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W 31
THERAPEUTICS
~._._ _- » A _ ¢w.. --
j)' J“ / I; I-
OF
Q
, ,..._ .1..- v-‘._,_-AA -¢-_.
NERVOUS DISEASES;
INCLUDING ALSO THEIR
DIAGNOSIS AND PATHOLOGY.
BY
CHARLES PORTER HART, M.D.,
LATE PROFESSOR OF DISEASES OF THE NERVOUS SYSTEM IN HAHNEMANN HOSPITAL COLLEGE,
SAN FRANCISCO; HONORARY MEMBER OF THE COLLEGE OF PHYSICIANS AND SURGEONS
OF MICHIGAN; MEMBER OF THE AMERICAN ASSOCIATION FOR THE ADVANCEMENT
OF SCIENCE; CORRESPONDING MEMBER OF THE CALIFORNIA STATE HOMcEOPA-
THIC MEDICAL SOCIETY ; FORMERLY SURGEON-IN-CHARGE OF THE SURGI-
CAL WARDS, CHIEF SURGEON TO THE EYE DEPARTMENT, AND
PRESIDENT OF THE BOARD OF MEDICAL EXAMINERS, OF
BROWN GENERAL HOSPITAL, U. S. A., LOUISVILLE,
KY.; AUTHOR OF TREATISES ON “DISEASES
OF THE NERVOUS SYSTEM,” “ INTRACRA-
NIAL DISEASES,” “DISEASES OF
THE SPINAL MARROW AND
ITS COVERINCS,”
ETC., ETC.

PHILADELPHIA :
F. E. BOEBIGKE,
HAHNEMANN PUBLISHING HOUSE.
1889.

TO
SAMUEL LILIENTHAL, M.D.,
PROFESSOR OF NERVOUS DISEASES IN THE HAHNEMANN HOSPITAL COLLEGE
OF SAN FRANCISCO,
THIS VOLUME
IS RESPECTFULLY INSORIBED BY HIS FRIEND AND CO-WORKER,
THE AUTHOR.
I’
PREFACE
WHEN the author of this work ﬁrst published his Treatise on
Diseases of the Nervous System, our practical knowledge of the
therapeutics of nervous diseases was, if not in its infancy, at
least far behind what it is to-day. Not only was our clinical
experience in many of these affections exceedingly scanty, but
as to some of their forms was entirely wanting. Not only SO,
but much of what was recorded was wholly unreliable, and
therefore worthless. It was unreliable, because many diseases
of the nervous system which are now known to depend on.
organic alterations of nerve tissue were then believed to be
purely functional, and the temporary ameliorations incident
to their course were frequently supposed to be the effects of
medical treatment. But now, it may be truthfully aﬂirmed,
our knowledge of the pathology and therapeutics of nervous
diseases will compare favorably with that of any other class of
disorders. The improvement is mainly due to the fact that in
most of our colleges competent professors of nervous diseases
have for years been constantly and earnestly engaged, not only
in imparting a knowledge of these diseases to medical students
——-among whom are included the majority of our present
practitioners—but in clinical investigations, based upon the
homoeopathic law, many of which have resulted in important
therapeutic discoveries. The consequence is, but few deﬁnite
lesions of the nervous system remain unprovided with remedies
possessing welI—recognized and clearly deﬁned characteristic
properties homoeopathic thereto, while the therapeutic effects
of those previously employed are now, as a rule, better under-
stood and more speciﬁcally determined. In short, it ispgratify-
ing to know that we are at present in the full tide of success
as regards the study and scientiﬁc treatment of this important
class of diseases.
4 PREFACE.
No apology, therefore, would seem to be needed for the
appearance of the present work. On the contrary, the time
has arrived when, in the author’s opinion, such a Manual of
Nervous Therapeutics as is here presented is demanded in the
interests of our School.
As the chief excellence of a work of this kind is reliability,
the author has been careful to make use of only such material,
out of the large amount available for the purpose, as he could
safely and fully indorse. Hence, comparatively few of the
more recently introduced remedies have been admitted, except
under the head of auxiliary treatment. This is especially true
as regards those occasionally employed in the treatment of the
more common nervous disorders, such as neuralgia, convul-
sions, etc., for the successful management of which we already
have an abundance of well-tried remedies. In excluding a
number of the more recent, irregular and unproved remedies,
the author is conscious of the fact that he has no doubt omitted
some which have proved curative in particular cases. But it
is a relief to him to know that deﬁciencies of this sort are quite
unavoidable. As Grauvogl has well remarked: “It is impos-
sible to prepare a complete special Therapia for any so-called
disease.” In other respects, also, the work doubtless has its
imperfections, as, indeed, every such work must have, since
there is yet a great deal to learn regarding the nature and
treatment of nervous and mental diseases. The importance,
however, of having what we do know concisely set forth will,
the author trusts, be regarded as a suﬁicient excuse, if any
were needed, for adding another supplementary volume to his
series of works on diseases of the nervous system.
In conclusion he would remark, that his chief aim has been
to furnish a handy, practical guide to the successful treatment
of every form of nervous disease, by presenting in one small
volume the diagnosis, pathology and therapeutics of one of the
most interesting, important and progressive departments of
medicine.
.CHARLEs Ponrnn HART.
Wyoming, 0., Sept, 1889.
CONTENTS.
PART I.
DISEASES OF THE BRAIN AND ITS MEMBRANES.
PAGE
Cerebral anaemia . . . . . . . . . ; . . . . . . . . . . . . . . . . 9
Cerebral hyperaemia . . . . . . . . . . . . . . . . . . . . . . . . . 14
Cerebral haemorrhage . . . . . . . . . . . . . . . . . . . . . . . . 21
Cerebral thrombosis . . . . . . . . . . . . . . . . . . . . . . . . . 27
Cerebral embolism . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Encephalitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Cerebral softening . . . . . . , . . . . . . . . . . . . . . . . . . . 34
Aphasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Cerebral hypertrophy . . . . . . . . . . . . . . . . . . . . . . . . 39
Cerebral atrophy . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Multiple cerebral sclerosis . . . . . . . ' ' ' . . . . . . . . . . . . 42
Athetosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Cerebral syphilis . . . . . . . . . .‘ . . . . . . . . . . . . . . . . 45
Cerebral tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Cerebral concussion . . . . . . . . . . . . ' ' ' . . . . . . . . . 50
Sunstroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Cerebral paralysis . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Infantilecerebralparalysis. . . . . . . . . . . . . . . . . . . . . . 56
External cerebral pachymeningitis . . . . . . . . . . . . . . . . . . 58
Internal cerebral pachymeningitis . . . . . . . . . . . . . . . . . . . 59
Cerebral arachnitis . . . . . . . . . . . . . . . . . . . . . . . . . 60
Traumatic cerebral leptomeningitis . . . . . . ‘. . . . . . . . . . . . 61
Simple acute cerebral meningitis . . . . . . . . . . . . . . . . . . . 62
Tubercular cerebral meningitis . . . . . . . . . . . . . . . . . . . 67
Chronic cerebral meningitis . . . . . . . . . . . . . . . . . . . . . 71
Chronic hydrocephalus . . . . . . . . . . . . . . . . . . . . . . . . 73
6 CONTENTS.

I
PART II.
DISEASES OF THE SPINAL MARROW AND ITS MEMBRANES.
PAGE
Spinal hyperaemia . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Spinal anaemia . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Spinal irritation . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Spinal haeraorrhage . . . . . . . . . . . . . . . . . . . . . . . . . 84
Spinal meningitis . . . . . . . . . . . . . . . . . . . . . . . 85
Myelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Myelomalacia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Spinal paralysis . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Acute ascending paralysis . . . . . . . . . . . . . . . . . . . . . . 94
Spinal paralysis of adults . . . . . . . . . . . ' . . . . . . . . . . . . 95
Infantile spinal paralysis . . . . . . . . . . . . . . . . . . . . . . . 97
Pseudo-hypertrophic spinal paralysis . . . . . . . . . . . . . . . . . 98
Glosso-labio-laryngeal paralysis . . . . . . . . . . . . . . . . . . . . 99
Progressive muscular atrophy . . . . . . . . . . . . . . . . . . . . . 101
Amyotrophic lateral sclerosis . . . . . . . . . . . . . . . . . . . . . 102
Multiple spinal sclerosis . . . . . . . . . . . . . . . . . . . . . . . 103
Primary spinal sclerosis . . . . . . . . . . . . . . . . . . . . . . . 104
Secondary spinal sclerosis . . . . . . . . . . . . . . . . . . . . . . . 106
Posterior spinal sclerosis . . . . . . . . . . . . . . . . . . . . . . . 107
Spinal tumors and other abnormal growths . .‘ .' . .' .' .' . .' . . . . . . 112
Spinal concussion . . . . . . . . . . . . . . . . . . . . . . . . . . 112
PART III.
CEREBRO~SPINAL DISEASES.
PAGE
Cerebro-spinal hyperaemia . . . . . . . . . . . . . . . . . . . . . . 116
Neurasthenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Cerebro-spinal meningitis . . . . . . . . . . . . . . . . . . . . . . 123
Infantile convulsions . . . . . . . . . . . . . . . . . . . . . . . . 129-
Postnatal convulsions . . . . . . . . . . . . . . . . . . . . . . . . 133
Puerperal convulsions . . . . . . . . . . . _ . . . . . . . . . . . . 134
Toxaemic convulsions . . . . . . . . . . . . . . . . . . . . . . . . 138
Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Hydrophobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Chorea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Hysteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Hystero epilepsy . . . . . . . . . . . . . . . - . . . . . . . . . . 159
CONTENTS. 7

PAGE
Catalepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Multiple cerebro-spinal sclerosis . . . . . . . . . . . . . . . . . . . . 162
Secondary cerebro-spinal sclerosis . . . . . . . . . . . . . . . . . . . 162
General paralysis . . . . . . . . . . . . . . . . . . . . . . . . 163
Paralysis agitans . . . . . . . . . . . . . . . . . . . . . . . . . 164
PART IV.
DISEASES OF THE PERIPHERAL NERVOUS’ SYSTEM.
. ~ PACE
Neuritis . . . . . . . . . . . . . . . . . . - _ . . . . . . . . . 166
N euralgia (in general) . . . . . . . . . . . . . . . . . . . . . . . . 167
Trigeminal neuralgia . . . . . . . . . . . . . . . . . . . . . . . 171
Mastodynia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Coccygodynia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Sciatica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . 177
Pharyngeal paralysis. . . . . . . . . . . . . . . . . . . . . . . 181
Paralytic aphonia . . . . . . ~. . . . . . . . . . . . . . . . . . . . . 181
Facial paralysis . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Diphtheritic paralysis . . . . . . . . . . . . . . . . . . . . . . . . 185
Glossoplegia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Facial spasm . . . . . . . . . . . - . . . . . . . . . . . . . . . . . 187
Torticollis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Writer’s cramp . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Spasm of the glottis . . . . . . . . . . . . . . . . . . . . . . . . . 189
Facial atrophy . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Peripheral anaesthesia . . . . . . . . . . . . . . . . . . . . . . . . 192
PART V.
I
DISEASES OF THE SYMPATHETIC NERVOUS SYSTEM.
PAGE
Hemicrania . . . . . . . . . . . . . . . . .. 195
Exophthalmic goitre . . . . . . . . . . . . . . . . . . . . . . . . . 198
Myxoedema . . . . . . . . . . . . . . . . . ..199
Angina pectoris. . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Gastralgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Ovaralgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Hysteralgia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Enteralgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

F
8 CONTENTS.
PART VI.
SYMPTOMATIC DISEASES.
PAGE
Cephalalgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
Vertigo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Coma somnolentum . . . . . - . . . . . . . . . . . . . . . . . . . 229
Insomnia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
PART VII.
MENTAL DISEASES.
PAGE
Melancholia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Hypochondriasis . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Moral insanity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Mania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Dipsomania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Mania 5 potu . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
THERAPEUTICS
OF
NERVOUS DISEASES.
PART I.
DISEASES OF THE BRAIN AND ITS MEMBRANES.

CEREBRAL ANEMIA.
Syn0nyms.—Brain-Fag, Cerebral Hypaemia, Cerebral Hy-
paemia et Hydraemia, Cerebrasthenia, Neurasthenia Cerebralis;
F02, Anemie Cérébrale; Ger, Anéimie des Gehirns, Gehirn-andmie.
Deﬁnition.-—A condition in which the blood contained in
the cerebral vessels is deﬁcient in quantity or defective in
-quality.
Diagnosis.-—The history of the case is usually suflicient to
establish the diagnosis. When, as is sometimes the case, the
symptoms resemble those of cerebral hyperaemia, the condition
may be recognized by the following comparison:

Cerebral Anwmia. Cerebral I-Iyperaamia.
I
Patient anaemic, weak and pale. Patient plethoric, red face.
Disposition to sleep. More or less insomnia.
Pulse small and weak. Pulse full.
N euralgic headache, chieﬂy limited to Cephalalgia of a dull, aching character,
forehead and vertex. and diffused.
Pupils dilated. Pupils contracted.
Relieved by stimulants and horizontal Aggravated by stimulants and by lying
position. down.
Anaemic murmurs. No abnormal heart sounds.

