for
which grants have been made by the British Medical Associa-
tion is "The action of Uranium salts in glycosuria ;" and the
results obtained are announced to be published in the British
Medical Journal as soon as complete. They have not yet
appeared; but I look forward to them with much interest and
equal confidence. In the meantime I may refer you to the
article on diabetes in the second edition of my Manual of
Therapeutics, where you will find further testimony to the
value of the drug, and a substantiation, from Senator, of the
existence of the distinct type of the malady to which I have
indicated it as suitable. You should also read Dr. Black's
observations upon Uranium in the essay on diabetes to which
I have already referred.*
The action of Uranium in Dr. Blake's proving was rather
to increase the total quantity and specific gravity of the urine
-the excess being either in urates or chlorides; and also to
render it more irritating, causing burning and mucous dis-
charge. It is thus homoeopathic to the diuresis described by
Dr. Bradford; another instance of which, with incontinence,
is related as cured by it in the twenty-fourth volume of the
British Journal of Homeopathy. But the most important
result obtained was the production of ulceration of the pyloric
end of the stomach and of the duodenum. This was well-
marked in three of the rabbits and one of the cats experi-
mented upon; and in ten more of the remaining fifteen
animals the pylorus was found more or less affected, while in
none was the drug introduced directly into the stomach.
These results show an unquestionably specific action of the
drug; and indicate it in gastric ulcers and in those which
occur in the duodenum after burns. Dr. Drysdale has already
turned the facts to good account by curing a case of ulcer of
the stomach with Uranium.†
Phosphoric acid is the only medicine which has (presumably)
the same relation as Uranium to saccharine urine. Kali bichro-
micum and perhaps Arsenicum correspond to its gastro-
duodenal action.
The lowest dilutions only have hitherto been used, save in
one case of cure of diabetes reported by Jousset, in which the
6th attenuation was employed.
* Brit. Fourn. of Hom., xxxvii., 122, 354. † Ibid., xxvii., 307.
LECTURE LVII.
URTICA, UVA URSI, VALERIAN, VERATRUM ALBUM AND
VIRIDE, VERBASCUM, VIOLA ODORATA AND TRICOLOR,
XANTHOXYLUM, ZINCUM.
My first medicine to-day is the common stinging-nettle,
Urtica urens.
The tincture is prepared from the entire fresh herb.
There is a proving of Urtica, conducted by two persons
with increasing doses of the first decimal dilution, in the
second edition of Dr. Hale's New Remedies.
The most interesting result of this proving was to show
that Urtica, taken internally, can produce on the skin an
affection very similar to that occasioned by its external ap-
plication, and which, when occurring idiopathically, is called
nettle-rash (urticaria, hives). Both provers also had dysenteric
stools, and continuous pain in the right deltoid muscle. A
case of poisoning from an infusion of the plant was reported
by Dr. Fiard to the French Academy of Medicine, in which
the upper half of the body was affected with extremely dis-
tressing burning heat, with formication, numbness, and violent
itching. Great cedema of the sub-cutaneous cellular tissue
ensued, and bullæ developed, which on rupture exuded much
serum. The urine was suppressed for days; but the breasts
swelled and formed a quantity of milk. The woman had had
no children for upwards of three years, and had not nursed
those she had previously borne.
Urtica is the favourite homoeopathic remedy for burns of
the first degree, i.e., where the injury does not involve the
cutis. It should be used both internally and externally.
Its employment in nettle-rash is obvious: it is reputed by
many the best remedy for this affection, though I myself
have always been satisfied with Apis. It is also useful to
relieve the rectal irritation caused by ascarides; and might
act well in acute dropsy, as from a chill. Dr. Terry speaks
highly of it in deficiency of milk in nursing women.
* Hom. Times, April, 1877.
*
870
UVA URSI.
Apis, Rhus and Cantharis are analogous medicines. I can
say nothing about dose.
And now a few words about the bear-berry, Arbutus
Uva ursi,
of which we prepare a tincture from the leaves.
There is no homœopathic proving of Uva ursi; but as there
is no doubt that it specifically affects the urinary mucous
membrane, it has found a place in our Materia Medica. It
is spoken of in old-school therapeutics as a "stimulant astrin-
gent;" and Dr. Phillips states that in large doses "it produces
inflammatory irritation of the lining membrane of the bladder
and of the urethra, accompanied by tenesmus, and often by a
bloody discharge, and later on, by a purulent and bloody one."
I do not know upon what authority he speaks; but I need
hardly say that this is the very condition in which it is reputed
curative as the same writer says "The principal value of
uva ursi is shown in chronic affections of the bladder, atten-
ded by mucous, bloody, or purulent discharges, with burning
in the urethra during urination; and especially when these
symptoms are produced by calculus." Pereira says of its
use in this affection :-"in some cases, the benefit obtained
by the use of it is marked; whereas, in other instances, it is
of no avail." It is my own impression that it acts more on
the kidneys than on the bladder, and is most useful in vesical
complaints when these are symptomatic of renal disease. It
has cured renal hæmaturia and pyelitis; and has much repute
in the West Indian chyluria.
We come now to a well-known medicine,
Valeriana.
The tincture is prepared with dilute alcohol from the root.
A short pathogenesis of Valerian appeared in the Fragmenta
de viribus. Hahnemann did not take it up again; but Stapf,
Gross, Franz and Wislicenus proved it, and their symptoms,
with his, appear in the Additions to the Materia Medica of the
first-named. Valerian was also proved by Jörg and his pupils,
twelve in all. Dr. Allen adds yet further experiments.
Valerian appears to exert a direct influence on the nervous
糖
​VALERIANA.
871
centres, of the same kind as, but more enduring than, that of
Ambra, Asafoetida, Moschus, and the other nervines. It es-
pecially affects the brain and the organs of sense. It causes
headache, giddiness, and mental excitement, with (as Heber-
den observed) "agitation and hurry of spirit"; and, in the
visual sphere, sparks and flashes of light, even to the extent
of objects seeming to be on fire. The motor centres are also
agitated, as shown by restlessness and even spasmodic move-
ments; and in the sensory sphere there is formication of the
hands and feet, and a sensation about head and spine which
has been compared to the aura epileptica. Franz suffered a
good deal in the eyes; and Jörg and all his pupils had turbid
urine, the sediment being now bran-like, now of brick-red sand,
now of slime.
19*
It is thus evident that Valerian is perfectly homeopathic to
those conditions of nervous erethism for which it has so long
been in repute. As Hahnemann says—“It is not to be
wondered at that Valerian in moderate doses cures chronic
diseases with excess of irritability, since in large doses, as I
have ascertained, it can exalt so remarkably the irritability of
the whole system. It has not been much used for them in
the homoeopathic school; but in the other camp it seems to
retain its credit. Dr. Ringer commends it especially in that
modification of hysteria which appears at the menopausia-
flushings of the face, hot and cold perspirations, restlessness,
nervousness, depression of spirits, sensation of suffocation at
the throat, throbbing at the temples, fluttering at the heart."
Dr. Phillips, who states that "perseverance in its use for too
long a period induces a decided tendency to low melancholy
and hysterical depression," says that "in hypochondriasis, it
calms the nervousness, abates the excitement of the circula-
tion, removes wakefulness, promotes sleep, and induces sensa-
tions of quietude and comfort; sadness is removed, and the
hypochondriac state of the mind in general abates." He
commends it also in the globus, headaches, flatulence, and
coughs of hysteria. In the only homoeopathic record of its
use with which I am acquainted,† it removed in one case hy-
sterical dyspnoea, coming on paroxysmally, and in another a
choreic condition accompanied with typhoid symptoms. In
both its effects were very marked. Dr. Guernsey mentions a
curious symptom as indicating it-"sensation as if a thread
were hanging down the oesophagus from the pharynx," causing
frequent urgings to vomit.
"
* Lesser Writings, p. 316.
+ See Philadelphia Fourn. of Hom., ii., 715.
M M
872
VERATRUM ALBUM.
The properties of Valerian seem due to two constituents,
valerianic acid and an etherial oil. The latter, in experiments
on animals, is found to be sedative to reflex excitability,
which is hardly the physiological action of the whole plant.
Valerianic acid, on the other hand, in combination with zinc
or ammonia, seems to produce all the nervine effects of the
drug it is in this form that Dr. Ringer commends it, though
Dr. Phillips pronounces it untrustworthy. Dr. Bartholow says
that the valerianic acid of pharmacy is derived from the oxida-
tion of amylic alcohol, and is not identical with that existing
in Valerian. I shall have more to say about the combination
of valerianic acid with zinc when I come to the latter medi-
cine.
Besides the nervines I have mentioned, Ignatia and
Stramonium compare well with Valerian.
The first decimal dilution answered well in the cases I have
cited.
I have now to speak of the white and green hellebores,
Veratrum album and viride. These, though called vernacu-
larly by the same name, are both botanically and medically
very different from the black hellebore, which has already
come before us. They were at first supposed to owe their
activity to veratria. But further investigation has shown that
the substance so described as existing in them is not iden-
tical with the veratria of Sabadilla, though so like it in physio-
logical action as to be called "veratroidia;" and that other
alkaloids are conjoined with it—“viridia" in the green variety
and “jervine” in the white-which have properties of their
own. I shall therefore speak of either Veratrum as a separate
entity in itself, using the results obtained with the alkaloids
as illustrative only.
We will take first the white hellebore,
Veratrum album.
The tincture is prepared from the root-stock.
The proving of Veratrum (so called ordinarily among us) is
in the third volume of the Reine Arzneimittellehre, and is an
enlargement of one which had already appeared in the Frag-
menta de viribus. It contains 315 symptoms from Hahne-
mann, 154 from five fellow-observers, and 247 from authors.
The majority of these last are from Greding; and, being ob-
served upon melancholico-maniac patients, must not be re-
VERATRUM ALBUM.
873
ceived without qualification. Lembke and Schelling also have
proved it, as you may see from Allen.
Some instructive cases of poisoning by Veratrum are con-
tained in Dr. Hempel's article on the drug. The picture they
present is decidedly choleraic. There is general coldness, with
prostration going on to collapse, embarrassed circulation,
copious watery vomiting and purging, cramps in the extremi-
ties, and severe spasmodic colic. The experiments cited by
Christison had already shown that the vomiting and purging of
Veratrum are specific, appearing however the poison may have
been introduced into the system. The more recent investiga-
tions of Schroff have further proved that these evacuations do
not depend upon gastro-enteritis, as Veratrum, when intro-
duced directly into the circulation, causes no inflammation,
and even when swallowed produces at most a transient hy-
peræmia of the parts with which it comes in contact. "If its
action be more intensified," he says, "it causes a rapid de-
generation of the gastric mucous membrane, but no gastro-
enteritis." The same results have been obtained from veratria.
Esche took half a grain of the acetate; and it produced
"collapse, with a pale, cold, wet skin, pinched features, a rapid,
thready, irregular pulse, violent vomiting, and marked mus-
cular tremblings " (Wood).
*
It is not surprising, therefore, that when Hahnemann had
to prescribe for Asiatic cholera on its first invasion of Europe,
he should have placed Veratrum in the first rank of its reme-
dies. In every epidemic since it has gained high commenda-
tion, especially in Russia and America. But Hahnemann
perceived that it met the disease less deeply than did Cup-
rum; and English physicians have observed the same thing
as regards Arsenicum. Dr. Russell's remarks on this point
are so valuable, that I will cite them here, especially as you
may not have access to his treatise.†
"As far as our expe-
rience goes, we feel at present inclined to trust to it more in
cases of violent vomiting and purging, and all the other pro-
minent phenomena of cholera, but which are destitute of what
we should call the essential physiognomy of the disease. Such
cases will pass for cholera in all reports, Homœopathic and
Allopathic, and they will be cured: but to a practical eye
there is something about them different from fatal cases, at
the very outset. The disease seems to be going inwards,
advancing towards the seat of life, not coming outwards from
it. That they are often fatal, there is no doubt; and that
* Lesser Writings, p. 842.
† On Epidemic Cholera (p. 226).
874
VERATRUM ALBUM.
Veratrum cures them, there is no doubt either: but still Vera-
trum is not sufficient in the worst type of the disease: and the
reason of its great exaltation is, that it cures so many curable
cases very like true cholera.
We have found it
most useful in cases where there was violent vomiting and
purging, without that sudden deadly collapse which we have
characterised as the indication for Arsenicum." It follows
from this that it is precisely suited to choleraic diarrhoea. I
used to give it in summer diarrhoea, but of late years have
abandoned it in favour of China. As the autumn comes on,
however, when vomiting is superadded to the purging, and
when the intestinal evacuations are expelled in a forcible
gush, with little or no griping, I give Veratrum instead of, or
in alternation with, China, and with great advantage.
The colic and cramps of cholera add to the indications for
Veratrum in its treatment, though the latter belong yet more
to the action of Cuprum. The colic of Veratrum, however, is
very well-marked. It is often associated with hiccough, and
is apt to cause a sense of suffocation in the chest and stomach,
which, as well as the abdomen, it affects. One of Hahne-
mann's earliest homoeopathic cures was a case of recurring
colicodynia of severe character and long standing, possibly—
as the patient was a printer-due to the action of lead. Vera-
trum was given because of the similarity of the symptoms to
those it causes; and, though the dose was so large as at first
to cause a painful aggravation, it effected a speedy and per-
manent cure. Hahnemann also found it specific in the so-
called "water-colic " which haunted some marshy parts of
Brunswick and Lunenburg.† Dr. Bayes commends it highly
in cases of pain after food and water-brash, with cold hands
and face; and it should be useful in spasmodic hiccough.
*
The spasms of veratria are found to be due to a direct
action of the drug upon the muscular substance. They are the
primary expression of a toxic influence exerted upon it which
soon goes on to paralysis. The heart, as being itself a hollow
muscle, shares in this effect; and hence the weakening and
retarding of its beats so marked in Veratrum-poisoning. This
property has been turned to account in the use of the American
species-Veratrum viride—as a cardiac depressant in fever
and inflammation, as we shall see presently. We rather utilise
it by giving Veratrum album as a “tonic” in cases of cardiac
and general muscular debility. The " great weakness and
exhaustion with cold sweat on the forehead" which is Dr.
* See Lesser Writings, p. 353.
+ Ibid., p. 605.
VERATRUM ALBUM.
875
Guernsey's chief indication for it; the intermitting heart, and
"debility with blue hands and cold feet," in which Dr. Bayes
finds it so useful, belong to this category. So also in all
probability does the paralytic state of the rectum which it
caused in one of Hahnemann's provers, and the constipation de-
pending on this cause which it has often proved able to benefit.*
Veratrum album was the hellebore much used by the
ancients in the treatment of chronic disease, and especially of
insanity. A learned account of the practice is given by
Hahnemann in the treatise De Helleborismo Veterum by which
he gained his licence in Leipsic in 1812. It was used as a
drastic emetic and purgative, and probably effected any good
which came out of the evil by the shock and change it gave
to the system. But Hahnemann thinks that it sometimes
acted specifically; and cites Aetius as saying-"it is not the
vomiting whereby the Veratrum album is of use in chronic
disease; for many have taken and digested it with scarcely
any evacuant action, and yet have experienced no less benefit
from its use than those who have been worked by it." He
says that at least one third of the cases of insanity occurring
in lunatic asylums might be cured by it in such small doses
as the twelfth dilution administered in the patient's drink.
The pathogenesis of the drug hardly supports this strong
statement. The marked symptoms of insanity which stand at
the end of Hahnemann's list are all from Greding—that is,
they were observed upon insane patients taking the drug, and
are worse than worthless. Delirium, however, is sometimes
caused by poisoning or overdosing; and Hahnemann wrote in
1806-I know not on what authority-"it produces in its
direct action a kind of mania, amounting from larger doses to
hopelessness and despair; small doses make indifferent things
appear repulsive to the imagination, although they are not so
in reality." In the preface to his proving he says it is useful
in some cases of hypochondriasis.
The coldness which we have seen Veratrum causing is
always a great indication for it in practice. Besides cholera, we
have it sometimes in ague and in typhus; and Hahnemann in
the former, and Wurmb and Caspar in the latter instance, have
testified to the value of the drug. In fact, where the general
condition characteristic of Veratrum is present-tendency to
copious diarrhoea and vomiting, with prostration, fainting,
coldness and cold sweating, it will benefit almost every case,
of whatever kind it may be.
* See Dr. Dunham's remarks in his Homœopathy the Science of
Therapeutics, p. 127.
876
VERATRUM VIRIDE.
Aconite, Autimonium tartaricum, Colchicum and Digitalis
are the chief analogues of Veratrum album.
The medium dilutions-from the third to the twelfth-have
been those generally used. But in cholera practitioners have
gone both higher and lower: the thirtieth has been in favour
with many, while in the last epidemic in Liverpool Mr. Proctor
got the best effects from the first decimal.
And now of the green or American hellebore
Veratrum viride.
The tincture is prepared from the root.
A proving of Veratrum viride by Dr. Burt, in substantial
doses, is contained in the second edition of Dr. Hale's New
Remedies; and the therapeutic portion of his fourth edition
relates numerous cases of over-dosing with it, besides giving
a full account of its clinical uses. Dr. Allen has collated
these with other provings and poisonings.
The green hellebore shows its relationship to the white by
occasionally causing a choleraic condition, as in a child of Dr.
Burt's whose case is related by Dr. Hale. But, though vomit-
ing is frequent and severe, there is rarely purging. The
symptoms come on rapidly, and depart as soon. More fre-
quently, however, the main action of the drug is expended on
the circulation. Either the condition of nausea may be in-
duced, with its usual phenomena, as we have seen them occur-
ring from Tartar emetic and other drugs; or there may be—
as with the salt just named and with Digitalis-great slowing
of pulse and respiration, without other symptoms; or there
may be from the first what always shows itself sooner or later,
a great loss of muscular power in both heart and arteries,
causing syncope and threatening death.
-
Veratrum viride has thus a three-fold sedative influence
upon the circulation, which it can reduce like Tartar emetic
through the medium of nausea, like Digitalis through the in-
hibitory influence of the vagi, and also by directly weakening
the force of the heart. It is not surprising that, with such
properties, it should be extensively used in the old school as
an arterial sedative in fevers and inflammations. It is less
natural that homoeopathists should follow the example, seeing
that the action is obviously one of a contrary rather than of a
similar. I cannot recommend you to imitate them; nor is our
manna so scant for such needs that we should lust after the
VERATRUM VIRIDE.
877
flesh-pots of Egypt. The only use of Veratrum viride of this
kind which I can advise is a local one. There is evidence
from many quarters* that the application of the pure tincture
or a strong lotion will arrest erysipelas, synovitis, and other
acute but superficial inflammations and congestions in a very
rapid manner; and, if it is so, it would be a pity that we should
not apply it for the purpose.
The real homoeopathic use of Veratrum viride grows out of
its action on the nervous centres. Dr. Ringer speaks of it as
causing "dull, heavy, frontal headache, sometimes accom-
panied by shooting or stabbing pain over one or both brows."
Dr. Burt had constant aching pains in the back of the neck.
and shoulders, so that it was almost impossible to hold the
head up; and in his case of poisoning paroxysms of opistho-
tonos appeared. Dr. Wood shows that viridia causes con-
vulsions, of cerebral origin; and Dr. Coe speaks of observing
choreiform muscular contortions from the use of the concen-
trated preparation," veratrin. Dr. Charles Adams, examining
microscopically animals poisoned by the drug, found "intense
capillary congestion of both the white fibrous structure and
gray cineritious substance," more in the cerebellum and pons.
than in the cerebrum. We are thus led to see the probability
of Veratrum viride acting as a true simile in erethistic and
hyperæmic conditions of the brain and cord; and experience
has proved it to be so. Dr. Hale esteems it very highly in
such conditions, considering it to act somewhat like Aconite
and Belladonna combined. His book contains numerous in-
stances showing its value in cerebro-spinal meningitis, the
acute cerebral irritations of childhood, and puerperal convul-
sions. Dr. Shuldham has lately published some
illustrating the same power of the drug;† and Dr. Cooper
comes in at the end of a long list of witnesses to testify to its
virtues in chorea. In all these affections it quiets nervous
irritation and disposes to sleep; and, if fever be present, it
disperses it in perspiration. Used in this way, Veratrum
viride seems a really valuable addition to our store of remedies.
It appears to be especially suited to the condition of the
nervous system and the circulation which obtains in the
puerperium, and is esteemed by many excellent practi-
tioners-it is sufficient to instance Dr. Ludlam-the best
initial remedy for the febrile and inflammatory states incident
thereto. Dr. Hale considers it indicated in pyrexia by a full,
cases
བ་
((
* Brit. Journ. of Hom., xxii., 651; xxv,, 256; xxxiv., 281.
† Monthly Hom. Review, xiii., 597; xiv., 37.
Brit. Fourn. of Hom., xxxiv., 272.
878
VERBASCUM THAPSUS.
hard, bounding pulse, and a tongue yellow at the sides with a
red streak, wide or narrow, in the middle.
I have already indicated the medicines most analogous to
our present one. The first decimal dilution has been most
frequently used.
I have now to say a few words about the great mullein, or
"high taper "-
Verbascum thapsus.
The tincture is prepared from the fresh herb.
There is a proving of Verbascum in the sixth volume of the
Materia Medica Pura, containing 32 symptoms from Hahne-
mann, and 141 from four others. Dr. Hempel has (accident-
ally of course) omitted it from his translation.
I mention this medicine rather because it is one of Hahne-
mann's than because of any active virtues it possesses. The
only applications to which its pathogenesis has led have been
to prosopalgia and migraine on the one hand, and to hoarse
dry night-coughs (like those of Sambucus) on the other. It
once indeed, in Dr. Clotar Müller's hands, cured radically a
migraine of twenty years' standing.* He was led to its choice
by a "peculiar sympathetic affection of the ear on the side
affected. At the height of the headache, which mainly con-
sisted in pressure and pinching in the temple and zygoma,
there commenced an intolerable drawing in the ear, with a
sensation as if something stopped it up." Dr. Cretin esteems
it highly in prosopalgia. Its symptoms, says Dr. Jousset, are
pains by flashes, excited by the least movement, in closing
the teeth and touching them with the tongue: face red, acid
eructations."
(C
Dr. Cushing, of Lynn, Massachusetts, tells us that he
places implicit confidence in Verbascum as a remedy for in-
continence of urine. He made a proving of the remedy ten
years ago, and one of the most prominent symptoms was a
constant dribbling from the bladder. Since that time," he
says, "I have treated many cases of enuresis, mostly nocturnal,
some of which had resisted years of treatment by old school
and new; and I do not know of one thus treated that has not
been cured."†
* Brit. Fourn. of Hom., xxi., 19. See also case of prosopalgia in
vol. xi., p. 299.
† Amer. Hom. Observer, xiii., 563.
VIOLA TRICOLOR.
879
The mother-tincture (as recommended by Hahnemann him-
self) has generally been used; but Dr. Cushing gives the third
attenuation.
We come next to two species of Viola. First, we have the
sweet violet itself,
Viola odorata.
The tincture is prepared from the entire fresh plant.
There is a short pathogenesis of Viola odorata in the
eighth volume of the Archiv, but without explanation as to its
origin.