2* (9)
10 NERVOUS THERAPEUTICS.
Pathology.-——That the characteristic symptoms of cerebral
anaemia are due, in most cases, to an insufficient supply of
blood to the brain may be readily shown by diminishing the
supply by compression of the carotid arteries, or by simply
suppressing the breathing. When caused by an impoverished
condition of the blood, the nutrition of the brain suffers
through a deﬁciency of the red corpuscles, which are the car-
riers of oxygen. In these cases the effects are similar to those
resulting from a deﬁciency in quantity, the chief difference
being that the symptoms are gradually instead of suddenly
developed.
Clinical Experience.——China, Ferram and Digitalis, aid ed by
a blood-making diet, have generally proved successful where
there was a deﬁciency of blood, the Digitalis being most useful
in cases attended by feeble action of the heart. The oaso-motor
form of cerebral anaemia generally yields promptly to Amyl
'n.it'r., Glonoin, Picric ac. and Am/m. brom. 3x. Chronic cases
have been greatly beneﬁted by New com. and Phosphorus. Ver-
tigo generally yields to Ac. ﬂuor, Baryta carb., Graph, Dycop.
and Silicea. Hale has found Atropine2 “an admirable remedy
in cases of advanced typhoid, when, with the general prostra-
tion, there is insomnia, with incoherent mumbling, coma vigil
and very dry tongue.” I have found Picric ac.6 well suited to
this condition.
Therapeutic Indications. —~Ghina. —-This remedy justly
stands at the head of the list of remedies for anaemia, when
caused by the excessive loss of animal fluids, as in haemor-
rhage, diarrhoea, leucorrhoea, spermatorrhoea and overlactation.
Its best effects are observed only after the drain upon the system
has been arrested. The symptoms calling for it are: headache,
especially in the morning ; ringing in the ears; pale, cold face;
coldness of the extremities; great debility; tingling and trem-
bling, or twitching, of the muscles and limbs; palpitation of
the heart; faintness, which is relieved by lying down; insom-
nia; vertigo, especially on raising the head.
Arsenicum.-—This is a good blood-making remedy, and is
best adapted to cases where the blood has become too watery,
or depraved, as in malarial fever, chronic quininism and chlo-
CEREBRAL ANEMIA. 11
rosis. It is also suited to cases aggravated by injudicious use
of Ferrum. The indications are: great prostration, with rapid
sinking of the vital forces; hammering headache; coldness of the
extremities; restlessness; bloating of the hands, feet and face;
thirst for small quantities of water; nausea; tendency to syn-
cope on raising the head; vertigo, with vanishing of the senses;
chilliness ; mental depression.
Ferrum.—Cerebral anaemia dependent on hydraemia, as shown
by great pallor of the face, lips and buccal mucous membrane;
bellows-sound of the heart; muscles ﬂabby and weak; beating
headache; slight exertion produces shortness of breath and
exhaustion. This remedy is generally best adapted to chlor-
otic cases and to those resulting from passive haemorrhages.
Avena sat.—Ooldness of different parts of the body, depend-
ing upon want of nerve-force; brain-fag; nervous debility of
school teachers and professional men; women who have be-
come anaemic and debilitated by household cares, worry, over-
nursing, etc.
Nux vom.—Anaemia from mental exhaustion or overwork,
as in students and professional people; also the anaemia re-
sulting from debauchery and overstimulation, the long-con-
tinued use of ardent spirits, late hours and high-seasoned food_
Especially indicated in all cases where there is gastric irrita-
tion, indigestion or constipation; nausea and vomiting, with fre-
quent eructations of sour-smelling fluids or food; insomnia; mus-
cular twitchings; trembling of the hands; frequent cramps.
OamphoI'.—Sync0pal form, resulting from the rapid loss of
vital fluids, and causing great embarrassment of the respiration
and circulation, spasms and convulsions; coldness of the body,
vertigo and loss of consciousness. This is a transiently acting
remedy, but very useful in meeting the primary symptoms,
especially when caused by diarrhoea, cholera, etc.
Ignatia.-—Cases occurring in weak, hysterical subjects, or in
women who have become anaemic through grief or mental anxiety;
melancholy, taciturn, nervous, seeks solitude, frequently gives
way to tears; sinking sensation at the pit of the stomach; con-
stipation; ooerlactation.
Helonias.——Cases resulting from diseases of the female sexual
12 NERVOUS THERAPEUTICS.
organs; menorrhagia; leucorrhoea, with general atony; pro-
lapsus uteri; loss of sercual appetite; pains in the back from
weakness and congestion; pulsatiie pains in the top of the head,
increased by stooping, and attended by vertigo.
Pulsatilla.-—Cerebral anaemia due to impoverishment of the
blood, and associated with menstrual irregularity, especially in
young girls approaching the period of adolescence; amenorrhoea,
with vertigo, chilliness, peevishness, aching pain in the small
of the back, beating headache, aggravated by stooping,-bloat
ing of the face, hands and feet; hysterical cases, with pale face,
disposition to faint and tremulous weakness.
Gina.——Hydrocephaloid cases, with marked paleness of the face,
especially around the nose and mouth ; transient dizziness, with
double vision and obscuration; dilated pupils; spasms and
convulsions; paresis; verminous irritation, producing irrita-
tive fever.
Ipecacuanha.-—Ansemia produced by the summer complaint
in children, and attended with nausea, with or without vomit-
ing, pale face, with blue margins around the eyes, coldness of the
extremities; restlessness and sleeplessness, or else great drowsi-
ness; convulsive movements of the limbs; stools frequent, emerald-
green, faetid, and ejected with great force.
Calcarea phos. — Chronic cases, caused by malnutrition;
anaemic headache of school girls; weakly, anaemic children, with
retarded development, especially of the teeth and osseous structures;
hydrocephaloid cases. _
Zincum.——Well adapted to old chronic cases, especially when
caused by the abuse of potassium bromide. Great mental and
bodily depression; cold extremities; twitching of the muscles,
with paralytic weakness; aching in the forehead after reading,
rwriting or study; loss of memory; restlessness at night, with
frightful dreams.
Zincum phos., brom. and picr.-—The indications for the employ-
ment of these remedies are: brain-fag of business men, teachers
and professional men, who have become pale, haggard, weak
and sleepless fro1n overwork, worry and prolonged mental
exertion.
Veratrum album.-—Acute cases caused by violent purging, at-
CEREBRAL ANPEMIA. 13
tended with fainting, spasms and convulsions, and followed or
accompanied by paralytic weakness.
Secale c0r.—Anaemia complicated with diarrhoea or metror-
rhagia, or with spasms and convulsions; small, intermitting
pulse; tinnitus aurium; delirium ; loss of consciousness;
numbness and coldness of the limbs.
Natrum s11lph.— Watery condition of the blood; constant chilli-
ness; hydrogenoid constitution; trembling of the body, with
jerking of the limbs; great languor and prostration.
Natrum mur.——Cerebral anaemia due to malarial poisoning;
profound melancholy; circulation excited by every movement of
the body; great weakness and constipation; pale, sallow com-
plexion; effects of onanism.
Sulphur. — Chronic cases, occurring in cold, phlegmatic,
scrofulous constitutions; also when preceded or acdompanied
by eruptions, or when caused by their suppression; also as an
intercurrent remedy, or when indicated medicines fail to pro-
duce any lasting beneﬁt.
Auxiliary Treatment.—When the anaemia is due to a
sudden or copious loss of blood, its quality should be improved
by such articles of diet as are not only easy of digestion; but
rich in blood-making elements; such as beef, milk, eggs, game,
ﬁsh, oysters, vegetables, etc. Only good food makes good
blood; hence pies, pastry, rich cake and all unwholesome
articles of diet should be strictly forbidden, and not permitted
to displace a liberal allowance of good nutritious aliment.
Fresh air and exercise are also of great importance, especially
in chronic cases. An ocean voyage, exposure to the mountain
or sea air, or even a complete change of climate, may be re-
quired in order to fully restore the patient to health. In very
bad cases, rest in the horizontal position, massage and electri-
city may not only be found serviceable, but even indispensable.
Salt-baths and sea-bathing are invigorating, and can generally
be practiced with great beneﬁt, provided proper precautions
are taken at the commencement, and the exposure Inade to
correspond at all times with the strength and susceptibility of
the patient.
14: NERVOUS THERAPEUTICS.
CEREBRAL HYPEREMIA.
Syn0nyms.—Congestion of the Brain; Fr., Hyperémie Cére’-
brale ; Ger, Hyperiimie des Gehirm, Gehirn-hyperéimie.
Deﬁnition.—An increase in the quantity of blood within
the cerebral vessels, causing a condition of congestion, undue
pressure and more or less irritation.
Diagnosis.-—Congestion of the brain should be carefully
distinguished from cerebral anaemia, auditory and gastric ver-
tigo, epilepsy, embolism and thrombosis of cerebral blood-
vessels, softening of the brain and urinaemia, to all of which
its symptoms bear more or less resemblance. The differential
diagnosis between cerebral congestion and cerebral anaemia is
given under the latter head, and need not be repeated here.
Cerebral congestion differs from cerebral haemorrhage in the
apoplectic symptoms being less pronounced. Thus, there are
no stertorous breathing and no puffing of the lips; nor are
consciousness, sensibility and the power of motion completely
lost, as in cases of haemorrhage.
Auditory and gastric vertigos are simply ear and stomach
troubles, the former due to disease of the semicircular canals,
and the latter to indigestion, which is always present at the
time of the attack.
In epilepsy an aura is often present, and this is generally
followed by a peculiar cry; the patient falls suddenly, instead
of slowly, to the ground, and the tongue is frequently bitten,
none of which symptoms belong to cerebral congestion.
In embolism the pulse and respiration are disturbed, being
more or less irregular and rapid, owing to valvular disease of
the heart, which is usually present; the heat of the head is not
increased in this disease, there is no premonitory stage, and the
symptoms are more permanent than they are in cases of cere-
bral hyperaemia.
In thrombosis, aphasic and paralytic symptoms are usually
present from the beginning, and, notwithstanding occasional
remissions, they gradually become more and more pronounced
as the disease progresses.
In cerebral softening the accession may be either gradual
CEREBRAL HYPERZEMIA. 15
or sudden, but the paralysis is permanent and progressive, the
speech is seriously impaired, the intellect is feeble and the
disease fatal.
Urinaemia may be distinguished from cerebral congestion
by the evidence afforded by a chemical and microscopical ex-
amination of the urine, by the anasarcous condition of the face
and limbs, and by the frequent recurrence of convulsions and
coma.
Patho1ogy.—-The essential pathological element in cerebral
hyperaemia is the congested state of the capillary vessels of the
brain, and to this is due the functional disturbance or irrita-
tion of that organ. The congestion is active when, owing to
arterial dilatation, oxygenated blood passes rapidly through
the cerebral capillaries; and passive, when, from venous Ob-
struction, the capillaries contain mostly venous blood, which
moves sluggishly through them.
Clinical Experience. —— Aeonite, Glonoin, Belladonna and
Hyoscyamus are generally prescribed in cases of acute active
congestion, the last two being preferred when there is a marked
tendency to delirium. Hale uses large doses (15 grs.) of Natr.
brom. and Kali brom. in these cases, which he pronounces supe-
rior to either Aconite or Belladonna. Opium and Apis have
been given successfully in the apoplectic form, or when there
was great cerebral depression. Gelsemium and Veratrum vir.,
both low, are usually given in cases of recent passive or venous
hyperaemia, the latter being preferred when the blood pressure
is very great, the face livid and the veins greatly distended.
Nux vom. and Arnica are used in chronic cases, the former
being prescribed for high livers and persons of sedentary life,
and the latter in paralytic cases, or where there is a suspicion
of thrombosis. Bryonia, Phosphorus, Salicylic ac. and Cuprum
have also been given successfully in special cases.
Therapeutic Indications.—Gl0noi11.—Acute active conges-
tion of the brain, with strong beating of the carotid and
temporal arteries, contracted pupils and very rapid pulse;
throbbing headache, with flashes of light before the eyes; tin-
nitus aurium; fulness in the forehead and vertex, with mental dul-
ness; vertigo, with impaired vision; great restlessness and im-
16 NERVOUS THERAPEUTIOS.
patience in mild cases; apoplectic and epileptiform cases,
especially when caused by exposure to the sun’s heat or by
menstrual suppression.
Belladonna.—Acute cases attended by delirium or by spasms
and convulsions; redness of the face and eyes; morbid vigil-
ance; sensitiveness to light and noise; contraction of the
pupils; stiﬂness of the tongue and neck; throbbing headache;
great mental excitement; double vision; children start suddenly
when falling asleep.
Aconite.--Great restlessness and anxiety, with dry, burning
skin and a full bounding pulse; throbbing in the head, with
sense of fulness and heaviness; contracted pupils; vertigo,
especially when stooping; heat, thirst and delirium; cardiac
palpitation. This remedy is specially indicated when the
attack is due to great emotional excitement or exposure to
extreme heat.
Hyoscyamus.——-Dark red face and sparkling eyes; violent de-
lirium; lascivious mania; epileptiform attacks; muscular
twitchings ; great nervousness; double vision; grating of the
teeth. Acute attacks in which the nervous and mental phe-
nomena predominate.
Stram0I1ium.—This remedy is indicated in cases similar to
those for which Hyoscyamus is recommended, the nervous ex-
citement being extreme, and the delirium of the most active
and furious character. The patient laughs, sings and gesticulates
in rapid succession, or shows great fright, terror or rage. In
milder cases, vertigo and temporary blindness are special indi-
cations.
Amyl nit.—Throbbing of the cerebral vessels, with sense of
heat and fulness in the head; buzzing and throbbing in the
ears; protrusion of the eyes, with ﬂushing of the face; visible
pulsations of the carotids ; violent cardiac action. At the very
beginning of active cerebral hyperaemia.
Bryonia.—-Painful outward pressure in the forehead and
temples; active cerebral circulation, attended with bleeding of
the nose; muscular twitchings during sleep; face red and
puffed; gastric disturbances and constipation.
Gelsemium.—-Dull, pressive and stupefying headache, extend-
CEREBRAL HYPERZEMIA. 17
ing from os frontis to occiput; vertigo, dimness of vision and
diplopia; drowsiness and mental confusion; dull, aching pain
in the nape of the neck, with disposition to throw the head backward ;
great muscular prostration; dropping of the upper eyelids. Most
useful in the passive form of cerebral congestion, especially in
malarial cases.
Veratrum Vir.—Fulness and sense of weight in the head, with
vertigo, confusion of mind and loss of memory; oppressed res-
piration; labored action of the heart; tingling and numbness in
the limbs. Passive congestions, especially such as result from
alcoholic stimulants and malarial poisoning.
Opium.—Apoplectic cases, with dark red and bloated face, slow
pulse and diﬂicalt articulation ; great drowsiness, with confusion
of mind, and sense of heaviness and pressure within the head;
coldness of the hands and feet, with mumbling delirium.
Suited to the passive and apoplectic forms, and also such as
arise from fright or debauchery.
Apis mel.——Sense of fulness and heaviness of the head, es-
pecially in the occiput; burning and throbbing in the head,
greatly aggravated by stooping; vertigo, with nausea; drowsi-
ness, with inability to sleep, owing to extreme nervousness;
redness and burning of the eyes and eyelids; sleep disturbed
by oppressed breathing and unpleasant dreams. Most suitable
in cases characterized by great cerebral depression.
Nux vomica.—-Gastric derangement, with dulness and con-
fusion of the head; sleeplessness during the latter part of the
night; drowsiness, with a tendency to coma; symptoms ag-
gravated by coffee, eating and exercise in the open air. Con-
stipation, haemorrhoids and derangements of the stomach
point to this remedy, especially in chronic cases caused by ex-
cessive mental labor, sedentary modes of life, overstimulation
by alcohol, the abuse of tobacco, worry and loss of sleep.
Arnica.——Heat and burning in the head, with coldness of the
rest of the body; throbbing in the forehead and temples, in-
creased by stooping or exercise; tinnitus aurium; vertigo, at-
tended with nausea, obscuration of sight or loss of conscious-
ness; delirium. Chronic congestions, and also such as result
from mechanical violence.
l8 NERVOUS THERAPEUTICS.
Phosphorus.——Heat and throbbing in the head, with vertigo,
buzzing in the ears and heat in the vertex; lightning-like pains
in the head; sense of weight in the forehead, increased by
stooping. Chronic cases, and such as are due to mental strain
or overwork.
Cuprum.—Violent convulsive movements, either general or
local; restless tossing about and constant uneasiness; pulse full,
quick and strong; eyes red and inﬂamed, looks wild, and
speech delirious; excessive thirst. Cases resulting from sup-
pressed eruptions or retrocedent exanthemata.
Gimicifuga.——Dull, heavy feeling in the head; pain in the
temple and vertex, with a sensation of pressure; heat and ful-
ness in the head, with throbbing and pressure; pain in and
behind the eyes, also in the back of the head and neck; the
brain feels too large for the skull; sensation as if the top of
the head would ﬁy off; severe pain over the right eye. Cere-
bral congestion, involving especially the base of the brain and
complicated with spinal irritation.
Aurum.—Heat and roaring in the head; scintillations before
the eyes; extreme melancholy, desire for death and suicidal
tendency; symptoms aggravated by mental exertion.
Goifea.—Heat in the head and face, with ﬂushing; bleeding
of the nose; great nervousness and exaltation of the senses;
hot head, red and glistening eyes and cold feet. Infantile
cases occurring during the period of dentition, especially when
associated with diarrhoea. ‘
Lachnanthes.—Dull headache, with sensation of upward press-
ure in the vertex; vertigo, with feeling of heat and congestion
in the chest; great outward pressure behind the eyes; burning
sensation in the head, while the whole body feels cold; expan-
sive feeling in the head, as if it was being split open.
Rhus tox.—Burning, throbbing pains in the head, with sense
of fulness; red and burning, or pale and puffy face; rvertigo
when lying down; great restlessness, especially at night; waver-
ing sensation in the brain; pains reappear after eating. Es-
pecially adapted to cases caused by prolonged exposure to
extreme cold, or by standing in cold water.
Asclepias syr.—Headache, with vertigo, dulness and stu-
CEREBRAL HYPERZEMIA. 19
pidity; sharp, stabbing pains, extending from one temple to the
other; severe headache, with quick, full pulse and nausea;
feeling of constriction across the forehead; scanty urine. This
remedy is particularly indicated in cases where the perspira-
tion has been suddenly suppressed.
Pulsatilla.—Oppressive, beating headache, with confusion of
mind; red and bloated face, with bright sparks before the eyes;
vertigo, with tinnitus aurium; double vision, nausea and pal-
lor of the face; bitter taste in the mouth; drowsiness during the
day and sleeplessness at night; scanty or suppressed menses;
symptoms worse in a warm room; ameliorated by pressure, or
by going into the open air. Especially called for in cases
caused by a sudden suppression of the menses, particularly in
young girls.
Sulphur.——Rush of blood to the head, producing redness and
heat of the face, vertigo, and a sense of fulness and pressure
within the cranium, with violent throbbing; pale face, with
coldness of the extremities. As an intercurrent remedy in
chronic cases.
Auxiliary Treatment.-The removal of the cause is gen-
erally the ﬁrst thing to be considered, for whenever it can be
effected it will greatly beneﬁt the patient, and in many cases
accomplish a cure. Where the exciting causes cannot be
entirely removed, they may be lessened, and their injurious
effects greatly palliated. Thus, the passive form requires rest,
both physical and mental; hence all excess in eating and
drinking, all excitement or gratiﬁcation of the animal appe-
tites and passions, in short, every form of bodily and mental
exertion, should be studiously avoided. The active form re-
quires similar restrictions, except that the injunction as to rest
need not, as a rule, be insisted on to so great an extent. The
patient, however, if able to be about, should abstain from all
severe muscular exertions, especially in a stooping posture.
But moderate exercise in these cases is often of great beneﬁt.
Dr. Kershaw relates several cases which were greatly beneﬁted
by regular and judiciously taken exercise, such as walking,
riding, etc., carefully regulated according to the strength and
health of the patient.
20 NERVOUS THERAPEUTICS.
Professor Preyer, of Jena, claims~ to withdraw an excess of
blood from the brain by making his patient stand with one
arm outstretched until the limb aches violently. By conduct-
ing the excess of blood to the arm in this way, the brain is
relieved, and a cure speedily effected.
Cold to the head is often of great beneﬁt in the active form of
the disease, if systematically applied. When the hyperaemia
is intense and the pupils very much contracted, ice and ice-
water should be applied to the head and neck until the symp-
toms abate, which may not be under several days, or even
weeks. I recently succeeded in curing a very severe case"in
this manner, in a patient over seventy years of age, and a hard
drinker at that, the congestion continuing over a period of
from six to eight weeks, more than four hundred pounds of ice
being used! Of course, such heroic treatment is only suited to
cases of the most active and intense form, with a very high
temperature, bounding pulse and greatly contracted pupils.
In mild cases it will be better and safer to use warm water in-
stead of cold, as the evaporation from it not only produces a
comfortable sense of coolness, but causes no depression, and is
followed by no injurious reaction.
There are various agents known to possess the power of con-
tracting the cerebral capillaries, such as galvanism, ergot and
the alkaline bromides. These are sometimes useful as pallia-
tives, and may be employed with beneﬁt in cases where the
homoeopathically indicated remedies, from any cause, appear
to be inadequate to the complete removal of the hypermmic
condition, which, however, will seldom be found to be the case.
The constant galvanic current should be applied by placing
one sponge over the sympathetic nerve in the neck, and the
other over the spine, opposite the seventh cervical vertebra.
The current from eight or ten Smee’s or Leclanché cells, acting
not to exceed three or four minutes at any one time, will be
sufﬁcient for the purpose.
Ergot and the bromides, being allopathic remedies, require
to be used in material doses. Hammond advises the former
in drachm doses of the ﬂuid extract, and the latter in twenty-
grain doses, in solution, three times a day. I have seldom had
CEREBRAL HZEMORRHAGE. 21
occasion to resort to either of these remedies in active cerebral
congestion, but have employed the bromides with apparent
beneﬁt in a few stubborn cases, giving them in two or three-
grain doses every hour.
Care should be taken in every case to keep the feet warm,
the head elevated, the chamber cool, and the clothing about
the chest and neck loose and comfortable. The diet should be
light and easily digestible; and in all severe cases it should
be entirely devoid of any stimulating quality. I have found
nothing better, for this purpose, than a thin broth made of a
bare knuckle of veal, and containing little 1nore than water and
gelatine.
CEREBRAL HJEIVIORRHAGE.
Syn0nyms.—Apoplectic Stroke, Cerebral Apoplexy, Apo-
plexia Sanguinia; Fr., Hemorrhagie Cérébrale Interstitielle; Ger.,
Hirnschlag, Schlagfluss, Gehirn-apoplescie, Hirnblutung.
Deﬁnition.—A rupture of a cerebral bloodvessel, and the
consequent escape of blood into the substance, or into the ven-
tricular cavities, of the brain.
Diagnosis.-—The distinctive character of cerebral haemor-
rhage is that of a brain lesion occurring suddenly. But as
apoplexia sanguinia is but one form of the apoplectic state, it is
important to distinguish it from the others, namely, the apo-
plectic variety of cerebral hyperaemia, embolism of cerebral
arteries, alcoholic and uraemic intoxication, sunstroke and
haemorrhage into the cerebral membranes.
The distinctive features of cerebral congestion have already
been given under the head of cerebral hyperaemia, which see.
Embolism of the cerebral arteries may commonly be dis-
tinguished from cerebral haemorrhage by the fact that in em-
bolism there are no prodromic symptoms, that the paralysis
is usually on the right side, and that the disease is almost
always associated with valvular disease of the heart.
The symptoms of alcoholic and uraemic intoxication some-
times closely resemble those of cerebral haemorrhage, but the
profound stupor of full inebriation can usually be satisfactorily
determined by the breath, habits and general appearance of
22 NERVOUS THERAPEUTICS.
the patient; while uraemic intoxication offers a suﬂicient guide
to the judgment in the existence of kidney disease and the
chemical and microscopical peculiarities of the urine.
The insensibility produced by sunstroke can be easily ac-
counted for by a knowledge of the previous exposure of the
patient to the direct rays of the sun, while the absence of one-
sided paralysis clearly distinguishes it from cerebral hmmor-
rhage.
Haemorrhage into the cerebral membranes may usually be
distinguished from cerebral haemorrhage by the fact that it is
seldom followed by hemiplegia, that violent headache is a
characteristic symptom of it, that coma comes on gradually or
not at all, and especially by the fact that its course is marked
by frequent remissions. '
Hysterical coma often closely resembles that of cerebral
haemorrhage, but in these cases there are usually other evi-
dences of the hysterical condition present, such as the super-
ﬁcial character of the symptoms, the unerhbarrassed state of
the general circulation, the absence of stertor, the age of the
patient, the hysterical history and constitution, etc.
Pathology. ——MM. Charcot and Bouchard have conclu-
sively shown that, in the great majority of cases of cerebral
haemorrhage, the vascular rupture is due to the formation of
rniliarg aneurisms upon the smaller branches of the cerebral
- arteries, in consequence of an inﬂammatory condition which
results in atrophy of the middle coat, on which their strength
chieﬂy depends. The cerebral bloodvessels are also sometimes
greatly weakened by atheromatous degeneration, which is a
common pathological condition in the aged, and is sometimes
the only known cause of the rupture. Other conditions, like-
wise, doubtless favor the rupture, such as an increased tension
of blood in the vessels of the brain; an unhealthy state of
the blood, such as exists in typhus, scurvy, etc., rendering it
unﬁt for the proper nourishment of the bloodvessels, cerebral
softening, etc.
Clinical Experience.—Aconite and Belladonna are generally
given to relieve the earlier and premonitory symptoms, the
former being preferred when there is much arterial excite-
CEREBRAL HEMORRHAGE. 23
ment, and the latter when congestion is the most prominent
symptom. Phosphorus not only retards calcareous degeneration,
but nourishes the brain substance, thereby lessening the danger
of vascular rupture, and is given whenever, from hereditary
predisposition, or tendency to cerebral congestion, an attack
of sanguineous apoplexy is apprehended. During the attack,
and until sensibility returns, the chief reliance usually is
upon Opium, aided, according to the state of the circulation, by
Aconite and Belladonna. At a later period, Arnica, Rhus tox., Nux
vom. and similar remedies are usually resorted to, partly to
promote the absorption of the clot, and partly to stimulate the
nerve centres, and thus relieve the paralytic condition.
Therapeutic Indications.—Phosphorus.——Probably this is
the most important remedy, so far as preventive treatment is
concerned, for the reasons above stated. Hereditary predisposi-
tion to the disease, a weak condition of the nervous system, the
existence of senile or scrofulous bronchitis, weak lungs, cough,
night-sweats and loss of memory, all point to the early use of
this remedy, especially in the aged, and more particularly if
subject to transient attacks of cerebral congestion.
Aconite is another 'very important remedy, as well in the
premonitory as in the inﬂammatory stages. Whenever the
head is hot, the pulse full, hard and strong, and the patient
complains of headache, thirst, numbness and formication, this
remedy is especially indicated.
Belladonna should follow Aconite, both in the premonitory
and initial stages of the disease, whenever the symptoms for
which the latter is given fail to yield, or when the head be-
comes hot, the eyes red and bloodshot, the pupils contracted,
the face flushed and the cerebral vessels throb with increased
violence. Convulsive movements, when spontaneous, are an
additional indication for this remedy.
Opium rivals all other remedies during the stage of insensi-
bility or when the face is dusky red, puffed and a deep coma-
tose state exists, with stertorous respiration, slow, irregular breath-
ing, dilated and insensible pupils, face and head covered with
cold sweat, dropping of the lower jaw and one-sided paralysis.
Baryta carb.——Sanguineous apoplexy of old people, especially
24 NERVOUS THERAPEUTICS.
when accompanied with partial paralysis, the patient being
unable to speak owing to paralysis of the tongue; anxiety, with
trembling of the limbs, and an inability to maintain the body
in an erect position; childish, fearful and forgetful. Specially
suited to those addicted to the excessive use of strong drink.
Rhus t0x.—-This remedy may be given with advantage after
the inﬂammatory symptoms subside, especially when there is
a loss of feeling as well as of motion. Rheumatic pains in the un-
paralyzed side, especially if aggravated by damp weather, also
point to the use of this remedy.
Arnica.—Paralysis of the left side of the body, with insensibility
and stertorous breathing; muttering delirium, with involun-
tary discharges of faeces and urine; symptoms of shock in old
people; also suitable for the middle-aged, possessed of strong,
plethoric constitutions. Arnica stands high as an anti-paralytic
remedy in these cases, owing to its power of promoting the ab-
sorption of the clot, or, rather, of the effused blood, whereby
the clot is contracted and the paralysis correspondingly re-
lieved.
SanguinaI'ia.—Attacks due to venous congestion; distension
of the temporal veins; burning heat and redness of the face;
burning of the ears; paralysis of the right side; bad odor of the .
breath and sputa; diﬂicult respiration, with pain in the chest,
and cough. Especially suited to cases complicated with senile
bronchitis.
Nux Vom.—Sanguineous apoplexy of high livers, professional
men and those leading a sedentary life; stertorous breathing,
stupefaction and paralysis; dropping of the lower maxilla;
attacks preceded by premonitory symptoms, such as vertigo,
headache, tinnitus aurium, etc., also for the premonitory
symptoms themselves.
Pulsatilla.-—Attacks attended by loss of consciousness and
preceded by drowsiness, especially when occurring in women
at the climacteric period, or when accompanied or preceded
by an arrest or disturbance of the menstrual function; con-
gested condition of the face, with difliriult breathing and pa-
ralysis.
Lachesis.—Insensibility, with sopor or drowsiness; absence
CEREBRAL HZEMORRHAGE. 25
of mind when conscious; congestion to the head, with blueness
of the face; slow, heavy, wheezing respiration ; full and hard,
or weak and irregular pulse; paralysis, especially on the left
side.
Laurocerasus.—Deep, quiet coma, more like natural sleep
than usual in such cases; pulse scarcely perceptible; cold,
clammy skin; palpitation of the heart; convulsions, with sub-
sequent paralysis, including paralysis of the sphincters; deﬁ-
cient susceptibility to the action of other remedial agents;
patient speechless even when conscious.
Sepia.—-Attacks preceded by cerebral hyperzemia or by ve-
nous congestion; intermitting pulse, cold feet and palpitation
of the heart; intense headache coming on suddenly after stop-
page of the menses. Especially adapted to women at the
climacteric period, and to men addicted to hard drinking and
venery.
Auxiliary T1'eatment.—Inasmu ch as, according to the old
adage, “an ounce of prevention is worth a pound of cure,”
great care should be taken in all cases where, either from age
and decrepitude, or from hereditary predisposition, there is
reason to apprehend an attack of cerebral haemorrhage, to guard
against its occurrence by a timely administration of such
remedies as will tend to improve the blood and strengthen the
enfeebled capillaries of the brain, such as Phosphorus, Nua: vom.
and Baryta, and also to quiet the circulation and subdue
any tendency to cerebral hyperaemia which may exist by such
remedial measures as we have recommended under that head.
(See the preceding section, and for fuller information on this
important subject the reader may also consult with advantage
the author’s work on Intracranial Diseases, pp. 99-108.)
After the attack, and especially during the period of uncon-
sciousness, the patient should be kept in such a position as
will most favor a return of blood from the head. Thus the
head and shoulders should be raised by pillows, the clothing
loosened about the neck and chest, and free ventilation of the
patient’s room at all times‘ secured. The paralyzed limbs
should be wrapped in cotton batting, or kept warm by means
of hot ﬁannels, frictions, etc.; and the bowels should be relieved
3
26 NERVOUS THERAPEUTICS.
from time to time by emollient or stimulating injections, as
the exigency of the case may require. Attention should
also be given to the bladder, and, if necessary, the catheter
should be used daily until the patient is able to void his
urine voluntarily.
The diet is such an important matter that during the early
stages of the attack nothing more stimulating than gum water,
barley or rice water, toast water and similar farinaceous drinks
should be given ; but after the period of inﬂammatory danger
is past and improvement commences, more nutritious sub-
stances may be allowed, such as animal broths, milk, soft-
boiled eggs, etc., but the effects produced by administering
such articles of nourishment as these should be carefully
watched, and if, on strengthening the diet, the face becomes
ﬂushed, and headache and restlessness or increased stupor en-
sues, all such stimulating articles of diet should be at once
withdrawn. If inﬂammation sets in around the clot, which is
apt to occur about the ninth or tenth day of the seizure, the
treatment for meningitis and encephalitis will be required.
No attempt should be made to overcome the paralysis until
the period of inﬂammation is past and the acute symptoms
have entirely disappeared. Measures may then be safely
taken for the relief of the paralysis, and for the prevention of
consecutive muscular contractions. One of the ﬁrst measures
to be employed for these purposes is massage, which should be
administered from one to three times daily by an experienced
masseur. Some beneﬁt may also be obtained from friction
with the ﬂesh brush and salt water, or with the electric brush)
which is still more stimulating. But the most efficient treat-
ment of the sort is galranism methodically applied. At ﬁrst,
the induced current is to be preferred, but it should be of
sufficient strength to produce contraction or cause slight pain.
It may be applied by means of wet sponges to the skin cover-
ing the muscles, or, if this proves ineffective, it may be applied
directly to the nerves. Such cases as will not yield to the in-
duced current, whether they be Old or recent, should be treated
with the primary interrupted current, the primary constant
current not producing contractions. The same efficient agent
CEREBRAL THROMBOSIS. 27
may be used to promote the restoration of sensibility, in cases
in which the anaesthesia does not spontaneously disappear.
After the patient has so far recovered as to move about,
moderate exercise in the open air, change of scenery, salt-
water baths and a diversiﬁed but tranquil life are to be com-
mended and, as far as possible, secured.
CEREBRAL THROMBOSIS.
Synonyms.-———Thrombosis of Cerebral Arteries, Veins and
Sinuses; Fr., T hrombose Gérébrale; Ger, Thrombose Cerebralis,
Hirnarterienversperrung, Thrombose der Hirnarterien.
Deﬁnition.——An occlusion of cerebral arteries, veins or
sinuses by the coagulation and deposition, in situ, of ﬁbrin
upon the internal coats, or within the lumen, of the vessels.
DiagnosiS.—The diagnosis of cerebral thrombosis is often
a matter of extreme difficulty. The disease may be distin-
guished, in a general way, from cerebral embolism and cerebral
haemorrhage by the gradual manner of its development;
but from cerebral heemorrhage, when, as is sometimes the
case, the haemorrhage takes place gradually, it can only be
certainly diagnosed by taking into consideration the predis-
posing causes, namely, pulmonary affections and valvular
diseases of the heart. Wlien there is valvular disease, the
diagnosis between cerebral thrombosis and cerebral embolism
may be satisfactorily made out by means of the following
table:

Cerebral Thrombosis. Cerebral Embolism.

Advanced age. Youth.
Evidences of atheroma. Absence of atheroma.
Fatty degeneration of heart. Previous rheumatic attacks.
Slight attacks of paresis. Decided paralysis.

Path0logy.—Owing to the diseased condition of the blood-
vessel its internal coat becomes roughened, which favors the
deposition of ﬁbrin at that point. The primary layer thus
formed becomes gradually thickened by fresh accretions, until
28 NERVOUS THERAPEUTICS.
ﬁnally it ﬁlls the whole caliber of the vessel and completely
obstructs it. While the artery is undergoing occlusion the
part of the brain to which it is distributed is rendered more or
less anaemic, and when the vessel becomes entirely closed the
anaemic parts undergo the process of softening—ﬂrst, red soft-
ening (which is probably a state of passive hyperaemia, com-
bined with oedema and haemorrhage), and afterwards, unless
the collateral circulation is speedily and adequately established,
necro-biotic or yellow softening quickly supervenes.
Clinical Experierme.—As this disease, when fully devel-
oped, depends upon the presence of foreign matter lying be-
yond the reach of ordinary remedial agencies, little benefit has
hitherto been derived from medical treatment; nor can much
beneﬁt be reasonably expected from such treatment in any
case, except so far as it may be capable of retarding the pro-
gress of the disease, and in contributing to the relief of some
of its most serious and distressing symptoms. How far the
following plan, prescribed by Dr. Stiles, has proven eﬂicacious
I have no means of knowing, but that it will palliate such
cases I have no doubt.
Wl16I1 the disease shows evidence of inﬂammatory action, or
is recent, Bellad., Nua; vom., Mercur.; where it is evidently due
to atheromatous conditions of arteries, Phosphor, Phos. ac.,
Anac., Zincum; for hemiplegia, Nua; vom., Coccul, Baryta carb.,
Arnica; for vertigo, Iodine (congestive); Sulphur, Digit. (cardiac);
for sleeplessness, Coﬂea, Hyosc. or Nun vom., and O'hamom., if
the patient has been addicted to the use of coffee; China, if he
has been a great tea drinker; for paralysis (general), Phosphor,
Conium, Coccul. (local), Caustic, Acon., Ignat., Bellad.; for con-
vulsions (simulating epilepsy), Bellad, Cale. carb., Cuprum,
Strychnine; for emotional disturbances, Ignat; headache (ac-
tive), Acon., Bellad., Bryon, Nurc vom., Glonoin; (passive),
Gelsem., Opium; for imbecility, Arnica, Ambra, Selen., Sepia;
or sensation of formication, Secale.
Therapeutic Indicati0ns.—These, so far as applicable to
the disturbances caused by cerebral thrombosis, may be found
under the respective heads of cerebral anaemia, cerebral hyperaemia,
cerebral haemorrhage, and encephalitis, which see.
cEREBRAL THROMBOSIS. 29
Auxiliary Treatment.—This consists for the most part (1)
in the removal, so far as possible, of all debilitating causes and
disturbances; (2) in aiding both the general and local circula-
tion by such constitutional and other means as the exigencies
of the case may require; and (3) in endeavoring to dissolve
the ﬁbrinous deposit by the administration of alkaline solvents.
Dr. B. W. Richardson, after citing a number of illustrative
cases, formulates the following rules, among others, for the
exhibition of Ammonia as a solvent of ﬁbrinous concretions in
the heart and bloodvessels:
1. The ammonia is best administered either in the form of
the strong aqueous solution, or of the saturated alcoholic solu-
tion. More than ﬁve minims at a time cannot easily be swal-
lowed. The best menstruum for the ammonia is milk, and if
the milk be chilled by ice, the patient takes the mixture with
great facility.
2. The ammonia must be relied upon exclusively. Seda-
tives and stimulants of all kinds are to be avoided as fraught
with danger. Wines-and spirits are most injurious; they pro-
duce a danger of movement of the ﬁbrinous mass; they excite
and, in time, exhaust the heart.
3. The diet should be, as nearly as possible, of pure milk,
with a11 occasional change to gravy soup or minced codﬁsh,
with bread or toast. Other solid substances do not digest
readily; they create ﬁatulency, and cause a restless movement
of the body, which is detrimental.
4. With the medicinal and dietetic treatment thus enjoined
there must be combined the most perfect rest of the body in
one position. The secret of success consists in producing solu-
tion of the obstructing mass while it lies sufficiently out of the
course of the circulation. If it loosen from its hold while it
remains semi-solid, however small it may be, it will be a source
of additional danger.
5. Together with this physical rest, every mental comfort
must be supplied. The patient must be harassed with no
unnecessary fears, agitated by no unnecessary comments.
Much of the success of the treatment depends on the gentle
ﬁrmness with which the practitioner enforces that the greatest
30 NERVOUS THERAPEUTICS.
advantage is secured by absolute repose of the mind as well as
the body.
6. \Vhen the secondary changes indicate the solution and
distribution of the ﬁbrin, the administration of the ammonia
is not to be immediately withdrawn. The alkali is still as im-
portant, under these circumstances, as in those which precede
them. ‘
7. The conditions warranting the withdrawal of the solvent
are: relief of venous engorgement; normal return of pulse and
temperature, and restored mental and physical power; i11 other
words, a complete restoration of all the normal powers and
functions. When these favorable conditions exist, it is fair to
infer that no obstruction remains in the circulatory canals,
and that the ammonia may be safely withdrawn.
But inasmuch as the ammonia, however far it may, with
reason, be carried, does no injury that is not quickly recovered
from, there exists.no cause for hurry in withdrawing it. It
may, therefore, be continued in less frequent doses for a few
days after every danger appears to have-passed away.
The above directions have been formulated with reference,
more especially, to embolism and thrombosis of the larger
circulatory vessels, but they apply equally well to the same
conditions of the capillary vessels of the brain, except that, in
the latter case, the injunctions as to absolute rest need not be
insisted on to so great an extent. Nevertheless, it is important
even in these cases that the complete solution of the ﬁbrinous
obstructions should take place in situ, unless the general
health of the patient should materially suffer from the conﬁne-
ment; hence it is best to have them rigidly observed in every
case of cerebral vascular obstruction in which the treatment
may be tried.
CEREBRAL EMBOLISM.
Synonyms.—Embolism of the Cerebral Arteries and Capil-
laries; Fr., Embolie Oérébrale; Ger., Embolie Cerebralis, Hirn-
arterienoersperrung, Embolie der Hirnarterien.
Deﬁnition.--The obstruction of arteries or capillaries of
the brain by solid particles of matter formed in other parts of
CEREBRAL EMBOLISM. 31
the body, and carried along in the course of the circulation to
points where they have become lodged.
Diag‘n0sis.—Occlusion of the left middle cerebral artery
causes right hemiplegia with aphasia, while obstruction of the
right middle cerebral produces left hemiplegia without aphasia.
Embolism of the ophthalmic artery gives rise to sudden am-
aurosis; and sudden plugging of the basilar artery produces
vomiting. These diagnostic points are sufficient, in connection
with the other symptoms mentioned below, to clear up the
majority of cases of cerebral embolism; but when the symp-
toms of apoplexy are present it may not be possible at first to
distinguish the disease with certainty from cerebral haemor-
rhage. When, however, the paralysis vanishes suddenly, we
know that it was not caused by cerebral haemorrhage; and if
recovery takes place within two or three days after the attack,
the latter can only be referred to an embolus. Moreover, there
are no premonitory symptoms in embolus; the disease occurs
irrespective of age; the paralysis, which is usually on the right
side, is generally combined with aphasia; and the disease is
almost always associated with valvular disease of the heart, or
a preceding attack of endocarditis. The differential diagnosis
between cerebral embolism and cerebral thrombosis may be
found under the latter head.
Path0logy.—Many competent observers have shown that
the cerebral bloodvessels may be obstructed by ﬁbrinous con-
cretions derived from the heart or large vessels; that this
obstruction produces anaemia of those portions of the brain to
which the affected artery is distributed; and that unless the
obstruction is quickly removed, or the collateral circulation
adequately and speedily established, softening of the brain
substance is sure to follow.
Anomalous cases of cerebral embolism sometimes occur, in
which general fever takes the place of hemiplegia or other
local paralysis. These cases are characterized by high fever,
with delirium, and without any, or scarcely any, deﬁnite pa-
ralysis or aphasia. The pathological condition consists in the
distribution through the brain of embolic dust, so ﬁne as to
traverse without hindrance the larger arteries of the base and
32 NERVOUS THERAPEUTICS.
substance of the brain, to be finally arrested in the minute
channels of the pia mater.
Clinical Experience.—-The only clinical experience worth
mentioning is that referred to under the head of thrombosis,
which see.
Therapeutic Indications.——As these have to do with eﬂects
rather than causes, they will be found given in detail under
their appropriate headings. See cerebral anaemia, hyperaemia,
hannorrhage and softening.
Auxiliary Treatment.—This is necessarily limited to such
measures as are calculated to favor the establishment of the
collateral circulation, to wit: lowering or raising the head, ac-
cording as the cerebral circulation is more or less embarrassed;
promoting the general circulation by friction with the ﬂesh
brush, wrapping the body and limbs in warm blankets, cotton
batting, etc., in case the patient is somnolent and the bodily
temperature much reduced; and, finally, by a cautious en-
deavor to dissolve away the ﬂbrinous concretions by the
“ammonia” treatment already described. (See p. 29.)
ENGEPHALITIS.
Syn0nyms.——Suppurative Inﬂammation of the Brain, Cere-
britis; Fr., Inﬂammation de l’Encephale; G'er., Enkephalentziln-
dung;—-Cerebral Abscess; Fr., Abcés Cérébrale, Abcés de l’Ence-
phale; G'er., Eiterbeule des Gehirns, H irngeschwiir.
Deﬁniti0n.—Partial inﬂammation of the brain substance,
usually complicated with meningitis, and tending to sup-
puration. _
Diagnosis.—The diseases for which encephalitis is liable to
be mistaken are: acute cerebral meningitis, cerebral haemor-
rhage, cerebral tumors, and the disease called general paralysis.
In acute meningitis the fever is much higher, the convulsive
movements more general, the headache more severe, and the
delirium more marked and constant. In cerebral haemorrhage
the symptoms generally become more and more ameliorated
as the disease progresses, whereas in encephalitis they become
progressively more pronounced. The symptoms which charac-
ENCEPHALITIS. 33
terize general paralysis, and also those which attend the de-
velopment of cerebral abscesses, closely resemble those which
accompany the growth of cerebral tumors, and can, as a rule,
only be distinguished by the history of the case and the fact
that encephalitis is usually of shorter duration than general
paralysis, and is not marked by the “mania de grandeur”
peculiar to the latter disease.
Pathology.—The tendency to suppuration is so great in
this disease that more or less softening of the brain substance
is always found after death, generally in circumscribed patches,
which usually terminate in one or more abscesses, involving
not only the gray matter, in which the inﬂammatory process
usually commences, but also the white substance of the cere-
brum, the basal ganglia, and, in some cases, the cerebellum.
In acute cases, the abscess, being surrounded by no limiting
capsule, encroaches more and more upon the adjacent tissues,
and may ultimately reach the surface of the brain, or break
through into the lateral ventricles. When the inﬂamination
is due to injury or caries of the cranial bones, it is no uncom-
mon thing for it to escape, sooner or later, through the ear or
nose. On the other hand, when the inﬂammatory process is
more chronic, the abscess is surrounded by a membranous
capsule composed of connective tissue, and if large will give
rise to symptoms of compression. There is no hope of recovery
after the disease has passed the stage of red softening.
Clinical Experience.—Our clinical experience in this dis-
ease is so mixed up with that of acute meningitis, with which
it is commonly associated, that no reliable distinction can be
made between them. This, however, is of but little conse-
quence in a practical point of view, as the treatment of sup-
purative encephalitis is, so far as our present experience goes,
altogether palliative. It is right to add, however, that Kafka ap-
pears to have treated a case successfully with Arsenicum, “ even
when cerebral softening, with progressive increase of the mor-
bid phenomena, coéxisted side by side with the symptoms of
cerebral hyperaemia,” the remedy having been employed after
the hyperaemic condition had been relieved by Glonoin and
Belladonna. Kali brom. and Cannabis ind. have proved bene-
34 NERVOUS THERAPEUTICS.
ﬁcial in some cases by diminishing the irritability of the
nervous system.
Therapeutic Indications.—Considering, as we do, that the
curative stage of this disease is limited to the initial or hyper-
aemio period, to detail the therapeutic indications would be
but to repeat what is said under that head regarding cerebral
hgperarnia and rneningitis. We will simply add that Iodine
and Plurnbum have been recommended, chieﬂy on theoretical
grounds, the former for its supposed power to control suppu-
rative inﬂammation, and the latter for its anti-paralytic action ;
Jllercurius iod. in syphilitic and scrofulous subjects, especially
when there is a history of chronic otorrhoea, enlarged tonsils or
rheumatism, with an aggravation of the symptoms at night or
from a change of weather; Pulsatilla, when the disease follows
the suppression of an eruption or of a chronic discharge from
the ear; Silicea, when an abscess is supposed to have formed;
and Zincwm in the later stages, when there is great depression
of both mind and body.
Auxiliary Treatment.—Hygienic measures, if instituted
sufﬁciently early, may be of service in warding off an attack.
Hence, in all suspicious cases, especially if the patient is weak,
scrofulous or ill-nourished, a good nutritious diet should be
recommended, and, where vertigo does not prevent, the patient
should exercise freely in the open air, live in a mild, equable
climate, and, if practicable, occasionally take an ocean voyage
—all of which will strongly tend, by invigorating the system,
to remedy any threatened invasion of the disease.
CEREBRAL SOFTENING.
Synonyms.—Softening of the Brain; Fr., Ramollissernent
Cérébrale; Ger, Erweichung des Gehirns.
Deﬁnition.——A necro-biotic process, involving brain tissue,
caused by defective nutrition, depending in most cases on vas-
cular obstruction and attended by diminished consistence.
Pathology.-When obstruction in any of the cerebral blood-
vessels takes place on the far side of the circle of Willis, necro-
biosis is quickly established, because there is no free vascular
CEREBRAL SOFTENING. 35
connection by which a collateral circulation can be speedily
effected. Hence the parts supplied by the obstructed vessels
at once become anaemic, and, nutrition being cut off, a condi-
tion known as red softening, i.e., hyperaemia, with oedematous
swelling and haemorrhage, soon supervenes. Subsequently,
the color, which is due entirely to the extravasation of red
corpuscles, gradually fades, and in a few weeks the affected
tissues present the appearance of yellow softening. In case the
patient survives a sufficient length of time white softening is
produced, the cerebral matter changing into milk-like emul-
sion, part of which eventually becomes absorbed, leaving in
some cases a cyst partially ﬁlled with liquid, resembling the
cysts found after ordinary attacks of cerebral haemorrhage.
There is another condition, called primary yellow softening,
in which the parts immediately undergo fatty degeneration,
without the previous changes above mentioned. This is sup-
posed to depend upon a weakened state of the heart, the blood
coagulating so quickly in the sphere of the obliterated vessel
as to prevent any reﬂux of blood through the corresponding
vein. '
Clinical Experience.—BeZladonna, Kali phos., Rlzus t0x., Glo-
noin, Picric ac. and Arsenienni have all been given with apparent
success in this disease——I say, with apparent success, because I
do not believe it to be within the power of any remedy to
effect a cure after the stage of red softening has passed, even
though the vascular obstruction should have ceased. Up to
and including this stage, however, these remedies have given
good results; indeed, more or less amelioration of the symptoms
has been produced by them at a comparatively late period in
the disease. So far as the pathological condition of the brain
is concerned, Arsenicmn and Picric ac. are eminently homoeo-
pathic to it, and if it be possible to set up a curative action in
the affected tissues at this stage of the disease, these are the
remedies most likely to prove successful.
Therapeutic Indications.—Picric ac.—-Necro-biotic soften-
_ ing of nervous tissue; intense cerebral hyperaemia; bleeding of
the nose; cerebral softening; extremities feel heavy, cold and
very weak; speedy exhaustion from slight exertion; general
state of asthenia.
36 NERVOUS THERAPEUTICS.
Arsenicum.-—Necro-biotic softening; headache, vertigo, wan-
dering pains, impaired sensibility of the limbs, delirium, coma,
lassitude, nervous debility, cramps, trembling, paralysis.
Strychnia.—Cerebral softening, accompanied by hemiplegia,
or by general paralysis.
Zincum phos.—Severe headache, dizziness, sleeplessness, loss of
memory, cardiac weakness; general debility.
Belladonna-—Fixed headache, with drowsiness, vertigo and
loss of memory; convulsions; local paralysis.
AbI'otanum.—Gloomy, despondent, irritable, ill-natured; brain
easily fatigued; head weak; face pale and wrinkled; indolent
and averse to physical exercise.
Auxiliary Treatment,—As embolism and thrombosis are
the two principal causes of cerebral softening, the auxiliary,
no less than the special, treatment recommended for those
conditions applies with equal force to this disease, and need
not therefore be repeated. The same is true of the treatment
recommended for cerebral hyperaemia and hmmorrhage, con-
ditions which belong especially to the curative stage of this
affection. Indeed, it is only by directing the treatment in this
way against individual symptoms and conditions that we can
stand any chance of curing, or even of greatly ameliorating,
the cerebral disorder.
From what has been said regarding the aetiology and path-
ology of cerebral softening, it follows that any inﬂuence or
treatment calculated to lower the tone of the system, no matter
what it may be, must have a prejudicial effect, and consequently
that the early adoption and steady use of supporting measures
are of the highest importance. If the general circulation is
much embarrassed, or if the patient is much reduced in strength
or his mind greatly impaired, he should be kept in a quiet,
recumbent position, the body and extremities kept warm by
artiﬁcial heat, friction, etc., and all intellectual e'xertion and
every form of mental and bodily excitement should be care.-
fully avoided. '
APHASIA. 37
APHASIA.
Syn0nyms.—Loss of the Faculty of Speech, A phemia,
Alalia; Fr, Aphasie; Ger., Sprachltthmung, Aphasie.
Deﬁnition.--A disease of the brain attended by a loss of
memory of words, or of the ability to express them in written
or articulate language.
Diagnosis.—-This disease is easily recognized, as there is no
other affection with which it is liable to be confounded. VVhen
due to cerebral haemorrhage, thrombosis, embolism, abscess or
tumor, it is almost invariably associated with right-sided hemi-
plegia; but in simple cases, such as are caused by mere func-
tional derangement, irritation, oedema, congestion, etc., there
is little or no attending paralysis, and the prognosis is far
more favorable.
Pathology.—-Broca ﬁrst made the discovery that the cere-
bral centre for articulate language is in the third left frontal
convolution of the brain, along the course of the middle cere-
bral artery in the island of Reil; and that irritation or injury
of this portion of the cerebrum causes aphasia. This discovery
has since been abundantly conﬁrmed by numerous post-mortem
examinations, from which it appears that the disease is
usually due, in fatal cases, to the blocking up of the left mid-
dle cerebral artery by an embolus or thrombus.
Clinical Experience.—Notwithstanding the fact that apha-
sia is often due to occlusion of the middle cerebral artery, it is
a singular fact that many cases of the disease have yielded to
homoeopathic treatment; from which we infer that, contrary
to the usual belief, aphasia results far more frequently from
irritation or congestion than from organic disease. Decided
improvement and, in many cases, satisfactory cures have been
reported from the use of Belladonna, Arnica, Stramonium, Phos-
phorus, Glonoin, Baryta, Lachesis, Kali bronv, Causticum, Lyco-
podium, Zincam, Conium and Bothrops.
Therapeutic Indications.-—Lycopodium.—Makes many mis-
takes in reading and writing; uses wrong words, and words
which do not express what he wants to say; mixes up letters
and syllables, and leaves out part of them; is very forgetful,
and troubled by confusion of thought.
38 NERVOUS THERAPEUTIOS.
StI'amonium.—Talks at random, using a perfect diarrhoea of
words without rational meaning; confusion of intellect, with
great weariness of mind; congestion of the brain, with con-
tracted pupils, and almost complete blindness; stuttering;
paralysis of the organs of speech; loss of memory; unconscious-
ness; extreme insensibility of all the senses.
Conium.—Very forgetful, especially of words; cannot under-
stand what he is reading; uses wrong words in speaking; loss
of memory, with great confusion of mind; entire loss of the
power of speech; hesitating and difficult speech; somnolence,
amounting to stupefaction.
Arnica.—-Aphasic symptoms following an attack of cerebral
haemorrhage; stertorous breathing; bruised, aching feeling iii
the brain; paralysis.
Glon0in.—Loss of memory for words and of the power of
expressing them; acute congestion of the brain; mental torpor.
Baryta caI'b.—Loss of memory for words and names; cannot
recollect the names of persons or things; great dulness of
mind and of the senses.
Lachesis.--Dulness of comprehension; does not understand
what he reads or hears; loses the sense of words; makes mis-
takes in writing; confuses numbers and dates; absence of
thought, with great weakness of memory.
Kali iod.—In syphilitic and epileptic cases; also when the
aphasic symptoms have been preceded by an attack of cerebral
haemorrhage.
Phosphorus.—In cases where the symptoms preceding the
attack show general depression of the nervous system, as mani-
fested by weakness, mental torpor, restlessness and indecision.
Caustioum.—Great weakness of memory; very forgetful of
words and names; head feels heavy and dull; absentmind-
ness; congestion of the brain; inability to think clearly on
any subject.
Colchic11m.—Inability to pronounce words correctly; loss of
memory for words; leaves out words and syllables in writing;
confusion of thought.
Ghamomilla.-—Omits words in speaking and writing; is very
forgetful and absentminded; great dulness of comprehension;
mental vacuity; stammering hesitancy of speech.
CEREBRAL HYPERTROPHY. 39
There are many other remedies the pathogeneses of which
contain aphasia symptoms, among which are: Olean., Thuja,
Anac., Graph, Ign., Natr. mur., China, Rhodod., Crocus, Arg.
nit., Hepar sulph., Merc., Puls., Nux vom., Nux mosch.; others,
like Opium, CEnan., Bell., are eminently suited to apoplectic
conditions; Hyosc., Bovis., Phos. ac., Cocc., Alum., P1at., when
absentminded and forgetful; Sulph. ac., Amm. carb., Sepia, Bov.,
awkwardness of expression.
Auxiliary Treatment.—Prof. Charcot has attempted to
show that the power to pronounce or to write words depends
upon an impression made upon the ear or eye, and therefore
that every aphasia or agraphia is a word amnesia situated in
some central ganglion of the brain, instead of being conﬁned,
as is generally thought, to Broca’s convolution. If Charcot’s
doctrine is correct, then much may be done in chronic cases
towards_recovering the faculty of speech, by educating, so to
speak, the corresponding sense centre. We know that some-
thing like this has already been accomplished in a number of
instances, but it has generally been referred to the “unedu-
cated” third frontal convolution of the opposite side of the
brain, namely, the right. May it not be possible, in these
cases, by careful practice every day, to so educate the previously
unused sense centres presiding over the faculty of speech, as to
greatly favor a cure, and in time, perhaps, overcome the
difficulty altogether‘?
CEREBRAL HY PERTROPHY.
Synonyms.—l-Iypertrophy of the Brain, Hyperplasia of the
Cerebral Neuroglia, Hypertrophia Cerebri; Fr., Hypértrophie
Cérébrale, Iiypértrophie dit C’erveaw; Gen, Hypertrophie des
Gehirns, Gehirn-hypertrophie.
Deﬁniti0n.—An overgrowth or hypertrophy, not of the
nervous tissue, but of the neuroglia, or interstitial connective
tissue of the brain.
Diagnosis.-—-In congenital cases, owing to the enlargement
of the head, the disease is liable to be mistaken for chronic
hydrocephalus; but children affected with cerebral hyper-
40 NERVOUS THERAPEUTICS.
trophy are mentally brighter and more precocious than usual,
while the subjects of hydrocephalus are unusually dull and
stupid. In other cases the diagnosis is more or less uncertain,
but when the enlargement is attended with frequent attacks
resembling epilepsy, its existence is highly probable.
Patho1ogy.—On exposing the surface of the brain in situ,
it immediately expands so as to overlap the bones of the
cranium ; but a careful examination shows that while there is
no undue amount of cerebral matter present, there is an ex-
cessive development of the neuroglia, rendering the brain
heavier, ﬁrmer and more elastic than the normal organ.
Clinical Experience.——It is not certain that the disease
has ever been materially beneﬁted by medical treatment.
Calcarea carb., Phosphorus, Kali iod., and a few other reme-
dies have been recommended, but only, I believe, on theoreti-
cal grounds.
Therapeutic Indicati0ns.—These pertain, almost exclu-
sively, to the remedies usually employed in cerebral hyperaemia,
convulsions, epilepsy and cerebral paralysis, and will therefore be
found under those headings.
Auxiliary Treatment.—-The most important accessory
treatment in these cases consists in improving the general
health, guarding against exposure to all injurious inﬂuences,
relieving cerebral congestion when present, and abstaining
entirely from the use of alcoholic stimulants.
CEREBRAL ATROPHY.
Synonyms.—Atrophy of the Brain, Atrophia Cerebri, Dif-
fused Cerebral Sclerosis; Fr., Atrophie Cérébrale, Atrophie du
Cerveau; Ger, Atrophie des Gehirns, Gehirn-atrophie.
Deﬁnition.—-A shrinkage or wasting of the brain, with or
without attending degenerative changes. .
Diagnosis.—(/longenital cases are, as a rule, easily recogniz-
able, as they constitute various grades of idiocy; but partial
cerebral atrophy, which is usually due to local lesions, such as
haemorrhage, softening and encephalitis, and general cerebral
atrophy, which occurs mostly in the aged, and is attended with
CEREBRAL ATROPHY. 41
a gradual loss of cerebral power, can only be conjecturally
determined during life, and that most satisfactorily by the
history of the case.
Pathology.--In simple, that is to say, in primary or un-
complicated cases, the brain is simply diminished in volume,
owing to a contraction or shrinkage of its constituent elements,
the cerebral cells, nerve tubes and arteries being all more or
less contracted.
. In the secondary variety, the neuroglia, or connective tissue
element, becomes atrophied or sclerosed, producing a shrinkage
of the convolutions, so that in some places they are widely
separated; the ventricles and subarachnoid space contain a
large amount of serum; and in some cases portions of the
brain tissue undergo softening, apparently from inﬂammatory
action, as the membranes are thickened and opaque.
Clinical Experience,—This has reference exclusively to
the physical, mental and nervous weakness experienced in
these cases, as the atrophy itself cannot, of course, be remedied.
The different salts of Baryta appear to have ameliorated the
symptoms to a greater degree than any other remedies which
have been tried.
Therapeutic Indicati0ns.—These are such as pertain to
the various lesions associated with the disease and their char-
acteristic symptoms. As they may possibly be of some service
in suggesting palliative treatment in certain cases, the reader
will do well to consult the indications given under the several
heads of cerebral heemorrhage, encephalitis, cerebral paralysis, con-
vulsions and epilepsy.
Auxiliary Treatment.—It is claimed that galvanism has
been employed with occasional beneﬁt in these cases, by pro-
moting the nutrition of the atrophied cells. I have myself
seen the paralysis diminish, the contractions relax, the mind
improve and the wasted limbs gradually increase in size and
strength under its stimulating inﬂuence.
Both the induced and primary currents may be required,
the interrupted secondary current being best for the paralysis,
and the constant current for the relaxation of contractions.
Ten Leclanché cells will generally furnish a current of sufﬁ-
4
42 NERVOUS THERAPEUTIOS.
cient intensity, the sponges being applied just behind the ears
every second or third day, for a period not exceeding four or
ﬁve minutes at one sitting.
Such hygienic measures should be adopted as are best calcu-
lated to improve the general health of the patient, since what-
ever improves the health also improves nutrition.
MULTIPLE CEREBRAL SCLEROSIS.
Synonyms. —— Primary Multiple Sclerosis, Disseminated,
Insular, Multilocular, or Idiopathic Cerebral Sclerosis; Fr.,
Sclerose en Plaques Disse’rninées; Ger., Multiple Slclerose des Ge-
hirns.
Deﬁnition.—-A cerebral lesion, consisting of plates or no-
dules of sclerosed tissue scattered throughout the substance of
the brain.
DiagnoSis.——Primary multiple sclerosis is liable to be mis-
taken for paralysis agitans; but in the latter disease there are
no head symptoms, no muscular incoiirdination, no inability
to trace a straight line with the dynamograph, no muscular
anaesthesia, no abnormal states of sensibility, and is more apt
to occur before than after ﬁfty years of age. Secondary or as-
cending multiple sclerosis may generally be distinguished by
the fact that the tremor precedes the paralysis, and also by the
fact that the trembling is associated with voluntary as well as
with involuntary muscular movements. Chorea may be dis-
tinguished from multiple sclerosis, not only by the history of
the case, but by the facts that it usually occurs in young
people, has no head symptoms, nor any actual tremor, the dis-
orderly movements being simply more marked degrees of in-
coordination, which render the movements more irregular and
pronounced.
Pathology.——The patches of sclerosed tissue are not conﬁned
to the hemispheres, though the cerebrum is their usual seat;
they are occasionally found at the same time in the medulla,
the pons and the cerebellum. Whether these cases are really
different, as Hammond and others contend, from those in
which the spinal cord is also implicated, is by no means cer-
MULTIPLE CEREBRAL SCLEROSIS.
tain. We know that multiple sclerosis is progressive, and we
also know that in many cases the spinal form is secondary to
that of the brain; but it does not follow that it is always so,
nor that the disease, in such cases, is always an independent
affection. What appears to be established is that, when con-
fined to the encephalen, it gives rise to symptoms sufficiently
characteristic to entitle it to be regarded as a distinct disease.
Clinical Experience.——Arge/ntum nit. and Ovalic ac. stand
at the head of the list in the treatment of this disease. Good
results have also been obtained from Plumbum, Baryta, Zincum,
Tarantula, Phosphorus, Sulphur and Rhus toss.
Therapeutic Indications.—0xa1ic ac.--Lancinating pains
like electric flashes in different parts of the body; electric-like
pains in the forehead and vertex; sclerosis of nerve-tissue; tremor
of the limbs; numbness of the ﬁngers and toes.
Argentum nit.—-Sharp, darting pains in the head, body and
limbs; paralytic weakness in the back and limbs; trembling of
the limbs; sensation of an epileptic aura; tremor increased by
emotional esccitement; tingling, followed by numbness in the
hands and feet.
Plumbum.—Tearing, shooting pains from occiput to forehead ;
paralytic weakness of the extremities, most marked upon the
right side; atrophy of the muscular tissue, especially when
arising from sclerosis of the cerebro-spinal system; trembling of
the limbs; excessive pains in the limbs.
Baryta 0arb.—Trembling of the hands and limbs, especially in
old people; great bodily and mental weakness; facial paralysis;
tremor of the feet when standing; arms heavy and tremulous;
numbness and tingling in the fingers; shooting pains deep in
the brain.
Zincum 0xyd.—Jerking and trembling of the limbs; remark-
able sinking of strength; paralytic weakness of the limbs, which
tremble violently; tingling numbness in the limbs; painful ten-
sion in the muscles when in action.
'1‘arant11la.—Ghorea-like movements in the limbs; extreme
restlessness; numbness of the trunk and limbs ; paralysis.
Phosph0rus.—Cerebral paralysis; tearing pains in the fore-
head and temples; numbness and formication in the limbs;
44 NERVOUS THERAPEUTICS.
tremor of the hands; great restlessness and weakness; sensation
as if completely paralysed.
Sulphur.— Tremor of the hands; unsteady gait; tearing pains
through the head, body and limbs; great debility and trembling;
numbness and formication.
Rhus tox.—Cerebral paralysis; trembling of the limbs; twitch-
ing of individual muscles; numbness, both general and local;
wavering sensation in the brain, especially when in motion;
lacerating pains in the head, especially when stooping; aggra-
vation of the symptoms during damp weather or just before a
storm.
Consult, also, the indications given under the head of cerebral
paralysis, where a number of other remedies, of greater or less
value in this disease, may be found.
Auxiliary Treatment.—What is said under this heading
concerning cerebral atrophy applies with equal force to multiple
sclerosis. This is especially true regarding galvanism, and yet
it cannot be doubted that, as a rule, electricity, in the indis-
criminate way in which it is frequently used, has done almost
as much harm as good. Overstimulation of any organ, espe-
cially when its functional activity is impaired by organic dis-
ease, is always more or less harmful, and this is emphatically
true of the brain. Extreme care, therefore, should be taken
whenever this potent remedy is employed in multiple cerebral
sclerosis.
ATHETOSIS.
Syn0nymS.——HammOnd’s Athetosis; Fr., Athetose; Ger,
Athetose.
Deﬁnition.--A condition characterized by a slow, steady
movement of the ﬁngers and toes, and by an inability to re-
tain them in any one position. ~
Diagnosis.-—The disease is liable to be mistaken for post-
hemiplegic chorea; but the movements in this variety of
chorea are quick, irregular, jerky and variable, while in athe-
tosis they are slow, systematic and uniform.
Pathology.—By some, athetosis is regarded as a symptom
rather than a disease, as the cases so far observed are mostly
CEREBRAL SYPHILIS. 45
found to be associated with some other nervous affection, such
as hemiplegia, chorea and cerebral embolism; but as these all
depend upon brain lesions, and, moreover, as bilateral athe-
tosis often occurs in idiotic children, the affection in question
is, I think, justly entitled to be regarded as a distinct disease.
Its seat appears to be chieﬂy in, and just exterior to, the cen-
tral cerebral ganglia——the corpus strictum and optic thalamus.
Clinical Experience.-—0annabis ind., Arsenicum and A gari-
cus have been credited with curative powers over this disease,
and from its resemblance, in some cases, to chorea, it is not
improbable that, when the central ganglia of the brain are in
a state of irritation simply, these remedies may prove effective.
Therapeutic Indications.——The cerebral symptoms in this
disease being similar to those given under cerebral haemorrhage,
chorea, epilepsy, cerebral embolism and paralysis, the appropriate
therapeutic indications may be found under those headings.
Auxiliary Treatment.-——Everything calculated to lessen
irritation and build up the system is likely to be of service;
hence good nutritious food and an abundance of fresh air
are of prime importance. VVhere the intellect is impaired, as
in the case of idiotic children, moral treatment may be neces-
sary. Most patients in this condition have strong imitative
faculties, and these may often be turned to good account.
The primary galvanic current is reported to have been success-
ful in stopping the movements after several months’ contin-
uous treatment. The positive pole may be placed over the
Spine or brachial plexus, and the negative on the affected
muscles.
CEREBRAL SYPHILIS.
Synonyms.—Syphilitic Disease of the Brain, Cerebral
Syphiloma, Gumma Syphiliticum Cerebri; Fr., Syphilis du
Cerveau; Ger., -Hirnlustseuche, Syphilitische Gehirn-Erlcranlcung.
Deﬁnition.-——Speciﬁc lesions of the brain and its membranes,
congestive, vascular and gummatous, due to secondary and
tertiary syphilis, especially the latter.
Diagnosis.-—First in the order of importance is the his-
tory of the case, which is often suﬂicient of itself to clear
46 NERVOUS THERAPEUTIOS.
up the diagnosis; next, as pointed out by Brown-Séquard,
the disorderly grouping of nervous phenomena should lead
us to interrogate syphilis as a cause, as, for example, pa-
ralysis of some muscle of the eye and paraplegia, or pa-
ralysis of one hand and the other foot, etc. Age is also of
great diagnostic importance, as paralysis occurring in youth-
ful persons is, in the great majority of cases, of syphilitic
origin. Violent paroxysmal headache is another character-
istic symptom of the disease; there is no form of headache so
intense as that which results from syphiloma of the dura mater.
In case the patient has no clear syphilitic history, the differ-
ence, which is often quite marked, between the real and appar-
ent age, the facial expression, and especially the ophthalmos-
copic symptoms are usually suﬂicient to establish the diagnosis
beyond a doubt. The most reliable ophthalmoscopic symp-
toms are: swelling, hyperaemia and oedema of the papilla, vari-
cosity of the veins, and a peculiar form of neuro-retinitis and
choroiditis known as syphilitic.
Pathology.—The essential, gross pathological features of
cerebral syphilis, according to Dr. Dowse, include (a) inﬂam-
matory thickening of the membranes, which may originate in
the lining membrane of the osseous system with which the nerv-
ous structures come into contact; (1)) invasions of the neuro-
glia by a diffuse form of gummatous inﬁltration, which may
be the result, primarily, of disease of the circulatory system;
and (c) the appearance of syphilomatous masses, usually located
in the upper convolutions of the anterior lobes, and almost
invariably at the cortex, closely united to the membranes,
extending into the surrounding tissue, which is generally
softened, hypervascular and of a faint yellow color; the nerve
cells and vessels giving evidence, under the microscope, of
degenerations resulting from vascular obstruction. _
Clinical Experience.—The cardinal treatment for cerebral
syphilis, as for syphilitic diseases generally, is Jllercurius and
Kali iod., in large doses. It is no use to speculate as to their
homoeopathicity, or anything of that sort; the fact stands out
prominently in the experience of every school that the best
and most reliable remedies for syphilitic affections, whatever
CEREBRAL SYPHILIS. 47
may be their seat, character, form or history, are large and
frequently repeated doses of these two remedies. It is useless,
therefore, and often worse than useless, to waste time in seeking
other remedies for this disease in any given case until these
have been fairly tried and failed. If experience is worth anything
as a guide to treatment, we have it here.
Therapeutic Indications.—Mercurius.—This is our sheet-
anchor in the secondary forms of cerebral syphilis, that is,
when associated, as is sometimes the case, with syphilitic
exanthems, or other varieties of secondary syphilitic manifes-
tations; mental and bodily anguish, with great restlessness
and complete insomnia; pain deep in the head, setting the
patient almost crazy; wishes he was dead.
Kali i0d.——Best and most reliable remedy for the tertiary
form of the disease, or when there are no other symptoms of
the disease present than what is manifested in and by the
nervous system; also in cases where mercury has been given
injudiciously, or without curative effect; irresistible desire to go
into the open air; torturing feeling of anguish, preventing sleep.
Aurum.—After abuse of mercury and iodide of potassium;
deep, tearing pains in the head; pains pressing from above
downward and from within outward; great mental depression,
with suicidal tendency.
Cinnabaris.—-Most useful where there is a scrofulous state of
the system coe'rcisting; also when complicated with scrofulosis
and previous mercurialization combined.
Berberis.—Tertiary form of the disease; tearing pains in the _
whole head, slightly ameliorated by going into the open air;
head feels swollen and bloated ; disposition to weep.
Silicea.—Gases complicated with scrofula; head feels as if it
was teeming with living things; pains much aggravated at night;
swelling of the superﬁcial glands.
Consult, also, the following remedies: Nitric ac., Lyce-
podium, Phytolacca, Stillingia, Kali bich., Mezereum, Corydalis,
Arsenicum iod., Mercurius nitrosus and corrosivus, Staphisagria,
Hecla lava, Argentum nit., Sarsaparilla.
Auxiliary Treatment.,—-This consists chieﬂy in endeavor-
ing to palliate the symptoms caused by cerebral hypereemia and
cerebral tumors, which see.
48 NERvoUs THERAPEUTICS.
CEREBRAL TUMORS.
Syn0nymS.—Tumors of the Brain; Fr., _Tumeurs du Cerveau;
Ger, Hirngeschwttlste, Geschwttlste des Gehirns.
Deﬁnition.—A swelling in the brain caused by some form
of new growth.
Diag‘n0sis.—Cerebral tumors are sometimes of easy recog-
nition; at others it is impossible to diagnose them with any
degree of certainty. Persistent headache, vomiting, double
optic neuritis and frequent epileptic attacks are among the
more common and prominent symptoms, and when they are
all present in any case we are justiﬁed, in the absence of the dis-
tinguishing signs of some other form of intracranial lesion, in
referring the morbid phenomena to cerebral tumor. VV here
the other symptoms correspond, very limited paralysis points
to this cause; and so, also, do epileptic convulsions occurring
late in life, especially if unilateral, or unattended with loss of
consciousness.
Certain characteristic symptoms will often serve to locate
the tumor with considerable accuracy. Thus, when seated in
the convexity there are epileptic spasms with severe headache,
but no anaesthesia or paralysis. When the anterior lobes are
concerned, there are frontal headache, anosmia and more or less
mental disturbance. When one of the parietal lobes is in-
volved there is anaesthesia, with slight unilateral paralysis.
Tumors of the corpus striatum produce hemiplegia; of the
corpora quadrigemina, ocular paralysis, blindness and hemi-
plegia; of the area near the optic chiasm, headache, anosmia,
hemiopia, paralysis of the ocular muscles, and anaesthesia of
the parts supplied by the ﬁfth nerve. When the cerebellum
is implicated, the symptoms are occipital headache, vertigo
and tottering gait. Tumors of the pons produce paralysis of
the muscles supplied by the third, ﬁfth and sixth nerves,
difﬁculty of swallowing and crossed paralysis of the limbs.
Tumors of the medulla oblongata produce convulsions, anaes-
thesia, defective articulation, difﬁculty in swallowing, diabetes
mellitus and paralysis of the bladder.
Pathology:-Tumors of the brain have been classiﬁed as
CEREBRAL TUMORS. 49
follows: (1) The diathetic, or cancerous, tuberculous and syphi-
litic; (2) the parasitic, or those caused by the echinococcus
(hydatids) and those produced by the cysticercus; (3) the vas-
cular, or aneurismal; and (4) the accidental, which include the
ﬁbro-plastic, gliomatous, cholesteatomatous, osseous, enchon-
dromatous, mucous, lipomatous, melanotic and other less
important varieties.
The pressure produced by cerebral tumors on the brain
substance not only causes local symptoms, but not infrequently
leads to fatty degeneration and atrophy of remote parts. It
also causes displacement of the parts in the immediate vicinity
of the tumor, renders the cerebral tissue dry and anaemic, and
causes more or less atrophy of the nervous structure.
Clinical Experience.——Marked relief has been obtained, in
a number of cases, by the administration of Calc. carb., Graph,
Sepia, Bell., Arn., Conium, Bry., Kali carb. and Bar. carb.
Calcarea has proven most useful in atheromatous, ﬁbrous and
lipomatous forms; Graphites and Baryta carb. in the atheroma-
tous and lipomatous; Sepia iii the fungoid and cancerous;
Belladonna and Kali carb. in the ﬁbrous; Arnica in the haema-
tomatous; Conium in the ﬁbroid and ﬁbro-scirrhous.
Therapeutic Indicati0nS.——Tumors not only produce by
pressure the symptoms of sclerosis, but they cause anaemia,
hyperaemia, hamorrhage, inﬂammation, softening, epilepsy, paralysis
and atrophy. According, therefore, as the symptoms in any
particular case correspond with one or more of these conditions,
the remedies should be selected agreeably to the therapeutic
indications given thereunder.
Auxiliary Treatment.—Litt1e can be done in these cases,
in the way of accessory treatment, except to aid in restoring
the contractility of the paralyzed muscles by the induced gal-
vanic current. A moderately weak current is generally to be
preferred, and in no case should it be strong enough to cause
much pain. The wet sponge of one electrode should be placed
upon the paralyzed muscle and the other held in the patient’s
hand, or applied to the nape of his neck, for a few minutes
every day or two. In no case should the current be allowed
to traverse the region of the tumor.
50 NERVOUS THERAPEUTICS.
CEREBRAL CONCUSSICN.
SynonymS.——Concussion of the Brain, Commotio Cerebralis;
Fr., Corn/motion du Cerreau; Ger., Erschiitterung des Gehirns.
Deﬁnition.—A shock or jar given to the nervous elements
of the brain, whereby its functions are temporarily suspended,
and the vital power more or less depressed.
Diagnosis.—The diagnosis is generally easily made, as
more or less external injury, the result of a fall or blow, is
usually associated with it. It may, however, be mistaken for
compression, unless the symptoms are carefully compared, as
in the following table:

Cerebral Concussion. Cerebral Compression.

Not always so.
Insensibility complete.
Development sudden.
Can usually be roused if loudly spoken
IO.
Respiration sighing, slow, irregular.
Pulse soft, feeble, ﬂuttering, intermit-
l
I
I
l .
1 Respiration stertorous, slow.
I
tent. )
I
l
a
Pulse slow.
No vomiting.
Urine and faeces retained.
Pupils insensible to light.
Paralysis usually hemiplegic.
Frequent vomiting.
Urine and faeces passed involuntarily.
Pupils react.
Paralysis usually none; if present, gen- I
erally of one or more cranial nerves.
Pathology.—The effects produced by concussion are gener-
ally the result of simple shock, the character of the injury
being such as to temporarily depress the vital power, and in
some cases to result in death. That this is always the case
where no lesion is discoverable after death, cannot, of course,
be proven, because a minute haemorrhage or other injury at
some vital point, as, for example, at the internal origin of the
pneumogastric nerve, would no doubt be sufficient to produce
speedy death; but it is more reasonable to refer the fatal issue
in these cases to shock alone than to causes which may have
no existence.
Clinical Experience.—- Glonoin, Arnica and Carnphora are
usually the ﬁrst remedies prescribed in these cases, Aconite
CEREBRAL cououssrou. 51
being given in alternation with them to moderate reaction
and to prevent inﬂammation. After reaction is established, if
attended with cerebral disturbances, Belladonna, Hyoscyamus or
Stramonium is usually given, as may be indicated. Opium
and Laurocerasus are sometimes used, in cases where there is
great depression, stertor and tendency to collapse.
Therapeutic Indications:-—Glonoin.—Reactive power feeble
and of slow development; pulse weak; surface cold but not
clammy.
Arnica.—-An excellent remedy for injuries of the brain at-
tended by insensibility and unconsciousness; if fever super-
venes, alternate with Aconite.
Gamph0ra.——During the first stage, to promote reaction; sur-
face cold and clammy; face pale; muscular twitchings.
Gic11ta.—First stage, insensibility profound; face cold and
deadly pale; cold hands, feet and limbs; inability to swallow;
great depression of the vital power; delirium; convulsions.
Hypericum.—-Second stage, with frequent pulse, swollen face,
short breathing and tendency to start, with shuddering over
the whole body.
BeIlad0nna.——Second stage, when attended by excessive reac-
tion; headache, ﬂushed face and delirium; if fever is high,
alternate with Aconite.
Hyoscyamus.-—Second stage, attended by low, furious delirium.
Ge1semium.—- wmains stupid and drowsy after slow reaction;
pain in back of the head, pupils still dilated; paralysis of the
lower sphincters. '
Lal1r0ceras11S.—Slow, feeble pulse; sunken countenance; skin
cold and blue; audible breathing, with moaning; trembling
of the limbs; involuntary discharge of fmces.
Vipera.—Pulse slow. feeble and irregular; ‘surface cold and
covered with cold perspiration; difficulty of swallowing; hemi-
plegia, or paralysis of a single limb; vomiting; delirium.
Lacl1esis.—Apoplectic symptoms, with low, muttering delirium,
pale face, cold extremities; paralysis of the left side.
Gonium.-—Apoplectic symptoms, slow, weak pulse; dilated
pupils; tendency to collapse; trembling of the li1nbs; delirium,
convulsions, numbness, paralysis.
52 NERvoUs THERAPEUTICS.
Auxiliary Treatment.—-Brandy internally, or Amyl nit.
by inhalation, is among the speediest means of overcoming
the depression of the vital power, but care should be taken
not to overstimulate the circulation, the aim being simply to
reestablish the normal condition. In most cases it is only
necessary to wrap the patient in warm blankets, apply friction
to the surface, and use dry heat to the extremities. As soon as
reaction sets in, the case is one for medical treatment only, no
other form of stimulation being appropriate.
SUN STR OKE.
Syn0nyms.—Insolation, Insolatio, Heatstroke, Thermic
Fever; Fr., Coup de Soleil; Ger., So-nnenstich.
Deﬁniti0n.—Various syncopal, asphyxial and hyperpy-
rexial conditions, resulting from exposure to solar or artiﬁcial
heat.
Diagn0SiS.——The appearance of the patient, taken in con-
nection with the history of the case, is usually sufficient to
establish the diagnosis. By comparing the symptoms with
those given in the table on page 50, it may be easily distin-
guished from concussion and compression, with which alone it
is liable to be confounded.
Patho1ogy.—-In rapidly fatal cases the brain and its mem-
branes, and also the lungs, are but slightly congested; the
greatest changes are observed in the venous trunks, especially
those of the abdomen, the right side of the heart and the pul-
monary vessels, all of which are sometimes engorged with
dark, grumous blood, while patches of ecchymoses are also
scattered over the surface of the body. These appearances
are chieﬂy due to nervous shock, which, by paralyzing the
heart and lungs, leaves the venous system engorged with
blood. In thermic cases a similar condition often exists, to-
gether with a more or less congested state of the brain and its
membranes. This condition is the result of heat on the nerve-
centres, and through them on the vaso-motor nerves. As a
consequence, the nerve-centres generally, and especially the
respiratory, suffer from overstimulation, and this is followed
by exhaustion.
SUNSTROKE. 53
Clinical Experience. — Glonoin, Arnica, Camphora, Amyl
nit, Gelsemium, Belladonna, Veratrum vir., Lachesis, Scutellaria,
Cactus and Carbo veg. are the principal remedies relied upon
in the treatment of sunstroke.
Therapeutic Indications.--Glonoin.--After reaction has
set in, or when there is intense headache, with throbbing in
all parts of the head ; painful constriction of the heart; sensation
as if all the blood had gone to the head; fainty feeling, with
complete muscular relaxation; oppression of breathing, with
numbness of the limbs. Especially adapted to the thermic
and syncopal forms.
Amyl nit.—Violent determination of blood to the head and
face; violent beating of the cervical and temporal arteries;
great difficulty of breathing.
Camphora.——-Great depression of both the nervous and circu-
latory systems; coldness of the body; tremors and cramps;
oppression of breathing; syncopal form.
Belladonna.——Indicated when apoplectic or irritative symp-
toms exist, such as coma, stertorous breathing, headache,
vertigo, delirium, rsensitiveness to light and sound, etc.
Antimonium crud.-—Syncopal form, with fainting, nausea,
vomiting, etc.
. Carbo Veg.—Extreme prostration of the vital power; heat
exhaustion.
Aconite.--Thermic form; burning heat, especially in the
head and face; heat and dryness of the skin, with thirst, head-
ache, redness of the eyes, anxiety and difficulty of breathing.
Veratrum vir.—Congestion to the head and chest; gastric
disturbances, especially vomiting; fainting, with coldness of
the limbs. Useful in both the ther1nic and syncopal forms
of sunstroke.
Stmtellaria.—Great fulness and oppression of the head, with
ﬂushed face; oppression of the chest, with throbbing about the
heart; general uneasiness, with twitching of the muscles;
sticking pains in various parts of the body.
Arnica.-—Often the only remedy required, especially in the
syncopal form ; also useful where there is great depression of
the vital power, with coldness of the limbs, stupor and semi-
paralysis.
54 NERVOUS THERAPEUTICS.
Digitalis.-—-Cardiac weakness, with great prostration and
tendency to syncope from heat-exhaustion.
Auxiliary Treatment.——In ordinary cases of sunstroke,
arising from long exposure to the direct rays of the sun, or
where the temperature is far above the normal standard, the
burning heat of the surface should be reduced as quickly as
possible by the free application of the cold water douche, ice
and ice-water to the head and neck, cool air, fanning, etc.,
being careful at the same time not to use the ice or the douche
too long, or after the skin becomes cool. On the other hand,
these measures should_never be adopted if the skin be cold
and clammy and the respiration sighing. The syncopal form,
arising from heat-exhaustion, requires precisely the opposite
treatment. In these cases there is an entire absence of fever,
the pulse is soft and compressible and the skin cool. The
indications here may be met by lowering the head and giving
the patient small and frequent quantities of hot beef-tea, store
tea, coca, etc. This condition calls for Digitalis rather than
alcohol, the remedy usually administered. For further in-
formation on this subject, see the author’s work on Intracranial
Diseases, p. 294.
CEREBRAL PARALYSIS.
Synonyms.——-Paralysis of Cerebral Origin, Common Palsy,
Hemiplegia; Fr., Paralysie Ce’re’brale; Gen, Gehirnla'hmung.
Deﬁnition.—-Loss of the power of voluntarily exciting the
contraction of muscles on one side of the body, caused by dis-
ease of the brain.
Diagnosis.—-Cerebral paralysis may generally be distin-
guished from paralysis of spinal origin by its being conﬁned
to one lateral half of the body. When complete, as in most
cases of cerebral haemorrhage and other varieties of apoplexy,
it usually takes the form of hemiplegia. Very rarely the
paralysis, instead of being unilateral, is bilateral; but then it
occurs as two separate hemiplegiae, not as a paraplegia, one
side being more severely affected than the other. Not infre-
quently the paralysis is limited to the parts supplied by par-
ticular nerves and plexuses. Cerebral symptoms, more or less
CEREBRAL PARALYSIS. 55
conspicuous, are almost invariably present, such as those
which characterize cerebral haemorrhage, thrombosis, embo-
lism, tumors, etc., these being the principal causes of the paral-
ysis. Motor irritation, in the forms of muscular spasm, twitch-
ing and contraction, is common in the affected parts, and so
also are epileptiform convulsions; but reﬂex movements are
commonly preserved, and even increased in energy, while
automatic and associated movements remain, as a rule,
unaltered.
Path0l0gy.——Encephalic lesions, of various kinds, constitute
the ‘gross pathological condition in cerebral paralysis. These
lesions are numerous and varied, comprising haemorrhage,
vascular obstruction, inﬂammation, softening, tumors, etc.
They give rise to certain characteristic symptoms, according
to the particular part affected. Thus paralysis arising from
lesions of the cortex takes the form of monoplegias, partial
hemiplegias, paralyses of the glossal, facial and brachial
nerves, or of the nerves of the face and arm, or arm and leg.
Lesions implicating the region of the basal ganglia, if exten-
sive, produce hemiplegia and cerebral hemianaesthesia. When
the region of the left middle cerebral artery is invaded we
usually have aphasia. Cerebellar disease produces incoiirdi-
nation and a titubating gait. A peculiar form of alternate
paralysis is produced by lesions in the lower and inner part
of the crus cerebri, and in the lower lateral half of the pons.
In the former case, the motor-oculi nerve is paralyzed on the
side of the lesion, and at the same time there is a hemiplegic
condition of the opposite side of the face and body; in the
latter, a paralysis of the face on the side of the lesion, and
more or less paralysis of the trunk and limbs on the opposite
side. Lesions of the medulla oblongata, in addition to paral-
ysis, give rise to respiratory and circulatory disturbances,
aphonia, dysphagia, anaesthesia, dysaesthesia, etc., from impli-
cation of nerve roots arising from it. Atrophy of the muscles
seldom occurs in connection with cerebral paralysis except in
disease of the pons.
The therapeutic indications pertaining to cerebral paral-
ysis are given under the several diseases of which the paralysis
56
NERVOUS THERAPEUTICS.
Initial stage.
is a symptom, especially cerebral haemorrhage.
See, also, infantile
cerebral paralysis and progressive general paralysis.
INFANTILE CEREBRAL PARALYSIS.
Syn0nyms.——Poliencepalitis Aouta, Hemiplegia Cerebralis,
Spastica; Fr., Paralysie Cérébrale de l’Enfance ; G’er., Kinder-
ltihmung des Gehirns.
Deﬁnition.—A peculiar form of infantile paralysis, of en-
cephalic origin, usually hemiplegic, and commonly attended
by athetosis, epilepsy and impaired intellect.
Diagn0sis.——The disease is most liable to be mistaken for
infantile spinal paralysis, from which it may be differentiated
by means of the following table:

Infantile Spinal Paralysis.
Cerebral Paralysis.

I
I Fever, convulsions, loss of con-
sciousness. These may all
’ fail, and this stage be un-
; noticed.
I Paralysis usually begins 1——4,
seldom later.
i Monoplegias and paraplegias,
Ii seldom hemiplegias.
Age.
Paralysis.
The nature of the l Muscles “ﬂail-like,” contract-

The same.
Generally under 4, may occur
immediately after birth.
Hemiplegias commonest, mon-
oplegias sometimes, para-
plegia rare.
paralysis. ures form after long time.
E l e c t r i c r e a c- Faradaism strongly reduced.
tions. ( R. D. obtained.
Sensation. : Unchanged.
Tendon reﬂexes. I Lost.
Temperature and 1 Lowered, and limbs look livid
color of limbs. and feel cold.
I n h i b i t io n of Strongly marked.
growth. 1
Motor affections. I Not present.
Intelligence. Unaffected.
Bladder and rec- f Not affected.
tum. i
Paretic contract- I Pgs varus, ll and COm_
ures. ‘
C‘
val us . .
g ’ blnations of
calcaneous, th
, , ese.
1 equinus,
Slight contractures form early,
recovery is constant.
F aradaism retained, no R. D.
Scarcely changed.
Exaggerated.
Temperature not lowered,
limbs of normal color and
warmth.
Not so marked, generally
mostly so in upper limb.
Athetosis and epilepsy.
Often lost.
Now and then slightly affected.
Generally nothing except equ-
inus spasticus, and con-
traction of knee.
INFAN TILE CEREBRAL PARALYSIS.
Pathology.—-The motor gray matter of the cerebral cortex
is the seat of an inﬂammatory process, pathologically resem-
bling that found in acute spinal paralysis, leading to perma-
nent loss of function of the part, due to subsequent atrophy
and destruction of the affected area.
Clinical Experience.—I can ﬁnd no well-deﬁned homoeo-
pathic clinical experience recorded concerning this newly-
described disease; but as it is of a similar nature to infantile
spinal paralysis, and as cerebral cases of what have heretofore
been regarded as cases of that disease have occasionally been
described under the name of the “essential paralysis of child-
hood,” we are justiﬁed, I think, in regarding the clinical his-
tory of such cases as belonging to this affection. This gives
us Stannum, Gelsemium, Arnica and Belladonna as being reme-
dies of marked value in this disease.
Therapeutic Indications.—Stannum.-—Paralyzed parts con-
stantly moist from perspiration; paralysis of the left side; pain,
accompanied with a sense of faintness in the brain.
Gelsemium.—-Loss of will-power over the muscles; pain in the
top and back of the head, with stupor, verging to coma; con-
vulsions, followed by paralysis.
Belladonna.-—‘-Paralysis of the right side; great restlessness,
with sudden startings; congestion and irritation of the brain.
Arnica.—Cerebral inﬂammation, followed by evudation; the
child cannot bear to have its head moved, owing to soreness of
the brain.
Consult, also, the indications given under acute hydrocephalus,
progressive general paralysis and infantile spinal paralysis.
Auxiliary Treatment.—-Ice or ice-cold water applied to
the head during the initial stage is useful, but at a later period
cloths wrung out of hot water are more serviceable. Great care
should be taken to keep the lower extremities, and especially
the paralyzed parts, warm. At a later stage, moral treat-
ment may be necessary, in consequence of the dementia,
especially as regards cleanliness, the imitative faculty being
trained for this purpose.
58 NERVOUS THERAPEUTICS.
EXTERNAL CEREBRAL PACHYMENINGITIS.
Synonyms.—Traumatic Cerebral Pachymeningitis, Second-
ary Pachymeningitis, Pachymeningitis Acuta; Fr., Pachymen-
ingite Secondaire; Ger., Seconddre Pachymeningite.
Deﬁnition.——InﬂammatiOn of the external layer of the
dura mater, usually acute, but sometimes chronic, secondary to
inﬂammation of the adjacent bone, and commonly due to
injury of the head.
Diagnosis.—This affection cannot be diagnosed with cer-
tainty, but fever, severe headache and stupidity, coming on
soon after an injury to the head, point to its existence. The
diagnosis is conﬁrmed if symptoms of pyaemia supervene, this
being a very common complication in these cases.
Pathology.——Both the pachymeningitis and the pyaemia,
when present, are due to inﬂammation of the bone. The pyaemic
infection is caused by the decomposing material from the seat
of injury ﬁnding its way into the circulation through the veins
of the diploe, which become inﬂamed in conjunction with
the gangrenous osteitis.
Clinical Experience.-—-Arnica, Hypericum, Belladonna and
Aconite are usually prescribed in traumatic cases as soon as
inﬂammatory symptoms appear, the two latter generally in
alternation, after Arnica or Hypericum has been given. Mer-
curius and Kali iod. are usually given when the symptoms
seem to depend upon syphilis or when the case has a syph-
ilitic history. Gelsemimn and Opium are resorted to when
there is much stupor. Chin. sulph. and Arsenicum are usually
preferred after toxaemia and adynamia make their appearance,
Calendula being sometimes previously given to prevent suppu-
ration. Eucalyptus and Salicylic ac. are also sometimes given
as antiseptic remedies.
Therapeutic Indications.——-These are similar to those
given ‘under the head of simple acute meningitis, which see.
Auxiliary Treatment.——External pachymeningitis is, at
the outset, a purely surgical disease, and demands surgical
treatment. After carefully cleaning the wound, if the bone is
depressed the trephine should be at once applied, so as to
INTERNAL CEREBRAL PAC/HYMENINGITIS.
prevent the supervention of meningitis, by elevating the bone,
removing detached fragments, if any, and allowing a free
escape of the secretions. A dressing of charpie, or of borated
cotton, saturated with Calendula or Hypericum lotion, should
then be applied, and this should be kept constantly moistened.
The diet should be nutritious and easily digestible, but not
stimulating.
INTERNAL CEREBRAL PAGHYMENINGITIS.
Synonyms.—-Cerebral Meningeal Haemorrhage, Haemor-
rhagic Pachymeningitis, Chronic Pachymeningitis, Haematoma
Durae Matris ; Fr., Hémorrhagie des Méninges, Hémorrhagie Men-
ingée Cérébrale, Apoplexie Méningée; Ger., Hirnhautblutungen.
Deﬁnition.--A peculiar form of meningeal haemorrhage,
the result of chronic inﬂammation of the dura mater, in which
the effused blood is collected in sacs formed of false membrane.
Diagnosis.—A constant and very severe headache, with a
gradually increasing tendency to stupor, slow and irregular
pulse, contracted pupils, but unattended by facial paralysis,
convulsions, fever or vomiting,-is regarded by Jaccoud and
others as suﬂicient to indicate the existence of this form of
meningeal haemorrhage.
Path0l0g‘y.—Extra and intra-meningeal heemorrhages are
almost always the result of direct injury, such as is produced
by wounds, trephining, etc. ; but haematoma of the dura mater
is the result of chronic pachymeningitis, and is met with under
the dura mater, in the form of oval sacs, sometimes several
inches in diameter, and half an inch or so in thickness. They
are generally seated near the sagittal suture, and extend to
both hemispheres, with only the arachnoid and pia mater
between. The contained blood is either in a liquid or a co-
agulated condition, and, as in other sanguineous collections,
exhibits in different cases similar stages of degeneration.
Clinical Experience.—This does not materially differ from
what is given under this head in cerebral hyperaernia, haemor-
rhage and tumors, which see.
Therapeutic Indicati0ns.—Identical with those given in
60 NERvoUs THERAPEUTICS.
treating of the above-named diseases, and to which reference
should be made.
Auxiliary Treatment.—-The great mental and bodily in-
ﬁrmity which sooner or later overtakes the patient may be
palliated, and its development retarded, by such hygienic
measures as are calculated to invigorate the system, such as
fresh air, good, nutritious food, agreeable company, etc.
CEREBRAL ARACHNITIS.
Synonyms.—-Inﬂammation of the Arachnoid Membrane of
the Brain, Traumatic Arachnitis; Fr., Inflammation dc l’Arach-
noide; Gen, Entzilndung der Arachnoidea. ‘
Deﬁnition.-——Inﬂammation of the cerebral arachnoid mem-
brane, due in most cases to injury of the head.
Diagnosis.——If the evidences of arachnitis are widely dif-
fused over one of the hemispheres, and are at the same time
accompanied by hemiplegia of the opposite limbs, the hemi-
plegia involving both sensation and motion, we may safely
conclude that the case is one of true cerebral arachnitis.
Pathology.-The possibility of the existence of cerebral
arachnitis has been called in question on the grounds that the
so-called parietal layer of the arachnoid does not exist, while
the inﬂammation of the visceral layer never occurs without
simultaneous inﬂammation of the pia mater; but this opinion
is successfully controverted by the fact that in cerebral arach-
nitis an even layer of purulent lymph is found to cover the
cerebral convolutions without dipping into the sulci, being
prevented by the intervening arachnoid membrane, which
stretches across instead of entering the cerebral depressions;
whereas, when the subarachnoid spaces are involved, the sulci
are ﬁlled with lymph, and the internal surface of the arach-
- noid remains free and unaffected.
Clinical Experience.—This is the same as in inﬂammation
of the adjacent I-nembranes——Aconite, Belladonna, Apis, Bryonia,
Mercurius, Kali iod. and Sulphur being given according to the
special indications.
Therapeutic Indications.—These do not materially differ
TRAUMATIC CEREBRAL LEPTOMENINGITIS. ' 61
from those given under the head of simple cerebral meningitis,
which see.
Auxiliary Treatment.--—Traumatic cases require surgical
treatment, similar to that given under the head of external cere-
bral pachymeningitis, to which reference should be made. Idio-
pathic‘ cases, which are comparatively rare, are usually com-
plicated with simple .cerebral meningitis, and therefore the
accessory treatment recommended thereunder will be appro-
priate.
TRAUMATIC CEREBRAL LEPTOMENINGITIS.
Synonyms.-—Traumatic Inﬂammation of the Pia Mater of
the Brain, Subarachnoid Meningitis, Leptomeningitis Cere-
bralis; Fr., Méningite Consecutifs e la Carie du Rocher; Ger.,
Seconddre Leptomeningite, Aleute Conneasitdts Meningitis.
DeﬁnitiOn.——An inﬂammation of the pia mater of the brain,
involving primarily the areolar tissue of the subarachnoidean
spaces, usually due to some injury implicating the base of the
skull.
Diagnosis.—-The disease may be suspected when, after sup-
posed injury of the base of the skull, vague cerebral symptoms,
unattended by decided paralysis, make their appearance; and
if the petrous bone has been fractured, as shown by bleeding
from the ear and deafness, with facial paralysis in the ﬁrst
place, then the existence of this form of meningitis may be
regarded as reasonably certain.
Path0l0gy.—The inﬂammation is supposed to gain access to
the subarachnoid spaces by traveling along the trunk of the
seventh nerve, and afterward spreading upward through the
posterior ﬁssures to the ventricles, or over the surface of the
hemispheres, or else downward on the medulla oblongata and
its connections. The subarachnoidean inﬂammation may,
however, result from the admission of air through the fracture,
either by way of the external meatus or the Eustachian tube,
for the fracture, instead of being a simple one, is actually coml
pound. Indeed, it is highly probable that this is the true
explanation, as the admission of air into wounds, especially
62 NERVOUS THERAPEUTICS.
suppurating ones, not only greatly changes the character of
the inﬂammation, but contaminates the air itself, which may
thereafter become the vehicle of its transfer to more distant
parts.
Clinical Experience.—Apis, Hypericum,Bryonia and Silicea
have been given with good results in this form of leptomenin-
gitis, though such cases, in the long run, almost always prove
fatal. Apis and Bryonia are given to promote absorption of
serous effusions, and Silicea to limit or prevent suppurative
action.
Therapeutic Ind.ications.—These are similar to those
given under the head of simple cerebral meningitis, which see.
Auxiliary Treatment.—-There is nothing very peculiar
about this form of meningeal inﬂammation, except so far as its
surgical features are concerned. Should the discharge from
the ear become purulent-—which, if the patient lives, it is
almost certain to do—great care should be taken to insure its
free and uninterrupted evacuation, and for this purpose I have
usually found nothing better than warm fomentations, or the
steam from a steam atomizer, applied to the aural region,
whenever the ﬂow becomes suddenly interrupted or the patient
suddenly comatose.
SIMPLE ACUTE CEREBRAL MENINGITIS.
Synonyms:-—Meningitis, Cerebral Meningitis, Simple Cere-
bral Meningitis, Idiopathic Cerebral Leptomeningitis, Lepto-
meningitis Cerebralis, Leptomeningitis Infantum, Hydro-
cephalus Acutus sine Tuberculosis; Fr, Méningite Simple ; Ger,
Allgemeine Alcute Ifirnhautentzlindung.
Deﬁnition.—A simple acute inﬂammation of the pia mater
of the brain.
Diagnosis.--Simple cerebral meningitis is most liable to be
mistaken for the tubercular form of the disease, especially
when it involves the base of the brain. The following table
gives the differential diagnosis between them:
SI.\I P LE ACUTE CEREBRAL
MENINGITIS. 63