Our fullest information as to the clinical uses of the violet
is given by Teste. He finds it particularly suitable in cases
of spasmodic cough and dyspnoea occurring in lymphatico-
nervous constitutions: the symptoms are more troublesome
in the day time. In one of his cases the cough and dyspnoea
were due to the retrocession of measles; and the eruption was
restored by the medicine. In a note, Teste says:-"Petroz
informs me that he has used Viola with success in various
rheumatic affections of the upper limbs." Later, in the
Gazette Homœopathique de Paris, Tessier published several
cases of rheumatism affecting the carpal and metacarpal
joints, in which striking results followed the administration of
Viola odorata. Dr. Kitchen translated these for the first
volume of the Philadelphia Journal of Homœopathy, adding
some confirmatory cases of his own. A curious point about
them all is that the rheumatism was always on the right
side of the body. In two cases where both wrists were
affected, the right one soon got well, but the left remained
in statu quo.
*
Teste thinks Viola is an analogue of Chelidonium.
The twelfth dilution in Tessier's hands and the first in Dr.
Kitchen's seem to have acted equally well.
The other species of Viola is the pansy, or heartsease,
Viola tricolor.
Here also the entire plant is used for making the tincture.
The same volume of the Archiv contains a similar patho-
genesis of this species of Viola also; and here again Teste is
our therapeutic informant. His facts, however, are not of his
* See Brit. Journ. of Hom., xxiv., 314.
880
XANTHOXYLUM FRAXINEUM.
own observing, but come from the older authors. They show
that the pansy enjoyed at one time a high reputation in crusta
lactea and other forms of impetigo.* One case he mentions.
is especially interesting, where it cured nervous paroxysms
in a young girl which seemed to have been caused by the sup-
pression of milk crust. For myself, I have rarely needed any
other medicine for this plague of children; and I have more
than once given it in recent impetigo in adults with very
satisfactory results. I have seen it act well even in the sixth
dilution, which proved curative in a case recorded by Dr.
Dudgeon:† but as a rule I give the first and second decimal.
Dr. Guernsey recommends it where the hair is so matted by
porrigo capitis as to resemble plica.
I have next another American medicine to introduce to
you, the prickly ash,
Xanthoxylum fraxineum.
The tincture is prepared from the bark and berries, in equal
proportions.
A good proving, on three men and three women, with
clinical remarks, may be found in the second edition of Dr.
Hale's New Remedies.
on
These provings, conducted with substantial doses, are not
a little notable, and ought to prove fruitful. The only symp-
toms which have as yet led to practical results are those of
the female generative organs. It caused in one woman the
appearance of the menses a week before their usual time,
and attended with much pain in another, there seemed
"an unnatural forcing of nature," the menses came
profusely, "with dreadful distress and pain, baffling descrip-
tion." It has accordingly been used to relieve dysmenorrhoea,
and with success. Like all drugs which help dysmenorrhoea,
it is applicable to after-pains: I have occasionally given it
for these with good effect. Dr. Hale says that it is specially
suitable to women of spare habit, nervous temperament, and
delicate organisation; and where the pain is neuralgic in
character. Dr. Massy thinks the prolongation of such pain
along the crural nerve an indication for it, which would sug-
* On this Hahnemann remarks:-" The pansy violet at first increases
cutaneous eruptions, and thus shows its power to produce skin diseases,
and consequently to cure the same effectually and permanently'
(Lesser Writings, p. 328).
*Brit. Fourn. of Hom., xi., 355.
ZINCUM.
881
gest it in cases of ovarian origin. My own choice of it is
determined by the concomitance of dysmenorrhoea with
menorrhagia, which is rare.
The dilutions from the first to the third decimal have been
used.
And now I come to the last medicine on my list, which is
a metal of some therapeutical importance,
Zincum.
We use indifferently the metal itself, its oxide, or its sulphate
—making triturations of each.
Hahnemann published a pathogenesis of metallic Zinc in
the first edition of the Chronic Diseases, containing 743 symp-
toms, which from the preface we may gather to have been
observed upon patients taking the 18th dilution. In the
second edition the list has swollen to 1,375. Some of the
additional symptoms (i.e., those of Franz, Hartmann, Haubold,
Rückert, v. Gersdorff, and Stapf) are taken from a proving
recorded in the sixth volume of the Archiv, in which the first
trituration was mainly employed: the remainder are from
"Ng." in Hartlaub and Trinks' Arzneimittellehre, and from
four others. Some experiments with the oxide, from Wibmer's
Toxicology and from the Hygea, are related by Hempel ;
and Dr. Allen gives pathogeneses of the chloride and the
sulphate. A full study of Zinc-containing all recorded.
homœopathic cures by it existing in German literature-has
been recently contributed by Dr. Gerstel to the Internationale
Homöopathische Presse (vols. iii-v), and is translated in the
North American Journal of Homeopathy.
It is very much the fashion to say that, save the emetic
effects of the sulphate and the irritant properties of the
chloride, the preparations of Zinc have no pathogenetic
action on the system. But the high repute it has gained at
various times in disorders of the nervous system-and especi-
ally in the form of the oxide-should have led to a doubt of
such a negation. Nil prodest quod non læditur idem. The
experiments of Wibmer show that the oxide has a marked
effect on the nervous centres, causing vertigo, sleeplessness,
formication, and oscillatory movements of the muscles of the
extremities. Bouchut found it produce sleeplessness and
restlessness by night; and on the other hand Orfila noted
stupor and inactivity in the dogs he poisoned by it. These
3 L
882
ZINCUM.
last represent the ultimate effect of the drug in man. Wibmer
says "The action of small doses, if their use is continued
beyond a certain period, may produce a general cachexia,
with complete prostration of the nutritive functions: the
intellectual faculties are likewise impaired, the beats of the
heart are slow and feeble, and the power of locomotion and
strength of body are enfeebled to a high degree." A good
illustration is afforded by a case mentioned by Pereira, in
which a gentleman, "for the cure of epilepsy, took daily, on
an average, twenty grains of the oxide, till he had consumed
3,246 grains, which must have taken him about five months.
At the end of this time he was found of a pale, earthy hue,
wasted away, and almost idiotical; his tongue was thickly
coated, the bowels were constipated, the inferior extremities
cold and oedematous, the abdomen tumid, the superior ex-
tremities cold and shrivelled, and their skin dry like parch-
ment: the pulse was about 60, thready, and scarcely per-
ceptible."
Dr. Headlam Greenhow has described an affection of
those who are exposed to the fumes of deflagrating Zinc, as
"brass-founders' ague." It is characterised by shivering, short
hot stage, and profuse sweating: during the chill there is
malaise, nausea, and constriction of the chest.* This closely
corresponds with what Wibmer describes as the primary effect
of the internal use of the oxide. "If small doses," he writes,
((
are continued for some time, the prover first experiences an
uneasiness and pressure in the stomach, together with eructa-
tions and constipation, frequently also vertigo, headache,
dulness and tightness of the head, spasmodically contracted
pulse, palpitation of the heart, cold hands and feet, pains in
the diaphragm, between the shoulder-blades, and down the
spine as far as the sacrum, sleeplessness, languor, formication
and drawing of the limbs. These symptoms generally abate
after vomiting or a discharge from the bowels, and still
more frequently after the bursting out of a general perspira-
tion."
Dr. von Tunzelmann has communicated an instance in
which water which had acted on the zinc of galvanized iron
pipes proved prejudicial to three persons who drank of it.†
The first suffered from paralysis of the sixth nerve, with
diplopia and strabismus; and had dark and turbid urine,
with pain in the loins. Another had the latter symptoms;
and the urine, on being examined, was found loaded with
* Med. Times and Gazette, 1862, i., 227.
† Brit. Journ. of Hom., xxxii., 610.
ZINCUM.
883
urate of ammonia and containing a small quantity of sugar.
In the third subject there was severe rachialgia, with photo-
phobia, insomnia, and total anorexia. The value of these
observations is somewhat impaired by the fact that all the
patients had not long before been the victims of lead-poison-
ing, which in each had affected the same parts that afterwards
became troubled by the zinc. Dr. Boardman has shown that
the minute quantity of the metal ordinarily present under
such circumstances is hardly capable of causing bad effects in
healthy persons.*
The uses of Zinc in all schools of medicine correspond with
these pathogenetic effects. The erethistic condition it first.
sets up in the brain, medulla oblongata, and spinal cord finds
its representative in the cerebral excitement without hyperæmia
in which the followers of Rademacher so highly esteem the
acetate; in the infantile convulsions for which Trinks and
Madden commend the sulphate; and in the epilepsy and
chorea in which it has traditional repute. Dr. Bayes has
found our minute doses to act very well in several cases of the
latter complaint. But the homœopathic use of the drug has
been mainly as a remedy for states of cerebral depression. It
has proved curative in chronic headaches† and in melancholia
where this condition was present. Dr. Kidd thinks he has
seen benefit from it in chronic atrophy of the brain, and the
late Dr. Elb of Dresden found it most useful in that threatened
paralysis of the brain which sometimes occurs in scarlatina,
whether before, during, or after the eruptive period.§ In
hydrocephaloid it vies with Phosphorus. Dr. Marcet's recom-
mendation of it (following Huss) in chronic alcoholism is of
the same nature. The febrile attacks induced by the metal,
moreover, have been unconsciously applied in the same way;
for Pereira reckons the sulphate an anti-periodic, and he and
Ringer concur in ascribing to the oxide a power of checking
the sweats of phthisis.
We are yet within the sphere of the nervous system when
we speak of the virtues of another preparation of Zinc-the
phosphide-in neuralgia. It is supposed by Mr. Ashburton
Thompson that it is solely in virtue of its Phosphorus that this
compound acts. But he himself allows that it often proves
emetic, which is a property of Zinc rather than Phosphorus.
He also related in the eleventh volume of the Practitioner two
* See London Medical Record, vol. ii.
† See Brit. Journ. of Hom., xii., 489.
‡ Annals, iii., 427.
§ Brit. Fourn. of Hom., vii., 40.
884
ZINCUM.
cases in which the Zinc phosphide, given for non-neuralgic
complaints in doses of the seventy-second of a grain, after
being taken a few times caused "severe frontal headache
accompanied by frequent stabs of pain apparently darting
from before backwards to the occipital region, but intra-
cranial, and not attended by any disturbance of sensation in
the scalp." These pains were removed by Phosphorus, which
makes it very unlikely that it was that element of the Zinc
phosphide which caused them; and shows us that Zinc, in
this form at least, is capable of causing neuralgic sufferings, as
Mr. Thompson has shown it to be of curing them. In his
book-of which I spoke when upon Phosphorus-he omits
this illustration of the pathogenetic power of Zinc phosphide,
while reiterating his confidence in it as curative. The same
thing may be said of the power of the valerianate of Zinc in
neuralgia, which Dr. Hale finds very effective in doses of from
the tenth to the hundredth of a grain. * In the same direction
points Dr. George Clifton's recent communication to the
British Homœopathic Societyf of the good he has got from
the sulphate in migraine. The vomiting here is an important
element in the homeopathicity of drug to disease; and it is
known that sulphate of Zinc excites it when introduced other-
wise than by the stomach, i.e., by a direct impression on the
nervous centre of the process, as in the malady itself.
There is some reason to think that the favour which Zinc
has gained as a local application to the eyes arises from a
specific action on this part, for Drs. Allen and Carroll Dunham
have each recorded a case of pterygium crassum cured by it,
and Dr. Leadam recommends it for granular lids remaining
after ophthalmia neonatorum-the drug in all these cases
being given internally.
The case I have cited from Pereira indicates Zinc as a suit-
able remedy for "tabes sicca," that primary atrophy without
hectic which we sometimes see in adults. Teste, moreover,
recommends it for cardialgia occurring in delicate and nervous
females, and for disorders of the nerves, motor and sensory,
which supply the heart and air-passages; also of those which
surround the joints and penetrate the bones.
Dr. Gerstel's view of the action of Zinc is in entire harmony
with what has now been said. He regards it as a pure neurotic,
related only to the cerebral complications of blood-diseases, and
influencing the organs only through the nerves which supply
them. Thus it relieves the brain from any depression caused
* See Brit. Fourn. of Hom., xxv, 163.
† Ibid., xxxiv., 108.
-
ZINCUM.
885
by scarlatina or typhus, or occurring during dentition; cures
chronic headaches lying deep in the cerebral substance, and
insomnia or drowsiness (as also vertigo) depending on anæmia
of the brain; and relieves nervous gastric and abdominal
troubles occurring with a clean tongue. He mentions two
cases in which involuntary fits of laughter were removed by it.
Dr. Guernsey recommends Zincum in constipation where
there is remarkable dryness of the stools, which are insufficient
and difficult of expulsion, as if the power of the rectum were
lost; also in painful states of the left ovary, when great relief
occurs during the menstrual flow. This last circumstance of
amelioration, and a fidgetty, restless state of the legs and feet,
are his chief general indications for the drug.
Cuprum and Plumbum are somewhat analogous medicines.
The lower triturations have generally been used.
LECTURE LVIII.
SUPPLEMENTARY.
With Zincum our main series of medicines terminates.
There are yet, however, à good many which must not be
passed over entirely without notice, though a brief notice is
all that can be given to them. And before entering upon the
consideration of these, I have a few words to say by way of
addition to the lectures on general topics with which I com-
menced the present course, for the sake of bringing down
their contents to the present time.
ર
In my Introductory Lecture, I spoke (p. 9) of “ the 'charac-
teristics' and 'key-notes' which have been largely used in
homœopathising of late, especially in America;" and men-
tioned Dr. H. N. Guernsey as foremost among their pro-
pounders. You have since heard me frequently citing this
physician's authority for symptoms of the kind; and I should
have told you at the outset whence I have obtained his obser-
vations. I did so at first from a series of notes of his lectures
on Materia Medica, delivered at the Hahnemann Medical
College of Philadelphia, which appeared as a supplement to
the American Journal of Homeopathic Materia Medica some
ten years ago. I have since drawn upon later and fuller
materials in the third edition of his Application of the principles
and practice of Homœopathy to Obstetrics and the Disorders
peculiar to Women and Young Children. While upon this
subject, moreover, I may commend to you a new Text-Book
of Materia Medica, by Dr. Cowperthwait, Professor of Materia
Medica in the Homoeopathic Department of the University
of Iowa, which applies (and indeed almost limits) itself to the
special record of these characteristic symptoms.
In the same lecture, I mentioned (p. II) among the books
which might profitably be used in connection with my course
"the New and Comprehensive System of Materia Medica and
Therapeutics of our indefatigable American colleague, Dr.
Hempel." Since I did so, this venerable physician, to whom
Homœopathic literature owes so much, has left us for his
SUPPLEMENTARY.
887
well-earned rest. To mitigate our regret for his loss, how-
ever, he has been devoting the last years of his life to pre-
paring-in conjunction with Dr. Arndt-a third edition of his
magnum opus; and he had the pleasure, in the blindness
which had fallen upon him, of hearing the proof-sheet of the
preface read to him a few days before his death. The work
has not yet appeared; but I feel sure that it will display that
"pruning of many redundancies and supplying of more defi-
ciencies which I ventured to desiderate in its previous
editions, and will be a most valuable possession to the
student.
>>
In the second of my two lectures on the sources of our
Materia Medica, I briefly mentioned as untrustworthy the
pathogeneses supplied by Dr. Houat, of Réunion. The use
of these in some recent American compilations (among which
I regret to have to include the Guiding Symptoms of Dr.
Hering) compels me to emphasise my condemnation of them.
Dr. Allen, who has wavered as to their use, sometimes in-
corporating them with the rest of his symptomatology, but
more frequently relegating them to an appendix, has recently
published a paper in the North American Journal of Homœo-
pathy (August, 1879) giving them up as genuine pathogenetic
effects, but accounting for them as being collections of symp-
toms cured by the several drugs. In the British Journal for
January of the present year, I have shown cause why even
this plea for them should not be admitted, and have counselled
their absolute rejection as falsehoods. The index to Dr.
Allen's work, now in progress, will (I am glad to say) omit all
reference to them.
Of Dr. Hale's New Remedies (p. 51) I should mention that
a fifth edition of the therapeutic portion has appeared. I
hope that when its companion volume follows it, it will be
found to contain those detailed provings which enriched the
second edition, and which continue to render it an indispen-
sable possession for us.
The general principles of drug-action, of which I treated in
my fourth and fifth lectures, have of late received much dis-
cussion in the French homoeopathic journals, in connexion
with attempts on the part of Drs. Jousset and Espanet in the
direction of a reconstruction of our Materia Medica. The
criticisms which their essays provoked in the bosom of the
Société Médicale Homœopathique de France are recorded at
length in its Bulletin, and the pages of L'Art Médical for the
corresponding months contain several valuable papers on the
subject. One of these, by Dr. Fredault, has been translated
888
SUPPLEMENTARY.
in the current number (April, 1880) of the British Journal of
Homœopathy; and is especially worthy of your attention.
While this has been going on in France, America has con-
tributed much thought and observation to one of the questions
raised in my seventh lecture, viz.: the effect of trituration on
insoluble substances like gold-leaf and flint. Dr. Conrad
Wesselhoft's microscopic examinations, to which I then briefly
referred, have since been more fully carried out; and the con-
troversy they have excited is far from being settled. Dr.
Wesselhæft inclines to the conclusion that very little reduc-
tion is effected in the size of particles after the first centesimal
trituration, and that the only result of attenuating farther is
to diminish the number present in any given specimen. The
Materia Medica Bureau of the American Institute has taken
up the question, and promises to report on it at this year's
mecting; so I hope that we shall soon have materials for
forming our own judgment. Further advance has also been
made in the examination of the so-called "fluxion potencies,"
of which I have there spoken, and which purport to raise our
attenuations to the millionth degree, and even higher. The
tests of arithmetic on the one hand, and of the rate at which
colour disappears on the other, have shown that dilution
practised in this way falls very far short of Hahnemann's; so
that the mm (millionth) of Swan would only be the 443rd
of the master's scale if carried out according to the method
propounded, while as actually prepared it is found to be about
equivalent to the 10th.* I was justified, therefore, in suggest-
ing that the beneficial effects of using these preparations have
been due to the fact that they were lower instead of higher
than the potencies their employers had been accustomed to use.
I now begin upon the supplementary list of medicines. The
first is the black spruce,
M
Abies nigra. A tincture made from the gum was proved
by Dr. Leaman on himself and two girls without much
result. But Dr. St. Clair Smith, chewing the gum, found it
produce a sensation as of an undigested hard-boiled egg in
the stomach. This led Dr. Allen to give it in dyspeptic con-
ditions so characterised, and both he and others have done so
with great success.‡ A patient of my own, after a fall from a
bicycle, vomited blood, and complained of a persistent sensa-
tion as if something were sticking in the œsophagus, towards
* See The Organon for April, 1880, and the North Amer. Journ. of
Hom. for February of the same year.
† See Ohio Medical and Surgical Reporter, vol. i.
See Hahn. Monthly, Oct., 1877.
SUPPLEMENTARY.
889
its lower end.
Arnica removed the hæmatemesis, but did
not touch the morbid sensation. Under Abies nigra 3x it
yielded immediately.
An Indian plant, the
Acalypha Indica, when taken by Dr. Tonnerre, of Calcutta,
in the dose of ten drops of a tincture prepared from it, caused
a severe fit of dry cough, followed by spitting of blood. Drs.
Holcombe and Thomas have used it successfully in pulmonary
hæmorrhage, and Mr. Clifton considers that in hæmoptysis
from pulmonary tuberculosis there is no medicine equal to
it in value.* The medium dilutions have been employed.
Ammoniacum is well known in ordinary practice as remedial
in bronchorrhoea. It is supposed to be a "stimulant expec-
torant," but no physiological evidence of its action in this
direction has been adduced. It has received a good homoeo-
pathic proving at the hands of Dr. Buchner, and Dr. Allen
can give us a pathogenesis of 291 symptoms obtained by eight
observers. S. 180 is " expectoration mucous, and more copious
than usual," which suggests that any influence the drug may
have upon bronchial fluxes conforms to the law of similars.
Aralia racemosa. This plant, the "spikenard," is in exten-
sive domestic use in America for coughs of all kinds. Dr.
Samuel Jones proved it on himself. He is inclined to asthma,
and an asthmatic paroxysm came on after taking it; but it
was, he says, very different from his usual attacks. It rather
resembled hay-fever; and in this complaint, and similar suffo-
cative coughs, Dr. Jones has found it very beneficial.
A tincture is prepared from the fresh root.
Aranea diadema introduces us to the family of Spiders, and
I shall speak of them all under its heading, as I have of the
serpent-poisons under Lachesis.
The use of the spider's web in medicine is of very old date.
Sir Thomas Watson cites many facts showing its undoubted
efficacy in ague; and Dr. Ozanam has suggested that it cures
by means of the albuminous substance which it contains, and
which Dr. Bence Jones discovered to be analogous to and
isomeric with quinine.* In favour of this view is the fact
* See Monthly Hom. Review, xii., 399.
His pathogenesis is given in the symptomatology of Hale's fourth
edition, but is omitted by Allen.
Bull. de la Soc. Med. Hom. de France, xvii., 454.
890
SUPPLEMENTARY,
that the web-that of the black spider is commonly used-
must not be too old, so as to have lost its glutinous feeling. Dr.
Jones, who makes this statement, has collected in the American
Observer a number of facts relative to the action, physiological
and therapeutical, of cobweb, whlch well deserve attention.
It seems to act as a general sedative, promoting quietness
and sleep in cardiac affections, asthma, phthisis, and similar
irritative conditions.
It is another thing to employ spiders themselves in medi-
cine, to counteract morbid states analogous to those produced
by their bites; and I need not say that to do so is a peculiarity
of the school of Hahnemann. Dr. Ozanam has here again
contributed to our knowledge, in an Etude sur le venin des
Arachnides, which—as reprinted from L'Art Médical-I lay
before you. He brings together here all authentic observa-
tions as to the effects of spider bites, and indicates their
therapeutic applications. Of the several members of the
group he includes the Tarentula, the Theridion, and the
Mygale, besides the Aranea, have taken their place in the
Materia Medica of Homœopathy.
Aranea diadema is of the genus "epeira:" it is the "cross
spider," "araignée a croix papale." Dr. Allen gives symptoms
obtained from it by two provers, and some more (from two
other provers) produced by the Aranea scinencia of Kentucky.
The former has been a good deal used in homoeopathic
practice for intermittents, to which it has been thought appro-
priate when the cold stage is the most pronounced. The
production, indeed, of coldness by spider bites, and the ten-
dency their symptoms show towards periodical recurrence, are
the facts which justify us in employing their venom in ague,
which their mere empirical repute would hardly have war-
ranted us in doing. Dr. von Grauvogl seized upon the
predominant chilliness of Aranea as indicating it in the subjects
of his "hydrogenoid " constitution, who are always deficient in
warmth as well as very susceptible to damp. He found it
beneficial in many affections occurring in such persons. Dr.
Chapman many years ago related a cure with it, in a very
nervous woman, of a nightly sensation as of the hands and arms
being enormously swollen, which had lasted for several years;
and von Grauvogl found a similar feeling indicative of it in
toothache.
Mygale. The venomous spiders of this genus are repre-
sented by the Mygale lasiodora of Cuba, and the Mygale
avicularia. Allen gives some symptoms of the bite of the
* Jan., 1876. See Brit. Journ. of Hom., xxxiv., 367.
SUPPLEMENTARY.
891
latter, and a few resulting from the tincture of the former.
M. avicularia has found some employment in chorea, but
it is inferior here to the next spider I shall mention, the
Tarentula. This is the creature whose bite developes the
peculiar nervous affections which music, in the measure called
Much
thereupon the tarentella, appears best able to remove.
doubt has been cast, in modern times, upon the reality of
this reputed disorder; but the records of Baglivi have been
substantiated by later observers of unquestionable qualifi-
cations. It is true that the dancing mania frequently epide-
mic during the middle ages in Italy was wrongly ascribed to
the bite of this spider, so that all "tarentism" is not "tarentu-
lism;" but that certain unique nervous phenomena do result
from the tarentula venom is indubitable.
-
*
Dr. Ozanam has devoted to this subject a considerable
portion of that Etude of his which I have already mentioned.
Homœopathic literature possesses also a monograph upon it
from the pen of the late Marquis Nuñez, the protagonist of
our method in Spain, whose translation into French by Dr.
Perry, of Paris, I have here. It contains an exhaustive account
of the history of tarentula-poisoning, and also the results of
a proving instituted by the author on ten male and five female
subjects. That the experiments were made with the third,
sixth, and twelfth attenuations is all the information we have
about them; and some of the symptoms are such that we
should like to have known a little more about their subjects
and circumstances. Dr. Perry has still further impaired the
value of the pathogenesis by interpolating a number of
"clinical symptoms" of his own observation; and these,
which in the French version are marked with his name,
appear without any distinguishing sign in the translation into
English contained in the twentieth volume of the North
American Journal of Homœopathy. From this Dr. Allen has
taken his symptoms,-with what misleading results may be
imagined. He also uses all Baglivi's cases, of which Dr.
Nuñez writes :-"in some, as in the first, it is unknown
whether the bite was given by a scorpion or by a tarentula ;
the third, fourth, and fifth are due to scorpions; the seventh,
copied from Epiphanio Fernando, is full of marvellous and
incredible details; and the eighth is insignificant, so that the
only ones which prove anything are the second and the
sixth."
For the pathogenesis of Tarentula, therefore, we had better
* The Spanish species of tarentula was used; but it appears that
this is of no less active character than its Apulian prototype.
892
SUPPLEMENTARY.
go at present no further than the effects of the introduction of
the venom, as certified by the best observers. These consist,
at first, of phenomena like those of serpent-bites and of bee-
stings. The affected part swells up, changes colour, and
becomes the seat of pain and itching: in the general system
is experienced depression, coldness, præcordial anxiety, and
vertigo. Instead, however, of going on to the local gangrene
and putrid infection of snake-bites, or proving only temporary
like the effects of the sting of the bee, the symptoms of taren-
tula-poisoning persist, but in the sphere of the nervous system
only. The prostration of strength and depression of spirits
increase, but with them there is an unappeasable restlessness:
the patient complains of neuralgiform pains in divers places:
respiration and circulation are embarrassed, and the muscles
are agitated with a convulsive trembling. Sexual excitement
is often present. The patients seem soothed by the sight of
bright colours, or by looking on smooth clear surfaces, as of
standing water; but music of the kind I have mentioned is
their great solace. Their bodies move in part or as a whole
to its measure, and they are often led to execute a kind of
dance. Under the excitement thus produced they may be
early cured; but otherwise their nervous system does not
ordinarily recover the shock it has received, and their malady
recurs from time to time, often at periodic intervals.
""
Dr. Ozanam perceived at once, from his study of the phe-
nomena of tarentulism, how many applications of the morbific
agent were possible, upon the homeopathic principle. Besides
the "rebellious intermittent fevers for which the other
arachnida are useful, he suggested its employment in hysteria,
hypochondriasis, chorea, satyriasis, nymphomania and other
affections. The cases given at the end of Dr. Nuñez's mono-
graph show that in several of these it has not disappointed
expectation; Dr. Jousset also commends it in chorea and con-
vulsive hysteria.
Theridion curassavicum. Under this name Dr. Hering has
introduced into medicine, and proved on himself and others,
the "orange-spider" found in the West Indian island of
Curaçoa and elsewhere. He has given its pathogenesis in his
volume of Materia Medica, including also all existing observa-
tions as to its therapeutic use. It seems to have cured the
anthrax of sheep, to which of course-like all venomous
biters-it is sufficiently homoeopathic. In the provers, it
caused a good deal of vertigo, with nausea even to vomiting;
also headache, preceded by flickering before the eyes. Dr.
Neidhard has reported the cure of some long-lasting sick
SUPPLEMENTARY.
893
headaches with it; and it seems suitable to true migraine.
The late Dr. Barlow esteemed it in infra-mammary pain,
and Dr. Baruch speaks warmly of it as an intermediate, but
deep-acting, remedy in scrofula.
All the spiders are prepared for medicinal use by trituration
after death, or in a tincture consisting of the alcohol in which
the living creature was drowned. The latter would seem the
best procedure when the symptoms for which the spider is
given are analogous to those excited by its bite.
Artemisia. In the first edition of my Pharmacodynamics I
had a short article upon the Artemisia vulgaris-the common
mug-wort. Our knowledge concerning it, I said, has been
mainly contributed by Burdach, and is to be found in Hempel
and the New Materia Medica. This shows that Artemisia
has a decided influence upon the nervous system, enabling it
to modify such disorders as epilepsy, chorea, somnambulism,
&c. It has had quite a reputation among the common
people as an anti-epileptic. The cases in which it is of most
value, according to Burdach, are those in which the paroxysms
recur several times daily. The curative effect is generally
accompanied by profuse and foetid perspirations. Burdach
considers it also quite a specific for the epileptiform convul-
sion of children, as those of dentition.
I mentioned there a great improvement which it had
wrought in my hands in a case of petit mal. This patient,
however, soon relapsed; and as Artemisia had never been
proved, and was not-so far as I knew-homeopathic to the
nervous disorders it seemed to benefit, I omitted it from the
second edition of my book, and have not since taken it up.
Quite a new light, however, has been thrown on the subject
by the observations made as to the effects of the excessive
use of absinthe, a drink prepared from another Artemisia, the
A. absinthium, wormwood. Besides general nervous dis-
turbances analogous to those induced by alcohol, the victims
of absinthe are liable to genuine epileptic attacks. A full
account of the phenomena is given in Allen's appendix from
a study of the subject by Dr. Challond, of Paris. This
observer writes as follows: The effects observed from
intoxication by absinthe are dependent upon disturbance of
motility: they are convulsive phenomena. The epilepsy of
absinthe developes itself in a relatively short time:
it
assumes at once and completely all the characteristics of that
disease.
Sometimes the epilepsy of absinthe is not
characterised by a complete attack, but has only vertigo or
894
SUPPLEMENTARY,
loss of consciousness,-symptoms which are found in true
epilepsy. ... Is the epilepsy of absinthe the effect of
come on.
acute or chronic intoxication? We believe that it is an acute
symptom manifested in the course of chronic intoxication,
found more often in those who drink to excess habitually;
its appearance is never delayed after the person has begun to
drink absinthe to excess. After drinking for six months or a
year, some day the person drinks to excess and the spasms
A circumstance of great importance is the
predisposition. We find a large number of drinkers who have
never had spasms, or only slight symptoms. There are
others, on the contrary, who are attacked at their first excess.
Dr. Voisin says that
the epilepsy of absinthe
is usually characterised by the very large number of attacks
in a very short space of time. I have reported a case of
epilepsy from absinthe in which there were from one hundred
and fifty to two hundred attacks in twenty-four hours."
These extracts are sufficient to show that the Artemisia
absinthium, at any rate, is a true epileptifacient. Let us
remember, then, that Cina is another variety of the same.
family the A. semen contra, and that both it and its educt
Santonine have caused convulsions when given in overdoses.
as worm-medicines; and we shall feel inclined to say that
whatever any Artemisia can accomplish in epilepsy is an
instance of homoeopathic action. To the value of the A.
vulgaris weighty testimony has lately been borne by Noth-
nagel;* and we may get better results still by using the more
potent A. absinthium.
The A. abrotanum has received a short proving from Dr.
Gatchell on two persons, whose results you may see in Allen's
first volume; but it does not appear to be possessed of any
great activity.
❤
Bufo is the common toad, the venomous character of the
secretion from whose cutaneous glands has led to its employ-
ment in medicine. It is not officinal in our Pharmacopoeia,
but Allen gives as its preparation, " trituration of the poison
from the cutaneous glands, obtained by irritating the animal."
His pathogenesis of Bufo is of little value, being made up
mainly of a few apocryphal ancient reports of toad-poisoning,
with the no less untrustworthy symptoms furnished by Houat.
Bufo also has obtained its reputation (such as it is) on the
ground of its alleged anti-epileptic virtues. Dr. Laville re-
ported some success with it at the Homœopathic Congress
* Ziemssen's Cyclopædia, xiv., 288.
SUPPLEMENTARY.
895
held at Bordeaux in 1854; and Drs. Andrien, Leydet and
Holcombe have confirmed his experience. You will find the
reports of the two latter physicians in the fourth volume of
the American Journal of Homœopathic Materia Medica (p. 139):
the former gave the medium dilutions, the latter the 200th. I
am not aware of any subsequent reports of the same kind;
nor have I myself ever tried the remedy. Dr. Hale says he
has done so without success.
Caladium seguinum. This is a plant of the Arum family,
and is a native of India. It is in domestic use there for de-
pressing the sexual passion; and Dr. Scholz, of Breslau, was
hereby led to employ it for pruritus vulvæ in which he found it
exercise a potent curative influence.* It has been proved in
the homoeopathic school by Hering and Schreter, and the
former found his genital organs considerably puffed and irri-
tated under its influence. It is in such conditions of the
pudenda of the other sex that we have chiefly used it, and I
can add my mite of confirmation to its value.
Carduus marianus. This plant, S. Mary's thistle, has a
great popular reputation in Germany for jaundice and other
bilious disturbances, and figures among Rademacher's "organ-
remedies as one acting on the liver. It has been proved by
Reil,† and he found it to cause distension of the whole abdo-
men, but especially in the right side, the whole hepatic region
being tender to pressure: the bile was deficient in the stools,
while its colouring matter was found by chemical tests to be
present in the urine. Carduus marianus is thus truly homœo-
pathic to hyperæmia hepatis and simple jaundice, in which-
and even in cirrhosis of the liver with dropsy-it has proved
curative in the hands of practitioners of our system.‡
The tincture is directed to be prepared from equal parts of
the root and seeds with the hull on. ·
در
Ceanothus Americanus is another organ-remedy; but the
seat of its influence is not the liver but the spleen. In the
third edition of his New Remedies Dr. Hale cited an old-
school testimony to its value in inflammation and enlargement
of this organ; and called attention to the statement made by
its employer that "in chronic cases, when the organ is no
* See Brit. Fourn. of Hom., xiii., 509; xxvii., 592; xxix., 400.
† Translated from the Vierteljahrschrift in N. Am. Fourn. of
Hom., iii., 379.
+ See Brit. Fourn. of Hom., xxiv., 667; xxxvi., 369; and Hale, sub
voce.
896
SUPPLEMENTARY.
longer tender, under the use of the tincture it soon becomes
painful and tender, and then sinks rapidly to its normal size."
This was sufficient to suggest its homoeopathicity, and led Dr.
Burnett to give it in some cases of splenic disease which hap-
pened to come under his notice, and with most satisfactory
results. He recommends it to be given whenever there is
complaint of deep-seated pain in the side, even when no ten-
derness or enlargement of the spleen can be made out; and
has found consentaneous affections, such as leucorrhoea, dis-
appear under its use with the pain itself.
Comocladia dentata. This is the "guao" of the West
Indies. It belongs to the natural order Anacardiacea; and
its effects on the skin closely resemble those of the Anacar-
dium orientale and of Rhus, but are more intense than either.
Dr. Navarro, of Cuba, describes deep hard-edged ulcers as
resulting from the local application of the juice; and he uses
the drug internally for similar conditions with success. Like
Anacardium, it has some repute in true leprosy. We may
not want it here, having its analogues at hand; but should
any of us find his sphere of practice in one of the West Indian
islands, he should bear it in mind. Dr. Allen gives a patho-
genesis of it derived from several provers and observers. The
tincture is prepared from the leaves and bark.
Equisetum hyemale. This remedy, like so many others,
comes to us from domestic practice, in which (in America) it
enjoys considerable repute as a remedy for urinary troubles.
Dr. Hugh M. Smith made it the subject of the thesis for his
degree at the New York Homoeopathic Medical College in
1876; and, proving it on himself and three others, found it a
decided irritant to the bladder. Its chief interest in our
practice, however, has arisen from the usefulness it has been
found to possess in that troublesome affection, the enuresis of
childhood. Here Dr. Carmichaelf and others have found it
most effective; and Dr. G. A. Heath, of Newark, records a
case of general paralysis in an old woman, in whom the con-
trol over the stools and urine, long completely lost, was
rapidly restored under its influence. A tincture or tritura-
tions are prepared from the whole plant, and the lowest
attenuations have been those employed.
f
* See Monthly Hom. Review, March, 1879; and Hom. World, Jan.
and March, 1880.
+ United States Med. Investigator, vol. iii., No. 2.
Hahn. Monthly, Sept., 1877.
SUPPLEMENTARY.
897
Eryngium. Of this we have provings of two species, E.
aquaticum and E. maritimum. Both seemed to depress the
sexual instinct and energy, so that the aphrodisiac virtues
popularly ascribed to the latter (the sea-holly) are probably to
be homoeopathically explained. E. aquaticum showed some
power of irritating the respiratory and urinary mucous mem-
branes, and has been found useful accordingly. Dr. Hale's
fifth edition contains some experience suggesting a power on
its part to dislodge urinary calculi. The root is the officinal
part.
Eucalyptus. The "blue gum-tree" of Australia, thus named,
has excited much interest of late by the anti-malarial pro-
perties it has displayed when planted in localities subject to
intermittents. It is supposed to act mainly by its great power
of draining the soil of moisture; but its balsamic exhalations
also are active in the same direction, and its internal adminis-
tration seems often to have proved effectual. It is also a
powerful deodoriser and disinfectant, acting in this capacity
even when given internally, as in malignant disease of the
stomach and gangrene of the lungs.
Of its physiological action little is generally known, save
that the essential oil it contains, eucalyptol, is somewhat
intoxicating. It has been heroically proved, however, by one
of our Australian practitioners, Dr. Fawcett. At his first
experiment it produced an herpetic eruption, glandular
enlargements, and the formation of foul indolent ulcers, with
intestinal irritation even to hæmorrhage. On a second occa-
sion he got rheumatic pains; and on a third the same erup-
tion, with swellings in different parts of the body, one of
which, under the right nipple, was of the size of a filbert, and
the seat of stabbing and darting pains. He also records the
case of a boy of 13, who ate largely of the gum and chewed
the leaves, and who came under treatment with nodular
swellings over the metacarpal and metatarsal joints, causing
much pain on movement.
Eucalyptus may thus one day find a place in homoeopathic
therapeutics. Dr. Woodbury, of Boston, speaks highly of it,
used locally as well as internally, in vascular tumours of the
female urethra. In two most obstinate cases, he says, a
perfect cure has been effected by this treatment without resort
to any surgical measures whatever.
Gnaphalium. This plant, the "everlasting" of common
nomenclature, has been proved in America in two forms, the
3 M
898
SUPPLEMENTARY.
G. polycephalum by Drs. Banks and Fuller, the G. uliginosum
by Dr. Woodbury. The first-named physician (who took the
1st and 2nd decimal triturations of the leaves and flowers)
suffered from marked neuralgic pains in both face and lower
extremities. In the former region the superior maxillary
nerve of both sides was affected, and the pains were inter-
mittent; in the latter, the seat of the suffering was the sciatic
(which side not stated), and the pain was accompanied by
cramps and sometimes replaced by numbness. This seems to
show that in Gnaphalium polycephalum we have a true
homoeopathic anti-neuralgic; and Dr. Banks and Dr. Woodbury
report each a cure of sciatica with it.
Grindelia. This is a genus of plants indigenous to Cali-
fornia; and we have learned of late years something about
two of its species, the G. robusta and the G. squarrosa. Both
are strongly resinous, and the usual action of such balsamic
substances may account for the virtues popularly ascribed to
G. robusta in chronic affections of the mucous membranes.
It appears to be especially beneficial in chronic bronchitic
asthma. A lotion of one part of the tincture to ten of water
is regarded by Dr. E. A. Gatchell as a sovereign application to
itching eruptions. The G. squarrosa was proved by Dr. J. H.
Bundy,* and produced acute pain, like that of rheumatic
inflammation, in the eyeballs, which were injected, and were
greatly distressed by movement. It also caused a sensation
as if the respiration would cease as soon as the prover fell
asleep, so that he had to rouse himself to avoid suffocation.
Dr. Hale justly remarks that such a symptom is not un-
common in chronic cardiac disease, and Dr .C. Wesselhoft
has reported a case of the kind in which the respiration was
greatly liberated by the remedy.
Guaco is one of the "lianas" of South America, and is in
much repute in its own country as an antidote to the bite of
venomous serpents. It is applied locally and taken internally.
The late Dr. Elb, of Dresden, was thus led to prove it,
thinking it would display on the healthy body symptoms
analogous to those of the snake-poisons. His results have
never been published. in full, but he gives some account of
them in an article on spinal diseases contained in the sixty-
first volume of the Allgemeine Homöopathische Zeitung. It
seems to have produced (in doses of from five to twenty drops
of the tincture) a good deal of burning and aching about the
* See Allen's Supplement, sub voce.
SUPPLEMENTARY.
899
}
spine, especially its upper part; and therewith some dysphagia,
constriction in the larynx, and heaviness with difficulty of
movement of the tongue. As the general condition was
rather excited than depressed, and he often had headache and
heat of the face, Dr. Elb inferred that the spine was in a state
of active hyperæmia. He was thus led to give Guaco in spinal
irritation occurring in robust and sanguine subjects, and found
it almost specifically helpful to them. Herein it evidently
resembles Naja. He also speaks highly of it to remove
paralysis of the tongue and even of the extremities resulting
from apoplectic effusion.
I have obtained this information from a communication
made by Dr. Dunham to the fourth edition of the New
Remedies, in whose "Symptomatology" it appears.
Guaraa is the "ball-wood" of the Antilles. It was proved
in 1854 by Dr. Petroz,* and from its effects on the eyes he
was led to give it in a severe case of conjunctivitis, with
chemosis, occurring after cataract extraction, in which it
proved rapidly curative. The remedy slumbered, however,
for a long time; and Allen does not even give its pathogenesis.
Dr. Claude, however, has recently disinterred his countryman's
discovery, and has recorded† several cases of the same kind
in which it did everything that could be desired. We must not
lose sight of it again. The presence of chemosis is the great
indication for it; and it has acted well in both the medium
and the lowest attenuations.
* Journal de la Soc. Gallicane, v., II.
†N. Engl. Med. Gaz., Dec., 1876; and L'Art Médical, May, 1879.
LECTURE LIX.
SUPPLEMENTARY.
We will resume to-day our supplementary list of medicines.
Gymnocladus Canadensis was introduced to us as far back
as 1851, in an article contributed by Dr. Hering to the first
volume of the North American Journal of Homœopathy, in
which he relates several provings. It has caused an erysipe-
latoid swelling of the head, inflamed throat with a purple
appearance of the right tonsil, and a violent cough (this last
symptom, contained in Dr. Sellers' report, is omitted by
Allen). The second of these effects has led to its only em-
ployment in homoeopathic medicine, viz: for sore-throats
with a bluish appearance or dark livid redness.
Hecla lava is, as its name imports, some of the matter which
has issued from the well-known volcano of Iceland. Analysis
shows it to consist of silica, alumina, lime and magnesia,
with some oxide of iron. It was observed that the animals
which fed in the pastures where the finer ashes of the moun-
tain fall suffered from immense exostoses on the jaw-bones;
and in some the cranial and other bones swelled and bulged
out Dr. Garth Wilkinson, becoming acquainted with these
results, saw the possibility of the lava becoming a homœo-
pathic remedy in some affections of the teeth and jaws. He
triturated some which he procured, and used it in toothache
and in swellings about the jaws, “with magical effect in several
cases; also in gum abscess from decayed teeth, and with ap-
parently good results in difficult teething." He communi-
cated his experience to Dr. Holcombe, who gave it (30th dil.)
with much benefit in neuralgic pains remaining after tooth
extraction, and in osteitis affecting the lower maxilla.
These facts were reported to the American Institute of
Homœopathy in 1870.* Since then, Dr. Gilchrist has got
good results from the remedy in exostosis and osteo-sarcoma,†
* See its Transactions for that year, p. 441.
† United States Med. Investigator, vol. ii., No. 1.
SUPPLEMENTARY.
901
and Dr. Scales in whitlow and gumboil,* while Dr. Helmuth
can speak of great relief to pain and arrest of growth as
occurring in three out of four cases of exostosis in which he
gave it. It is a promising medicine.
Iberis. This is the Iberis amara, the "bitter candytuft" of
our country, to which it is indigenous. Dr. Sylvester com-
municated to the South Eastern branch of the Provincial
Medical and Surgical Association, in 1847, his experience with
the seeds of this plant (which are the officinal portion), report-
ing it to be remarkably sedative to the heart's action, without
displaying the retarding influence characteristic of Digitalis.
Dr. Hale was thus led to prove it, and found three students
in his class who undertook to do so. A marked cardiac
action was displayed, showing itself in pain, palpitation, and
even irregularity and intermission of the pulsations, which
were sometimes weaker, but quite as often more forcible than
usual.
Some doubt rested for a time on the validity of these ex-
periments, as it was asserted that the provers were under
the influence of expectant attention: Dr. Samuel Jones, too,
found no effect from repeated and large doses in his own
person. Dr. Hale, however, utterly denies that the provers
were told of the drug's action on the heart; and Dr. E. A.
Gatchell, experimenting on frogs, found the plant to act very
much as Digitalis does, prolonging and intensifying the systole,
and retarding the circulation accordingly.§ Iberis should
therefore find a place in our treatment of cardiac maladies.
Jatropha. The seeds of the Jatropha curcas are very analo-
gous to those of the croton tiglium; and, like them, cause
serous vomiting and purging. Hering, Thorer, Lembke and
others have proved them, and their accidental ingestion has
occasionally caused poisonous symptoms, so that Allen can
give them a pathogenesis of 523 symptoms. Their effects
led to their employment in choleraic conditions, but they have
hardly taken place among the remedies for this state; and
they are only used in occasional cases of diarrhoea. Jatropha
seems indicated when the stool is preceded and followed by
much rumbling, and at times a noise as if a bottle were being
* N. Engl. Med. Gazette, June, 1876.
+ System of Surgery, p. 436.
I See United States Med. and Surg. Fourn., vol. vii.
§ N. Am. Fourn. of Hom., Feb., 1877.
902
SUPPLEMENTARY.
*
emptied; and also when the symptoms are ameliorated by
putting the hands into cold water.
Juglans. The walnut-Juglans regia-was proved many
years ago by Clotar Müller, in the form of a tincture of the
rind of the green fruit. He found it a specific cutaneous
irritant, developing itching eruptions of furuncular and ecze-
matous character, lasting a long time, and leaving the affected
part of bluish-red colour and swollen appearance. Dr. Sook,
of Ohio, U.S., who made a subsequent proving, was relieved
permanently thereby of a burning itching eruption on the
lower extremities, always beginning to annoy him as soon as
he undressed. The allied butter-nut-Juglans cinerea-has
been proved in America, where it is indigenous, and found to
exert a similar action upon the skin, for whose eruptions it
has long been in domestic repute. Dr. Hale cites a series of
cases showing its efficacy in eczema, impetigo and ecthyma;
and Dr. Burnett in this country reports† a similar experience,
calling it the "vegetable Arsenic." He has also found it both
cause and cure a suffocative post-sternal pain, occurring on
walking, and resembling in a mild way angina pectoris.