Tubercular Meningitis.
l
r
I
Simple Basilar Meningitis.

Onset gradual.
Temperature 102° to 103°, not continu-
ous but very irregular, falling some-
times for a day or so down to
normal, or nearly so.
Pulse compressible, rapid, and, after
ﬁrst week, intermitting, losing occa-
sionally a beat.
Face looks usually pale.
Eyes not injected; squinting toward
end of disease; pupils uncertain,
later dilated.
Tongue slightly coated.
Vomiting ‘frequently in the beginning;
will appear by itself, not only after
eating; ceases generally when con-
vulsions begin, toward latter part
of disease.
Bowels very constipated.
Cough harassing and obstinate; gen-
erally physical signs of tubercular
deposits in the apices.
Convulsions appear at beginning of
about last third of the ailment; may
continue for one or more weeks,
gradually increasing in number
and severity as death approaches.
I
l
l
i
l
I
l
Duration about three weeks; may be ‘
much longer.
Prognosis: invariably fatal.
Post-mortem appearances: deposits of
small tubercular bodies, mainly at
the base of the brain; signs of in-
ﬂammation of membranes, effusion
of ﬂuid and formation of lymph;
deposits in other parts of the body.
Beginning most abrupt.
Temperature 102° to 103%° ; continues
at that height throughout the dis-
ease; never sudden and great
changes.
Pulse rapid and somewhat tense; always
regular, except, perhaps, during
agony of death.
Face ﬂushed.
Eyes always injected, occasionally
squinting; eyes apt to be very sensi-
tive to light; pupils often con-
tracted.
Tongue red.
Vomiting generally ﬁrst symptom, and
continues to the last; happens only
immediately after eating.
Bowels not constipated; there is often
diarrhoea.
Cough mild; mostly due to bronchial
irritation ; percussion clear.
Convulsions immediately before death,
never continuing longer than a
day, or at most two, followed by
a comatose condition.
Duration less than a week; sometimes
only two to four days; never longer
than seven.
Prognosis: grave, but not necessarily
fatal.
Post-mortem appearances: never any
granular deposits; signs of inﬂam-
mation of arachnoid and pia mater,
often severe, especially at the base;
associated with abundant effusion
and copious accumulation of
lymph.

Pathology.—It is generally supposed that no gross patho-
64 NERvoUs THERAPEUTICS.
logical changes involving the pia mater are discoverable
after death by this disease; but this is not, strictly speak-
ing, correct. Abnormalties are found, according to the stage
of the disease, consisting either of a gelatinous white or yellow
lymph-like matter, puriform, or else in the form of membranous
layers. They are generally limited to the convexity, but some-
times they involve both the lateral regions and the base of the
brain. The inﬂammation is not always conﬁned to the pia
mater, but sometimes implicates the adjacent tissues, in which
case we have a meningo-cerebritis, of variable seat and extent.
Clinical Experience.-——The remedies most commonly em-
ployed in simple meningitis are: Aconite during the initial
stage, with high fever, delirium, etc., followed by Belladonna,
Atrophine 35c, Hyoscyamus, Stramonium or Bryonia, as the
delirium,pains, etc.,become more pronounced and severe. Apis,
Helleborus, Bryonia, and sometimes Opium are given when
there are much depression and stupor, indicating effusion, or
when there are low muttering delirium, coldness of the ex-
tremities, etc. Zincum and Zincum brom. have proved beneﬁcial
in advanced cases, even after paralysis has supervened.
Therapeutic Indications.—Aconite.-—At the outset of the
disease, or when there is high fever, with dry, burning heat of
the skin, red inﬂamed eyes, pulse full and hard, pupils con-
tracted and burning, throbbing or lancinating pains in and
through the whole head; anxiety or great anguish; delirium;
vomiting of bile; convulsions; spasmodic contractions; pa-
ralysis.
Belladonna.—Face and skin red, burning and swollen; red
and sparkling eyes; lancinating, stinging or burning headache;
delirium, with frequent vomiting; pulse small and quick, or
intermittent; insensibility, spasms and paralysis.
Hy0scyamus.—Delirium, gradually passing into stupor and
coma; red, burning face, red and sparkling eyes, con-
tracted pupils, strong and quick pulse, sticking pains in the
head; wild delirium, the patient singing, muttering, smiling,
talking wildly; starting suddenly; picking at the bed-clothes,
with loss of consciousness, dilated pupils, cold and pale face,
weak and intermitting pulse and paralysis.
SIMPLE ACUTE CEREBRAL MENINGITIS.
Digitalis.——Stupor, gradually deepening into coma; irregu-
la-r action of the heart, sometimes very weak, at others strong;
small and slow pulse; dilated pupils, with insensibility of
vision; general or partial convulsions; especially suited to the
last stage, or stage of depression.
Apis Inel.—Infantile cases, with delirium, loss of conscious-
ness and occasional shrill screams; bending back and rolling of
the head; squinting of the eyes; child puts its hand to its
head while it screams, even when unconscious; face pale, or
marked with red streaks or spots; scanty or suppressed urine;
very frequent and weak pulse, or else slow and irregular; con-
vulsions, trembling of the limbs and paralysis. Secondary
meningitis from suppressed erysipelas or other exanthem.
Stramonium.—Violent delirium, accompanied by frightful
screams ; opisthotonos; vomiting; red face, with thirst and
great dryness of the mouth; convulsive movements of the
limbs; moaning and tossing about; staring look, especially on
waking; feverish heat, moist skin; sleep almost natural, but on
being aroused patient does not recognize his friends; retention
of urine.
Cuprum.--Head hot, with sharp, lancinating pains shooting
through it; red, inﬂamed and rolling eyes, with delirium or
stupor; quick, strong pulse, with more or less vomiting; tonic
spasms and convulsions; suited also to the last stage, attended
with slow, small and weak pulse, blue, shrunken face, dimness
of vision, moist hands and paralysis; specially adapted to cases
in which there is irritation of the spinal cord.
Bryonia.—-During the ﬁrst stage, with sharp, shooting pains
in the head, especially through the temples, red and inﬂamed
eyes, hot and burning skin, delirium, cramps, etc.; also, at a
later period, when the disease is verging into that of depression, with
stupor, dim and glossy eyes, slow and irregular pulse, cold,
pale, moist skin, dry and brownish tongue; also when the
patient bends the head backward, constantly works the jaws,
or starts suddenly from sleep, screaming, with cold sweat on
the forehead.
Glonoin.-—Intense headache, with throbbing of the temporal
arteries, red face, full and rapid pulse, hot and staring eyes,
66 mmvous THERAPEUTICS.
ringing in the ears and vomiting; brain feels too large for the
skull; globe of the eye feels sore; irregular pulse, with moist skin.
Suited to every stage of the complaint.
Gelsemium.——Child drowsy and wants to be let alone; fre-
quent startings in sleep; bores its head backward into the pillow;
constant fever, though without much thirst; head hot, but the
hands and feet cool and moist; nausea, with blindness; espe-
cially suited to children teething.
Cimioifuga. — Pain in and behind the eyeballs, extending
through to the occiput; tongue clean, but pointed and trem-
bling; pain increased by movement of the eyes; soreness and
stiﬂness of the muscles; excruciating pains in the head, increased
by movement; delirium, with incessant talking.
Helleborus.——Head drawn back, with stiffness of the cervical
muscles; eyes staring and oblique; forehead contracted and cov-
ered with perspiration; frequent starting and screaming during
sleep; working of the jaws; breathing irregular, sometimes
quick, at others slow and deep, or sighing ; jerking of the limbs,
with convulsive movements of individual muscles.
Opium.-—-Stupor and insensibility, with stertorous breathing,
dilated pupils, half-open eyes, small, weak, irregular pulse and
suppressed urine; when aroused, patient relapses immediately
into a state of insensibility.
Ethusa cyn.—Obstinate vomiting; pupils dilated and in-
sensible to light; coma, with cold skin, pale face and collapsed
appearance; drawing in the back of the neck; tetanic convul-
sions.
Anacardium.—Sequlae of brain fever, with total loss of mem-
ory; weakness of all the special senses; mental dulness and
confusion ; incomplete paralysis of the voluntary muscles.
Auxiliary Treatment.——During the active, inﬂammatory
stage, marked by high fever and excitement, ice to the head is
almost indispensable; at a later period, and especially during
the stage of depression, cloths wrung out of hot water are more
suitable. As the power to digest proteids is nearly, if not
quite, abolished, and the secretion of saliva greatly diminished,
only such articles as sweet whey, fruit decoctions, water gruel,
etc., will be appropriate until the beginning of convalescence,
TUBERCULAR CEREBRAL MENINGITIS. 67
when we may gradually administer more concentrated farina-
cious preparations, milk, with malt extract, light broth or
Liebig’s infant food. This cautious diet is necessary during
the stage of convalescence, because, if complicated with fever,
as it is apt to be from indigestion, the disturbance thus pro-
duced is liable to retard the absorption of the exudation.
TUBERCULAR CEREBRAL MENINGITIS.
Synonyms. —— Tubercular Inﬂammation of the Cerebral
Meninges, Granular Meningitis, Acute Hydrocephalus, Hy-
drocephalus Internus, Tubercular Leptomeningitis; Fr., Fiévre
Cérébrale, Méningite Tuberculeuse, Méningite Granuleuse; Ger.,
T uberculose Hirnhautentzitndung. ,
Deﬁnition.—An acute inﬂammation of the cerebral mem-
branes, especially of the pia mater, at the base of the brain,
complicated with, and dependent upon, a growth of tubercles
in the brain and other parts of the body.
Diagnosis.—The differential diagnosis between this disease
and simple basilar meningitis is given under the latter head,
which see. Typhoid fever, to which at times it bears a very
close resemblance, may be distinguished from it by means of
the following table:

Tubercular Meningitis. Typhoid Fever.

FIRST STAGE.
There is a gradual loss of ﬂesh, extend- l Loss of ﬂesh only apparent after fever-
ing over some weeks or months.
I rritability more intense and prolonged;
restless during sleep.
Shunning light is common.
Temperature has no characteristic
change; may be high in the morn-
ing and low in the evening, or the
same morning and evening.
Vomiting causeless, and not connected
with ingesta. May ﬁnd a clean
tongue.
process has existed some time.
Irritability not so intense; quieter dur-
ing sleep.
Absent.
Typical fever curve; gradual ascent,
having low fever in the morning
and higher in the evening.
Vomiting nearly always connected with
curdled milk or repugnant medi-
cine. Coated tongue.
68 NERvoUs THERAPEUTICS.
SEOOND STAGE.
Headache not aggravated at any partic-
ular time of the day.
Nearly always constipation.
N o abdominal tenderness.
Pulse of good volume, moderately slow,
and occasionally irregular.
N o epistaxis.

Headache always aggravated toward
evening, when the fever ascends.
Diarrhoea, as a rule; exceptionally,
constipation.
Abdominal tenderness and tympanitis.
Pulse soft, rapid, and never irregular.
Often epistaxis.
THIRD OR ADVANCED STAGE.
Irregular temperature curve or no fever
at all.
Now the vomiting generally ceases.
Stupor is continual, patient not easily
aroused, and immediately falls
back again into his former state.
Obstinate constipation.
Retraction of abdomen.
Tache cérébrale; sudden and spontane-
ous blushing of check and of parts
exposed to pressure.
Cheyne-Stokes breathing.
Pulse very irregular.
Spleen normal.
Local palsies and local spasms; ﬁxed-
ness of the eyes; unequal or di-
lated pupil.
Extreme tenderness elicited on press-
ing the femur.
Urohaematin, but no albumen or indi-
can in the urine.

Continued fever, stationary, or ascend-
ing gradually with the morning re-
mission.
May have vomiting of ingesta.
Is easily aroused; remains awake for a
time and requests drink. Is usually
rational during the time of being
awake.
Generally diarrhoea, yellow or brown-
ish stools.
Tympanitis and tender abdomen.
Roseolar eruption.
Breathing at times very irregular, quite
sighing, but not the rhythmical ir-
regularity. One day regular, and
the next very irregular.
Pulse weak and regular.
Spleen enlarged and tender.
N 0 such manifestations.
No tenderness on pressure.
Indican and albumen always present in
the urine.
Pathology.—The tubercular matter is mainly found along
the course of the vessels of the pia mater, at the base of the
brain, a fact which serves to explain the motor disturbances
observed in this disease.
Its ordinary seat is along the middle
meningeal artery and its branches; but it is sometimes depos-
ited, though rarely, on the convexity. The pia mater is always
TUBERCULAR CEREBRAL MENINGITIS. 69
more or less inﬂamed, thickened, inﬁltrated, and covered with
sero-plastic or purulent exudates. The ventricles are distended
with serum, sometimes to the point of rupture. The tuber-
cular matter is not conﬁned to the brain, but is usually met
with in other organs, especially the lungs.
Clinical Experience.—Dr. Price, of Baltimore, thinks that
he has cured at least four cases of this disease by means of
Helleborus, Bryonia, Apis and Artemisia vulg. Other remedies
which have been given with greater or less beneﬁt in tuber-
cular meningitis are: Cicuta, Veratrum alb., Argentum nit., Kali
iod., Calcarea phos., Zincum, Belladonna, Spongia, Gelsemium
and Gina.
Therapeutic Indications.—Artemisia vulg.--Child lies in
a sleepy or dreamy state, drinking freely of -water without
being aroused; surface cold, left side paralyzed, right in a state
of chronic convulsion; involuntary stools» Especially indicated
in the last stage.
Helleborus.-—-Soporose condition; forehead wrinkled and
covered with cold perspiration; dilated pupils; involuntary
throwing about of one arm or leg; lower jaw hangs down;
paralysis of one side. Chieﬂy indicated in the last stage of the
disease, or after paralysis has set in.
Bry0nia.—Constant working of the jaws; lips dry and
parched; the least motion produces fainting or nausea; constipa-
tion; symptoms changing to those of depression. Indicated after
eﬂusion has set in, and the system has become more or less
depressed.
Apis.—Stupor; constant motion of one arm or leg; urine
scanty or ‘suppressed; involuntary stools, which are green,
lumpy and slimy; pulse irregular; one side paralyzed, the
other convulsed. Specially indicated after exudation has taken
place. -
Calcarea carb.—Lively, precocious, large-headed children,
with tender constitutions, a swollen abdomen and irregular
bowels, inclined to looseness; profuse perspiration during
sleep; child screams out unexpectedly without cause. Espe-
cially indicated during the prodromic or irritative stage. '
Galcarea phos.-—Scrofulous children, greatly emaciated, den-
70 NERVOUS THERAPEUTICS.
tition retarded; stools loose and green, occasionally slimy;
child feverish and always wanting to nurse; craves potatoes
and other forms of starchy food; slow in learning to walk; face
pale, or yellowish and sallow; looks stupid, and takes no
interest in anything; fontanelles open. Scrofulous constitu-
tions, both before and after tubercular disease has set in.
Kali i0d.—Darting pains in the head, preventing sleep; pain
and heat in the head, with red and burning face; epistaxis;
drowsiness; dry and hacking cough; spasmodic muscular
contraction; chilliness alternating with ﬂashes of heat; hemi-
plegia. Kafka advises the early use of this remedy before
exudation has taken place as well as afterward, the remedy having
acted favorably at both periods.
Cina.—Irritative fever, with daily exacerbations, remitting
after midnight; pallor about the nose and mouth; child bores
into and picks its nose; constantly whining and moaning;
cannot hear to be touched ; frequently dizzy, and occasionally
loses consciousness. Prodromal symptoms.
Belladonna.—Child lies in a drowsy or semicomatose state,
from which it starts suddenly at times, but is never fully
aroused; is dizzy when suddenly raised up, and not infre-
quently vomits; opisthotonos; pupils dilated; cannot see any-
thing that is transpiring in the room ; pupils dilated.
Lyc0p0dium.—Somnolency, gradually deepening into coma;
convulsions, either partial or general; child sleeps with half-
open eyes; is very restless, throwing its head from side to
side; moans and screams out in sleep; face pale and cold;
neck stiff; body greatly emaciated; bowels costive. This is a
highly important remedy in tubercular affections, especially
when the head is involved.
Spongia.—Redness of face, with anxious expression of coun-
tenance; hyperaemia of the brain; bending of the head back-
ward; face alternately red and pale; eyes staring, lids wide
open; double vision; child frequently wakes with a start;
muscular twitchings accompany the fever; somnolency and
stupor. This remedy is highly recommended by Hering for
this disease.
Veratrum alb.—Great inequality in the distribution of heat;
cnaoruc CEREBRAL MENINGITIS. 71
the least motion causes nausea or vomiting; neck stiff, with
great tendency to convulsions; face pale, or one cheek pale
and the other red; great prostration after stool; symptoms
aggravated by raising the patient up; extreme thirst.
Silicea.—-—Children with enlarged heads and slowly-closing
fontanelles; heat and redness of the face, with cold extremi-
ties; sweat about the head, face and neck; great drowsiness,
but frequent startings during sleep; stomach easily sours;
sour eructations, accompanied with nausea or vomiting.
Auxiliary Treatment.-—Children predisposed to this dis-
ease, by reason of having inherited a scrofulous or tubercular
constitution, should be carefully guarded against those unhy-
gienic inﬂuences which favor malnutrition, such as depriva-
tion of fresh air, sunlight, wholesome food, and especially
guarding against a diet that tends to induce functional de-
rangement of the digestive organs. Even after the disease
has set in, it is important to avoid all food that might increase
the vomiting, and hence milk is to be omitted, giving Liebig’s
or some similar infantile food instead.
Where the coughing is so severe as to produce congestion of
the brain, Dr. Price, whose success in the treatment of this
disease is exceptional, advises the inhalation of the fumes
of Cresoline, which he says mitigates the cough more than
Drosera, or any other remedy.
CHRONIC CEREBRAL MENINGITIS.
Synonyms.—Chronic Meningitis, Chronic Basilar Menin-
gitis, and Verticular vel Convexital Meningitis, Chronic Syphi-
litic Meningitis; Fr., M éningite Cérébrale Chronigue; Ger.,
Chronische Hirnhautentzitndung.
Diagn0Sis.—There being no broad distinction between these
several varieties of chronic meningitis, except that which is
based on the location or aetiology of the morbid process, I shall
include them all under one head.
The comparative mildness of the symptoms, no less than
the chronicity of their course, will serve to distinguish the
chronic from the acute forms; and when originating in the
72 NERvoUs THERAPEUTICS.
latter, the previous history of the case will be sufficient to
establish their nature. The softening resulting from cerebral
thrombosis may be known both by the intensity of the symp-
toms and by the nature of the cause producing it. Thus,
while the pain is less in softening than it is in inﬂammation
of the membranes, the mental symptoms are more severe, and
vice versa. Chronic basilar meningitis may be distinguished
from the convexital variety by the disturbances produced by
implication of the cranial nerves, as one or another of them
becomes involved in the inﬂammatory process.
0 Path0logy.—The thickening and opacity observed in most
cases of chronic cerebral meningitis are believed to arise, in
most cases, from Overstimulation, either syphilitic, alcoholic
or mental. This is highly probable, since we know that these
various forms of irritation are among the most common causes
of chronic meningitis. By some, the changes above referred
to are regarded as a mere result of degenerative overgrowth,
brought about partly by conditions incident to advancing age,.
and partly by frequent or long-continued congestions. Syphi_
litic deposits (gumma) are sometimes found upon the surface
of the brain, but they are much more frequently met with at
the base, a fact doubtless due to the much greater vascularity
of that region.
Clinical Experience.—-Kali iod. and Mercurius well sustain
their reputation as anti-syphilitic remedies in chronic meningeal
affections of the brain. Experience shows, also, that the various
remedies used in other forms of meningitis are equally bene-
ﬁcial in this whenever the causes can be effectively removed
or suspended. Thus all undue mental strain, excessive
alcoholic stimulation, veneicy, etc., must be abandoned before
the irritation and inﬂammatory action will yield to any form
of medication.
Therapeutic Indications.—These are similar to those
given under the heads of simple and tubercular meningitis, en-
cephalitis and cerebral hyperaemia, which see. The following are
special indications in paralysis of the muscles of the eye
and face:
Causticum.—-Paralysis of the facial and of any or all of the
ocular muscles, especially when resulting from cold.
CHRONIC HYDROCEPHALUS. 73
Gelsemium.-—-Paralysis of the oculo-motor nerve, or when it
gives rise to double vision; also for paralysis of the facial
muscles, and of the tongue and organs of speech.
Stram0nium.——Paralysis of the ocular muscles when dependent
on brain troubles, or when associated with facial paralysis.
Kali iod. and Mercurius.——When the paralysis is of syphilitic
origin.
Nux vom.-—VVhen aggravated by the use of stimulants or
tobacco.
Spigelia.-—When the paralysis is associated with sharp, stab-
bing pains through the head.
Opium.-—Paralysis of the ciliary and facial muscles.
Auxiliary Treatment,—-The best moral and supporting-
measures, in addition to medical treatment, are generally
required.
CHRONIC HYDROCEPHALUS.
Synonyms.—-Dropsy of the Brain, Water on the Brain,
Hydrops Capitis; Fr, Hydrocéphale, H ydropsie du Cerveau; Ger,
Der Wasserkopf, Hirnwasser-sucht.
Deﬁnition.—A gradual effusion of serous ﬂuid into the
ventricles of the brain, in such quantity as to distend them
and enlarge the head.
Pathology.—As the ventricles become more and more dis-
tended by the gradually accumulating ﬂuid, the hemispheres
slowly expand, the convolutions unfold, and the whole cerebral
mass becomes thinned and distended, until at last it resembles
a mere bag of brain-matter ﬁlled by the expanded ventricular
membranes and their ﬂuid contents. At the same time both
the membranes and the brain substance, instead of becoming
softer and less compact, are rendered tougher and denser, the
lining membrane of the ventricles thicker and more resisting,
the brain-matter harder and tougher. This cannot always, nor
even generally, be due to previous inﬂammatory action; for
while there is little, if any, atrophy of the brain substance, there
is apparently an overgrowth of the neuroglia, due, probably,
to the long-continued mechanical congestion of the tissues.
Clinical Experience.—C'alcarea carb., I/Ethusa and Sulphur
6
74 NERVOUS THERAPEUTICS.
are said to give the best results in chronic hydrocephalus, al-
though Arsenicum is, perhaps, more frequently given than any
other remedy. Helleborus, Apis and Digitalis are also frequently
prescribed, especially when the urine is scanty and the circu-
lation feeble and embarrassed. Arsenicum iod., Kali iod. and
Calcarea phos. are given in cases manifesting scrofulous and
tubercular cachexiae, tardy dentition, etc.
Therapeutic Indications-—Ga1carea carb.—Head greatly
enlarged; anterior fontanelle open ,- old, pale, haggard expression
of the face, which is thin and wrinkled, or swollen and puffed ;
copious sweat on the head, neck and shoulders, especially
wheasleeping; scrofulous swelling of the superﬁcial glands.
Ethusa cyn.—-Child cannot hold up its head, which is greatly
enlarged; lies in a stupor; pulse feeble; pupils dilated and
insensible to light; vomits soon after nursing; scrofulous
swelling of the cervical and axillary glands.
Sulpl1u1'.——Most valuable as an intercurrent remedy; great
torpor of the system; dulness of the senses; face pale and ema-
ciated; retention of urine; constipation.
Helleborus-—Forehead wrinkled and bathed in cold perspira-
tion ; urine suppressed or scanty and dark; somnolency, with
dulness of the senses; pupils dilated; limbs tremble from
weakness; gait tottering ; passive congestion, with serous
effusion.
Arsenioum.——-The child strikes or clutches at its head, as
though for relief; retention or involuntary discharge of urine;
breathing anxious and oppressed; special senses dull ; stomach
emaciation and muscular weakness ; swelling of the head and face;
irritable and weak.
Digitalis.—-Head enlarged by copious serous exudation; weak,
irregular action of the heart; great prostration ; coldness of the
body and limbs; weak feeling at the pit of the stomach -;
tendency to faint.
Apis mel.——Urine scanty or suppressed; pulse irregular; trem-
bling of the limbs, with tottering gait; copious sweat of the head ;
stools small; great emaciation and prostration; dry, hot skin,
but no thirst; pulse very weak, while the heart beats with great
violence.
cnnourc HYDROCEPHALUS. 75
Calcarea ph0s.—Child takes no interest in anything; is un-
able to hold up its head, which is large and heavy; posterior
fontanelle wide open; ears and nose cold; face pale or sallow;
great desire for potatoes and other forms of starchy food.
Kali iod.——Stupor, with irregular and labored breathing;
superficial glands enlarged; urine suppressed; pupils dilated;
scrofulous constitution.
Apocynum can.—-Forehead projecting, sutures open, head en-
larged; stupor, with dulness of the senses, especially that of
sight; urine scanty or suppressed; serous exudation.
Pl11mbl1m.—Heaviness of the head from dropsical enlarge-
ment; pulse small and frequent, or slow and feeble; emaciation,
with trembling of the limbs; somnolence, with mental dul-
ness; retention or involuntary emission of urine; obstinate consti-
pation; constantly growing weaker and more debilitated.
Zincun1.-——Small,~ weak pulse; great prostration; coldness of
the body; breathing oppressed; limbs tremble and feel heavy;
dulness of the special senses; head enlarged, with great out-
ward pressure; restlessness, especially at night; vertigo, espe-
cially when raised up, with nausea ; constipation.
Auxiliary Treatment.—-Hygiene is of great importance in
the management of these cases. The head should be sup-
ported on pillows, or by some suitable mechanical contrivance,
in a comfortable position, and the child exposed daily to fresh
air and sunshine. A.liberal supply of good, nutritious, easily
digestible food should be given to it with regularity. In
short, everything possible should be done to strengthen and
build up the system.
As for local treatment, it has usually done more harm than
good. Tapping appears to have relieved a few cases; but the
ordinary result of the measure has been to hasten the fatal
termination. Treatment by compression is as cruel as it is
senseless, and is now happily abandoned.
PART II.
DISEASES OF THE SPINAL MARROW AND ITS
MEMBRANES.