Lachnanthes tinctoria, the red-root, was proved by Dr.
Lippe (in the dilutions) nearly twenty years ago. It has,
however, come into little use, though it has been recommended
when one of its symptoms, "pain and stiffness in the neck,"
which may draw the head to one side, is present. Dr. Alabone,
of London, claims to have had striking success with it in
phthisis; and Dr. H. Nankivell, in the paper on the therapeutics
of this disease read before the British Homœopathic Congress
of 1879, reported‡ some favourable experience with it in
cases of the second and third stages, even when the amount
of lung destruction has been considerable, but where the
destructive process is for the time arrested, and the evening
temperature is not over 100 or thereabouts." He gave the
mother-tincture, from 3 to 5 drops three times a day.
(<
Lapis albus. This name was given by the late Dr. von
Grauvogl to a kind of gneiss found near the celebrated Gastein
springs. When on a visit to that place, he tells us, he observed
that the inhabitants of the valley of the Ache, who drank the
water of that torrent as it rushes through its bed of gneiss,
* See Allen's S. 279.
+ Monthly Hom. Review, xxii., 205
‡ Ibid, xxiii., 680.
SUPPLEMENTARY.
903
are much affected with goitre. He drank the water himself,
and his thyroid gland swelled. Dr. Bellows, of Boston, had
previously maintained that the prevalence of bronchocele in
Derbyshire is due to the presence of a similar gneiss in the
drinking-water, and he describes it as a silico-fluoride of
calcium.* Von Grauvogl, however, made a further observa-
tion, which was that the thermal waters which rise from the
depths of the gneiss hill acted unfavourably in malignant
growths and ulcerations; and this led him to prove the gneiss
itself. He triturated and diluted it up to the 6th decimal,
which he gave to several men and women. The symptoms
most frequently observed were burning and shooting pains
in the cardia and pylorus, in the mammæ, and in the uterus.
He administered it in a case where a cancerous ulcer of the
cheek, in a woman of 50, had made an opening as large as
half-a-crown, and rendered chewing and talking difficult. The
hole filled up and healed, the woman's complexion at the
same time exchanging its yellowish and cachectic appearance
for the hue of health. He thereupon gave it in uterine
scirrhus, and reports five cases as completely and permanently
cured by it. He also found it extremely beneficial in scrofu-
lous ulcers, in diseases of the lymphatic glands, and in adenoid
tumours growing in places where no glandular structure is
normally found.†
This experience has hardly been confirmed by others; but
its source should prevent its being despised.
Melilotus. This is the sweet clover (M. officinalis), and
might be supposed a very harmless flower. The tincture, how-
ever, is found to cause in sensitive people a very severe head-
ache, which may be accompanied with determination of blood
to the head and even with epistaxis. It has been found
markedly beneficial in nervous headaches and conditions of
cerebral oppression-one great advantage of it being that it
acts so rapidly that five minutes have hardly elapsed ere its
beneficial effects are experienced. I value it much in nervous
headaches, and always carry it in my pocket-case, in the form
of the mother-tincture, which I administer by olfaction.
Mentha piperita. The peppermint is not used in our prac-
* See also Dr. Pease, in United States Med. Investigator, vol. i.,
No. 3.
+ See Allg. Hom. Zeitung, June 15, 1874.
See United States Med. Investigator, viii., 156; Bibl. Hom., ix.,
29.
904
SUPPLEMENTARY.
tice as a " carminative," but it should be more largely employed
than it is in coughs. Dr. Demoures reported to the fourth
volume of the Journal de la Société Gallicane some symptoms
observed upon himself after taking one drop of the mother-
tincture, and among them was a very persistent dry irritative
cough, excited by drawing the least cold air into the larynx,
by reading aloud, by tobacco-smoke, or smoke of any kind.
He further says of it-"It is to dry cough, however caused,
what Arnica is to injuries, and Aconite to inflammatory com-
plaints. It relieves even the cough of consumption. A single
dose (one globule of the 30th) was always sufficient whenever
there was dry cough; however long it might have lasted, I
could safely promise a cure in twenty-four hours, provided
the affection corresponded with that caused by this agent."
Mentha piperita seems an analogue of Rumex crispus in
its relation to cough.
Myrica cerifera is the bayberry. It is in extensive use
among the herbalists, and is reputed by them a detergent to
the mucous membranes. It has been well proved in the
school of Hahnemann, by seven members of the Massachu-
setts Homœopathic Society on the one hand, and by Dr. G.
S. Walker on the other. The former set of provers did not
elicit much from it; but Dr. Walker, who pushed it rather
more boldly, had on two occasions a decided attack of jaundice
from its use.* There was "bronze-yellow skin, fulness of the
hepatic region and abdomen; scanty, yellow, frothy urine;
loose, mushy, clay-coloured stools, destitute of bile; much de-
bility, and drowsiness almost amounting to stupor." This
jaundice resisted Podophyllum, Leptandra, Nux vomica and
Mercurius, but yielded promptly to Digitalis; which would
suggest that it arose from catarrh of the bile-duct. Dr. Sharp,
wishing to see if in small doses the effect would be opposite
to that produced by large, got a friend to take a drop of the
first dilution night and morning for a week. During this time,
he reports, his bowels were rather more active than usual, and
the colour of the excreta much lighter, ie., of a lighter and
brighter yellow than usual.† This reminds us of Chamomilla;
and suggests Myrica in icteric conditions similar to those
for which that remedy is suitable.
Nitri spiritus dulcis. This is the Latin form of the common
name ("sweet spirits of nitre") of the Spiritus ætheris nitrosi
* Hale, New Remedies, second edition.
† Monthly Hom. Review, xx., 748.
SUPPLEMENTARY.
905
of the Pharmacopoeia. Its interest in homoeopathic practice
is derived from a recommendation of it made by Hahnemann
in his paper on the treatment of the fever of 1814, to which
I have already more than once referred. "There sometimes,"
he writes there, "occurs a third state, a sort of a lethargy of the
internal sensorium commune, a kind of half paralysis of the
mental organs. The patient remains indolently lying, without
sleeping or speaking; he scarcely answers whatever we may
do to induce him to do so, he appears to hear without under-
standing what is said, or without allowing it to make any
impression upon him (the few words he says are whispered
but not irrelevant); he appears to feel almost nothing, and to
be almost immovable, and yet not quite paralysed. In this
case a remedy is useful that previously used to be employed
in large doses for purposes not very clearly defined; I mean
the sweet spirits of nitre. It must be so old, that is to say, so
thoroughly sweetened that it no longer reddens the cork of
the bottles. One drop of this is to be shaken up with an
ounce of water, and given by teaspoonfuls to be consumed
in the twenty-four hours. In the course of a few days this
state passes into health and activity.'
>>*
The medicine has been proved by Lembke, as you may read
in Allen; who also gives effects of the inhalation of nitrous
æther vapour. The late Dr. Liedbeck esteemed it highly as
an antidote to the ill-effects of the excessive employment of
salt.
Palladium. This rare metal was proved by Dr. Hering in
1850. Thirteen persons took part in his experiments, and the
third trituration of the precipitated metal was employed. A
full account of the proving, and of all that is known about the
substance, is given by the venerable author in the North
American Journal of Homeopathy for November, 1878. The
alliance with Platina suggested by the natural history of Pal-
ladium came out manifestly in its proving; and Dr. Hering
suggested its trial in cases where Platina seemed to be indi-
cated, but did not cure on account of its non-accordance with
the mental symptoms. This advice has several times been
acted on with success, especially in ovarian affections on the
right side. Now that (for the first time) we have the full
pathogenesis, we may make a larger use of the inetal.
Piper methysticum. Under this its botanical name, the
"kava-kava" of the Tahitian islands has been introduced into
* Lesser Writings, p. 715.
906
SUPPLEMENTARY.
homoeopathic practice by our Californian colleagues,-three of
whom-Drs. Griswold, Hiller, and Wolff-have proved it on
their own persons, with results which you may read in Allen.
It has inebriating and aphrodisiac properties, for which it is
used by the Pacific islanders: in the provers these were mani-
fested in much dreaming, often of amorous nature, and in
erethistic headache, with sense of fulness and enlargement. It
also contains an oleo-resin, which acts upon the mucous
membranes like the terebinthinates; so that it has been used
to some extent for gonorrhoea and gleet, as you may read in
the fifth edition of Dr. Hale's book. Dr. Griswold has found
two characteristics of its pains to be, “amelioration for a time
from diverting the attention" and "restless desire to change
the position." Guided by these features, both he and Dr.
Skinner† have given it with much advantage to relieve neu-
ralgia and colic. The mother-tincture has generally been
*
used.
Plantago. This is the common plantain-the "Plantago
major" of Linnæus. Its virtues as an application to wounds
and inflamed surfaces have been known from of old, and
homoeopathic practitioners have often used it for this purpose.
Dr. Humphreys, of New York, published a monograph upon
it in 1861, containing provings by eleven observers; many
symptoms have also been observed from it on his own person
by one of our London chemists, Mr. Heath, of Ebury Street.
All these you will find in Allen.
Plantago had (and has still in Switzerland) much repute as a
local remedy for toothache, the root or leaves being put into
the ear of the affected side. As it caused much pain in the
teeth and jaws among its provers, it has been used in homoeo-
pathic practice as an internal remedy for odontalgia. Dr.
Reutlinger says that with the 2x dilution of this medicine he
cures seven-tenths of all cases of this kind in about fifteen
minutes; and Dr. Humphreys confirms the statement. Dr.
Hale was at first inclined to doubt its efficacy, but acknow-
ledges himself now obliged to admit its value, saying that of
all homœopathic remedies for toothache, none can compare
with the Plantago. I can say the same.
Some practitioners have found it useful in enuresis noc-
turna. It seems indicated here by the co-existence of diuresis,
which is in a marked manner caused by it.
Prunus spinosa. An extensive list of symptoms, purporting
* Hale, New Remedies, 5th ed. p. 58. † The Organon, i., 298.
SUPPLEMENTARY.
907
to be a pathogenesis of this plant,' was furnished by Wahle to
the fourteenth volume of the Archiv. There is the usual lack
of information as to how the symptoms were obtained; and
Wahle is one of Hahnemann's disciples who has followed the
later rather than the earlier manner of the master in their
collection. I would not advise you to build much upon his
pathogenesis; but may tell you that two of its eye-symptoms
have led to a very useful application of the medicine. They
are-" A sharp pain beginning in the right side of the fore-
head, shooting like lightning through the brain and coming
out at the occiput," and "Pain in the right eyeball, as if the
inner portion of the eye would be torn out." On these Drs.
Allen and Norton remark: "as a remedy for ciliary neuralgia,
whether originating from some diseased condition of the eye
or not, there are few if any drugs more often called for than
Prunus. The pains to which Prunus is adapted are especially
found in disorders of the internal structures of the eye, there-
fore it has been given in many of these cases and with marked
benefit." They enumerate sclerotico-choroiditis posterior,
chorio-retinitis, irido-choroiditis and irido-cyclitis among those
deep-seated ocular inflammations which it has benefited. It
not only relieves the pains, but checks the inflammation and
clears the vision.
Senna is known in old-school therapeutics as a tolerably
active purgative, influencing mainly the small intestines,
and causing a good deal of colic in its operation. It may
thus be homoeopathically administered in some forms of
diarrhoea. Its chief value for us, however, resides in the
changes it induces in the urine, in which Martins ascertained
that it always causes an increase in the amount of urea,
chloride of sodium, earthy phosphates and urates, so that the
specific gravity of the secretion is increased.* Dr. Drysdale
has told us how to turn this action of the drug to good account,
by recording a case of oxaluria with excess of urea (the
specific gravity of the urine being 10359), the stools also being
diarrhoeic, in which Senna 4, four drops twice a day, brought
about rapid amendment.†
Sticta pulmonaria, the "lung-wort," is, as its name imports,
in much repute for chest complaints. The few provings it
has received did not develope any catarrhal or pulmonary
symptoms; and I can find nothing to warrant Dr. Hale's
* Brit. Fourn. of Hom., xvii., 555.
† Ibid, xxv., 657.
908
SUPPLEMENTARY.
statement that "it was found to cause severe coryza with
violent sneezing." Equally baseless seems his statement
that these imaginary attacks "were preceded or followed by
rheumatic pains and swellings of the small joints." Dr. Bur-
dick, from whose experiences this picture appears to be
drawn, had merely such pain and fulness in the ethmoid cells
as might accompany coryza, and sharp dartings in many of
the muscles and joints. However, there is no doubt of its
being curative in hay-fever and influenza, and in harassing
coughs accompanying these and allied disorders. It has also
given rather rapid relief in acute but non-febrile rheumatism,
which in one of the cases reported seems to have attacked the
diaphragm. Dr. E. C. Price, of Baltimore, esteems it very
highly in acute bursitis, as of the knee.*
The first and second decimal dilutions have been employed.
Stillingia sylvatica is a native of the Southern States of
America; and has some reputation as an "alterative" in
syphilis, scrofula, and similar morbid diathetic states. It has
been proved by several persons, but naturally has hardly
elicited conditions answering to those it is able to benefit.
Dr. Hale regards it as a periosteal remedy, like Phytolacca
and Mezereum : he also esteems it in the cutaneous manifes-
tations of syphilis. He reports a case of secondary nodes,
with severe dolores osteocopi, in which striking benefit followed
from its use. "It had a wonderful, and I might almost say in-
stantaneous effect. The patient has slept well ever since he
had it The immense nodes have gone from the head and
legs; and from the most deplorably down-hearted (sometimes
almost raving), miserable, thin-looking object, he is changed
into a buoyant, joking, rotund-looking fellow."
In the New England Medical Gazette for October, 1877, Dr.
Hale has some remarks on the value of Stillingia in scrofula,
which he has not transferred to the fifth edition of his New
Remedies. He gives the following as a group of symptoms
which, in the first to the third dilution, it is pretty safe to
cure:" Enlarged cervical glands; moist, brownish, excoria-
ting eruptions on the scalp; muco-purulent discharge from
the nose, with excoriation of the upper lip and alæ nasi ; a dull,
pasty complexion; capricious and unnatural appetite; tumid
and enlarged abdomen; white, pasty stools, very foetid; dull
red, soft, tubercular eruptions on the skin, ulcerating, and fur-
nishing a large quantity of unhealthy pus; a tendency to
laryngeal cough.
})
* See Hom. Times, July, 1875; United States Med. Investigator,
Jan. 1, 1878.
SUPPLEMENTARY.
909
Symphytum is another plant which carries its reputation in
its name. It was considered to promote the "growing to-
gether" of broken bones; and Homœopathy, here as in so
many similar instances conserving the ancient traditions, has
applied it for this purpose, and with eminently satisfactory
results. It had hardly received any other use, however, till Dr.
Cate, of Salem, U.S., conceiving that the action on bone thus
displayed should not stand alone, gave it in a case of psoas
abscess from disease of the vertebræ, and in another of inflam-
mation of the inferior maxillary bone. In both instances a
complete cure followed the steady administration of the
second and third dilutions of the remedy.* Dr. Gerstel has
since reported a rapid cure of traumatic periostitis with it.†
Titanium. The rare metal thus named was proved on
himself in 1856 by Dr. Sharp, two grains of the first tritura-
tion being taken every day for a week. "I became," he says,
"greatly disordered, and felt and looked wretchedly ill."
Among other symptoms he experienced he mentions giddi-
ness and vertical hemiopia. He gives one case, and refers to
others, of general derangement of the system, with loss of
strength and flesh, in which he has given smaller doses of
the same potency with curative results. It seems to promote
sanguification.
}}
Trillium, generally employed as trillin, a "concentrated
preparation" made from the root of the Trillium pendulum, is
in much favour among the American "eclectics as a hæmo-
static. It has not been proved; but Drs. Hale and Peterson's
experience with it (as given by the former) in uterine hæmor-
rhage shows it effective in such small doses that we must
suppose it to act homoeopathically. We must remember it
when Hamamelis and Millefolium fail us.
gh
Vinca minor. This is the lesser periwinkle,-the plant so
named, I mean; not the mollusc. We use a tincture pre-
pared from the whole plant, which has been proved upon four
persons in doses of from 20 to 60 drops, with little effect.
"Excessive menstruation," however, is noted; and in my
hands the medicine has four times availed to check passive
uterine hæmorrhage occurring in women long past their cli-
* New England Med. Gazette, Oct., 1876; see also Brit. Fourn.
of Hom., xxxiv., 378.
† Ibid, xxxvi, 101.
‡ Essays in Medicine, p. 394.
910
SUPPLEMENTARY.
macteric. In three of these cases, indeed, the flow afterwards
returned, and proved to have been the initial symptom of car-
cinoma; but the effect of the medicine was not less real for
the time. I used the first decimal dilution. Vinca is said to
be useful in such cutaneous affections as crusta lactea, and even
to have cured the plica Polonica.
-
Viscum album. This plant-the familiar mistletoe-appears
likely to find a place in therapeutics. Some cases of Dr.
Huber's showing its virtue in several affections, especially
rheumatism, sciatica, and metrorrhagia, were translated in the
twenty-second volume of the British Journal of Homœopathy.
Then Dr. Laville communicated some facts about it in rela-
tion to epilepsy, for which it has an old reputation.* He
obtained two products from it,--an alkaloid which he
calls viscine, and a resin. Two grains of the latter placed
on the tongue of a large rabbit caused a violent fit of epilepsy,
which lasted more than half an hour. He finds it of great
value in the treatment of this disease in the lower animals,
especially in herbivora. In the twelfth volume of the Monthly
Homœopathic Review we have communications from Drs.
Wilde and Belcher, showing the mistletoe to have a high and
deserved repute among the common people in this country
for the cure of chorea. A short pathogenesis of Viscum is
given by Allen; but it deserves further proving and testing.
And now my remarks must end. Dr. Hale, our indefatig-
able purveyor of "new remedies," presents in his fifth edition
many more which may yet be noteworthy. Such are the
bromide of camphor, which he some time ago recommended in
cholera infantum, and which has lately been reported† as very
effective therein; the Cornus florida, which seems a true ague-
remedy, and the Cornus circinata, which is valuable in aphthous
mouths; the Corydalis formosa, which acts in secondary
syphilis like Stillingia; Cypripedium and Scutellaria, which
are "nervines" of some energy; Erechthites and Erigeron,
possessing hæmostatic properties, and the latter relieving
tympanites like Terebinthina; the Geranium maculatum,
which causes ineffectual desire for stool, like Nux, and dis-
orders the ocular accommodation like Conium; Gossypium,
which acts on the female sexual organs; Myositis and
Silphium, which seem good in bronchorrhoea; Populus tremu-
loides, a vesical irritant, and beneficial in tenesmus of the neck
* See an account of his book in Brit. Fourn. of Hom., xxv., 673.
† Amer. Observer, April, 1880.
SUPPLEMENTARY.
911
of the bladder; Robinia, which has caused and cured gastric
acidity; Triosteum, which seems not undeserving of its name
"fever wort";* Ustilago maidis, which is to maize what ergot
is to rye, and has a similar influence on the uterus, controlling
passive hæmorrhage therefrom; and the Viburnum opulus,
which is a really valuable remedy for spasmodic dysmen-
orrhoea. For these, however, I must refer you to his book:
my own list of medicines, primary and supplementary, has
come to its close.
One remark only I will make in conclusion. It is now often
admitted that there are some uses of medicines which seem
consonant with the "homoeopathic hypothesis," and that
some of the remedies which have been arrived at by its em-
ployment are really useful agents. But it is always assumed
that such instances constitute a small minority of the curative
applications of drugs, and in no way warrant the adoption of
the principle as a general method of treatment. Well; we
have now considered together every important constituent of
the Materia Medica. I have sought to bring before you as
fully as possible the ascertained facts of the physiological and
therapeutical action of each, and impartially to discuss the
connection of the two. You will bear me out, I think, when I
say that the result has been that nineteen-twentieths of the
direct curative actions of drugs manifestly appear to be
homœopathic in respect of modus operandi, and either have
been or might have been arrived at by the application of the
rule, "let likes be treated by likes." I venture to affirm that
no other result can come of a fair survey of the facts of the
case, conducted with this object in view. This is our position,
and here we take our stand. Our opponents must meet us
on the field of Materia Medica if they wish to convince us;
and I think you will agree with me that they must retire,
either vanquished or themselves convinced.
I have now merely to thank you for your attention, and to
bid you farewell.
* See Transactions of N. York Hom. Med. Society, viii.,
53.
APPENDIX.
HAHNEMANN'S DOSAGE.*
In the discussions about dose which from time to time arise in the
school of Hahnemann, the practice of the master is frequently cited by
either side, and statements made on the point by one party are fre-
quently contradicted by the other, so that the, would-be learner is left in
confusion. It has seemed to me that it would be a useful contribution
to the controversy if a chronological account were given-taken from
the original documents-of all that Hahnemann wrote on this subject
from his first promulgation of the homeopathic method until his death.
I am not unmindful of the valuable materials brought together by Dr.
Dudgeon in relation to Hahnemann's dosage in his Lectures on
Homœopathy. But at the time of their publication it is obvious that
my esteemed colleague had not at his command several of the most
important sources of information on this score :-I refer to the first
edition of the Reine Arzneimittellehre and the Chronischen Krank-
heiten, and the second edition of the first and second volumes of the
former work. With these now before me, I am able to fill up certain
gaps in his statement, and to present a complete account of the facts.
1796-1798.
It was in 1796 that, in his essay entitled "A new principle for as-
certaining the curative power of drugs, with a few glances at those
hitherto employed," Hahneman first propounded the homœopathic
method. In this paper he several times speaks of" small doses” as
being necessary when similarly-acting medicines are given, the context
showing (and, indeed, sometimes stating) that he means doses too
small to produce the physiological effects of the drugs. That such
smallness did not, in the case of most medicines, mean their use in even
fractional quantities, appears from his recorded practice during the next
two years. In 1797 we find him reporting a case of colic in which he
gave Veratrum album in four-grain doses, and another of asthma
treated by Nux vomica in the same quantities. In 1798 he relates a
series of cases of continued and remittent fevers occurring in that year,
in which he gave a few grains of Arnica root," Ignatia in doses of
two or three grains to children from seven to twelve, from one-fifth to
half a grain of Opium, thirty to forty grains of Camphor, six to seven
grains of Ledum. In another paper "On some periodical and hebdo-
madal diseases," appearing in the same year, he speaks of giving
eight grains of Ignatia and half-drachm and drachm doses of Cinchona.
(C
* Reprinted from the British Journal of Homœopathy for April, 1878.
3 N
914
APPENDIX.
1799.
To this year belongs the introduction, sudden and without explana-
tion, of what are now known as infinitesimal doses. In a pamphlet
"On the cure and prevention of Scarlet Fever," published in 1801,
Hahnemann relates his treatment of an epidemic of this disease com-
mencing in the summer of 1799. He mentions the use of four medi-
cines only-Ipecacuanha, Opium, Belladonna, and Chamomilla, and
speaks of all as given in quantities of a minuteness hitherto unknown
in medical practice. His tincture of Ipecacuanha was to contain one
part of the drug in two thousand of alcohol; of this from one to ten
drops were to be taken, according to the age of the patient. Opium
was so diluted that a drop should represent only the five-millionth of a
grain, and children below four were to have even this dose broken up.
Belladonna was given in a dose of the 432,000th part of a grain of the
extract; and for prophylactic purposes a solution was made contain-
ing only a twenty-four millionth part of a grain of the same, of which
from one to forty drops, according to age, were to be taken every third
day. The tincture of Chamomilla was to contain the 800,000th part of
a grain of the dry extract, of which one, two, or more drops were to be
given.
1801.
In the second part of Hufeland's Journal for this year Hahnemann
answers the question aroused by his pamphlet-What effect can these
minute doses of Belladonna have? I am not now concerned with his
defence of them; I have only to note that he speaks several times of the
effects of a millionth part of the ordinary dose, and says,—“ Those who
are satisfied with these general hints will believe me when I assert, that
I have removed various paralytic affections by employing for some weeks
a quantity of diluted solution of Belladonna, where for the whole treat-
ment not quite a hundred-thousandth part of a grain of the extract was
required; and that I have cured some periodical nervous diseases,
tendency to boils, &c., by not quite a millionth of a grain for the whole
treatment."
1806.
Hahnemann says nothing more upon the subject of dose (not even in
his Fragmenta de viribus medicamentorum positivis, published in
1805) until his essay on "The Medicine of Experience," which ap-
peared in Hufeland's Journal in 1806. Nor, indeed, does he advance
here beyond the point he seems to have reached in 1799-1801. He
speaks of the smallest possible dose" sufficing, of its being of little
or no importance how small the dose is; but whenever he comes to par-
ticulars, he mentions only the hundredths, thousandths, and millionths
of an ordinary dose with which we are already familiar.
1809.
I find no further mention of dose (beyond such general statements
about smallness as those cited above) until we come to 1809. In a paper
APPENDIX.
915
..
))*
entitled "Observations on the three current methods of treatment,"
published in Hufeland's Journal of that year, we meet with a para-
graph stating that in certain so-called "bilious conditions a single
drop of the tincture of arnica-root will often remove, in the course of a
couple of hours, all the fever, all the bilious taste, all the tormina; the
tongue becomes clean, and the strength is restored before night. But
in another communication belonging to the same year we find that in
the case of two potent poisons Hahnemann had come to attenuate much
farther than three years back. For a fever which had prevailed for a
twelvemonth past in Germany, and which he describes in the Allg.
Anzeiger der Deutschen for 1809, he names as remedies Nux vomica
and Arsenicum, according to the symptoms, recommending the
former to be given in doses of a trillionth, the latter in those of a sex-
tillionth of a grain, i.e. in the 9th and 18th dilutions respectively.
1810.
In this year appeared the first edition of the Organon; and we na-
turally expect to find in that section of it devoted to the subject of dose
some more detailed exposition of Hahnemann's views upon the point
than had as yet been vouchsafed. Little is said, however, beyond what
we have already seen in the "Medicine of Experience.' In a note to
§ 247, he writes:-"When I speak of the dose employed in homoeo-
$
pathic practice being the smallest possible, I cannot, on account of the
difference in the power of medicines, give a table of the right measure
and weight of the medicines."
""
1814.
In 1814, in an article "On the treatment of the typhus or hospital fever
at present prevailing" (it was the time of the uprising of Germany
against Napoleon which followed his retreat from Russia), we have
further insight into Hahnemann's posology. The medicines he re-
commends, according to the symptoms, are Bryonia, Rhus, and
Hyoscyamus. The first two are to be given in the twelfth dilution, and
the third in the eighth, of a scale different from the centesimal, in that
six drachms instead of a hundred drops of alcohol are to be used at
each advance in attenuation. This would (as Dr. Dudgeon says†)
make the 12th dilution correspond to something between our 15th and
16th, and the 8th to our 10th. Sweet spirit of nitre is also directed to
be given under certain circumstances, and a drop of it is to be shaken
up with an ounce of water, the mixture to be consumed by teaspoonfuls
in the course of the twenty-four hours.
1816.
This year is an important epoch in the history of Hahnemann's
dosage, or at least in our knowledge of it. In the first volume of the
Reine Arzneimittellehre, published in 1811, he had not said a word,
in his prefatory remarks to the several pathogeneses, as to the doses of
* Lesser Writings, translated by Dudgeon, p. 599.
+ Lectures, p. 401.
916
APPENDIX.
the medicines he thought most suitable to be given. We thus know
nothing of his views at that time regarding the dosage of Belladonna,
Dulcamara, Cina, Cannabis, Cocculus, Nux vomica, Opium, Moschus,
Oleander, Mercurius, Aconite, and Arnica. Now, however, this
reserve is abandoned; and in the second volume (published in 1816)
and its successors, nearly every medicine is given its appropriate dose.
In that now before us we find the following recommendations:-
Of Causticum a drop of the original preparation is to be given for a
dose.
Arsenicum is to be administered in the 12th, 18th, or 30th dilution,
preferably the last.
Of Ferrum the 10th, 10th, or 50th of a grain is mentioned as
appropriate.
Ignatia is recommended in the 9th or 12th potency; and
Rheum, in acute affections, in the 9th.
As to Pulsatilla, Rhus, and Bryonia, very similar directions are given.
If the patient be robust, aud his malady of some standing, a drop of
the pure juice will be an appropriate dose. But in delicate subjects
and acute affections attenuations are to be given-the 12th being
specified for the first medicine, the 12th or 15th for the second, the 18th
for the third.
These views are well illustrated by the two celebrated cases published
at this time by Hahnemann as examples of homoeopathic treatment,
and which are given in the preface to the present volume. The first
was one of gastralgia, with water-brash, of three weeks' standing, occur-
ring in a robust woman otherwise in good health. She received a drop
of the juice of the root of Bryonia. The second was one of spoiled
stomach, which had existed five days, and whose subject was a weakly
and delicate man. His remedy was half a drop of the twelfth dilution
of Pulsatilla. Both these cases were treated towards the end of 1815.
From the same preface, moreover, we learn that Hahnemann had
now adopted the centesimal scale of attenuation,-great care being
taken (in which later homoeopathic pharmacy has not followed him) to
make each potency what it professes to be. Dry plants are to be
treated with twenty parts of alcohol, and each drop of this tincture to
be reckoned as containing a twentieth part of medicinal power
(Arzneikraft) in making the dilutions. Correspondingly, the tinctures
prepared from fresh plants by mixing their expressed juice with equal
parts of spirit are to be considered as of half-strength, so that two
drops are to be added to 98 of alcohol to make the first centesimal
dilution.
1817.
This year brings us a third volume of the Reine Arzneimittellehre,
and in it we find the following recommendations as to dose.
China is to be given in the 12th dilution,
Asarum in the 12th or 15th,
Ipecacuanha in the 3rd,
Scilla in the 15th or 18th,
Stramonium in the 9th,
Veratrum in the 12th.
Nothing is said on this score as to Chamomilla and Helleborus. In
the preface Hahnemann speaks of a drop of the thirtieth dilution of
Arsenicum as being sometimes "altogether too large a dose."
APPENDIX.
917
1818.
A fourth volume of the R.A.M.L. now appears, containing twelve
medicines. The following are the statements and recommendations
about dose to be found in it.
Of Hyoscyamus, it is said in the preface to the medicine, that a dose
which contains the trillionth part of a drop of the juice (i.e. of the 9th
dilution) is more than sufficient for homœopathic purposes; and in a
note to one of the symptoms, suggesting its use in hydrophobia, and
warning against giving it in too large doses, the 12th, 15th, and 18th
dilutions are mentioned as most suitable.
Digitalis is recommended, with the qualification as to "often more
than enough," in the 15th dilution.
About Aurum he gives no definite advice, but speaks of using the
first and and second triturations of gold-leaf (this mode of preparation
is now introduced for the first time), and the 15th and 18th dilutions of
the muriate.
Of Guaiacum a drop of the mother-tincture is said to be a full dose.
Camphor is to be given in drop doses of the primary solution, which
is in the proportion of one part in eight.
Ledum is recommended in the 15th dilution;
Ruta in a dilution containing one part of the juice in 100,000, ¿.e.
what we should now call the 5th decimal;
Sarsaparilla in drop doses of the mother-tincture;
Sulphur, Hepar Sulphuris and Argentum in grain doses of the second
trituration.
1819.
This year gives us several expressions of Hahnemann's views on the
subject of dose.
1. The fifth volume of his Materia Medica Pura bears its date.
In this we find him making the following recommendations:-
Of Euphrasia, Menyanthes, and Sambucus, "the smallest part of a
drop of the juice" is mentioned as a sufficient dose.
Cyclamen is to be administered in the same proportion of the third
dilution.
Of Calcarea acetica a drop of the saturated solution is advised;
Of Muriatic acid, the smallest part of a drop of the thousand-fold
dilution, .c. our 3rd decimal;
Of Thuja a similar quantity of the 30th.
A single drop of the juice of Taraxacum is to be given,
A small part of a drop of Phosphoric acid in the second dilution ;
Of Spigelia and Stapĥisagria the smallest part of a drop of the 30th.
2. In this year was published the second edition of the Organon.
The paragraphs on the subject of dose are very differently worded from
the corresponding ones in the first edition, and are identical with those
of the fifth, which we all have in our hands. In a note to one of them
Hahnemann refers to the prefaces to the several medicines in his Reine
Arzneimitiellehre for the appropriate dilution of each, but says that
further experience has shown that it is better to go still "lower than
the doses there indicated. By "lower" he evidently means what we
understand by "higher.'
>>
3. In the same year we have a short communication to a popular
918
APPENDIX.
journal "On uncharitableness towards suicides," in which he states
that "this most unnatural of all human purposes, this disorder of the
mind that renders them aweary of life, might always with certainty be
cured if the medicinal powers of pure gold for the cure of this sad con-
dition were known." For this purpose he recommends an attenuation
to the billionth degree, i.e., the sixth potency. In the previous year he
had spoken of effecting cures by using altogether from three to nine
grains of the first trituration.
1821.
In this year was published the sixth and last volume of the first
edition of the Reine Arzneimittellehre. The phrase "the smallest
part of a drop," which we have so often encountered in the fifth volume,
is now constantly used, and seems to imply the regular employment of
globules as the form of administration. Understanding this, I may
briefly state Hahnemann's recommendations as to the suitable dilutions
of each medicine.
Of Angustura he mentions the 6th ;
Of Manganum aceticum the 24th;
Of Capsicum the 9th ;
Of Colocynth the 18th and 21st.
Of Verbascum the pure juice is to be given;
Of Spongia the mother-tincture for goitre; for other purposes higher
attenuations (the range not specified);
Of Drosera the 9th dilution;
Of Bismuth the 2nd trituration;
Of Stannum the 6th.
In a note to one of the symptoms of Cicuta Hahnemann speaks of
giving a small part of a drop of the juice for a dose in impetigo.
In the same year Aconite and Coffea are recommended as the
remedies for "
purpura miliaris.”
The former is to be given in the
24th, the latter in the 3rd dilution.
1822.
Hahnemann now began to issue a second edition of his Materia
Medica Pura, the first volume appearing in the present year. As in
the corresponding volume of the first edition nothing was said about
dose, I must limit myself to stating the dilutions now mentioned.
Of Belladonna the 30th is recommended;
Of Dulcamara the 24th;
Of Cina the 9th;
Of Cannabis the pure juice;
Of Cocculus the 12th;
Of Nux vomica the 30th ;
Of Opium the 6th ;
Of Moschus the 3rd decimal (1000 facher);
Of Oleander the 6th;
Of Mercurius solubilis the 12th (trituration);
Of Mercurius corrosivus the 15th;
Of Aconite the 24th;
Of Arnica the 6th.
APPENDIX.
919
""
The phrase "small or "smallest part of a drop" is used for each
of these, save that of Mercurius solubilis "a grain or less" is to be
given.
1824.
The second volume of this edition, appearing in 1824, can have its
recommendations as to dose compared with its fellow in the former
issue. Making such comparison,`accordingly, we find that the only
material change which has occurred relates to Rhus and Bryonia. Of
Pulsatilla it is still allowed to give a drop of the pure juice in a suitable
case; but of the two other drugs, about which formerly the same direction
was given, it is now said that the juice is never required, the 30th dilu-
tion answering equally well for all cases. Arsenicum, Ferrum, Ignatia,
and Rheum are to be given as in 1816; and of Causticum the original
solution is still prescribed, in doses of "a drop or less."
1825.
Two volumes-the third and fourth-of the second edition of the
Reine Arzneimittellehre appeared during this year. In the third the
recommendations as to China, Asarum, Ipecacuanha, Scilla, Stramo-
nium, and Veratrum remain unchanged; and the twelfth is for the first
In the fourth
time specified as the appropriate dilution for Chamomilla.
the doses of Guaiacum, Camphor, Ledum, Ruta, Sarsaparilla, Sulphur
and Argentum remain as they were in the first edition. Hyoscyamus is
raised from the 9th to the 12th dilution; and in the note about hydro-
phobia the 24th and 30th are substituted for the 12th, 15th, and 18th, as
the most appropriate potencies. Of Digitalis the 30th is said to be
still better than the 15th; and of Aurum he states that he now gives
the 12th dilution instead of the 1st and 2nd triturations. Hepar
sulphuris is raised from the 2nd to the 3rd.
1826.
In the fifth volume, published in this year, the only changes which
occur are as to Muriatic and Phosphoric acids. Ths former is now to
be given in a millionfache" instead of a "tausendfache" solution,
i.e., in the 3rd potency; the latter in the 9th attenuation instead of, as
hitherto, in the second.
There also occurs, in this volume, one of the few notices given by
Hahnemann of those potencies above the 30th which afterwards played
so large a part in homœopathic posology. He says that, in sycosic
gonorrhoea, he finds Thuja more potent in the 60th than in the 30th
dilution. It would seem, however, that he did not attach much impor-
tance to this observation, as subsequently, in both editions of the
Chronischen Krankheiten, the appropriate dose for Thuja in sycosis
is said to be the 30th.
1827.
-
In the sixth volume, Angustura, Capsicum, Verbascum and Bismuth
920
APPENDIX.
remain as they were in respect of dose. Manganum is raised to the
30th, Colocynth to the 24th or 30th, and Drosera also to the latter point.
Cicuta, of whose dosage in Hahnemann's hands the only trace hitherto
was his use of the pure juice in a case mentioned, is now recom-
mended in the 30th; and this dilution is specified as the one most
appropriate for Spongia in all affections save goitre. On the other
hand, Ambra, Carbo animalis and Carbo vegetabilis-here introduced
for the first time-are all to be given in a small part of a grain of the
third trituration; and of Stannum he says that he has hitherto used the
6th, but now finds the 3rd to answer every purpose. We shall see
directly that this last exhibits his usual practice somewhere about this
time with all drugs prepared by trituration and given in chronic
disease.
1828.
This year brings us a very important addition to our knowledge of
Hahnemann's posology at the time which we have reached. It is
the first edition of the Chronischen Krankheiten, of which the first
three volumes now appeared. I will give all the statements about dose
which they contain.
In the introductory essay, speaking of the "antipsoric" medicines
generally, he says that he began by giving a small portion of a grain
of the 2nd or 3rd trituration (by which process all then recognized were
prepared); but that later, feeling this to be an uncertain quantity, he
prepared and used the subsequent attenuations. In accordance with
this statement we find him mentioning in a note cases of itch which he
had treated with half-grain doses of the third trituration of Carbo
vegetabilis and Sepia respectively. In speaking of the treatment of
the three miasmatic diseases he describes, he recommends-for sycosis,
Thuja 30 and Nitric acid 6; for syphilis, Mercurius solubilis 6; and for
recent itch, three globules saturated with a tincture made by treating
five grains of Sulphur with a hundred drops of alcohol. If a second
dose is required, he advises the 6th dilution to be used, as prepared in
the usual way; and if Carbo animalis or vegetabilis should be required,
they are to be given in the 12th. Recommending Antimonium
crudum where a spoiled stomach was annoying the patient, he mentions
the 6th potency as appropriate; and in a letter dated April, 1829, we
find him using the medicine at this strength in certain intermittent
fevers.*
In the prefaces to the several medicines the following recommen-
dations are made as to dose:
For Ammonium carbonicum and Baryta carbonica the 18th is said to
be most suitable;
For Calcarea carbonica, Graphites, and Lycopodium the potencies
from the 18th to the 30th.
For Iodium the 30th.
Of Magnesia carbonica he says that he has long employed the 12th,
but now prefers the 24th and 30th.
For Magnesia muriatica he mentions the 6th as the most generally
suitable, but says that we may at times go with advantage to the 12th
and 18th.
Natrum carbonicum he at first employed in an aqueous solution to
the 3rd degree: but now recommends the 12th potency prepared from
the third trituration.
See Brit. Fourn. of Hom., xi., 64.
APPENDIX.
921
Nitric acid, as an antipsoric, should be given in the dilutions from the
18th to the 30th ;
Petroleum in the 18th;
Phosphorus and Sepia in the 30th ;
Silica and Zincum from the 18th to the 30th.
1829-1843.
We have now tracked Hahnemann through the whole course of his
posology from 1796 to 1828. We have seen him diligently following his
experience in whatever direction it led him, on the whole advancing
from lower to higher attenuations, but never hesitating (as in the case
of Stannum) to take the opposite step when the facts seemed to require
it. We have found him recognising throughout the great difference
between medicines as regards their dose, so that his latest instructions
fix this for one and the other at all points of the scale of dilution from
the mother-tincture to the 30th. All has hitherto shown life and
But at
progress, and the history is worthy of our best attention.
the point we have now reached a chilling blast sweeps over the scene,
and stiffens it to a rigid and monotonous blankness. At some time
in the course of 1829 Hahnemann determined to fix the dose of all
medicines indiscriminately at the 30th dilution. The thing was done
solely, as he himself says, for the sake of uniformity. The "medicine
of experience" had nothing to say to it, for we are told in the fifth
edition of the Organon, published in 1833, that it "holds good, and will
continue to hold good, as a homoeopathic therapeutic maxim, not to be
refuted by any experience in the world, that the best dose of the pro-
perly selected remedy is always the very smallest one in one of the high
dynamisations (x)," which last is his sign for the 30th. Accordingly,
in the fourth volume of the first edition of the Chronischen Krank-
heiten (1830), in the first and second of the third edition of the Reine
Arzneimittellehre (1830-3), and throughout the second edition of the
later work (1835-39), every medicine whose pathogenesis is given is
directed to be employed in the 30th dilution.
Not that Hahnemann himself rigidly observed the uniformity he in-
culcated. Without laying any stress on the cases which Dr. Dudgeon
has cited, as treated by him in 1842-3, where the language is obscure;
or on the contents of his pocket-case found after death, in which all
dilutions from the 3rd to the 30th were present, it is sufficient to refer to
the second edition of the Chronic Diseases. In the introductory essay
thereto (1835) Nitric acid is still recommended for sycosis in the 6th;
and in the preface to the third part (1837) he states that if, after the
30th potency has exhausted its action, the medicine is still indicated,
it should be given in a lower potency, suggesting the 24th. At the
end of this preface he speaks of giving, where the same medicine had
to be continued several days, a dose daily each time in a lower degree
of potency. On the other hand, there are indications of a tendency to
look beyond the limit of the 30th; for we read in the Organon of 1833
The higher we carry the attenuations accompanied by dynamisation,
with so much the more rapid and penetrating action does the prepar-
ation seem to affect the vital force and to alter the health, with but
slight diminution of strength even when this operation is carried very
far--in place, as is usual (and generally sufficient) to X, when it is
carried up to XX, L, C, and higher; only that then the action always
922
APPENDIX.
appears to last a shorter time." By these figures he meant what we
should call the 60th, 150th, and 300th potencies. In the preface to the
fifth volume (1839) he speaks of "obtaining, even in the fiftieth potency,
medicines of the most penetrating efficacy;" and von Bönninghausen
tell us, that in his last years he not uncommonly employed the both.
On the basis of this survey of the facts of the case it is not unfair to
argue that the truest disciples of Hahnemann in the matter of dose are
those who follow him as he was in the years from 1796 to 1828, rather
than those who count the 30th itself a low potency, and dwell habitually
in an exalted region far above that which the master but looked into
and himself but seldom entered.
ALPHABETICAL
LIST OF
TREATED OF IN THIS MANUAL,
N.B.-The different types indicate the relative importance of the medicines, and
may afford useful hints as to order of study.
Abies nigra
Acalypha
Acidum benzoicum
Acidum carbolicum
Acidum fluoricum..
Acidum hydrocyanicum
Acidum muriaticum..
ACIDUM NITRICUM
Acidum oxalicum
ACIDUM PHOSPHORICUM
Acidum picricum
Acidum salicylicum
Acidum sulphuricum
ACONITUM
•
Actea racemosa
Esculus Hippocastanum
Ethusa cynapium
Agaricus muscarius..
Agnus castus..
Ailanthus
Allium Cepa
Allium sativum
Aloes
Alumen
Alumina
Ambra
.
•
•
..
•
•
Ammoniacum
Ammonium carbonicum
Ammonium muriaticum
Amyl nitrosum
Anacardium
Angustura vera
Antimonium crudum..
ANTIMONIUM TARTARICUM
APIS..
•
PAGE
888
889
107
IIO
I12
113
120
124
129
132
136
140
144
147
167
170
173
175
179
180
HH
184
184
186
THE MEDICINES
187
188
∞k
889
189
191
192
194
196
198
200
212
Apocynum cannabinum
Apomorphia..
Aralia racemosa
Aranea diadema
Baptisia..
183 Baryta acetica
Argentum metallicum..
Argentum nitricum..
ARNICA..
ARSENICUM
Arsenicum iodatum
Artemisia
Arum maculatum.
Arum triphyllum
Asafoetida
Asarum..
Asclepias..
Asterias rubens
Atropia..
AURUM
• ·
··
Baryta carbonica
Baryta iodata..
Baryta muriatica
BELLADONNA..
Berberis..
Bismuthum
Borax
Bovista..
Bromium
BRYONIA
Bufo..
Cactus
Caladium
•
•
•
:
•
•
·
•
:
•
·
PAGE
210
712
889
890
220
220
228
235
262
893
264
264
265
267
267
268
306
269
273
282
281
283
283
283
308
309
311
312
314
323
894
336
895
924
LIST OF MEDICINES.
Calcarea acetica..
Calcarea arsenica..
CALCAREA CARBONICA
Calcarea caustica..
Calcarea chlorata..
Calcarea fluorata..
Calcarea iodata
Calcarea phosphorica..
Calcarea muriatica
Calcarea sulphurica
Calendula
Camphora..
Cannabis Indica..
Cannabis sativa
Cantharis
Capsicum
Carbon sulphuratum
Carbo animalis
Caulophyllum
Causticum
Ceanothus
Cedron
CARBO VEGETABILIS
Carduus marianus..
CHAMOMILLA
Chelidonium..
Chimaphila
Chininum
Chloral
Chlorum
Cicuta
Cina
•
CINCHONA
Cinchoninum..
•
Cistus Canadensis
Clematis..
•
•
Coca
Cocculus Indicus.
Coccus cacti
Codeia
Coffea
Colchicum
Collinsonia
Colocynth
Comocladia
Conium
Copaiba
Corallium rubrum
Crocus
Crotalus..
Croton
•
•
·
Cundurango
CUPRUM..
Curare
Cyclamen
•
• •
•
:
•
•
•
•
•
•
•
•
••
•
•
•
•
•
•
•
•
•
•
•
•
•
..
PAGE
340
341
341
346
387
346
346
346
347
348
349
350
357
355
359
365
367
368
369
895
371
372
895
376
378
382
384
409
385
386
421
425
429
431
896
434
439
442
443
595
444
445
447
DIGITALIS
Dioscorea
Drosera.