SPINAL HYPEREMIA.
Synonyms. Spinal Congestion, Congestion of the Spinal
Cord; Fr., Hypéremié de la Moelle Epiniere; Cer., Ritckenmarks-
hyperamie; Spinalhypertimie.
Deﬁnition.——A general or local excess of blood in the
spinal cord and its membranes. '
Diagnosis.—Spinal hyperaemia is liable to be mistaken for
spinal anmmia, myelitis and spinal meningitis. Hyperaemia
of the cord is characterized by more or less anaesthesia or
numbness, spinal anaemia by its opposite, hyperaesthesia,
which is often excessive. The former is always aggravated
by the recumbent position, while the latter is ameliorated by
it. Myelitis may be distinguished from spinal hyperaemia by
the greater intensity of the symptoms, and spinal meningitis
by the severity of the symptoms, by the pains produced by
movement of the paralyzed limbs, and by the tonic contrac-
tion of the muscles, especially those of the back.
Pathology.—-The anmsthesia is supposed to be due to
pressure upon the white substance of the cord, which is always
greatest when the back is in a dependent position; the same
is true of the paralysis; while the hyperaesthesia and mus-
cular twitchings are caused, rather, by hyperaemia, and con-
sequent overexcitation, of the gray substance.
Clinical Experience.—-T he remedies most frequently pre-
scribed for this condition of the cord are: Rhus to:v., Lachesis,
Silicea, Secale and Lathyrus sat. Next in frequency are: Aconite,
Gelsemium, Nux vom., Argentum nit., Oscalic ac., Colchicum,
Belladonna, Agaricus and Rhododendron.

SPINAL HYPEREMIA. 77
Therapeutic Indications.—Rhus tox.——Ach ing in the spine,
with tingling, numbness and paralytic weakness in the lower
limbs, especially when caused by exposure to cold, straining,
etc ; aggravated by rest or by lying down.
Lachesis.—Prickling sensation in the limbs; sinking sensation
in the back; stinging pains in the limbs, with numbness and
trembling weakness.
-Silicea.-——Limbs “ go to sleep” easily, are sore, lame and
cold; legs tremble and are very weak; numbness and prick-
ling in both upper and lower extremities; pain and laming
soreness in the back, increased in the recumbent position.
Secale c0r.—Weakness and numbness in the lower extremi-
ties; prickling sensations in the legs and feet; paralysis of
the bladder and rectum; produces such intense congestion of the
cord as to destroy its functions.
Colchicum.-—Spinal hyperaemia caused by suppressed per-
spiration, or by getting the feet wet; numbness of the limbs,
with prickling pains; twitching pains in the limbs and side,
with sensation of lameness. ,
Belladonna.-—Spinal hyperaemia attended by severe pains in
the back, which are increased by lying down.
Agaricus.-—Laming numbness‘ and formication in the lower
limbs; tingling, prickling sensation in all the limbs; violent
pains in the back, worse when standing.
Ac0nite.—-Paralysis from congestion of the cord; crampy,
contractive pain in hand and arm; painful bruised sensation
in the spine, attended by stiffness and lameness of the back ;
trembling weakness in the lower limbs.
Rhododendron.—Paralytic weakness during rest; heavy, weak
feeling and formication in back and limbs, worse when at rest,
especially when lying down.
Argentum nit.—-The pain in theback is relieved by standing;
trembling in the lower limbs, as after afatiguing walk; nightly
pains in the back.
Berberis vulg.—Numb, bruised feeling in the back, worse
when lying; paralytic feeling in the limbs, with sensation of
tingling and prickling in them.
Gelsemium.—Dull, aching pains in the upper part of the
78 NERVOUS THERAPEUTICS.
spine, worse after lying down ; pains shooting out from the
spine to other parts, and sometimes in the opposite direction,
causing the patient to cry out; cerebro-spinal congestions.
Arnica.——Spinal congestion caused by overexertion, strain
or mechanical injury; also when produced by the cold stage
of intermittent fever.
Lathyrus sat.-—-Numbness, followed by paralysis, of the lower
extremities; band feeling around the body; patient unable to
stand or take a step; sometimes unable to distinguish one
limb from the other.
Auxiliary Treatment.--The hot douche is one of the best
local applications in this disease. The water, at a temperature
of about 100° F., should be made to fall from a height of two
or three feet over the affected part of the cord for a few
minutes every day. Very satisfactory results sometimes follow
the systematic administration of the constant current of elec-
tricity, by passing it through the affected portion of the spine
daily for a few minutes at a time, employing as strong a
current for the purpose as the patient can conveniently bear.
As soon as the numbness and hyperaesthesia disappear, the
induced current should be applied to the paralyzed muscles,
to excite them to contract.
SPINAL ANZEMIA.
Syn0nyms.—Anaemia of the Spinal Cord, Anaemia of the
Antero-lateral Columns, Spinal Paralysis, Spinal Exhaustion,
Myelasthenia, Neurasthenia Spinalis, Reﬂex Paraplegia, In-
hibitory Paralysis, Functional Paralysis of the Cord, Paralysis
from Peripheral Irritation; Fr., Paraplégie Reﬂe:ce; Paraplégie
Functionelle; Ger., Reflex Paralysis Spinalis.
Deﬁnition.-—A disease characterized by such a general or
local deﬁciency of blood in the vessels of the spinal cord as to
impair its functions.
Diag‘n0SiS.—Spinal anaemia may be distinguished from
spinal hyperaemia, ﬁrst, by the fact that the symptoms, instead
of being aggravated by the recumbent position, are always
ameliorated by it; secondly, by the fact that it is not pro-
SPINAL ANEMIA. 79
i
gressive; thirdly, when the bladder is involved it usually pre-
cedes the paralysis. Anaemia of the antero-lateral columns is
distinguished from that of the posterior columns by the absence
of any considerable disturbances of sensibility, and by the
presence of well-marked, though incomplete, paraplegia.
Pathology:-Reﬂex paraplegia and spinal neurasthenia are
believed to be due to spinal anaemia because, there being no
visible alterations of structure in these cases, the symptoms
admit of no other rational explanation. The irritation is sup-
posed to operate (1) upon certain sensory nerves which trans-
mit the impression to the gray matter of the spinal cord, from
which it is reﬂected (2) either along vaso-motor nerves regu-
lating the caliber of the bloodvessels which supply either (a)
the portion of the spinal cord in relation with the paralyzed
parts, or else (b) the nerves of the paralyzed muscles them-
selves. In either case the irritation is supposed to lead to a
persistent spasm of certain vaso-motor vessels, so as to cause
an anaemic condition of certain vascular territories in the
spinal cord, or else of the related nerve-trunks and muscles,
and thus, by interfering with the nutrition of the parts, de-
prive them to a greater or less extent of their functions.
Clinical Experience:-Nux vom., Phosphorus and Strychnia
appear to be the remedies most frequently employed in this
disease. Rhus ton, though it sometimes appears to help
the paralytic condition, seldom does any permanent good in
spinal anaemia. Arsenicum, China and Calcarea phos. are ex-
cellent remedies, especially when the disease is associated with
general anaemia, or with an impoverished condition of the
blood.
Therapeutic Indications:-Nux vom.—Gre-at debility of
the nervous system, with partial paralysis; reﬂex paralysis;
paralysis from nervous exhaustion; pain as from a bruise in the
small of the back; heaviness and weariness in the lower ex-
tremities; torpor of the liver, stomach and bowels; paralysis of
the bladder.
Pl1osphorus.—Bruised feeling in the back and limbs; great
heaviness and weariness from the least exertion; spinal neu-
rasthenia ; extreme mental and physical prostration.
80 NERvoUs THERAPEUTICS.
Strychnia phos.-——One of the best remedies we have for anaemia
of the cord; paralysis from exhaustion of the reflex motor power
of the spinal nerve-cells.
Erythroxylon coca.—Sleeplessness and disinclination to work
or move; mental depression, with anxiety and palpitation of
the heart; loss of appetite; constipation, with abdominal dis-
tension ; oppression of breathing, arising from debility; faint-
ing ﬁts from nervous weakness; coldness of the extremities; .
general debility, the least exertion being attended by fatigue.
China.—-Paralysis due to general anaemia or loss of vital fluids ,-
spinal anaemia following severe and exhausting illness; neu-
rastlienia spinalis induced by overexertion, either bodily or
mental; nervous trembling of the lower limbs.
Arsenicum.—-Paretic condition of the lower limbs, especially
when associated with general anamia ; constant disposition to lie
down; sensation of weakness in the small of the back; para-
lytic weakness preceded or accompanied by excessive or watery
alvine discharges; trembling of the limbs from debility; rest-
lessness, especially at night; thirst for small quantities of water.
Calcarea phos.—-Coldness and weakness of the lower extrem-
ities from defective circulation of blood in them ; nervous pros-
tration, with great depression of spirits; face pale and wan ; sore,
bruised feeling in the back, with desire to lie down upon it.
Kali ph0s.—Spinal anaemia from exhausting diseases; reﬂex
paraplegia, with burning pains, aggravated by rest, but worst
on ﬁrst moving about.
Alumina.-—Paralytic symptoms induced by cold, or when as-
sociated with pain in the back; coldness of the surface; weak-
ness and heaviness in the lower extremities; great exhaustion
after slight exertions ; unrefreshing sleep; weakness of the
genito-urinary organs.
Lycopodium.—Great nervous prostration; neurasthenia from
Spinal anaemia; ﬂatulency; constipation.
Auxiliary Treatment.—Good, nutritious food, such as
milk, eggs, beef, etc., and an abundance of fresh air and _sun-
shine, should always be provided. Change of climate and
scenery, an ocean voyage, pleasant company, agreeable occupa-
tion, etc., are often highly beneﬁcial in these cases. Every
SPINAL IRRITATICN. 81
source of peripheral irritation to which the patient is exposed
should be removed or guarded against. Whatever beneﬁts
the general health will beneﬁt the spine in these cases, and
vice versa. See Cerebro-spinal anxmia.
SPINAL IRRITATION.
Syncnyms.—-Anaemia of the Posterior Columns of the
Spinal Cord, Posterior Spinal Anaemia, Neuralgia of the Spine,
Spinal Neuralgia, Rachialgia; Fr., Rachialgie; Ger., Ritch-
gratschmerz. '
Deﬁnition.—A condition characterized by a greater or less
degree of spinal tenderness, and by a morbid excitability of
the nerves proceeding from the affected portion of the cord.
Diagnosis.——-Spinal irritation is liable to be mistaken for
spinal hyperaemia, hysteria, chronic myelitis and spinal men-
ingitis. In spinal congestion there is, instead of hyperaesthesia,
more or less anaesthesia, numbness and formication ; and when
a sponge, dipped in hot water, is applied to the spine an
intense aching is produced, which is not the case in spinal
irritation. Chronic myelitis is characterized by anaesthesia,
painful muscular contractions and paralysis——symptoms that
do not belong to this disease. Spinal meningitis is a far more
acute disease than spinal irritation, the hyperaesthesia and
pains on motion being very much more severe. Hysteria
often resembles spinal irritation so closely as to be mistaken
for it; and, indeed, it frequently coexists with it in the same
patient. It may be best distinguished by the history of
the case.
Path0l0gy.—Hammond and others regard spinal irritation
as being essentially an anaemia of the posterior columns of the
cord, basing their opinion on the following grounds: 1st, the
general condition of the patient is one of debility, a condition
which the exciting causes of the disease tend to produce; 2d,
the symptoms indicate that the disease is seated in the posterior
columns of the cord; 3d, whatever improves the quality of
the blood, or increases the amount of it in the spinal vessels,
always beneﬁts the patient, and vice versa. Of course, it will
only apply to those cases in which the nerves of sensibility are
82 NERVOUS THERAPEUTICS.
alone affected; when those of the motor sphere are implicated,
the antero-lateral columns must be involved. But this view »
appears to be too exclusive. Some cases are best explained
by supposing that the two opposite conditions of hyperaemia
and anaemia coexist in different portions of the cord, while in
others the symptoms appear to be due to hyperaemia alone.
It is generally conceded, however, that in the majority of
cases the essential pathological condition is one of anaemia,
involving the posterior columns of the cord.
Clinical Experience.—The remedies which have proved
curative in this disease are: Cocculus, Gelsemium, Cimicij"uga,
Strychnia phos., Hypericum, Belladonna, Tarantula, Secale cor.,
Natrum mur., Tellurium, Rhus toa:., Ignatia and Scutellaria. In
addition to these, the following remedies have beneﬁted
particular cases: Santonine, Silicea, China, Phosphorus, Sulphur,
Zincum met., Calcis hypophos., Piper menth., Naja, Veratrum oz'r.,
Calcarea carb. and iod., Nucc oom., Colocynth., Kali hypophos.,
Agaricus and Aconite.
Therapeutic Indications.--Cocculus.—-Great hyperaesthesia
of all the senses, and an exalted susceptibility to impressions;
dreadful headaches and sleeplessness; her sufferings are for-
gotten when her mind is turned away from herself; pain in
the lower portion of the spine; stiffness of the neck; palpitation
of the heart and oppression of the chest; trembling of the
limbs; numbness of the right upper and lower limbs.
Gelsemium.—-Stiffness and pain in the back of the head and
neck; sleeplessness from soreness and pain in the back; great
depression of spirits; extreme weakness and prostration.
Cimicifuga.—-Severe aching pain in the lower part of the
back and in the occiput, with occasional shooting pains in the
chest, and great weakness, amounting almost to paralysis, of
the lower extremities; constant nausea and retching on press-
ure upon the spine, between the fourth and ﬁfth vertebrae; fre-
quent fainting; palpitation 011 least movement; amenorrhoea;
aggravated by cold, movement, and at the menstrual period.
Strychnia phoS.—Tenderness on pressure over the dorsal
vertebrae; pain, sometimes burning, but chieﬂy aching, ex-
tending frequently to the front of the chest, causing a feeling
SPINAL IRRITATION. - 83
of uneasiness and nausea; cold feet, covered with clammy
perspiration; insomnia.
Hyperioum.-—-Tenderness of the whole spine; pain in the
joints, accompanied by mania; laming-aching in the dorsal
region; frightful illusions, screaming if approached; no recol-
lection of the attack ; stiches and paroxysms of pain in different
parts of the body. '
Belladonna.-——Pressure over the dorsal vertebrae causes her
to cry out and turn pale and nauseated; continual burning
pain in the spine; tenderness of the stomach, with nausea and
vomiting on eating; pressure on the fourth dorsal vertebra
produces a shriek, followed by a dry, violent cough, red face,
headache in forehead, photophobia and perspiration.
Tarantula.—A slight touch along the spine causes spasmodic
pains in the chest and great distress in the cardiac region;
also cardiac disturbances, intense headache and sensation of
burning all over the body; muscular contractions; convulsive
movements, tremblings and general chilliness.
Secale cor.- Tenderness over the superior spinous processes,
with stiffness of the neck; pains radiate from the affected
portion of the spine to the chest, producing anxious, oppressed
breathing, with palpitations, and tendency to convulsive
movements and cough.
Natrum mur.—Sensitiveness of the spine, with pain in the
back; eyes sore on pressure; supraorbital neuralgia, with
nausea and sensitiveness to bright lights; vision clouded with
black spots; hemiopia; sleeplessness; morning headache;
anorexia; constipation; restlessness and debility.
Tellurium.—Tenderness of the spine, with extreme sensitive-
ness to pressure; patient so sensitive and irritable as even to
dread the approach of any one.
Rhus t0x.—Violent pain in the head and down the back,
with extreme sensitiveness of the spine to pressure; lies on her
back with the head and spine drawn backward; the slightest
touch or movement causes extreme pain; anxious, oppressed
breathing, with violent palpitations, occurring i11 paroxysms;
complete sleeplessness.
Ignatia.-—Aching pain as if bruised in the cervical and
84 ' NERvoUs THERAPEUTICS.
dorsal portions of the spine; lancinating pain in the nape of
the neck, also in the small of the back, extending through the
loins; pains increase by pressure over the spine; cases com-
plicated with hysteria.
Auxiliary Treatment.—The \Veir Mitchell treatment of
absolute rest, combined with gentle galvanization of the spine
by the constant current, positive pole below,negative above, is
perhaps the best local treatment, in most cases, when it can be
rigidly carried out; but where reﬂex excitations to distant
parts, causing palpitations, neuralgia, congestion and engorge-
ment of pelvic and abdominal organs, etc., are due to engorge-
ment of the cord, rather than to anaemia, cold to the spine is
found to be eminently remedial. Other cases, on the contrary,
are beneﬁted by hot water to the spine. The diet should in all
cases be generous.
SPINAL HZEMORRHAGE.
Syn0nymS.——Haemorrhage into the Spinal Cord or its
Membranes, Spinal Apoplexy, Haemorrhagia Medulla Spi-
nalis, Haematomyelia ; Fr., Hémorrhagie Intrarachidienne, Him-
atomyéle, Apoplerrie de la Moelle Fgoiniere; Ger., Rilckenmarks-
apoplevie.
Deﬁniti0n.—Haemorrhage into either the substance of the
cord or into its membranes, to which latter variety most cases
of spinal haemorrhage belong.
Diagn0siS.—Usually, the chief reliance must be upon the
history of the case, the existing symptoms affording but few
diagnostic marks. When, however, paraplegia occurs sud-
denly, and is the result of an accident, we shall generally be
warranted in attributing the paralysis to spinal haemorrhage.
Path0l0g'y.—When effused into the substance of the cord,
the clot, which is almost invariably seated in the gray matter,
shows a greater tendency to extend in the course of the long
axis of the cord than laterally, and varies in length from
half an inch or less to several inches, sometimes involv-
ing the entire central portion of the cord. In the meningeal
variety the blood is generally extravasated between the bones
SPINAL MENINGITIS. 85
and the dura mater, but very rarely it is etfused into the pia
mater, where it more or less compresses the cord and produces
the anaesthesia and motor paralyses observed in such cases.
When the extent and situation of the haemorrhage are such as
to cause irritation instead of compression, the effect is to pro-
duce hyperaesthesia and spasm.
Clinical Experience—-—Hypericum, Arnica and Calendula are
given after severe injury to the spine followed by numbness
and paralysis, with a view to promote the absorption of any
clot which may have formed and is causing compression.
Secale cor. is given to prevent further effusion by contracting
the spinal bloodvessels.
Therapeutic Indications.—These are given under the
heads of cerebral haemorrhage, spinal paralysis and anmsthesia,
which see.
Auxiliary Treatment.—Whenever there is reason to appre-
hend the existence of spinal haemorrhage, ice should be applied
to the spine and the patient made as quiet and comfortable
as possible. Absolute rest is essential, not only to prevent fur-
ther effusion of blood, but to render the consequences of the
haemorrhage as light as possible.
SPINAL MENINGITIS.
Synonyms:-Inﬂammation of the Spinal Meninges, Menin-
gitis Spinalis; Fr., Méningite Spinale. DURA MATER:
Spinal Pachymeningitis; Fr., Pachyméningite Spinale; ARACHNCID: Spinal Arachnitis; Fr., Arachnite Spinale; PIA MATER: Spinal Leptomeningitis; Fr., Leptoméningite Spi-
nale ; Ger., Rilckenmarkshautentzilndung.
Deﬁnition:-Inﬂammation involving one or more of the
membranes of the cord. As it is usually limited to the soft
membranes, it is immaterial whether we call the disease
spinal meningitis or spinal leptomeningitis.
Diagn0sis.—The diagnosis of spinal meningitis, either
acute or chronic, depends upon the presence of the following
symptoms: (1) pains in the back and limbs, greatly aggra-
vated by every movement of the spine; (2) muscular rigidity
86 NERVOUS THERAPEUTICS.
similar to, but less severe and general than, that of tetanus; (3)
hyperaesthesia and increased reﬂex excitability; and (4) reten-
tion of urine and faeces, followed by more or less paralysis,
anaesthesia and incontinence of urine and faeces. The absence
of cerebral symptoms is sufficient evidence that the disease is
not tubercular.
Clinical Experience.—The remedies which appear to stand
the highest in the treatment of this disease are: Aconite, Bella-
donna, Bryonia and Nux uom. Others which have received
clinical indorsement are: Rhus to:c., Causticum, Plumbum, Hy-
pericum, Cuprum, Veratrum oir., Mercurius, Secale cor. and
Oxalic ac.
Therapeutic Indications.-—-Aconite.—-High fever, with bor-
ing pain in the spine, increased on motion; painful stiffness
in the dorsal region, extending to the neck; numbness extend-
ing from the small of the back into the lower limbs; formica-
tion in the arms; spasms caused by spinal inﬂammation;
insensibility and coldness of the hands and feet; the arms
hang powerless, as if paralyzed.
Belladonna-,-Lancinating pains in the vertebrae, resembling
stabs with a knife; tonic muscular contractions; cramplike
pain in the middle of the spinal column; painful stiffness in
the back of the neck;. intense dyspnoea, as if the chest were
violently compressed; complete or incomplete paralysis, with
or without incontinence of urine.
Bry0nia.—Sticking pains in the back on the slightest move-
ment of the spine; promotes absorption of serous eﬂusion, and
thus relieves paralysis from compression; sticking pains in
the chest, with fever.
Nux v0m.—Violent pains in the back, especially in the dorsal
and lumbar regions; pains extending from the back to the
sternum, producing shortness of breath; pains aggravated
by movement; hypochondriac and epigastric regions sensitive to
pressure ; numbness and weakness of the arms and legs; reten-
tion of urine; constipation.
Hypericum-—Fever, with wild, staring looks, hot, bloated
face, thirst and white-coated tongue; painfulness of the back
from injury to the spine, greatly increased by any movement
SPINAL MENINGITIS. 87
of the body; the slightest movement of the spine extorts cries ; the
cervical vertebrae sensitive to the touch; spells of short, hack-
ing cough and difficult breathing; desire for warm drinks.
Plumb\1m.—Chronic cases, attended with frequent attacks of
violent colic, with retraction of the abdominal walls; paralyzed
parts greatly emaciated; limbs become painfully contracted;
coldness and paralysis of all the limbs, especially of the lower;
extreme constipation.
Cuprum.—Suffocative breathing from spasm of the respiratory
muscles; rigidity, with painful contractions of the limbs, toes
and ﬁngers; excessive weakness, especially in the lower ex-
tremities; painful jerkings in various parts of the body and
limbs; paralysis, with incontinence of urine.
Rhus tox.——High fever from getting wet, or from repercussion
of an exanthem; numbness, and loss of sensibility and power
of motion in the limbs; formication; dyspnoea; inﬂammation
following concussion of the spine.
Secale cor.—-Spinal meningitis, attended with suppression of
urine; spasms, followed by paralysis, numbness and insensi-
bility.
Mercurius.——-Violent pain in the spine, aggravated by motion;
great restlessness and sleeplessness at night, or when warm in
bed; paralysis of the lower limbs, bladder and rectum ; anaes-
thesia of the skin; occasional jerks in the paralyzed parts.
Physostigma.—-Spinal meningitis, with tetanic spasms; back
very weak; stiffness and pain all along the spine, with incli-
nation to bend forward; stiffness of the neck, with feeling of
drawing and tension.
StraIn0nium.——Constant pain in cervical and upper dorsal re-
gions of the spine, which is sensitive to the touch; sudden
jerks through the body; tonic spasms, with consciousness un-
aﬂected ; muscles will not obey the will; trembling contractions
Cicuta.——Violent spasmodic pains in the paralyzed lower
limbs; trembling of the limbs during remission; painful stiff-
ness in the muscles; frequent involuntary jerking and twitch-
ing in the limbs, followed by paralysis; feeling of soreness in
many parts of the body.
Kali iod.—Constant violent pain in the small of the back;
88 NERvoUs THERAPEUTICS.
spasmodic contraction of the muscles; fever, with excessive thirst;
burning sensation at the pit of the stomach; great desire to go
into the open air; paralysis of the lower extremities.
Auxiliary Treatment:-Ice to the spine usually gives most
relief in acute cases, especially to the pains. Chronic cases are
beneﬁted by the primary galvanic current and by the electro-
cautery. The patient should lie on his side or face, on a com-
fortable spring mattress, in a large, quiet, airy roo1n. Animal
broths, soups, milk, eggs and other nutritious articles of food
should constitute the diet, strengthened, when required, by a
moderate allowance of stimulants. Bed-sores should be pre-
vented as long as possible, and after they have formed they
should receive careful attention. A mild current of electricity
passed daily through the affected parts will often cause them
to heal. Great care should also be taken to relieve the blad-
der and rectum, especially after paralysis has occurred.
MYELITIS.
Syn0nyms.——Inﬂammation of the Spinal Cord, Inﬂamma-
tory Softening of the Cord, Myelitis Acuta; Fr., Myélite, Inflam.
de la Molélle Epiniere, Ramollissement de la Molélle 1l'piniere,' G'er.,
Rilckenmarksentzilndung, Erweichun g des Rttckenmarks.
Deﬁniti0n.—An acute inﬂammation of the whole, or of any
part, of the substance of the spinal cord.
Diagnosis.—The history of the case, especially in traumatic
injuries, is often sufficient of itself to determine the diagnosis.
The disease may also be distinguished from other affections of
the spine by the characteristic symptoms of the disease, such
as the “ band feeling” about the body and the rapid develop-
ment of paraplegia, together with the reﬂex phenomena of pain
and convulsive movements.
Pathology.-The essential pathological feature of acute
myelitis consists in hypertrophy of the neuroglia, and conse-
quent atrophy or degeneration of the nervous elements of the
cord, resulting ﬁnally in inﬂammatory softening, or else in
sclerosis.
Clinical Experience.——The remedies most frequently em-
MYELITIS. 89
ployed in myelitis are: Aconite, Gelsemium, Belladonna and
Mercurius in recent cases; and Arsenicum, Plumbum, Oxalic ac.
and Strychnia in chronic cases. Arnica, Hypericum, Rhus tow.
and Sulphur are most frequently given in traumatic cases.
Therapeutic Indications.—Aconite.-Acute cases, attended
with high fever, spasms, numbness, formication, icy coldness
of hands and feet. Push the remedy to the extent of produc-
ing a profuse perspiration.
Gelsemium.-—Cerebro-spinal symptoms, such as confusion of
the head, extending from the occiput to the forehead; paresis
of tongue and glottis ; pains in the back of the head and spine,
with pains darting laterally from the latter to other parts;
spinal exhaustion; loss of voluntary motion; incontinence of
urine; myelitis involving the anterior horns of gray matter.
Belladonna.—Both acute and chronic cases, where there are
pains in the back, with weakness and weariness; paralysis of
the ocular muscles and iris; partial or general paralysis; dysp-
noea; tonic and clonic spasms; chronic cases caused by retro-
cession of eruptions.
Mercurius.—Great restlessness and sleeplessness, especially at
night; pains in the spine, violent, and worse from motion;
, paralysis and anaesthesia of the lower limbs; occasional jerking
in the paralyzed muscles.
Plumbum.—-Chronic cases, especially when attended by colicky
pains; painful tonic contractions; paralyzed parts become
greatly emaciated; dyspnoea from hyperaesthesia of the inter-
costals; atrophy of the muscular tissues; extreme constipation.
Arsenicum.-—Chronic cases attended by great dyspnoea and
anxiety; twitching, trembling, violent starting and weariness
in the limbs; tetanic spasms; great restlessness, especially at
night, with sleeplessness.
Angustura.—Twitching and jerking along the back like elec-
tric shocks; tonic contraction of the muscles of the jaw;
bruised pain in the dorsal region, or in the muscles of the
neck; tension of the facial muscles; tremulous stitches in the
thighs.
Secale cor.-——Violent pains in the back, especially in the sacral
region ; muscular twitching and jerking in the limbs; tingling
90 NERvoUs THERAPEUTICS.
in the back, extending to the ﬁngers and toes; painful contrac-
tion of the ﬂexor muscles; paralysis and anaesthesia of the
limbs; especially indicated in cases complicated with spinal
meningitis.
Gausticum.—Lancinating pains iin the back, arresting the
breathing; numbness and insensibility of the ﬁngers and toes,
with ice-cold sensation and tendency to cramp.
Veratrum alb.——Aching and sticking pains in the back;
. tingling in the hands; painful jerking in the limbs; cramps
in the legs ; paresis.
ArI1ica.—Subacute and chronic cases of traumatic origin;
should be given previous to the setting in of the degenerative
process.
Phosphorus.—Chronic cases resulting from sexual excesses, or
where there is a tubercular condition of the system; paroxysmal
pains in the back, with paralytic weakness; dyspnoea, with
sensation as if the chest was oppressed by a load resting upon
it. "
Picric ac.—Tonic and clonic spasms; extreme weariness and
exhaustion; tendency to softening of the cord; great chilliness,
can’t get warm; sensation of worms crawling over the ears ;
paralysis.
Oxalic ac.—Limbs stiff, numb, weak, heavy, powerless;
muscular twitchings ; acute pain in the back, with numbness
and weakness, extending to the limbs; pains excited and
aggravated by movement; they are usually like short stitches,
conﬁned to a small spot, and lasting only a -few seconds.
Auxiliary Treatment.——This is similar to that recom-
mended under the head of spinal meningitis, which see. Kafka
also advises the spray douche, frequently repeated, to the
spinal column.
MYELOMALACIA.
Syn0nyms.—Softening of the Spinal Cord, Simple, White,
Non-inﬂanimatory Softening, Mollities Medullae Spinalis; Fr.,
Ramollissement de la Moélle Epiniere ; G'er., Erweichung des
Rilckenmarks.
MYELOMALACIA. 91
Deﬁnition.—A primary, non-inﬂammatory, and apparently
idiopathic, softening of the spinal cord.
Diagn0sis.—The condition, in striking contrast with every
other affectiori of the cord, is best known by its negative symp-
toms, there being no pains or exalted sensibility, nor any
muscular twitchings, spasms or contractions, even when the
whole structure of the cord is involved in the process.
Path0l0g‘y.——Some writers still adhere to the old notions
concerning softening of the cord, regarding as inﬂammatory
not only the forms resulting from the so-called acute central
myelitis and myelitis diffusa, but also the large class of
primary softenings, due chieﬂy to vascular disturbances, and
which belong to the degenerative type of diseases. Even
secondary degenerations of the cord are sometimes classed as
inﬂammatory, notwithstanding the fact that hyperplasia of the
neuroglia subsequently sets in, giving rise to sclerosis. There
is, however, but one true form of inﬂammatory softening,
namely, that resulting from acute myelitis. All others belong
to the category of non-inﬂammatory softenings, and constitute
the simple white softening known as myelomalacia, in which
the tissues of the cord are found to have undergone fatty and
granular degeneration, the constituents consisting chieﬂy of
oil-globules, debris of nervous matter, and broken-down con-
nective tissue. (Further information on this subject may be
obtained by consulting the author’s article on “ Diseases of the
Nervous System” in Arndt’s System of Medicine, Vol. II, pp.
610,614)
Clinical Experience.—All the clinical experience we have
on this subject is given under the head of myelitis, which see.
Picric ac. will produce softening of the cord, but whether it is
capable of restoring the degenerated cord to a state of integrity
is another question, and remains to be proved.
Therapeutic Indicati0ns.——These are given under the
heads of spinal hyperaemia, myelitis and spinal paralysis, which
see.
Auxiliary Treatment.—Hopeless as may be the case, so
far as a cure is concerned, much may be done toward render-
ing the patient more comfortable and prolonging his life.
92 NERvoUs THERAPEUTICS.
Thus, the weakened cord should be guarded against any
further injury by carefully avoiding any sudden jar or fall;
bed-sores should be prevented or promptly and methodically
treated; and the bladder should be emptied with regularity,
either spontaneously or, as will generally be required, by
means of the catheter. Passive exercise in the open air should
be taken as long as practicable; and in no case should the
patient be unnecessarily deprived of fresh air and sunshine,
which are no less essential to his support than good and
wholesome food.
SPINAL PARALYSIS.
Syn0nyms.——Paralysis of the Spine, Spinal Palsy, Para-
plegia, Paraplexia; Fr., Paraplégie, Paralysie Spinale; Ger.,
Paralysis Spinalis, Spinalparalysie, Spinalliihmung.
Deﬁnition.-—Paralysis of the lower extremities, with or
without paralysis of the lower part of the trunk, bladder and
rectum.
Diag‘n0siS.——There are three distinct forms of organic
paralysis depending on the seat of the disease, namely, the
hemiplegia or cerebral, the paraplegic or spinal, and the general
or cerebro-spinal. To these may be added the reflex or peri-
pheral, which usually assumes the paraplegic form, and may
be known partly by the absence of the distinctive symptoms of
organic paralysis, and partly by the rapid improvement which
usually attends the removal of the irritation which causes it.
Pathology.—-The pathological changes which characterize
the various forms of organic paraplegia will be given in the
succeeding articles treating of the different varieties of spinal
paralysis, which see. Toxic and reﬂex paraplegias exhibit no
pathological alterations, being simply due to vaso-motor spasm
caused by disease or injury of remote organs, without any
appreciable evidences of organic disease in the cord or its
membranes.
Clinical Experience.e—Reserving for special mention under
their appropriate heads the clinical experience pertaining to
the several forms of organic paraplegia, we shall here give
only what relates to the toxic and reﬂex varieties, viz.:
SPINAL PARALYSIS. 93
(a) Toxrc PARALYSIS.
When caused by lead poisoning: Kali iod., Opium, Cupr.,
Plat.
When caused by mercury: Nitric ac., Sulph., Hepar Sulph.,
Stram., Staph.
When due to arsenical poisoning: Ferr., Chin., Hepar sulph.,
Nux vom., Graph.
(b) REFLEX PARALYSIS.
When caused by worms : Cina, Santonine, Tereb., China, Ign.,
Cicuta.
When due to dental irritation: Cham., Bell., Gels., Acon.,
Hyos., Stram., Cupr., Ign., Cicuta.
When produced by intestinal irritation: Merc., Arsen., China,
Phos. ac., Baptis., Ipec., Verat., Calc.
When due to genito-urinary irritation: Bell., Apis, Canth.,
Dulc., Equise., Hyos., Gels., Lycop., Cactus.
When caused by diphtheria: Gels., Arsen., Natr. mur., Rhus
tox., Lach., China, Phos., Kali phos., Nux vom., Ferr.
When caused by cold or dampness: Dulc., Gels, Rhus tox.,
Apis, Verat., Bell.
When due to external injury: Arnica, Hyper., Cicuta, Rhus
tox., Sulph.
When caused by pleurisy or pneumonia: Bry., Phos., Tartar
emet., Sang., Sulph.
When due to sexual excesses: Helonias, Agnus cast., Phos.,
Nux vom., China, Pic. ac., Nit. ac., Dios., Sarsap., Aurum,
Sepia. '
When due to exhausting diseases: China, Phos., Arsen., Zinc.
phos., Pic. ac., Calc., Carbo veg., Phos. ac., Nux vom., Calc.
hypophos.
Therapeutic Indications.——These will be found under the
various forms of paralysis hereafter to be described. See,
also, spinal meningitis, myelitis, locomotor ataxia and spinal
concussion.
94: NERVOUS THEBAPEUTICS.
ACUTE ASCENDING PARALYSIS.
Synonyms.—Acute Progressive Paralysis, Landry’s Paraly-
sis, Paralysis Ascen dens Acuta; Fr., Paralysie Ascendante Aigulé ;
Ger, Paralysis Ascendens Acuta.
Deﬁnition.—An acute disease of the spinal cord, character-
ized by a rapidly progressive paralysis, and unattended by any
appreciable lesion.
Diagnosis.—This disease may be distinguished from the
“ acute spinal paralysis of adults,” and also from subacute
forms of spinal paralysis, (1) by the absence of rapid muscular
atrophy, and (2) by the fact that the electrical excitability of
the muscles is unimpaired. Moreover, the disease is regularly
progressive in its character, in which respect it differs from
acute spinal paralysis, where the impairment of muscular
power occurs simultaneously in every part affected.
Patho1ogy.——No pathological changes, not even hyperaemia,
have yet been discovered after death by this disease, either in
the cord or in its membranes. The disease is supposed to be
due to some peculiar disturbance of nutrition.
Clinical Experience:-Aluminum met., Ledum, Cocculus and
Gelsemium occupy the ﬁrst rank in this disease, and Phosphorus,
Rhus tox., Nux com. and Secale cor. the second.
Therapeutic Indications.——A1uminum met.— Wl1ile the
paralysis is conﬁned to the lower limbs, or when there is so
much heaviness of the legs that the patient is scarcely able to
lift them, or when they are so weak that he is obliged to sit
down, and experiences great weariness even when sitting;
staggers in walking; numbness of heel and pain in the sole of
the foot when stepping ; constant inclination to lie down.
Ledum.—Paralysis ascending from the feet upward; pains in
the soles of the feet when walking; sensation as if the posterior
muscles of the thighs were paralyzed.
(l0cculus.—-Paraplegia occurring in debilitated nervous per-
sons, and where the circulation is impeded or sluggish; gen-
eral sense of prostration from paralysis of organic life ; sense of
constriction through the whole spine.
Gelsemium.-—General sense of helplessness, arising from the
SPINAL PARALYSIS or ADULTS. 95
muscles not obeying the will-power of the patient; complete re-
laxation of the whole muscular system ; pain in the back of the
head and neck; dimness of vision; great drowsiness.
Picric ac.—I believe this to be the nearest similium we have;
the great sense of prostration and the acuteness of the symp-
toms appear to call for it, but it should be used comparatively
high; it ought to cure in the 30th potency.
Nux V0m.—-Paretic condition, in which the power of voluntary
motion is not wholly lost ; feeling of great weakness, especially
in the back; staggers in walking, and sometimes falls; paral-
yzed parts numb and cold; paralysis from exhaustion of the
spinal cord; drags his feet in walking.
Rhus tox.-—Paraplegia attended with painful stiffness, ting-
ling and numbness in the paralyzed limbs; pain in the back
ameliorated by lying on something hard; paralysis of the rec-
tum and bladder, as well as of the lower extremities.
Phosphorus.—Where the paralysis seems to depend on per-
verted nutrition ; pains in the soles of the feet, with sensation
as if they were asleep; insupportable pains in the spine, pre-
venting walking; partial contraction of the affected muscles,
with formication and tearing pains.
Secale cor.—Severe spinal pains, especially in the sacral re-
gion; paralysis of the lower sphincters; destroys the activity of
the cord.
Auxiliary Treatment.—The majority of cases are so acute
that but little good can be expected of accessory treatment.
The constant galvanic current to the spine may, however,
prove to be of some benefit, if methodically applied.
SPINAL PARALYSIS OF ADULTS.
Synonyms.-—Atrophic Spinal Paralysis, Inﬂammation of
the Anterior Horns, Poliomyelitis Anterior; Fr., Paralysie
Spinale Atrophigue, Paralysie Spinale de l’Adulte; Ger., Spinallc'th-
mung bei Erwachsenen, Poliomyelitis Anterior.
Deﬁnition.-—A peculiar form of paralysis in the adult,
acute, subacute or chronic, resulting from inﬂammation and
degeneration of the gray matter of the anterior horns of the
96 NERVOUS THERAPEUTICS.
spinal cord, and followed by more or less atrophy of the
paralyzed muscles.
Diagnosis.——The regressive character of the muscular
weakness and paralysis, almost, if not wholly unattended by
febrile symptoms, but accompanied by wasting of the limbs,
by abolition of the patellar tendon reﬂex, and by sensations
of numbness, yet without loss of tactile sensation, and without
paralysis of the bladder or rectum, will render the diagnosis
clear and indisputable. It may be distinguished from that
form of peripheral neuritis which is attended by paralysis and
muscular atrophy, by means of the following table:

Poliomyelitis.
Peripheral N euritis.

Disease usually begins suddenly.
Paralysis regressive. Involves at the
start all the members affected, some
parts quickly recovering.
Usually no pain. May be general
hyperaesthesia at the beginning.
Muscles not sensitive to pressure.
N 0 recovery after the disease has lasted
some time.
Sets in gradually. .
Paralysis progressive. Involves differ-
ent members, generally in the na-
ture of an ascending palsy.
Pain is usually continuous; especially
marked upon handling, and in-
volves certain nerves.
Muscles sensitive to pressure.
Perfect recovery may take place after
the paralysis and atrophy have

lasted a long time.

Patho1ogy.—The pathological changes in the cord are
chieﬂy confined to the anterior horns of gray matter, and
consist in atrophy and yellow pigmentation of the motor
nerve-cells, and in centres of softening, showing that the
disease is essentially a myelitis. Whether, as Hammond
supposes, the muscular atrophy is due to the destruction of
trophic cells in the cord, of the existence of which we have
no other evidence, or whether, with Charcot, we refer it to
atrophy of the motor cells alone, there can be no doubt of its
dependence on the spinal affection, which is always associated
with it.
Clinical Experience.——The remedies which seem to have
done the most good in this disease are: Gelsemium, Belladonna,
Acomlte, Phosphorus, Strychmla, Rhus tom. and Argentwm nit.
INFANTILE SPINAL PARALYSIS. 97
Therapeutic Indicati0ns.——These have already been given
under the head of myelitis, which see. Consult, also, spinal
hyperamia, spinal meningitis and progressive muscular atrophy.
Auxiliary Treatment.——After the inﬂammatory process
has been arrested, the paralyzed and atrophied muscles should
be stimulated to contract by the methodical application of
electricity. Massage is also useful in these cases, especially the
electro-massage of Dr. Butler.
IN FANTILE SPINAL PARALYSIS.
Syn0nyms.——Essential Paralysis of Childhood, Antero-
spinal Paralysis of Infancy; Fr., Paralymle Essentielle de l’En-
fance, Paralysie Atrophtque Gravlsseuse de l’Enfanee; Gen, Spvlnale
Kinderléihmnng.
Deﬁnition.-—An acute disease of the spinal cord in chil-
dren, characterized by the three successive stages of fever, mus-
cular paralysis and atrophy.
Diagnosis.—The fact that progressive muscular atrophy
sometimes attacks children has led occasionally to the mistake
of confounding it with this disease, from which it may be
differentiated as follows:

Infantile Spinal Paralysis. Progressive Muscular Atrophy.

Causes unknown. Heredity in some cases; in others, ex-
posure to wet and cold and exces-
sive muscular exertion.
Patients, infants and children. Mostly adults.
Always acute. Always chronic.
The paralysis appears ﬁrst, and is fol- The atrophy appears ﬁrst, and the mus-
lowed later by muscular atrophy. cular weakness and paralysis de-
pend upon its extent.
Course of the atrophy stationary or re- Always progressive.
gressive.
Electrical reaction corresponds to the Electrical irritability altered according
degeneration of the cord. to the extent of the muscular