Dulcamara
453
454
Gambogia
Gelsemium
Glonoin..
Gnaphalium
GRAPHITES
Gratiola
Grindelia
Guaco
Guaiacum
Guaræa
Elaps corallinus
Elaterium
Equisetum
Eryngium
Eucalyptus
Eupatorium perfoliatum
Eupatorium purpureum
Euphorbium
Euphrasia
FERRUM..
•
388
389
394
413
413
414
416 Hyoscyamus
Hypericum
417
420
711 Iberis
··
··
Gymnocladus..
•
•
IGNATIA
Indigo
IODUM
IPECACUANHA
Iris versicolor
Faborandi
Jatropha..
•
•
•
Hamamelis
Hecla lava
Helleborus niger
Helonias dioica
HEPAR SULPHURIS
Hydrastis
Hydrocotyle
•
··
•
Juglans cinerea
Juglans regia
··
•
·
•
KALI BICHROMICUM
Kali bromatum
Kali carbonicum..
Kali chloricum
•
•
:
•
•
•
❤
·
•
•
•
•
:
•
··
:
•
•
·
•
•
•
•
•
:
··
•
•
..
PAGE
457
455
468
471
608
475
896
897
897
476
477
478
479
481
488
488
494
898
499
501
898
898
503
899
900
505
900
509
511
514
520
525
526
532
901
534
533
537
563
559
57I
901
902
902
574
317
580
582
LIST OF MEDICINES.
925
Kali cyanatum
Kali iodatum
Kali muriaticum
Kali nitricum
Kali permanganicum
Kali phosphoricum
Kali sulphuricum
Kalmia
Kreosotum
LACHESIS
Lachnanthes ..
Lactuca virosa
Lapis albus
Laurocerasus..
Ledum palustre
Leptandra
Lilium tigrinum
Lithium carbonicum
Lobelia inflata
•
LYCOPODIUM
Lycopus Virginicus
• •
Magnesia carbonica
Magnesia muriatica
Manganum
Melilotus
Mentha piperita
Menyanthes
MERCURIUS
Mercurius biniodatus
Mercurius corrosivus
Mercurius cyanatus
Mercurius iodatus
•
Murex purpurea
Muscaria
Mygale
Myrica cerifera
• •
··
Nux moschata
NUX VOMICA
Nitri spiritus dulcis
Nitrum
Nuphar luteum
•
:
•
•
::
Mercurius oxidatus ruber
Mercurius sulphuratus..
Mezereum
Millefolium
Morphia..
Moschus.
•
•
►
•
Naja
Natrum carbonicum
Natrum chloratum
Natrum muriaticum..
Natrum sulphuricum
•
•
•
·
·
•
•
•
•
•
•
•
•
•
PAGE
119
537
582
585
ал
586
582
582
588
589
595
902
592
902
120
609
611
612
613
614
617
622
665
666
667
903
903
668
624
662
656
660
662
663
663
669
672
711
673
674
178
890
904
595
675
387
676
680
904
585
681
695
682
Enanthe crocata..
Oleander..
Oleum jecoris aselli
OPIUM
Origanum
Osmium
..
Pæonia
Palladium
Paris quadrifolia
Petroleum
Petroselinum
Phellandrium..
PHOSPHORUS
Physostigma..
Phytolacca
Piper methysticum
Plantago major
Platina..
PLUMBUM
Podophyllum
Prunus spinosa
PULSATILLA
Sabadilla
Sabina
RHUS
Rumex crispus
Ruta
..
Ranunculus bulbosus
Ranunculus sceleratus
Ratanhia
Rheum
Rhododendron
Sambucus
Sanguinaria
Santonine
Sarracenia
Sarsaparilla
Scilla
Secale cornutum
..
Selenium..
Senecio
Senega
Senna
SEPIA
SILICA
Spigelia..
Spongia..
Stannum
Staphisagria
Sticta
Stillingia….
Stramonium
• •
• •
·
•
..
•
·
•
·
•
•
··
•
•
•
•
•
❤
•
·
::
PAGR
696
697
558
698
712
713
714
905
714
715
716
716
726
717
721
905
906
759
748
761
907
765
774
774
776
777
777
779
787
788
791
792
793
795
391
796
797
798
799
803
804
805
907
807
814
822
825
828
831
907
908
9∞
833
926
LIST OF MEDICINES.
Strychnia
SULPHUR
Symphytum
Tabacum
Taraxacum
Tarentula
Tellurium
Terebinthina
Teucrium
Theridion'
Thuja
Titanium
Trillium
Uranium
..
··
•
:
··
··
•
··
PAGE
693
837
909
850
853
891
854
855
859
892
859
909
909
866
Urtica `..
Uva ursi..
Valeriana..
VERATRUM ALBUM
Veratrum viride..
Verbascum
Vinca minor
Viola odorata.
Viola tricolor..
Viscum album
Xanthoxylum
Zincum
•
··
•
•
•
• O
:
:
·
•
PAGE
869
870
870
872
876
878
909
879
879
910
880
881
ABSCESS (See Suppuration).
ACIDITY.
Acid. sulph.
Arg. nit.
Calc. c.
Robin.
ACNE.
Hep. s.
Hydrocot.
K. brom.
K. iod.
Sulph.
ADENITIS.
Bell.
Brom.
Carb. an.
Cistus
Iod.
Merc.
Phyt.
AFTER-PAINS.
Act. rac.
Caul.
Cham.
Gels.
Secal.
Xanth.
AGALACTIA.
Asaf.
Calc. c.
Puls.
Urt.
AGUE.
.....
...
…….
•
Acid. phos.
Amm. mur.
Apis
Aran. diad.
Ars.
Caps.
Cedron
Chinin.
……
……………
……………
Ign.
Ipec.
Natr. m.
··
Cina
***
Eup. perf.
Eup. purp.
....
Nux v.
...
Puls.
Ver. alb.
CLINICAL INDEX.
...
..
PAGE
144
224
343
910
518
526
320
556
100
844
306
315
369
414
551
647
714
169
372
379
49I
802
850
266
345
772
869
135
192
219
890
240, 243
356
377
397
391
476
477
537
569
677
692
772
875
ALBUMINURIA.
Acid. phos.
Bell.
Sil.
....
ALCOHOLISM.
Nux v.......
Zinc.
ALOPECIA.
Acid. fluor.
Ars.
AMAUROSIS.
Bell.
Phos.
Plumb.
...
ANEMIA.
...
AMBLYOPIA.
....
Nux. v. (alcoholic) ..
Sant.
AMENORRHOEA.
··
(See Menstru-
tion, defective.)
Helon.
ANESTHESIA.
ANEURISM.
Acon. (dolorosa)
Cann. Ind.
Bar. mur.
K. iod.
Lycopod.
..
...
•
...
Acid. picr. (sub-oxidation)... 138
Ars. (pernicious)
260
Calc. ph. (nutritive)……….
Ferr........
....
.....
ANGER, EFFECTS OF.
Cham.
ANGINA FAUCium, Acute.
Acon.
Apis (œdematous)
Bar. carb. (tonsillar)
Bell.
Gymnocl.
Merc.
Naja
Phyt.
...
•
Arum (
··
throat.")
....
"
....
..
.....
PAGE
ANGINA FAUCIUM, CHRONIC.
Acid. oxal.
Æscul.
Alumina
Arn. ("clergyman's sore-
)............
134
302
821
688
883
113
251
302
747
757
692
392
347
481
512
161
359
283
557
622
380
151, 154
214
281
298
900
651
601
722
129
172
187
230
265
928
CLINICAL INDEX.
Cinnab.
Ign.
K. bich.
Cupr.
Naja
Spig.
Lach.
....
Phyt.
ANGINA PECTORIS.
Acid, hyd.
Ars.
Graph.
Ratanh.
APHONIA.
ANUS, FISSURE of.
Acid. nit.
Spong.
APHTHÆ.
Ars.
Borax
K. chlor.
Merc.
APOPLEXY.
Acon.
Bell.
Nux v.
Op.
ARTHRALGIA.
Arg.
Zinc.
Acid. oxal.
Caust.
Gels. (catamenial)
••
...
Ars.
Bell.
•
··
•
Cupr.
Grind.
…………
....
ASCARIDES. (See Helminthiasis.)
ASCITES.
Apoc.
ASTHENOPIA.
Act. rac. (effects of.) ......
Crocus
Natr. mur. (muscular).
Ruta
ASTHMA.
Acid. hyd.
Acon.
...
....
....
....
Sulph.
ATHEROMA.
Phos.
ATHETOSIS.
Strychn.
AZOTURIA.
Caust.
Senna
...
··
Ipec.
Lob.
Nux v.........
Samb.
...
……………
***
...
……
...
••
..
··
PAGF
664
536
►
577
601
725
117
254
449
602
824
157, 161
292
688
709
125
500
776
132
324
491
827
248
311
583
649
220
S84
210
170
444
680
789
117
11 2
158
253
289
449
898
568
615
691
794
847
744
694
375
907
BACK-ACIE.
Kali carb......
BALANITIS.
Merc.
Thuja
BLADDER, IRRITABLE.
Apis
Bell.
……………
..
Copaib. (in women)
Eup. purp.(,,
Ferr. (diurnally)
Nux v.
BLADDER, PARALYSIS OF.
Canth.
Secal.
BLEPHARITIS.
Clem.
…………………
BOILS.
Graph.
Hep. s.
Merc.
Merc. ox. rub.
Puls.
·
...
Staph.
BLEPHAROSPASM.
Agar.
Codeia
Physost.
Puls.
Gels.
Glon.
••
...
...
··
BRAIN, ANÆMIA OF.
Zinc.
BRAIN, ATROPHY OF.
Zinc.
BRAIN, CONGESTION OF.
Ast. rub.
Bell.
Bry.
Cupr.
Ferr.
•
Bell.
Calc. mur. (locally).
Sulph. (to prevent recurrence)
………………
...
...
Phos.
BRAIN-FAG.
..
Nux v.
Op.
Sulph.
Ver. vir.
BRAIN, PARALYSIS OF.
Zinc.
BRAIN, SOFTENING OF.
....
...
...
)……………….
Acid. picr. (of meat. aud.)... 140
Arn.
233
………
....
Acid. phos.
Athus.
Anac.
Calc. ph.
Sil.
...
•
PAGE
581
653
865
218
303
440
477
486
691
363
803
416
500
518
654
663
770
833
177
711
731
770
299
347
844
885
883
268
292
330
45I
485
492
497
688
718
849
877
883
732
133
175
195
347
818
CLINICAL INDEX.
929
BRIGHT'S DISEASE.
Apis
Ars.
Dig.
Ferr.
Merc. corr.
Plumb.
Tereb.
BRONCHIECTASIS.
Stann.
BRONCHITIS.
Amm. carb.
Ant. tart.
Ars.
Bry.
Calc. iod.
Carb. v.
Hep. s.
Ipec.
K. bich.
Lach.
Lycopod.
Merc.
Phos.
Puls.
··
BUBO.
...
BURNS.
....
Seneg.
Solan.
Sulph.
BRONCHORRHŒA.
Acid. benz.
Sil.
Stann.
Acid nit.
Carb. an.
Canth.
Rhus
Urt.
BURSITIS.
..
..
...
....
....
...
....
………….
CACHEXIA, MALARIAL.
Ars.
Natr. mur.
Sulph.
CÆCUM, INFLAMMATION Of.
Lach.
CALCULI, PASSING OF.
Berb.
Calc. c.
Chin.
Nux v.
CANCER.
Ars.
Ars. iod.
··
Calc. c.
Carb. an.
Con.
Cundurango
PAGE
..
218
255
466
486
659
756
857
831
180
206
250
333
346
371
519
568
578
602
621
653
739
769
805
474
847
Sil. (housemaid's knee) ...... 819
Sticta
908
109
816
831
126
369
361
781
869
244
678
848
607
308
344
408
69I
261
262
344
369
438
446
Hydrast.
Phos.
Sil.
Thuj.
CANCRUM ORIS.
Ars.
...
K. chlor.
Merc.
CARBUNCLE.
Bell.
Bry.
Lach.
··
Sil.
CARDIALGIA. (See Gastralgia).
CARIES.
Acid. fluor.
Acid phos.
Asaf.
Aur.
Merc.
Phos.
Sil.
CATARACT.
Caust.
Colch.
...
...
··
...
Con. (traum.)
Magn. carb.
Sant.
Sil.
CATARRH, CHRONIC NASAL.
Amm. brom.
Hydrast.
K. carb.
...
Merc. iod.
Puls.
Sabad.
Sang.
Sep.
CHOLERA Asiatica.
Acon.
Æthus.
Elat.
Iris
CHOLERINE.
Acon.
Ars.
Camph.
Cupr.
Phos.
Secal.
Ver. alb.
•
•
..
...
CHOLERA INFANTUM.
.
·
Bry.
Camph. brom.
Euphorb. cor.
CHOLERA NOSTRAS.
Ipec.
CATALEPSY.
Cann. I.
....
100
…………….
...
……….
··
…………
..
**
PAGE
522
745
821
863
248
256
584
650
299
334
605
816
II2
135
266
271
654
736
817
376
429
438
666
392
819
322
521
581
663
769
792
796
813
157
244
351
450
737
802
873
157
174
332
910
475
450
500
566
359
30
930
CLINICAL INDEX,
CHANCRE.
Acid nit. (soft)
Ars. (phag.)
Merc. (soft)
Merc. corr. (phag.)
CHILBLAINS.
Agar.
Petr.
CHLOROSIS.
Arg. nit.
Ars.
Ferr.
Helon.
Plumb.
CHOREA.
...
...
Act. rac.
Agar.
Ars.
Coca.
Cupr.
Hyosc.
Mygale
Stram.
Tarent.
...
CLAVUS.
CHYLURIA.
Ver. vir.
Zinc.
CHOROIDITIS.
Bry.
Gels.
Ign.
Nux v.
Puls.
COLIC.
....
50
Ipec.
Merc. corr.
Sant.
•
··
Acid phos.
Uva ursi
··
Bell.
Cham.
Cina
Cocc.
Coloc.
Diosc.
Nux v.
Plumb.
Stann.
•U
•,
DIGI
Ver. alb.
CONCUSSIONS.
Arn,
•
………….
.....
CLIMACTERIC, SUFFERINGS OF.
...
………1
..
...
·
...
•
PAGE
……………
126
250
653
659
178
716
226
260
481
512
757
169
193
Act. rac. (mental state)
Amyl nit. (flushings)
Glon. (cerebral symptoms)... 497
Lach. (flushings)
Sang. (
Sep. (congestions)
Valer. (hysteria)
603
""
168
177
259
420
450
530
891
836
892
877
883
335
492
570
659
392
134
870
536
688
772
796
810
871
305
379, 381
391
418
433
455
690
750
830
873
229
78
9
CONDYLOMA.
Acid. nit. ....
Thuja
CONJUNCTIVITIS.
Ars.
Chloral
Euphr.
Guaræa (chemosis)
CONSTIPATION.
Acid. nit.
Alumina
...
Bry.
Caust.
Collins.
Graph.
Hydrast.
Iris
...
··
•
…………
……………
....
Lycopod.
Magn. mur.
Natr. mur.
Nux v........
Op.
Plat.
Plumb.
Sep.
Sulph.
Ver. alb.
CONTUSIONS.
Arn.
CONVULSIONS.
·
·
·· ...
...
Acon. (puerperal)
Æthus. (infantile)
Bell. (puerp. and infant.)
Cupr. (in pertussis)
Glon. (puerperal)……..
Ign. (spinal)...
K. brom.
All. Cepa (fluent)
Ars. (influenzal)
Camph. (incipient)
Euphr. (fluent)
Iod. (
""
Ipec.
K. bich. (
K. iod. (
Merc.
""
Nux v. (dry)....
Samb. (,,)
""
""
...
""
..
•
··
…………………
·
....
....
……..
""
…………
...
00
535
317
En. croc. (puerp. and inf.)... 697
Stram. (,,
)... 836
Zinc. (infantile)
883
CORNEA, AFFECTIONS OF.
Apis (inflammation)………….
Ars. (ulceration)
Aur. (inflammation)
Cann. s. (opacity)
Euphr. (,,
,,)
Hep. s. (suppuration).
K. bich. (opacity)
Coryza.
...
•
··
...
...
……….
OATIA
PAGE
•
126
862
249
386
489
899
127
187
331
376
429
501
522
561
619
666
677
690
707
760
750
810
845
875
229
157
174
239
449
498
217
249
272
356
480
518
578
183
249
353
479
553
566
578
553
653
691
794
CLINICAL INDEX.
931
COUGH.
Acid. nit.
...
All. sat.
Alumina (dry)
Ambra (nervous)
Ant. tart.
Bell.
Bism. ("stomach ").
...
Brom. (laryngeal).
Bry.
Caps. ("throat ")...
Caust. (laryngeal)
Con. (dry night-cough)
Corall. (spasmodic)
Crotal. (phthisical)
Dros. (spasmodic)
Hep. s. (hoarse)
Hyosc. (dry night-cough)
Ipec.
Lach.
...
CRAMPS.
...
CROUP.
•
Acon.
Cupr.
Plumb.
...
Bry.
Hep. s.
Iod.
Lact.
Lob.
Menth. pip. (dry).
Merc.
Naja (phthisical)
Nux. v.
Phos.
Puls.
Rumex (dry).....
Samb.
Scill.
Seneg. (irritative)…….
Spong. (laryngeal)
Verb. (hoarse)
Viol. od. (with dyspnoea)......
CYSTITIS.
...
Ipec.
K. bich.
Sang.
Spong.
...
..
....
....
Acon.
Ant. tart. (catarrhal)
Brom.
··
...
...
CRUSTA LACTEA.
Dulc.
Viol. tric.
Vinca m.
·
Canth.
Chimaph.
Dulc.
..
Puls.
Uva ursi
I
··
•
***
··
…….
•
…….
··
D
PAGE
127
184
187
189
207
305
310
315
332
366
375
438
442
607
469
519
530
568
601
594
615
904
653
607
691
740
769
788
794
799
805
827
898
879
158
449
754
154
207
315
333
518
554
568
577
795
826
472
880
910
362
385
472
769
870
DEAFNESS.
Acid. sal. (with tinnitus)....
Chinin. (
Dig.
Graph.
Mang. (
Petr. (
DEBILITY.
Iod. (Eustachian)………….
....
··
DENGUE.
Acid. phos. (nervous)
Anac.
Agar....
Ant. tart.
Hyosc.
Nux v.
Op.
Stram.
DEMENTIA.
Anac.
•
Carb. v.
China (from drain)
Curare (nervous)
Helon.
DIABETES.
""
....
""
...
··
Eup. perf.
Rhus ven.
Ver. alb. (circulatory)……………………
DELIRIUM.
Bell.
Hyosc.
DELIRIUM TREMENS.
....
...
Ant. cr.
Apis
Apoc. c.
Arg. nit.
Ars.
Bism.
..
Bry.
Calc. a.
Camph.
)
""
………
Acid. fluor.
Acid. phos.
Acid. sul.
Aloes
..
99
•
)..
)..
DENTITION, troubles of.
Bell.
Cham.
Kreos.
Acid. phos.
Sil.
Uran.
DIABETES INSIPIDUS.
""
..
…………•
··
Bry. (rheumatism)
Cact. g. (spasm)
Sticta (rheumatism)…...
DIARRHEA.
Polyuria.)
DIAPHRAGM, AFFECTIONS OF.
Act. rac. (myalgia)
}
..
..
)......
• ··
..
(See
PAGE
144
410
465
500
553
668
716
133
195
370
396
453
512
874
291
528
178
209
529
688
708
835
195
476
784
305
380
591
134
821
866
169
328
338
908
II2
135
145
185
199
217
211
224
249
310
332
341
353
932
CLINICAL INDEX.
Chin.
Colch.
Croton
Cupr.
Dulc.
Gamb.
Iod.
Ipec.
Magn. c.
Merc.
Nuphar
Nux v.
Petr.
Phos.
Pod.
Puls.
Rheum
Rhus
Rumex
Sulph.
Ver. alb.
DIPHTHERIA.
Acid. carbol.
Acid. mur.
Apis
Brom.
Calc. chlor.
Canth.
Guaiac.
...
..
……
Acon.
Apis
Helleb.
Scilla
Tereb.
...
...
…….
•
....
•••
••
...
...
………….
……….
Hep. s.
Iod.
K. bich.
K. permang.
Lach.
Merc. cyan. .....
Merc. iod.
………
Phyt.
DROPSY, ACUTE.
...
··
...
Apis
Apoc. c.
Ars.
··
....
DROPSY, CHRONIC.
....
....
·
•
Bry.
Dig.
DUODENITIS.
Ars.
Pod.
DUODENUM, ULCER OF.
K. bich.
Uran.
DYSENTERY.
Acid. nit.
Aloes
Arn.
...
…………
...
··
PAGE
406
426
···
445
448
472
489
553, 556
565
665
556
per a aer
LOLON H
652
681
690
715
737
763, 764
769
777
785
787
845
874
112
122
214
315
387
364
504
519
554
577
587
606
660
663
722
157
218
510
799
857
218
210
256
334
464
249
763
577
868
128
185
233
Colch.....…………………………………………………………… 426
Coloc.
Ipec.
Merc. c.
...
Nux v.
Rhus
Sulph.
DYSMENORRHEA.
struation, painful).
DYSPEPSIA.
Abies nig.
Acid. carbol.
Alumina
...
Apoc. c.
Arg. nit.
Ars.
*..*
··
Bry.
Calc. c.
Carb. v.
Hydrast.
K. bich.
Lob.
Lycopod.
Nux v.
Phos.
Puls.
DYSPHAGIA.
Curare
K. brom.
DYSURIA.
....
..
....
...
•
...
Bovist.
Canth.
..
Acid. benz.
Apis
Camph.
Canth.
Chim.
Cop.
Eup. purp.
Ferr.
Puls.
Sars.
EAR-ACHE.
··
Cham.
Puls.
ECTHYMA.
Ant. tart.
Juglans
ECZEMA.
Ant. crud.
Ars.
U
...
*
..
··
•
Clem.
Croton
Graph.
Hydrocot.
Juglans
Merc. c.
Oleand.
Rhus
EMPHYSEMA.
………….
………………
....
....
...
• ...
(See Men-
Lobel. (dyspnoea of)
****
1
I
****
PAGE
432
566
658
679
5∞ +
690
785
846
888
III
187
210
224
248
331
343
370
521
577
615
619
689
737
768
453
321
109
218
354
362
385
440
477
486
769
798
379
771
208
902
199
251
313
363
415
445
500
526
902
660
698
751
616
CLINICAL INDEX.
933
EMPYEMA.
Hep. s.
ENCHONDROMA.
Sil.
ENDOCARDITIS.
Ars.
Spig.
ENDOMETRITIS.
Ars.
ENTERITIS.
...
Lycopod. (in infants)
Merc. c. (large intestine)
Pod. (smail
""
ENURESIS.
Acid. benz.
Bell.
Canth.
Caust.
Equisetum
Ferr.
...
Gels.
K. brom.
K. nit.
Sant.
Sep.
Sulph.
EPILEPSY.
··
Acid. hydr.
Arg. nit.
Ars.
……
··
Artem.
Bell.
Bufo
Calc. ars.
Calc. c.
Cicut.
Cocc.
Cupr.
Ign.
...
K. brom.
Plumb.
Sil.
Stram.
Strychn.
EPISTAXIS.
Carb. v.
Ferr. ph.
Millef.
...
Hyosc.
Origan.
Phos.
Plat.
Stram.
Tarent.
EROTOMANIA.
Acid. picr.
Grat.
...
...
ERYTHEMA.
Apis
Rhus
··
··
...
•
……….
··
>
..
***
··
...
...
···
PAGE
517
817
254
824
250
620
658
763
109
286
363
376
896
486
491
321
586
391
813
843
114
225
257
893
259
895
341
345
388
420
450
535
317
755
818
835
694
371
485
673
139
503
529
713
733
760
835
892
217
781
ERYSIPELAS.
Acon.
Apis
Arn.
Bell.
Canth.
Rhus
EXOSTOSIS.
Calc. fluor.
Hecla lava
………
Caul.
Cham.
Euphr. (
Gels. (
Lil. tigr. (astigmatism)
Physost. (ciliary spasm)…………….
Rhus (paralysis)
Seneg.,,
}
EYELIDS, QUIVERING OF. (See
Blepharospasm).
FALSE PAINS.
""
Merc. c.
EYE-MUSCLES, AFFECTIONS OF.
170
Act. rac. (myalgia)
Agar. (spasm)
177
Arg. nit. (ciliary paresis) 226
Caust. (paralysis)
Cor.
""
""
...
""
FALSE PRESENTATION.
Puls.
FATTY DEGENERATION.
Phos.
FEVER.
Acid. mur. (typhoid)
Acid. phos. (
(typhoid)
""
Acon. (inflammatory)
...
··
..
...
……………TU
Cham. (bilious)
China (hectic)
Cina (remittent)
Crotal. (yellow)
Eup. perf. (bilious)…..
Gels. (remittent)
Hyosc. (typhoid).
Lach. (yellow)
Op. (typhus).....
Rhus (typhoid)……………….
FISTULA.
..
...
...
··
W
...
.....
(puerperal)
(urethral)
Agar. (typhus)
""
Ars. (typhus and typhoid) ...
""
(hectic)
Baptis. (gastric, typhoid, and
relapsing)
Bell. (typhoid)
273
297
Bry. (gastric and relapsing) 328
380
396
...
....
....
...
……………
PAGE
157
213
233
299
369
781
346
900
660
375
436
480
491
613
720
785
806
372
379
772
743
121
135
154
157
157
177
243
243
391
604
476
Acid. fluor. (lachr. and dent.) 113
Acid. nit. (rect.)
Sil. (lachr.)
493
528
604
708
784
125
819
934
CLINICAL INDEX.
FLATULENCE.
Acid. carbol.
Carb. v.
Lycopod.
Nux mosch.
FLUSHINGS.
Amyl. nit.
Jabor.
Lach.
Sang.
Sulph.
FRACTURES, UNUNITED.
Calc. ph.
Ruta
Symph.
Bism.
Bry.
Cina
FRIGHT, EFFECTS of.
Ign.
GALL-STONES.
GANGLION.
Acid. benz.
GANGRENE.
Lach. (traum.)
Secal. (senile)
GASTRALGIA.
Acid. hydr.
Acid. sul.
Anac.
Arg. nit.
Atr. sul.
..2..
……….
Ant. cr.
Ipec.
K. bich.
Nux v.
GASTRITIS.
··
Merc. c.
Phos.
GLEET.
…………
Acon.
Aur.
Bell.
Coloc.
Phos.
201
Acid. oxal.
Ars.
··
..
Nux v.
Ver. alb.
GASTRIC CATARRH.
…………
..t
•
Chimaph.
Hydrast.
K. iod.
Petrosel.
Thuja
···
•
...
.....
IND
...
(See Calculi).
…….
..
GIDDINESS. (See Vertigo).
GLANDERS.
Crotal.
K. bich.
GLAUCOMA.
....
·
……
....
*
....
....
·
• ·
C
•
...
··
··
PAGE
III
370
619
696
193
573
603
795
849
347
789
909
535
IIO
604
802
117
145
196
224
306
310
331
391
689
874
199
565
577
689
129
249
658
737
607
578
161
272
300
433
747
385
521
555
716
864
PAGE
GLOSSITIS. (See Tongue, Affections of.)
GOITRE.
Acid. fluor.
Calc. c.
Iod.
Spong.
Amyl. nit.
Bell.
Iod.
GOUT.
...
GOITRE, EXOPHTHALMIC.
Led.
Puls.
Lycopus
Natr. mur.
GONORRHEA.
Cann. s.
Copaib.
Gels.
Sep. (in women)
Thuj.
GRAVEL.
•
Acid. benz.
Colch.
Sabin.
Sulph.
·
Ign.
GUMBOIL.
...
Berb.
Lycopod.
Sars.
...
100
.....
GRIEF, EFFECTS OF.
Hecla lava
Phos.
HÆMATEMESIS.
Ham.
Ipec.
HÆMATURIA.
Bell.
Ham.
Millef.
Tereb.
HÆMOPTYSIS.
..
....
...
•
..
Acalypha
Acon.
Ferr. acet.
Ipec.
Led.
Millef.
HÆMORRHAGE.
Acon.
...
Co
....
...
Arn.
Ham.
Ipec.
Millef.
HÆMORRHOIDS.
Acid mur.
Escul.
Aloes
Collins.
...
..
……….
•
A
....
…………
..
' •
*
•
•
...
113
343
547
826
194
304
549
623
679
356
439
494
810
864
IIO
427
610
769
795
843
309
621
797
535
900
736
507
569
302
507
568
673
856
889
159
485
569
610
673
157
231
506
549
673
123
171
185
429
CLINICAL INDEX.
935
Ham.
Nux v.
Puls.
Sulph.
HAIR, FALLING OF.
Acid. fluor.
Acid. phos.
Graph.
HAY FEVER.
Aral. rac.
Ars.
Ipec.
Sabad.
HEADACHE.
Acid. phos.
Acid. picr.
Act. rac.
Aloes
****
...
Spig.
Zinc.
Amm. c.
Arg. nit.
Bell.
Bovist.
Bry.
Cact. g.
Calc. c.
Cann. s.
Chinin.
Cocc.
Ferr.
Gels.
Glon.
Hep. s.
Ign.
Iris
•
•
...
Lach.
Naja
……….
Natr. carb.
Nux v.
Phell.
Plumb.
Sang.
Sil.
Cact. g.
Dig.
Kalm.
Lach.
Lith.
...
....
→
Act. rac.
Amyl. nit.
Arn.
Ars.
HEART, AFFECTIONS OF.
Acid. hydr.
Acon.
Lycopus
Naja
Spig.
Spong.
…………….
....
•
...
PAGE
506
691
.....
770
845
..
113
135
500
889
249
567
792
135
141
170
186
190
226
292
313
330
338
345
357
410
497
518, 519
536
560
602
602
676
688
419
485
491
717
757
796
818
823
883
194
226, 234
254
337
463
589
602
117
164
168
614
623
602
824
828
HEARTBURN.
Arg. nit.
HELMINTHIASIS.
Cina
Sant.
Spig.
Stann.
Teucr.
Urtic.
HEMIOPIA.
....
Aur. (horizontal)
Lith. (lateral)
HEPATALGIA.
Amm. mur.
HEPATITIS.
HERNIA.
Merc. dulc.
Phos.
HERPES.
Nux v. (strangulated)
Op. (incarcerated)
Plumb. (strangulated)
....
Ranunc.
Rhus
Tellur. (circinatus)
HICCOUGH.
Acid. sul.
Caps.
Cicut.
Mosch.
……….
Aur.
Hep. s.
HYDROCELE.
Nux mosch.
…….
...
Ver. alb.
HOARSENESS.
Arg. met.
Carb. v.
Spong.
HYDRARGYROSIS.
··
Hyosc.
Stram.
……….
……
Graph.
Iod.
Puls.
Rhod.
HYDROCEPHALOID.
Phos.
Zinc.
………….
…….
....
...
...
Calc. ph.
Helleb.
HYDROPHOBIA.
Bell.
·
HYDROCEPHALUS, ACUTE.
Acid. carbol.
Apoc. c.
Calc. c.
Dig.
Helleb.
HYDROCEPHALUS, CHRONIC.
....
··
•
***
......
......
..
•
14..
PAGE
224
389
391
824
829
859
869
272
614
191
638
744
690
708
750
778
78 5
775
781
855
145
366
388
674
696
874
13
220
371
827
271
515
501
556
771
778
732
883
112
210
345
466
510
347
511
289
529
835
936
CLINICAL INDEX.
HYDROTHORAX.
Apis
Ars.
Ranunc.
HYPOCHONDRIASIS.
Act. rac.
Arg. nit.
Ars.
Con.
………
ILEUS.
Hyosc.
Natr. mur.
Stann.
Tarent.
Valer.
Ver. alb.
HYSTERIA.
Asaf.
Ign.
Magn. mur.
Mosch.
Plat.
Tarent.
Valer.
IMPETIGO.
Bell.
Nux v.
Plumb.
....
IRITIS.
•
K. bich.
Mez.
Sil.
Viol. tric.
··
...
Ant. tart.
Calc. mur. (i. capitis)
Cicut.
...
………….
...
··
....
Bell.
Clem.
Merc.
Merc. c.
....
IMPOTENCE.
Acid. phos.
Agn. cast.
Selen.
INFLUENZA.
Ars.
Brom.
Eup. perf. (bone-pains)
K. bich.
Rhus
INFRA-MAMMARY PAIN.
··
··
....
·
…………
Act. rac.
Puls.
Ranunc.
INTERTRIGO.
Lycopod.
Merc.
INTESTINES, ULCERATION of.
K. bich.
Merc. c.
••
………………
D
…………….
...
•
***
··
***
··
PAGE
218
253
775
170
226
259
437
529
679
830
∞∞∞
892
872
875
266
535
667
674
760
892
872
305
690
750
208
233 LOLO ∞ ∞
487
347
388
578
671
816
880
135
180
804
249
314
476
577
784
169
772
775
621
654
577
658
300
416
654
656
Rhus
Tereb.
Thuja
ISCHURIA. (See Urine, Suppres-
sion of.)
ITCH. (See Scabies.)
JAUNDICE.
Aur.
Card. mar.
Cham.
Chel.
Crotal.
Dig.
Hydrast.
Iod.
Merc.
Phos.
Viper.
....
………
……….
JOINTS, AFFECTIONS OF.
Cistus c. (white swelling)
Led.
Merc. c. (ulc. of cartil.)
Puls. (inflam.)
Sabin. (rheum. arthritis)
Sil.
KIDNEYS, Congestion of.
....
Op.
LEPRA.
...
...
Ars.
Cupr.
Merc.
...
Mang.
Selen.
...
...
Bell.
302
Tereb.
856
KIDNEYS, FATTY DEGENERATION of.
Phos.
745
...
LARYNGITIS, ACUTE.
K. bich.
LEAD COLIC.
Alumen
....
Sang. (oedematous)
Spong.
LARYNGITIS, CHRONIC.
...
Arg.
Arg. nit.
K. bich.
A
LABIA, INFLAMMATION OF.
Apis
216
LACHRYMAL SAC, INFLAMMATION OF.
819
Sil.
LARYNGISMUS STRIDULUS.
Bell.
Chlorum
Corall. r.
Cupr.
Samb.
………….
..
……………
...
•
LEUCORRHEA.
.....
··
Acid. nit. (vaginal) ……….
Alumina
……………
...
...
•
PAGE
786
858
865
...
272
895
380
383
604
466
521
556
637
....
742
604
770
793
817, 819
414
610
660
289
386
442
449
794
577
795
827
220
224
578
667
804
187
708
251
452
654
126
187
CLINICAL INDEX.
937
Bovist.
Calc. c.
Copaib.
Magn. mur.
Kreos. (foetid)
Puls.
Sabin. (corrosive)
Sep.
LICHEN.
...
....
*
………
..
Apis
Ars.
LIENTERIA.
Ferr.
Oleand.
LITHIASIS.
Lycopod.
Sep.
LIVER, ACUTE ATROPHY OF.
*****•
Phos.
LIVER, CIRRHOSIS OF.
Aur.
Phos.
...
..
…………….
LIVER, CONGESTION OF.
Agar.
Berb.
Bry.
Card. mar.
Chel.
...
....
...
...
...
""
".
....
...
..
..
•
Acon.
Act. rac.
..
Ant. tart.
Bry.
K. bich.
Rhus
Sulph.
LUMBRICI. (See Helminthiasis.)
··
PAGE
313
345
...
440
666
591
771
793
810
Eup. perf.
Hep. s.
K. bich.
Leptandr.
Lycopod.
Magn. mur.
Merc.
Nux v.
Pod.
Sep.
Sulph.
Viper.
LIVER, FATTY DegeneraTION OF.
Phos.
LOCHIA, MORBID STATES OF.
Bell. (offensive)
Carb. an.
Kreos.
...
Caul. (prolonged)
LOCOMOTOR ATAXY.
Arg. nit.
Bell.
LUMBAGO.
247
25I
485
698
300
621
812
743
272
744
178
308
♡ m∞ m
332
895
383
476
517
579
611
620
666
637
691
762
812
849
605
743
304
369
591
372
225
280
163
168
209
328
579
783
844
Lungs, Edema OF.
Ant. tart.
Phos.
LUNGS, GANGRENE OF.
Caps.
LUNGS, PARALYSIS OF.
Solania
LUPUS.
Ars.
Hydrast.
Hydrocot.
K. bich. (non-exedens)
MALIGNANT PUSTULE.
Lach.
MANIA.
...
Bell.
Hyosc.
Stram.
.....
•
..
...
•
MELANCHOLIA.
...
……..
Acon.
Camph. (retrocedent)
Cupr.
Euphr.
"
Merc.
Puls.
...
...
MASTITIS.
Bell.
306
Bry.
334
Graph. (indurations from)... 501
Merc.
658
Phos.
747
724
Phyt.
MASTODYNIA.
Act. rac.
Con.
Croton
Phell.
Phyt.
MEASLES.
Act. rac. (in women)
Agn. cast.
Ars.
MENINGITIS,
SPINAL.
....
Aur. (suicidal)
Bell. (acute)
Helleb. (of puberty)
Plat. (in women)
Plumb.
Zinc.
MENIERE'S DISEASE.
Acid. sal.
Arn.
MENINGITIS.
...
***
...
Acid. oxal. (spinal)
Bry. (cerebral)
... …………
...
....
Act. rac. (spasms of)
Cicut.
Crotal.
Cupr.
………….
EPIDEMIC
·
•
…………….
....
·
291
528, 529
835
PAGE
•
207
739
366
474
261
522
526
578
605
169
438
445
717
724
154
354
45I
479
648
769
169
180
259
270
291
50g
760
757
883
143
234
130
330
CEREBRO-
1 36
170
389
604
452
938
CLINICAL INDEX.
Ipec.
Ver. vir.
MENSTRUATION, DEFECTIVE.
Graph.
Helleb.
K. carb.
Magn. c.
Natr. mur.
Puls.
Senec.
MENSTRUATION, EXCESSIVE.
Acid. nit.
Apoc. c.
Ars.
..
..
Calc. c.
Chin.
Croc.
Ferr.
K. carb.
Magn. carb.
Plat.
Ruta
Sabin.
Sec.
··
……….
Bry.
Ham.
MENTAGRA.
•
MENSTRUATION, PAINFUL.
Act. rac.
Amm. acet.
Bell.
Borax
Caul.
Cham.
Cocc.
Gels.
Guaiac.
...
··
•
....
……………
··
Ham.
Puls.
Sep.
Viburn.
Xanthox.
MENSTRUATION, SUPPRESSED.
Acon.
Glon.
MENSTRUATION, VICARIOUS.
.....
...
..
……………
……
....
..
•
..
PAGE
569
877
.... ***
500
511
581
665
677
771
805
128
210
250
345
407
443
486
581
665
760
789
793
803
169
182
304
312
372
379
419
49I
504
508
771
810
Cicut.
Graph.
MESENTERIC GLANDS, DISEASES OF.
Bar. mur.
Calc. c.
Calc. iod.
Iod.
METRITIS.
Nux v.
Sabin.
Secal.
METRORRHAGIA. (See also remedies
for Excessive Menstruation.)
Bovista
HS
911
850
157
497
335
507
388
500
283
343
341
551
692
793
803
313
Cham.
Ham.
Ipec.
Vinca m.
MIGRAINE.
Acid. carbol.
Bry.
Calc. ac.
...
Calc. c.
Coff.
Cycl.
Iris
Sang.
Sep.
Stann.
Therid.
Verbasc.
***
·
……..
Apis
Ars.
Zinc. sul.
MISCARRIAGE.
Caul.
Sabin.
Sec.
MOLLITIES OSSIUM.
...
....
Phos.
MOLLUSCUM.
Sulph.
………………………
MOUTH, ULCERATION IN.
Acid. mur.
Acid. nit.
....
K. chlor.
Merc.
MUCOUS PATCHES.
Acid. nit.
MUGUET. (See Stomatitis.)
MUMPS.
••
Merc.
MYALGIA.
Act. rac.
Arn.
MYDRIASIS.
Bell.
MYELITIS.
Acid. oxal.
Ars.
Plumb.
MYOPIA.
Physost.
NÆVUS.
Thuja
NEPHRITIS.
……………
Canth.
Merc. c.
Phos.
Tereb.
……………
NEURALGIA.
Acon.
Ars.
Bell.
··
··
J
.....
……………
....
…………..
……….
...
··
...
••
PAGE
379
507
565
909
III
331
341
345
423
455
560
795
∞∞∞ ∞ ∞*
943976
30 3∞ +
813
830
893
878
884
372
793
802
744
844
123
125
584
649
126
650
169
230
301
131
257
754
720
863
218
255
2 36 78
565
362
659
745
856
160
257
292
CLINICAL INDEX.
939
Cedr. (periodic)
Cham.
Chel.
Chin.
Chinin. (supra-orbital)
Coloc.
Glon.
Ign.
K. bich. (supra-orbital)
Kalm.
Mez.
Phos.
Plat.
....
...
Ranunc. (intercostal)
Spig.
Stann.
NODES.
...
Staph.
Sulph.
Verb. (facial)
Zinc. ph.
Zinc. val.
NIGHTMARE.
K. brom.
Pæon.
Aur.
Mez.
Stilling.
...
....
Apis
ESOPHAGISMUS.
Naja
OPHTHALMIA.
...
………….
...
Acid. nit. (scrof.)
Acon. (rheum.)
Æthus. (scrof.)
Apis (catarrh. and scrof.)
Arg. nit. (pur.)
Ars. (scrof.)
Aur. (scrof.)
Bar. iod. (scrof.)
Bell. (catarrh. and scrof.)
...
…………
...
•
....
···
NOMA PUDENDI.
Ars.
NOSE, INFLAMMATION OF.
Acid. fluor.
Aur.
NYMPHOMANIA. (See Erotomania.)
CEDEMA GLOTTIDIS.
9
...
...
PAGE
377
379
384
407
412
432
498
Bry. (rheum.)
Calc. c. (scrof.)
Euphr. (catarrh., scrof. and
...
536
576
589
672
729
760
775
823
830
∞ ∞ ∞ ∞
833
847
878
883
883
321
714
270
670
908
250
113
270
214
602
126
163
174
217
224
249
271
283
300
335
345
rheum.)
480
518
578
Hep. s. (scrof.)
K. bich. (catarrh. and rheum.)
Merc. c. (scrof. and rheum.) 659
Puls. (pur. and scrof.)
Rhus (scrof.)
Spig. (rheum.)
Sulph. (catarrh., scrof. and
rheum.)
770
786
823
845
OPTIC NEURITIS.
Acid. picr.
Bell.
ORCHITIS.
Cham.
Ham.
Puls.
Rhod.
Spong.
•
Acon.
Bell.
Caps.
Merc.
Puls.
OTORRHOEA.
OTALGIA. (See Earache.)
OTITIS.
***
………….
Hydrast.
Puls.
Sil.
Tellur.
Naja
Pallad.
··
OZÆNA.
Plat.
Puls.
OXALURIA.
OVARIES, AFFECTIONS OF.
Apis (inflammation)
Aur. (induration)
Canth. (inflammation)
Coloc. (neuralgia)
Con. (congestion)
Graph. (induration)
Ham. (inflammation)
K. brom. (dropsy)
Iod.
Lach.
Lilium
...
...
Acid. nitro-mur.
Acid. nit.
Aur.
··
Hydrast.
Iod.
K. bich.
K. carb.
PALPITATION.
Coff.
Iod.
Mosch.
500
Acid. hydr.
Acon.
…………
...
PANCREAS, Disease of.
Iod.
Iris
PARALYSIS.
Arg. nit. (paraplegia)
Bell.
""
Caust. (local)
Cocc
..
..
··
.. .....
PAGE
240
300
415
508
771
778
827
156
304
366
655
771
521
771
816
855
218
273
364
432
438
501
508
322
557
607
613
607
905
760
771
127
126
271
521
553
578
500 H
55 57
581
117
164
424
557
674
556
562
226
290
374
419
940
CLINICAL INDEX.
Con. (local)
Cupr.
Curar.
Gels.
Phos.
Physost.
Plumb.
Hyosc.
Merc.
Rhus (rheumatic)
PARALYSIS AGITANS.
...
••
...
PARALYSIS, FACIAL.
Caust.
K. chlor.
PARALYSIS, GENERAL, OF Insane.
Cann. Ind.
Physost.
PARAPLEGIA. (See Paralysis.)
PEMPHIGUS.
Ars.
Rhus
PERICARDITIS.
Ars.
Bry.
Colch.
...
Dig.
Spig.
PERIOSTITIS.
Asaf.
Aur.
K. bich.
...
Mang.
Merc.
Mez.
Phos.
Phyt.
Sil.
...
....
...
PERITONITIS.
Apis
Bell.
....
PERTUSSIS.
....
...
Bry.
Coloc.
Merc. c.
PERSPIRATIONS.
•
•
Sil. (local)
Acid. fluor. (local)
Acid. phos.
Carb. an.
Jabor.
Merc.
..
Chel.
Cina
Cocc. cact.
...
...
Op.
Petrol. (local)
Samb.
Acid. hydr.
Arn.
Bell.
...
...
...
··
……………
•
PAGE
436
451
453
491
731
720
753
785
530
656
374
584
359
720
27
251
2500
II
781
253
330
428
466
824
266
272
579
667
654
670
735
724
817
218
305
330
432
660
113
135
369
573
654
709
715
794
819
117
254
289
383
391
421
Corall. r.
Cupr.
Dros.
Ipec.
K. carb.
...
PHLEBITIS.
Ham.
Lach.
Puls.
PHLEGMASIA ALBA DOLens.
...
Bism.
Ham.
PHOTOPHOBIA.
Act. rac.
Ant. tart.
Con.
Nux v.
PHRENITIS.
Bell.
PHTHISIS.
Ars.
Bapt.
Calc. ars.
...
Calc. ph.
Dros.
Ferr.
Iod.
K. carb.
Kreos.
Lycopod.
Phos.
Spong.
Stann.
..
Acon.
Apis
Ars.
.....
Sulph.
PHYSOMETRA.
...
•
..
..
Asclep.
Bry.
Canth.
...
...
•
Acid. phos.
Brom.
....
PILES. (See Hæmorrhoids.)
PITYRIASIS.
Ars.
Mez.
PLEURISY.
··
Dig.
Hep. s.
K. carb.
Ranunc.
Scilla
Sulph.
PLEURODYNIA.
Act. rac.
Arn.
Ranunc.
..
··
....
·
·
....
••
...
··
……….
...
PLICA POLONICA.
Lycopod.
....
...
•
·
•
PAGE
442
449
469
568
580
506
605
770
310
506
170
209
437
692
292
243
279
34I
347
470
486
557 57
555
581
590
621
740
827
831
847
135
316
251
670
154
218
253
268
329
363
466
517
581
775
799
846
168
230
775
621
CLINICAL INDEX.
941
Vinca m.
Viol. tric.
PNEUMONIA.
Acid. oxal.
Ant. tart.
Brom.
Bry.
Chel.
Hep. s.
Iod.
...
Lycopod.
Phos.
Sang.
Sulph.
POLYPI.
Calc. c.
K. bich.
Teucr.
Thuja
POLYURIA.
Colch.
Collins.
Acid. phos.
Arg. m.
Murex p.
Natr. m.
Scill.
Uran.
PROCTITIS.
……….
..
...
Sep.
Stann.
1
....
………….
PROSTATITIS.
Iod.
Puls.
Staph.
Thuja
PRURIGO.
Ars.
Mez.
Rhus
Rumex
Sulph.
PRURITUS.
...
··
··
...
..
...
****
...
··
Phos.
PROGRESSIVE MUSCULAR ATROPHY.
Phos. (pseudo-hypertr.)
Physost.
Plumb.
PROLAPSUS ANI.
Arn.
Ferr.
Ign.
Pod.
PROLAPSUS UTERI.
Bell.
Ferr.
Secal.
Acid. nit. (pud.)
Acid. sul.
Calad. (pud.)
...
▸ ...
………….
PAGE
910
880
•
132
206
314
333
383
355
516
554
620
739
795
846
344
578
859
862
134
220
675
679
799
868
427
430
738
732
720
752
230
487
536
763
304
486
764
803
831
557
771
833
864
251
670
781
787
844
126
145
895
Carb. v. (pud.)
Chloral
Collins. (pud.)
Dulc. (,,)
Lycopod. (ani)
Mez. (vagin.)
Morph.
PSORIASIS.
Acid. carbol.
Ars.
Graph. (palm.)
Hep. s. ( )
PTERYGIUM.
Ratanh.
Sulph.
Zinc.
PTYALISM.
Iod.
Iris
……….
Jabor.
Merc.
PURPURA.
PYÆMIA.
Arn.
Ars.
....
Acid. phos.
Ham.
Lach.
Phos.
Chinin.
Lach.
""
Acid. phos.
Calc. c.
Phose
Sil.
RANULA.
Thuja
..
...
PYELITIS.
Uva ursi
C
QUINSY. (See Angina Faucium.)
RACHITIS.
RETINA, DETACHED.
Aur.
Gels.
RETINITIS.
Acid. picr.
Bell.
...
..
Gels.
Lach. (apoplectic)
Merc.
Merc. c. (album.)
...
Sant.
RHAGADES.
Cund.
RHEUMATISM.
Acid. benz.
Acid. sal.
Acon.
Act. rac.
Ant. tart. (musc.)
...
··
..
··
·
•
•
PAGE
371
386
430
473
621
672
711
III
251
500
518
776
845
884
556
562
573
650
135
507
603
745
231
243
412
605
870
135
342
736
816
865
272
492
140
300
492
604
655
659
392
446
109
141
162
168
209
942
CLINICAL INDEX.
Bry.
Caul.
Chin.
Chinin.
Colch.
Dulc.
Guaiac.
K. bich.
Kalm.
Merc.
Phyt.
Puls.
....
Rhod.
Rhus
Ruta (wrist and ankle)
Sars. (gonorrh.)
Sulph.
Viol. od. (right wrist)
RHEUMATOID ARTHRITIS.
Act. rac.
Caust.
Iod.
Puls.
Sab.
RINGWORM.
Sep.
RUPIA.
..
••
SCALDS.
Phyt.
SARCOCELE.
•
Hep. s.
Sulph.
*
..
*****
……
··
***
SCARLATINA.
·
Aur.
SATYRIASIS. (See Erotomania.)
SCABIES.
Canth. (locally)
*****
Acid. mur.
Acon.
Ailanth.
Amm. carb.
Apis
Arum
Bell.
.....
**
Camph. (retrocedent)
Cupr.
Lach.
Merc.
Rhus
Stram.
SCIATICA.
Acon.
Amm. mur.
Ars.
Coloc.
Gnaphal.
Natr. sul.
Ranunc.
Rhus
Tereb.
...
""
……………
...
...
***
PAGE
327
372
407
411
438
472
504
576
588
647
724
770
778
782
789
798
843
879
168
376
552
770
793
813
724
270
517
844
361
1000
122
154
181
190
214
264
297
354
451
606
648
784
835
160
191
258
486778
1700 20
1 5300
433
898
681
755
783
858
SCLERODERMA.
Bry.
SCLEROTITIS.
Thuja
SCROFULA.
Calc. c.
Cistus ...
Con.
Iod.
Merc.
Sil.
··
Stilling.
Sulph.
Therid.
SEA-SICKNESS.
……………
...
Apomorph.
Cocc.
Petr.
Staph.
Tabac.
SEPTICEMIA. (See Pyæmia.)
SHINGLES.
...
Canth. (locally)
Cistus
Mez.
Ranunc.
Rhus ...
SLEEPLESSNESS.
....
Acon.
Act. rac.
Ambr.
Coff.
Gels.
Iod.
....
…….
…………….
Chin.
Hyosc.
K. brom.
SMALL-POX.
Ant. tart.
Bapt.
Bell.
•
Chin.
Dig.
Iris
Nuphar
Nux v.
Phos.
Staph.
....
SLEEP, DISOrdered.
...
...
....
...
Crotal. (hæmorrhagic)
Merc.
Sarrac.
Thuja
SOMNAMBULISM.
...
....
...
K. brom.
SPERMATORRHŒA.
Acid. phos.
Camph.
Canth.
....
...
•
...
****
... ...
………….
....
PAGE
334
865
343
413
437
549
647
817
908
843
893
712
418
715
832
853
361
414
670
775
781
157
169
188
422
494
557
407
527
321
208
279
297
604
647
796
865
321
135
354
363
406
467
562
681
691
733
832
CLINICAL INDEX.
943
SPINAL CORD, AFFECTIONS of.
Acid. picr. (softening)
Agar. (irritation)
Bell. (inflammation)
Gels. (congestion)....
Guaco (irritation)
Naja (
Secal.
Tellur.(
Ver. vir. (inflammation)
SPLEEN, AFFECTIONS OF.
Agar. (enlargement)
Ceanoth.
SPRAINS.
Arn.
Rhus
STAMMERING.
Hyosc.
Stram.
STERILITY.
Borax
Con.
Iod.
STIFF-NECK.
Acon.
Act. rac.
Bry.
Colch.
Dulc.
STINGS.
Lach.
Led.
STYE.
...
....
··
""
""
""
…………
STOMACH, Ulcer of.
Arg. nit.
Ars.
Atrop. s.
K. bich.
Uran.
STOMATITIS.
Arum
K. chlor.
Merc.
Merc. c.
STRABISMUS.
Cyclam.
Hyosc.
STRICTURE, RECTAL.
C
Coff. (spasm.)
Phos.
STRICTURE, URETHRAL.
Clem.
...
……….
...
...
…………✔
Sulph. (
SUNSTROKE.
Glon.
SUPPURATION.
Arn.
Calc. sulph.
··
**
Puls.
Staph. (recurring)
""
....
....
...
...
PAGE
139
177
290
492
899
607
802
855
877
178
896
229
783
2700
23
520
836
312
438
557
163
168
328
428
472
607
610
227
135
307
577
868
265
504
649
658
455
530
424
738
415
770
833
844
496
231
348
Calend. (locally)
Hep. s.
Sil.
SYCOSIS.
··
Acid. nit.
Plat.
Thuja
SYNOVITIS.
Apis
Bry.
SYPHILIS.
Cinnab.
Cundur.
Acid. fluor. (tongue and
throat)
Acid. nit.
Aur.
Iod.
K. bich.
..
.
Kreos. (infantile)
Merc.
Merc. bin.
Phyt.
Plat.
Stilling.
TABES SICCA.
Zinc.
TETANUS.
Acid. hydr.
Acon.
Nicot.
Strychn.
TETANY.
....
Dig.
Graph.
...
....
....
Acon.
THRUSH.
TINNITUS AURIUM.
Acid, sal.
Carb. sulph.
Chinin.
(See Aphtha.)
Hyosc.
Kreos.
TONGUE, AFFECTIONS OF.
Acid. fluor. (syphilis)
Acid. mur. (ulcers)
Acid. oxal. (inflamm.)
Apis (œdema)
K. cyan. (cancer)
Merc. (glossitis)
TONSILS, ENLARGEMENT OF.
Baryt.
Calc. phos.
TOOTHACHE.
Bell.
... ......
....
Calc. c. (in pregnancy)
Cham.
Coff.
..
...
****
Magn. c. (in pregnancy)
Merc.
•
...
10.
...
......
PAGE
349
515
813
126
761
862
219
331
112
126
270
664
446
551
576
592
640
662
724
761
908
884
116
159
852
686
159
143
367
410
465
500
I12
123
129
216
119
650
281
347
305
345
379, 380
422
531
591
661
650
94.1
CLINICAL INDEX.
!
Plant. m.
Staph.
Sep. (in pregnancy)…………….
TRISMUS.
Acon.
TUBERCULOSIS.
Calc. c.
TUMOURS.
•
150
343
Calc. c. (cystic)
344
Eucalypt. (vasc. t. of urethra) 897
Hydrast.
………………….
K. brom. (cystic)……….
Sil. (fibroid)
ULCERS.
TYMPANITES.
1
...
Asaf. (hysterical)
Colch. (in oxen) ..
Eryng.
..
Tarax. (t. hysteralgique)
Tereb. (typhoid and puer-
peral)
Ast, rub.
Calend. (locally)
Comocl.
....
Hep. s....
Hydrast,
K. bich.
Lach.
Merc.
Mez.
Pæon.
Sil.
Sulph.
URÆMIA.
Acid. carbol.
Op.
URINE, MORBID STATES OF.
……..
Acid. benz.
***
756
...
...
Acid. nit.
Acid. phos.
Sep.
URINE, RETENTION OF.
Op.
URINE, SUPPRESSION OF.
K. bich. (in cholera)
Tereb.
URTICARIA.
Anac.
Ant. cr.
Apis
Ars.
…………………
••
...
•
.. ..
•
Chloral
Copaib.
Dulc.
Urtic.
UTERUS, AFFECTIONS OF.
Act. rac.
Arg. m.
Aur.
Bell.
•
...
…………
··
•
..
******
……….
....
...
PAGE
906
832
810
....
523
322
821
266
427
910
854
858
268
349
896
517
522
578
607
647
671
714
816
844
112
708
108
128
133
812
708
579
856
1000
195
199
216
251
386
440
472
869
169
220
273
303
Ferr.
Helon.
Hydrocot.
Iod.
Lilium
Magn. mur.
Murex
………
·
Sil.
VARICOSIS.
...
Natr. chl.
Secal.
Sep.
VACCINATION, ILL EFFECTS OF.
Sil.
VAGINISMUS.
Ham.
Plumb.
…………
...
Bry.
Coca.
Iod.
Phos.
Tab.
VOMITING.
Acid. fluor.
Ham.
Puls.
VERTIGO.
Ambra
Arg. nit.
Arn.
Bell.
...
..
…..♥
•
....
··
...
••
...
Acid, carbol.
Æthus. (milk)
Ant. tart.
Apomorph.
Ars.
Cocc.
Ferr.
Iod.
Ipec.
Iris
..
WHITLOW.
.....
………….
•
....
Kreos.
Merc. (milk)
Nux v.
Petr.
VULVITIS.
Sep.
WARTS.
Calc. c.
Thuja
WATERBRASH.
Bry.
Lycopod.
Puls.
Ver. alb.
...
•
……………………. ··
....
***
..
...
Acid. fluor.
Hep. s.
Ledum (traumatic)
Sil.
…………..
10.
•
……………
PAGE
486
513
526
557
613
666
675
387
802
810
820
508
755
820
113
507
770
189
226
233
292
331
418
557
732
853
III
174
203
712
248
418
485
553
564
560
590
652
692
715
810
345
862
331
619
769
874
113
519
611
816
CLINICAL INDEX.
945
Arn. (contused)
WHOOPING-COUGH. (See Pertussis.)
WORMS. (See Helminthiasis.)
WOUNDS.
46
PAGE
229
Calend. (incised)
Hyper. (lacerated)
Lach. (poisoned)
Led. (punctured)
UNIV. OF MICHIGAN,
DEC 19 1912
3 P
...
PAGE
349
532
607
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priate Medicines, with their Doses. Special directions are also given in
respect to Diet, and other Hygienic considerations, which, in these
diseases, are subjects of the highest importance, both as preventive and
curative measures. 8vo, Cloth, Fourth Edition, price 2s. 6d.
Pocket Glossary of Medical Terms. A valuable and constantly
useful Companion to Homœopathic works. 32m0, Cloth, Is.
Russell (J. Rutherford, M.D.)-The Treatment of Rheu-
matism, Epilepsy, Asthma, and Fever. Being Clinical Lectures delivered
at the London Homeopathic Hospital. With a comparative view of the
fallacies of the old school, and the improved treatment generally by
Homœopathy, Dr. Russell introduces the subjects of Acute Rheumatism,
Affections of the Heart, in connection with that disease; Rheumatism
affecting the Brain: Rheumatic Gout: Chronic Rheumatism; Doses and
Attenuation of Medicines; Epilepsy; Asthma; Fever, &c.: affording a
complete epitome of the diagnosis, treatment, and peculiarities of each.
The whole is illustrated by numerous cases, and presents an admirable
compendium for the use of the student and practitioner. Price, bound in
Cloth, Post 8vo, 7s. 6d.
Russell.-A Contribution to Medical Literature: relating
to the Theory and Practice of Homœopathy. This Work gives a popular
digest of valuable matter on most subjects pertaining to the art of Medi-
cine; and is written in a style which will be found highly attractive to the
general reader. Whilst advocating and explaining the theory and prac-
tice of the Homœopathic system, general information is given on many
interesting subjects of daily experience. The latest results and generali-
sations of the art are also recorded; so that the volume affords an
admirable epitome of the literature of Homœopathy. 8vo, Cloth, price.
IOS. 6d.
Russell. Hints on Diet, with Special Reference to Homœo-
pathy. The question of Diet naturally interests every one, and hence it
has formed a frequent subject on which books innumerable have been
written. Generally speaking, however, a certain amount of self-denial
or asceticism is recommended, which few patients can follow. Dr.
Russell consults previous habits, and deals with the patient as he is,
rather than as he should have been. The whole Work is therefore emi-
nently practical; and although primarily intended for those who follow the
Homœopathic system, it is of equal value to all classes. Third Edition;
8vo, sewed, price is.
W
Russell. Heart (Treatise on the); its Functional and
Organic Diseases. Second Edition; price is.
Russell.-Digestion; and Structure and the Uses of the
Liver. Second Edition; price Is.
Russell.-Pneumonia, under Prompt and Effectual Treat-
ment (Homœopathic Treatise on). Second Edition; price is.
6
Russell.-Nervous System, including Epilepsy (Treatise
on Affections of the). Second Edition; price is.
Russell.-Skin and its Diseases (Homœopathic Treat-
ment of). Second Edition; price 2s. 6d.
Spillan (D., M.D.)-Homœopathic Prescriber's Pharma-
copoeia. This Work, commencing with observations on the general nature,
forms, dose, &c., of Medicines, gives a detailed description of each, and
their chemical constitution, source, uses, antidotes, &c. The Medicines
are classified in relation to their object. At the conclusion, minute
instructions are given in respect to the treatment of cases of Poisoning;
and the Work forms an excellent Hand-book for the Homœopathic Prac-
titioner. Royal 32m0, Cloth, price 4s.
Theobald (R.)-Homœopathy, Allopathy, and Expectancy.
A Criticism of Sir John Forbes' " Nature and Art in the Cure of Disease;"
and an Exposition of Homœopathy. 8vo, sewed, price is.
Turrell (L., M.D.)—Winter Residences on the Oceanic and
Mediterranean Coasts. A book of much importance to the Invalid in
search of change of air and residence. 18mo, Cloth, 25.
Veterinary Homœopathy. A Concise yet Comprehensive Treatise on
the Homœopathic Method of treating Diseases in Domestic Animals ;
and adapted alike to the Farm, Stable, Kennel, &c., &c. 18mo, Cloth,
price 8s.
Watts (W. H., M.R.C.S.)-Repertory to the Materia Medica
of Charles J. Hempel, M.D. Price 5s.
Wyld (George, M.D.)—Diseases of the Heart and Lungs;
their Physical Diagnosis, and Homeopathic and Hygienic Treatment.
By George Wyld, M.D., formerly Physician to the Hahnemann Hospital,
and the London Homœopathic Hospital. When it is remembered `that,
in Europe and America, about one-third of the mortality is caused by
diseases of the heart and lungs, the importance of the subject cannot be
over-rated. The present Work embraces a disquisition on the nature,
functions, &c., of the heart and lungs; with a full exposition and diag-
nosis of the diseases to which they are subject; whilst their Homœopathic
Treatment is pointed out. In the Appendix, valuable advice is given in
respect to the Hygienic Treatment of patients, especially in regard to
Ventilation, Climate, Bathing, and other accessory measures. Price,
bound in Cloth, 5s.
Yeldham (S., M.D., M.R.C.S.)-Homœopathy in Acute
Diseases. A valuable guide in the Homœopathic Treatment of such dis-
orders. Fourth Edition; price 2s. 6d.
The following are simple Hand-books on each subject:—
Constipation and Piles. Their Homœopathic Treatment by Eight
Remedies. Price 6d.
Croup.—Its Homœopathic Treatment by Eight Remedies. Price 6d. By
W. V. Drury, M.D., Edin.; Physician in charge of the Diseases of Chil-
dren to the London Homœopathic Hospital.
Indigestion.—Its Homœopathic Treatment by Eight Remedies. Price 6d.
By William Bayes, M.D., M.R.C.S., Eng.
7
Rheumatism.-Its Homœopathic Treatment by Eight Remedies. Price 6d.
By William Bayes, M.D., M.R.C.S., Eng.
Sea-Sickness.-How to prevent and treat it Homœopathically by Eight
Remedies. Price 6d.
Teething.-Derangements incidental to, and their Homœopathic Treat-
ment by Eight Remedies. Price 6d. By W. V. Drury, M.D., Edin.;
Physician in charge of the Diseases of Children to the London Homœo-
pathic Hospital.
Tic-Douloureux.-Its Homœopathic Treatment by Eight Remedies.
Price 6d.
WORKS EXPLANATORY AND IN DEFENCE OF HOMEOPATHY.
Curie (Dr.)-The Annals of the London Homœopathic
Dispensary. A series of Papers, Lectures, &c., on Practical Homœo-
pathy. Published in Parts. No. 1 to 16, One Shilling each. No. 17 to 21,
Sixpence each. No. 22 to 28, Eightpence each.
Drury (W.V., M.D., M.R.I.A.)-Homœopathy and its Oppo-
nents; being a Reply to Sir B. Brodie and others. Price 6d.
Eadon (S., A.M.) Dialogue between a Lady Homœopath
and an Allopathic Physician. Price 6d.
Fair Play; an Examination of the Rival Claims of
Homœopathy and the Chartered Schools of Medicine and Surgery. By a
Barrister. Price Is.
Fischer (Carl)-A Biographical Monument to the Memory
of Samuel Hahnemann, the founder of Homoeopathy. Translated from
the German, with Additions from various sources. 8vo, Cloth, price is. 6d.
Granier (Dr. Michel)-Conferences on Homœopathy. This
Work is an exposition of the nature, proofs, and applications of the
Homœopathic system, embraced under the following heads :-
CONFERENCE
I.—I do not believe in Homœopathy-The prudence to be observed before
either denying or affirming anything.
II.-My conversion to Homœopathy-Why and how I was converted to
Homœopathy.
III.-The Allopaths and the Academicians-The obstacles which stand in
the way of conversions; and the opposition to the progress of our
doctrine.
IV.—The spread of Homœopathy-The state of our doctrine in all parts of
the world.
V. The Temple of Hippocrates-A general glance at the History of Medi-
cine-An exposition of the old systems.
VI. The same subject.
VII.-The Temple of Hahnemann-Exposition of the new medicinal doctrine.
VIII.-The same subject.
IX.-The possible-The action of infinitesimal doses, considered as possible
proofs furnished by reason, and by the phenomena of nature.
8
X.-The fact-The action of infinitesimal doses, considered as a fact-
Proofs furnished by negative, positive, general, and particular facts
-Homœopathy among the railway workmen at Nîmes.
XI.—At Home-Homœopathic medicines; their doses; preparation, ad-
ministration, &c.
XII.—Our failures-Confessions; explanation of the failure of Homœopaths.
XIII. How long ?-Old prejudices-Bleeding, leeches, &c.
XIV. A comedy always new-Evacuants, purgatives, &c.
XV.-A new organ-Blisters, cauteries, setons, moxas, &c.
XVI.-The Messiah of Medicine-Sketch of Hahnemann's Life-How he
constructed the edifice of Homoeopathy. Price 2s. 6d.
Granier's (Dr. Michel)—The Rights of Man in the Domain
of Medicine; or the Right of Private Judgment advocated in respect to
Medicine. Price Is.
Henderson (W., M.D.)-Homœopathy Fairly Represented;
in Reply to Dr. Simpson's "Homœopathy Misrepresented." By William
Henderson, M.D., Professor of General Pathology in the University of
Edinburgh. Second Edition; price is. 6d.
Henriques (A.)-Art versus Nature in Disease; a Refuta-
tion of Naturalism. By A. Henriques, Member of the Royal College of
Surgeons, Fellow of the Royal Medical and Chirurgical Society, &c., &c.
In the words of the author, this Work owes its existence to one bearing
the title of Nature and Disease," by Sir John Forbes. Whilst the
object of the latter is to extol the power of nature in healing, the writer in
"Art versus Nature" has endeavoured to prove "that nature has no
power to cure diseases." Arguments are offered in direct refutation of
naturalism, from physiological, nosological, and therapeutical points of
view; and practical conclusions are drawn in support of the Homœopathic
system. Price Is. 6d.
Homœopathy Vindicated; being a Reply to Objections
made against its doctrines. By an Amateur. 18mo, sewed, price is.
Homœopathy, what is it? and is it True? By a Convert of
Seven Years' standing. 8vo, sewed, price 6d.
Joslin (B. F., M.D.)-Principles of Homœopathy; in a Series
of Lectures. This Work gives an exposition of the principles and practice
of Homœopathy, in the form of a series of Lectures. The subjects of
them are, respectively-Obstacles to Homœopathic Investigation and
Relief; Evidences of the Power of Small Doses and Attenuated Medi-
cines, including a Theory of Potentisation; the use of Chemical and
Mechanical means, in connection with Homœopathic Practice; the Law
of Cure; and, lastly, Pure Homœopathy. The Work is free from techni-
calities, and affords a full exposition of the system. Price is.
Sugden (Samuel)-Homœopathy Disclosed; or, a Word to
the Allopathists. With Cases successfully treated; and Objections
answered. Sewed, price 6d.
Tuckey (Charles, A.B., M.D., &c.)-A Dialogue on
Homœopathy. Price 2d.
Wilkin (G., M.D.)-Short Sketch of Homeopathy; its
Principles and Practice. Price 6d.

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