atrophy.
Pathology.—-As in spinal paralysis of adults, the essential
lesion in this disease is found to be situate in the anterior
98 NERVOUS THERAPEUTICS.
horns of gray matter, and to consist of a myelitis, which
results in an atrophy of the part affected, a degeneration of its
structure and a disappearance of its cell-elements.
Clinical Experience.—-Gelsem/tum, Rhus tox., Belladonna,
Atropine, Nux vom., Strychnia and Cocculus are preferred in the
more acute, and Phosphorus, Secale cor. and Plumbum in the
less acute cases.
Therapeutic Indications.—-These have already been given
under the head of myelitis, which see. Consult, also, spinal
hyperwmia, spinal meningitis and progressive muscular atrophy.
Auxiliary Treatment.—Dr. Mossdorf claims to have treated
a large number of cases successfully with the descending cur-
rent of central galvanization of the spinal cord. In some cases
over one hundred applications were made before motility was
restored. So long as the paralyzed muscles retain their electro-
contractility the treatment by electricity may .be made effec—
tive. The number of cells to be used is best determined by
trial. The positive electrode should be placed over the nerve-
trunks supplying the atrophied muscles, and the negative
upon the affected muscles themselves, interrupting the current
from time to time by slowly lifting and replacing the negative
sponge.
Should the physician be called during the acute or inﬂam-
matory stage, the cold douche, frequently applied to the spine,
will be of benefit.
PSEUDO-HYPERTROPHIG SPINAL PARALYSIS.
Synonyms. —— Pseudo-Hypertrophic Muscular Paralysis;
Lipomatosis Musculorum Luxurians, Atrophia Musculorum
Lipomatosa; Fr., Paralysie Pseudo-Hypertrophigue, Paralysie
Myosclérosique, Paraplégie Hypertrophique de l’Enfance; Ger.,
Jlluskel-atrophie mit Interstitieller I/ipomatose.
Deﬁnition.——A progressive paralysis, belonging almost ex-
clusively to infancy and childhood, caused by inﬂammation of
the anterior tract of gray matter of the spinal cord, in which
certain muscles appear to be hypertrophied, although the
ultimate ﬁbres of the affected muscles atrophy.
GLOSSO-LABIO-LARYNGEAL PARA 1.YsIs. 99
Diagnosis.—The gradually advancing paralysis of the lower
extremities, accompanied by an enlargement of the gastroe-
nemii muscles, and afterward of those of the thigh and gluteal
region, will serve to distinguish it from every other affection.
Pathology.-—The pathological changes in the cord consist
in atrophy and disintegration of the nerve-cells of the anterior
horns, and sclerosis of the lateral columns. The muscular
hypertrophy appears to be due to proliferation of the adipose
and connective tissues, probably in consequence of morbid
nutrition.
Clinical Experience.——Argentum nit. and Phosphorus are
the only two remedies that have so far proved to be of any
special value in this disease.
Therapeutic Indications.—These will be found under the
heads of myelitis and spinal sclerosis, which see. Consult, also,
spinal hyperaemia and progressive muscular atrophy.
Auxiliary Treatment.—Duchenne is said to have cured
two cases of this disease with the induced current, but others
have not been so fortunate. Improvement, however,-has fol-
lowed the application of the primary current to the spine and
the faradaic current to the affected muscles; in one case even
where there were extreme atrophy of the extremities and
absolute loss of muscular contractility to both currents, until
after many weeks of constant eﬂbrt there was produced a slight
reaction, followed by increasing improvement up to approxi-
mate recovery.
GLOSSO-LABIO-LARYNGEAL PARALYSIS.
Synonyms.—-—Duchenne’s Disease, Labio-Glosso-Pharyn-
geal Paralysis, Progressive Glosso-Labio-Laryngeal Paralysis,
Progressive Bulbar Paralysis, Myelitis Bulbi; Fr., Paralysie
' Glosso-Labio-Laryngée ; Ger., Progressive Bulbarparalysie.
Deﬁnition.—-An acute or chronic, progressive and sym-
metrical paralysis of the lips and adjacent facial muscles, of
the tongue, pharynx, and sometimes of the larynx, with or
without conspicuous muscular atrophy.
Diagnosis. —— Progressive muscular paralysis somejzimes
100 NERVOUS THERAPEUTIUS.
resembles this disease, especially when the tongue is ﬁrst
involved, but that affection seldom commences in these parts,
and never until after atrophy has set in. Facial paralysis
might be carelessly mistaken for this disorder, but facial
paralysis is conﬁned to the parts animated by the facial nerve,
whereas in this disease only the muscles of the lower part of
the face are affected.
Pathology:-The microscope shows that there is degenera-
tion of the ganglion-cells in the motor nuclei of the hypo-
glossus, portio-dura, spinal accessory and pneumogastric
nerves, the nucleus of the cell being destroyed and its place
supplied by numerous brown granules. Chronic sclerosing
myelitis has also been observed at the'points of origin of these
nerves, in the medula oblongata and upper part of the spinal
cord, the nerve ﬁbres being reduced in size and number, their
contents in a state of fatty and granular degeneration, and the
cylinder axis either atrophied or hypertrophied. The wasting
of the ganglion cells is not always in proportion to the atrophy
of the affected muscles, a fact which Duchenne and others
attempt to explain by supposing that the ganglion cells in the
motor nuclei are partly motor and partly trophic.
Clinical EXperience.—AnacardtQ1/m and Argentum nit. are
said to have cured bulbar paralysis, but I am obliged to con-
fess that I have obtained but little beneﬁt from either of these
remedies in this formidable complaint. Baryta and Phos-
phorus have also been recommended. I recently had an
opportunity of trying Plwmbu/m., and for a time it seemed to
arrest the progress of the disease, but ﬁnally neither it nor
any other remedy seemed to do any material good. I am
strongly of the opinion, however, that if the remedy had been
given from the time the disease ﬁrst made its appearance it
would have proved more effective.
Therapeutic Indications.-—-These will be found under the
heads of myelitis and posterior spinal sclerosis, which see.
Auxiliary Treatment.—But little can be done, in the way
of accessory treatment, to beneﬁt the patient. Electricity,
though unsuccessful as a curative agent, has seemed to do
somagood in lessening the suffering, especially in relieving
’ ‘.1 IO! ‘Q. I
I
PROGRESSIVE MUSCULAR ATROPHY. 101
the sense of constriction in the throat and chest. The food,
which should be both nourishing and easily digestible, requires
to be reduced to a semi-solid condition before any attempt is
made at swallowing it.
PROGRESSIVE MUSGULAR ATROPHY.
Synonyms.——Wasting Palsy, Myopathic Paralysis, Amyo-
trophic Paralysis, Gruveilhier’s Atrophy, Progressive Poly-
myositis, Paralysis Atrophica; Fr., Atrophie Musealaire Grais-
seuse Progressive, Paralysie Mnscalaire Progressive Atrophiqne ,-
Gr., Muslcelatrophie, Maslcelliihmung.
Deﬁnition.—A chronic wasting and degeneration of the
muscular tissue, more especially of the muscles of the ex-
tremities, in consequence of which there is a corresponding
loss of motor power.
Diag‘n0siS.—Progressive muscular atrophy is not easily
mistaken for any other disease, as its slow progress and suc-
cessive.implication of certain muscles and groups of muscles
is very characteristic. There are forms of paralysis com-
plicated with muscular atrophy, but in these cases the paraly-
sis precedes the atrophy, while in progressive muscular atrophy
the paresis, for it is mainly muscular weakness rather than
paralysis, accompanies and keeps pace with the wasting of the'
muscles.
Path010gy.—The disease does not originate, as was formerly
believed, in the muscles themselves, but in structural changes
in the spinal cord. These changes consist chiefly in atrophic
degenerations of the ganglion cells of the anterior horns of the
gray matter from where the motor roots emerge which preside
over the nutrition of the affected muscles. The muscular
atrophy, though sometimes consisting only of simple atrophy
without degeneration, is in the majority of cases accompanied
by the fatty and granular forms of muscular degeneration, and
in others by the waxy or vitreous. When the muscles of the
face are involved, it gives rise to the affection known as labio-
glosso-laryngeal paralysis. (For further information on this
subject consult the author’s work on Diseases of the Nervous
System, p. 179, et seq.)
102 NERvoUs THERAPEUTICS.
Clinical Experience.—The remedies mostly to be relied
upon ‘in this disease are: Plumbum, Phosphorus, Picric ac.,
Arsenicum, Sepia, Argentum nit., Cuprum and Lachesis. The
following have also been recommended: Physostigma, Sulphur,
Nux vom., Belladonna and Strychnia.
Therapeutic Indications.-These will be found under the
heads of myelitis and posterior spinal sclerosis, which see.
Auxiliary Treatment.—The chief dependence is on central
galvanization, with persistent and methodical Faradization
and galvanization of the affected muscles.
AMYOTROPHIG LATERAL SGLEROSIS.
SynonymS.—Inﬂammation of the Lateral Columns, and of
the Anterior Tract of Gray Matter, of the Cord; Fr., Sclérose
Latérale Amyotrophigue; Ger., Amyotrophigue Lateralskler0sc des
Rilckenmarks.
Deﬁnition.—A form of spinal sclerosis in which the lateral
columns of the cord are symmetrically sclerosed, and the
anterior horns of gray matter symmetrically atrophied and
degenerated, and which, beginning in the cervical portion of
the cord, extends to the lumbar region, and ﬁnally proves
fatal by implicating the medulla oblongata.
Diagnosis;-—Amyotrophic lateral sclerosis differs from the
spinal paralysis of adults, to which it bears some resemblance,
not only by the greater intensity of its symptoms, but by the
existence of both ﬁbrillary twitching and spasmodic contrac-
tions of the limbs, neither of which occurs in the latter disease.
As for progressive muscular atrophy, of which it was formerly
supposed to be a peculiar form, the muscular atrophy is never
preceded by paralysis, as in amyotrophic lateral sclerosis;
neither do spasmodic contractions occur in it, as they do in
this disease. ~
Patho1ogy.—“ I propose,” says Charcot, who ﬁrst separated
this disease pathologically from progressive muscular atrophy,
“to call that disease in which the two systems of the pyramidal
fasciculi are affected, both in the cord and in the medulla
oblongata, amyotropic lateral sclerosis; only the lesion cannot
MULTIPLE SPINAL SCLEROSIS. 103
be followed upward ordinarily beyond the cerebral peduncle.
The alteration reacts on the gray substance of the anterior
cornua of the cord and on the analogous gray parts of the
medulla oblongata; and it follows two methods. In certain
regions it is a destructive lesion of the cellular elements. The
consequence is, then, an atrophy of the muscles which are in
relation with the nerves emanating from the diseased gray
substance. In other parts it is a simple irritative functional
lesion of the ganglionary elements. As a result, in the parts,
besides the paralysis more or less pronounced, there is a
notable exaggeration of the tendinous reﬂexions, and even,
at a certain moment, a considerable contracture, occasionally,
of the members. The contracture or, in its absence, the exag-
geration of the tendinous and muscular reﬂexions distin-
guishes clinically, according to my observation, this form of
spinal muscular atrophy from that in which the cellular
elements are destroyed without any participation of the white
fasciculi.” ‘
Clinical Experience:-I am not able to give any satisfac-
tory clinical experience pertaining to this disease, though
what is said under this heading in regard to progressive
muscular atrophy applies equally to this affection.
Therapeutic Indications.——-These, so far as our present
knowledge of the disease enables us to give them, will be
found under the head of posterior spinal sclerosis, which see.
Auxiliary Treatment.—We can add nothing of value to
what has been said under this heading in the preceding article.
MULTIPLE SPINAL SCLEROSIS.
Syn0nyms.——Disseminated Spinal Sclerosis, Insular Spinal
Sclerosis, Disseminated Multilocular Sclerosis; Fr., Sclérose en
Plagues Disséminées ; Ger, Multiple Sklerose des Rilckenmarks.
Deﬁnition.—A form of spinal sclerosis characterized by the
presence of scattered patches of sclerosed tissue in the antero-
lateral columns of the spinal cord, but not often conﬁned to
them.
Diagnosis.—When the disease is conﬁned to the lateral
104 NERVOUS THERAPEUTICS.
columns of the cord there is nothing to distinguish it from
the symmetrical form of spinal sclerosis next to be described,
and when the posterior root-zones are implicated the symp-
toms are similar to those of posterior spinal sclerosis or loco-
motor ataxia; consequently it is impossible, in the present
state of our knowledge, to diagnose the disease with certainty,
unless the symptoms of both these conditions should happen
to be united in the same case.
Path0l0g‘y.———The distinctive pathological feature of this
disease is the existence of masses of sclerosed tissue, varying
from one to two lines in thickness, distributed through dif-
ferent portions of the cord. They are not conﬁned to any
particular portion of it, though they are most frequently met
with in the lateral columns. Examined with the microscope,
the nerve-tubes of the white and the nerve-cells of the gray
substance are found to have disappeared, or to have greatly
diminished in number, and to have been replaced by prolif-
eration of the connective-tissue element, the pressure of which
upon the nerve-cells and tubes is the cause of their disin-
tegration and wasting, the ﬂuid portion undergoing fatty
degeneration.
Clinical Experience.—Plumbu/m, Alwminum, Phosphorus,
Secale and Argentum mlt. are the principal remedies which have
been given, with greater or less success, in the various forms
of spinal sclerosis.
Therapeutic Indications.——These will be given under the
head of posterior spinal sclerosis, which see.
Auxiliary Treatment.—-This is chieﬂy conﬁned to preserv-
ing, as far as possible, the general health of the patient.
Electricity can be of but little use in these cases, though the
primary galvanic current (constant) is said to be of some bene-
ﬁt in relieving the contractions.
PRIMARY SPINAL SCLEROSIS.
Syn0nyms.—Spasmodic Spinal Paralysis, Primary Lateral
Sclerosis, Primary Symmetrical Lateral Sclerosis, Idiopathic
Lateral Spinal Sclerosis, Paralysis Spinalis Spastica; Fr.,
PRIMARY SPINAL SCLEROSIS.
T abes Dorsal Spasmodiqae; Ger., Spatisehe Spinalparalysie,
Prirniire Lateralslelerose des Riiekenrnarks, Prirnéire Slclerose der
Seitenstréinge des Riiclcenrnarlcs.
Deﬁnition.——A spasmodic spinal paralysis, caused by a sym-
metric and systematic primary sclerosis of the lateral columns
of the cord.
Diagn0Sis.——The disease can only be recognized by the
characteristic symptoms, viz.: paralysis with contractions, but
without conspicuous muscular atrophy, pain in the back and
limbs, and the absence of any intracranial lesion capable of
accounting for the disease as a secondary disorder. Hence the
difficulty of distinguishing between the symptoms of this dis-
ease and those of chronic spinal meningitis, multiple spinal
sclerosis, and tumors pressing on the cord and giving rise to
similar phenomena——a difficulty so great that, in the language
of Dr. Hammond, I know of no sure sign by which, in the
present state of our knowledge, the discrimination can be
made.
Path0l0g‘y.——The pathological changes observed in the
spinal cord in this disease are in perfect harmony with the
symptoms as interpreted by what is known concerning the
physiological action of the different parts of the cord. Thus
Charcot has shown that proliferation and hardening of the
neuroglia, with simultaneous wasting of the nerve-cells and
fibres (sclerosis), occurs to a greater extent in the cervical por-
tion of the cord than elsewhere, the sclerosed condition, when
this part is affected, extending as far as, and even beyond, the
outer angle of the anterior horn of gray matter, while pos-
teriorly it almost reaches the posterior tract of gray matter.
As we descend the cord it becomes more and more circum-
scribed, while at the same time it approaches closer and
closer to the cortical layer, until in the lumbar portion of the
cord it touches the cortical layer, and at the same time only
occupies about one-fourth the area of the lateral columns.
When it extends to the medulla oblongata it is conﬁned to
the anterior pyramids, and does not involve the nuclei of the
bulbar nerves, as in the amyotrophic form of lateral spinal
sclerosis.
/ 8
106 NERvoUs THERAPEUTICS.
Clinical Experience.-—This does not differ from that of the
other forms of spinal sclerosis already considered.
Therapeutic Indications.--These will be given in detail
under the head of posterior spinal sclerosis, which see.
Auxiliary Treatment.—See previous articles under this
heading.
SECONDARY SPINAL SCLEROSIS.
Syn0nyms.———Secondary Spinal Degeneration; Fr., Les Dé-
générations Secondaires de la Mo'e'lle Epiniere ; Ger., Seconddre Er-
krankung Einzelner Rilckenmarksstrdnge.
Deﬁniti0n.—-Secondary spinal sclerosis is a lesion which
occurs in certain regions of the spinal cord, either as a result
of some previous disease of the cord itself or as a consequence
of intracranial disease. .
Diagn0sis.—Charcot’s “ foot phenomenon,” Westphal’s “ ten-
don reﬂex,” or knee phenomenon, and Onimus’s “associated
movements” are usually relied upon as diagnostic signs of
secondary degeneration of the cord. (See the author’s article
011 this subject in Arndt’s System of Medicine, Vol. II., p. 641.)
Pathology-The degenerative changes in this disease are
similar to those which have already been described as charac-
terizing the various forms of sclerosis, viz.: atrophy and
degeneration of nervous ﬁlaments, the formation of granular
corpuscles in the degenerated tissue, and the proliferation of the
neuroglia. When muscular atrophy is associated with the
paralysis and contracture resulting from the sclerosed condi-
tion of the cord, the anterior cornua are involved in the de-
generative process, the nerve-cells undergoing more or less
disintegration and wasting.
Clinical Experience.-—’l‘his is similar to that of other
forms of spinal sclerosis already described.
Therapeutic Indications.—-These will be given in full
under the head of posterior spinal sclerosis or locomotor ataxia,
which see.
Auxiliary Treatment.—See above reference.
POSTERICR SPINAL SCLEROSIS. 107
POSTERIOR SPINAL SCLEROSIS.
Synonyms.—-Locomotor Ataxy, Progressive Locomotor
Ataxia, Sclerosis of the Columns of Burdach, Tabes Dorsalis;
Fr., Ataxie Locomotrice; G’er., Graue Degeneration der Hinter-
strdnge des Ritckenmarks.
Deﬁnition.—A form of spinal sclerosis involving the poste-
rior root-zones of the spinal cord, characterized by loss of power
of coordinating movements, whereby voluntary movements,
and especially those concerned in walking, are rendered more
or less unsteady.
Diagn0Sis.——When the characteristic symptoms are present,
such as fulgurant pains, paraesthesia in the extremities, marked
staggering on closing the eyes, the girdle sensation, the general
lack of precision of movements, visual disturbances, etc., and,
especially, loss of deep reﬂexes, the diagnosis is suﬂiciently
clear; but when only two or three of them are present the dis-
ease is liable to be mistaken for mere functional disturbances
producing ataxia. In estimating individual symptoms, we
should remember (1) that sclerosis of the posterior columns
always begins with sensory disturbances; (2) that the pains are
fulgurant, intermittent and of irregular occurrence; (3) that
they may be located in any part of the body, as the limbs, face,
back, viscera; (4) that they precede the motor disturbances by
months or years; (5) that they may for an indeﬁnite period
constitute the only symptoms of the disease; (6) that the con-
tinuance of the first stage, previous to the appearance of the
ataxia, is usually about three years, though often not more
than one, and sometimes as many as ﬁve; (7) that during this
stage the patient may enjoy excellent health, though occasion-
ally marked, perhaps, by slight functional disturbances, ocular,
arthritic, etc., which scarcely attract attention; at last (8)
ataxia, with the more prominent symptoms of the second
stage, makes its appearance, and then, if not before, the disease
is clearly recognized. In order to render the diagnosis more
certain, tests may be made by means of the various reﬂex and
associated movements referred to under the head of secondary
spinal sclerosis, which see.
108 mcnvous THERAPEUTICS.
Pathology.--The pathological alterations consist in a pecu-
liar degeneration, with subsequent atrophy and hardening of
the posterior columns of the cord and the posterior roots of the
spinal nerves. The white substance of the cord is converted
into a grayish softened mass. The microscope shows few
nerve ﬁlaments, granular cells, fatty molecules and corpora
amylacea imbedded, as it were, in a matrix of sclerosed tissue,
the result of proliferation of the neuroglia or connective tissue
element. The diseased cord ultimately shrinks and indurates,
constituting real atrophy of its essential constituents.
Clinical Experience.-—The remedies which have been
found to be of the greatest value in this disease belong mostly
to the mineral class. They are: Plumbum, Aurum met, Aurum
rnur., Aurum cyan., Phosphorus, Argentum nit , Zincum met. and
sulph., Alumina, Physostigma, Gelsemium, Belladonna, Lathyrus
cic., i/Esculus hip., Baryta carb., Angustura, the last three, espe-
cially, for the fulgurant pains.
Therapeutic Indications.—Plumbum.--'l‘his remedy pro-
duces the anatomical lesions of disseminated sclerosis, the tremor, the
paralysis and the muscular atrophies, and it has repeatedly cured
these symptoms.
AuruIn.—This metal and its preparations, the muriate and
cyanate, have repeatedly cured both the fulgurating pains and the
ataxia; weakness and paralytic feeling chieﬂy noticed when
walking; amaurotic blur before the eyes.
Alumina.——Pain and paralysis of the lower extremities;
impossible to walk with the eyes closed; soles of the feet feel as if
they were swollen and too soft; numbness of the heels when
stepping on them; when Walking he staggers and is compelled
to sit down.
Phosphorus.—Sexual irritation; involuntary sexual emis-
sions; great irritability and nervousness; paralytic feeling in
the feet and limbs, with trembling of the knees; pains darting
from the hip-j oint; anaesthesia, with increased heat; periodically
returning insupportable pains in the spine, preventing walking;
pain and tenderness in the soles of the feet. This remedy is
suited to every stage of the complaint; the fulgurating pains
and visual disturbances of the ﬁrst, the ataxic symptoms and
POSTERIOR srman scnnnosrs. 109
genital excitement of the second, and the paralytic, atrophic
and degenerative condition of the last.
Argentum nit.—Vertigo as if turning in a circle, preventing
standing; momentary blindness; irregular movements of the
extremities; limbs retracted toward the abdomen; instability
of the limbs; vacillating gait; cannot walk in the dark without
staggering. I once cured a well marked case of posterior
spinal sclerosis with this remedy after the ataxic symptoms
had set in.
Zincum.-—Great weakness in the lumbar region and in the
knees when walking; weakness, numbness and tremor in the
limbs; lancinating pains extending to the knees, which feel as
if they would give way; paralysis of the bladder.
Phys0stigma.——Feeling of unsteadiness and insecurity in
walking; has to tread carefully, especially if the eyes are shut
or when in the dark; feels the need of a cane or some other
means of support; feeling of weakness, as though paralyzed,
passes downward through the whole length of the spine to
the lower extremities, which feel as if asleep; staggering gait,
as if drunk. '
Lathyrus cic.——Weakness and trembling of the limbs, followed
by a sort of stupefaction ; almost total loss of power in the extrem-
ities; pigs that eat it are said to drag their feet after them.
Gelsemium.—Paralysis of all the li1nbs; cannot move them,
they feel so heavy; electric-like pains through the limbs; un-
steady gait; muscles will not obey the will; sense of helpless-
ness fro1n brain-weakness; temporary blindness; paralysis of
the bladder.
Belladonna.-—Loss of power to coordinate muscular move-
ments; when walking he raises his feet slowly and puts them
down with force; trembling of the muscles and limbs; weak
and tottering gait; paralytic weakness of all the muscles,
especially of the feet; paralysis of the motor ocali; fnlgnrating
pains; especially valuable during the initial period of the
disease.
Helleb0rus.—Muscles do not act in harmony unless the
attention is ﬁxed upon them; walk slow and tottering; twitch-
ing, tearing pains in the limbs; sudden relaxation of certain
110 NERvoUs THERAPEUTICS.
muscles; he lets fall an object held in the hand; staggering
gait, with want of ﬁrmness in the legs and bending of the
knees; vesical tenesmus ; impotence, with ﬂaccid penis.
Esculus hip.—Lameness and paralytic feeling from neck
down; back and legs weak, can hardly walk, must lie down;
fulgurant pains; ocular and vesical tabetic symptoms. This
remedy is indicated even when the sclerosis is well advanced.
Ignatia.—Weakness and trembling in the limbs; he was
unable to walk, but was obliged to remain sitting, because
when walking the knee was involuntarily drawn upward.
Baryta carb.-—-When standing he felt a blow in the thigh,
above the right knee, so violent that he believed he would
fall forward; in the right knee a rapid momentary pain, like
cutting with a knife, which makes the leg lame; trembling of
the hands and limbs; great mental and bodily weakness;
constant inclination to lie down.
Angustura.—Twitching and jerking along the back like
electric shocks; paralytic weakness of the whole body; in-
dicated in the spasmodic form, or when the paresis is associated
with fulgurant pains.
Silicea.—Trembling in the limbs, as if he had lost all power
over them; wandering pains, passing quickly from one part
of the body to another; sense of great debility, wants to lie
down; limbs sore, lame and cold, go to sleep easily; paralytic
weakness in the joints when sitting or walking; drawing,
jerking pain in the hip-joint; tearing pains in the thighs,
followed by numbness.
Oxalic ac.——Pains shooting down fro1n the spinal cord to
the limbs, especially the lower ones; back feels too weak to
support the body; dyspnoea, followed by general numbness;
jerking pains, conﬁned to small spots and lasting only a
moment.
Nux vom.—Staggering walk; when he walks he drags his
feet; numbness and deadness of the legs and feet; incomplete
paralysis, with the power of motion not entirely gone;
paralysis of the bladder; obstinate constipation.
Auxiliary Treatment.—The operation of nerve-stretching
has, until very recently, been regarded as an efficient means of
rosrnnron SPINAL SCLEROSIS. 111
relieving the most distressing symptoms of locomotor ataxia,
but at present the consensus of opinion on the subject among
those whose opportunities of forming a correct estimate of its
value in this disease are the greatest, is, that it is doubtful
whether any marked symptoms have been permanently re-
lieved by it.
Karl Pauli highly recommends the lukewarm baths introduced
by Westphal as the best way of relieving the fulgurating pains,
employing them almost constantly for weeks, or until the pains
subside.
Both Mochoukowsky and Charcot speak very highly of the
treatment by suspension. The former, who was the originator
of the treatment, makes use of the apparatus of Dr. Sayre, of
New York, the suspension at ﬁrst being of only half a minute
duration; this is gradually increased to three minutes, the
maximum not exceeding four minutes. Treatment every
other day sufﬁces, no beneﬁt accruing from its daily practice.
Charcot ﬁnds that after twenty or thirty treatments Romberg’s
symptom disappears, followed by amelioration of the urinary
and vesical symptoms; in a number of cases the plantar anaes-
thesia passed off. Other experiments, however, have been less
successful with this mode of treatment, one case resulting, after
two suspensions, in spasmodic paraplegia, which disappeared
again after three days.
After all, however, we ﬁnd that the most efﬁcient agent in
ameliorating the symptoms during the initial stage is electricity.
Usually the positive pole of the galvanic current is placed on
the nape of the neck and the negative sponge swept up and
down the spine and limbs. Of late, Rumpf’s treatment with
the electric brush——the rapidly interrupted Faradaic current
, —-along the back and legs, has seemed to do the most good, and
almost entirely superseded every other form. The anode is
applied to the sternum, and the cathode energetically carried
over the spine and extremities until the surface turns to a deep
red, each séance lasting ten minutes.
112 NERVOUS THERAPEUTICS.
SPINAL TUMORS AND OTHER ABNORMAL GR OWTHS.
Synonyms:-Meningeal and Intramedullary Spinal Tu-
mors; Fr., Tumeurs Rachidiennes, Tameurs de la Moelle Elpiniere;
Ger, Kranlchafte Geschwitlste des Rilclcenmarks.
Deﬁniti0n.—Tumors, foreign growths and adventitious
products within the spinal canal.
Diagn0sis.——The diagnosis is necessarily more or less un-
certain, since the same symptoms may be produced by very
different causes. Most cases, however, are attended by one or
more of the following characteristics: (1) a very gradual onset
of the symptoms; (2) exacerbations and remissions correspond-
ing to changes in the size and vascularity of the tumor or
other growth; (3) symptoms depending on the seat and cir-
cumscribed character of the lesion; and (4) the presence or
absence of any other disease of the part capable of producing
the symptoms. The nature of the foreign growth is, as a rule,
still more difficult to determine. When the patient exhibits
unmistakable signs of a scrofulous, syphilitic or cancerous
dyscrasia, the presumption will be in favor of its belonging to
the prevailing diathesis. Some light may also be thrown upon
the subject by the presence of tumors elsewhere.
Clinical Experience.-—This does not differ materially from
the clinical experience given under the head of cerebral tumors,
which see.
Therapeutic Indications.—-These will be found under spi-
nal meningitis, myelitis, acute ascending paralysis and other forms
of paraplegia, which see.
Auxiliary Treatment.—In cases of debility, and especially
when of a scrofulous, syphilitic or cancerous nature, the vital
power should be raised, the nutritive functions improved, and_
the patient kept under the most favorable hygienic conditions.
SPINAL GONGUSSION.
Synonyms.— Concussion of the Spinal Cord, Commotio
Medulla’ Spinalis; Fr., Commotion Spinale, Commotion de la
Moelle Epiniere; Ger, Erschiitterung des Ritclcenmarlcs.
SPINAL conoussron. 113
Deﬁnition.——A shock communicated to the spinal cord and
interfering with its functions.
Diagn0sis.—-In the absence of deﬁnite paralysis it is often
necessary, in order to ascertain whether any organic lesion has
taken place, to wait until sufﬁcient time has elapsed after the
accident to determine that question. This is the more neces-
sary because meningitis, myelitis and anaemia of the cord
are liable, sooner or later, to result from spinal concussion.
These results, when present, will of course manifest themselves
by their characteristic symptoms; but it should be remem-
bered that several weeks may elapse after the injury before
spinal symptoms are developed. Moreover, the difficulty of
forming a correct estimate of the nature and extent of the
spinal injury is greatly enhanced, in many cases, by the dis-
position of the patient and his friends—we refer especially to
railroad accidents—to exaggerate the symptoms, either in
consequence of their excited imagination or from interested
motives, the question of pecuniary damage being in many
instances an important factor in the diagnosis. The physi-
cian owes it to himself, no less than to others, to exercise the
utmost care and intelligence in coming to a correct conclusion
in such cases.
Pathology:-On this subject Erichsen, the leading writer
on concussion of the spine, says: “We should be taking a
very limited view of the pathology of concussion of the spine
if we were to refer all the symptoms, primary and remote, to
inflammatory conditions, either of the vertebral column, the
sheaths of the spinal nerves, the meninges of the cord, or the
substance of the medulla itself. Important and marked as may
be the symptoms that are referable to such lesions as these,
there are undoubtedly states, both local and constitutional,
that are primarily dependent on molecular changes in the
cord itself, or on spinal anaemia induced by the shock of the
accident either directly on the cord itself, or indirectly, and
at a later date through the medium of the sympathetic, in
consequence of’ which the blood distribution to the cord be-
comes disturbed and diminished.”
Clinical Experience.—(/‘alendala, Hypericum, Arnica, Rhus
114 NERvoUs THERAPEUTICS.
tox., Conium, Cicuta, Sulphuric ac. and Hepar sulph. are among
the leading remedies resorted to in this condition, the ﬁrst
three being prescribed immediately after the accident, both
internally and locally.
Therapeutic Indicati0ns.—These will mostly be found
under spinal hyperxmia, anwmia, haemorrhage, myelitis, menin-
gitis, paralysis and sclerosis, which see. We shall here conﬁne
ourselves to those above mentioned.
Hyperi0um.—Crreat nervous depression following spinal con-
cussion; vertebrae very sensitive to the touch; inability to
walk after the injury, especially when the attempt is accompa-
nied by violent pains; retention of urine, with shuddering
and desire to urinate.
Calendula.-—Traumatic cases, with stinging pains at the seat
of injury; the patient is very uneasy in every position;
great tendency to start, especially on hearing a noise; the in-
jured part becomes red and inﬂamed; shuddering in the back;
frequent micturition.
Arnica.——Spinal concussion attended by intrarachidian
haemorrhage; limbs cold, pulse slow and weak, and sickness
of the stomach; paresis, with or without numbness of the
limbs; pain aggravated by movement; symptoms better by
lying quiet.
Rhus tox.-——Paralysis, following spinal concussion; extreme
coldness of the hands and feet; muscular startings and
twitchings; pains and numbness in the paralyzed limbs.
Cicuta.—Paralysis, with insensibility; convulsive twitchings
of the muscles; coldness of the body, with an excited and
apprehensive state of the mind; irritability of the bladder;
constipation.
Sulph. ac.—Weakness in the back and lower extremities so
great as to prevent standing without support; shooting pains
in the limbs, with trembling of the whole body; violent press-
ure on the neck of the bladder, with retention of urine.
Conium.—Spinal concussion attended by a sensation of
numbness in the paralyzed parts; sensation in the limbs as if
they were surrounded by tight bands.
Hepar sulph.—Great weakness of the limbs, with nervous
I
SPINAL coucossrou. 115
depression ; shiverings from below upward ;‘ very excited
and irritable; nervous trembling; weakness of the bladder,
with involuntary discharges of urine.
Auxiliary Treatment.—If reactive fever sets in, accompa-
nied by much pain in the back, ice or ice-water should be
applied to the spine, for which purpose Chapman’s rubber-
bags will be found convenient. If necessary, the temperature
of the body, and especially of the extremities, should be raised
and maintained at the normal standard by artiﬁcial means.
The continuous galvanic current will be found beneﬁcial in
hyperaesthetic states of the spinal cord. Cold salt-water douches
and the shower-bath will sometimes prove useful in advanced
cases. In most cases perfect rest in the recumbent position
will be required for some time after the accident. Unless the
shock is a very severe one, these measures, with rest and sleep,
plenty of fresh air and a simple, nutritious diet, will be sufﬁ-
cient in most cases to restore the patient to health; but care
must be taken not to permit any exercise until after the nerv-
ous system has recovered from its enfeebled and exhausted
state; then the patient will often be beneﬁted by a change of
air and scene.
PART III.
CEREBRO-SPINAL DISEASES.

GEREBRO-SPINAL HYPEREMIA.
Synonyms. — Cerebro-spinal‘ Congestion; Fr., Congestion
Cérébro-spinale, Hyperémie Cérébro-spinale; Ger., Cerebro-spinale
Hyperitmie.
Deﬁnition.—A simultaneous excess of blood in any portion
of both the cerebral and spinal tissues.
Diagnosis.—Cerebro-spinal congestion is not usually recog-
nized as a distinct affection, partly because it is partial rather
than general, and partly because it is most frequently a symp-
tom of some other disease. Those cases usually regarded as
belonging to the convulsive form of cerebral congestion, but
unattended by loss of consciousness, are of this character.
The characteristic symptom is stiffness and aching in the back
part of the head and neck, which may subsequently develop
into epileptiform convulsions, or into a tonic contraction of
the extensor muscles of the spine.
Path0logy.—The congestion is usually limited to the base
of the brain and upper portion of the spinal cord. The con-
vulsive action is due to implication of the medulla oblongata,
and when the cerebral hemispheres are involved there is also,
in most cases, loss of consciousness.
Clinical Experience.—— Gelsemium and Cimicifuga are the
two leading remedies in this disease, and are almost infallible.
Belladonna, Natrum brom., Kali brom. and Passijlora incar. are
also useful remedies, especially the last.
Therapeutic Indications. ——These are given under the
heads of cerebral and spinal hyperamia, which see.
(116)
NEURASTHENIA. 117
NEURASTHENIA.
Syn0nyms.—Nervous Exhaustion, Nervous Debility, Brain
Fag, Gerebro-spinal Anaemia, Cerebrasthenia et Myelasthenia;
Fr., Anémie C’e’re’bro-spinale; G'er., Oerebro-spinale Antimie.
Deﬁnition.——A functional disease affecting the whole nerv-
ous system, both cerebro-spinal and sympathetic, and marked
not only by great mental and physical debility, but by other
well-deﬁned, but constantly varying symptoms, which appear
and disappear suddenly without any regular order of suc-
cession.
Diagnosis.--The disease is liable to be confounded with
anaemia and hysteria. The following tables, prepared by
Dr. Beard, give the differential diagnoses between them :

Neurasthenia.
General Anaemia.
Chieﬂy found in nervous diathesis.
Impoverishment of nervous system ; no
necessary anaemia. Patient may be
plethoric.
Found chieﬂy between the age of ﬁfteen
and sixty.
Not at all necessarily dependent on any
important recognizable organic dis-
ease.
Pulse may be full or normal, but some-
times very rapid or very slow.
No cardiac murmurs.
N o pallor, sometimes even a rubicund
appearance.
Easily fatigued by exertion; mental
labor in cerebrasthenia more ex-
hausting than physical. Memory
often temporarily weakened, and
consecutive thought and sustained
mental activity frequently impos-
sible, even when prolonged muscu-
lar labor causes little or no fatigue.
Appears also in the tuberculous, or
rheumatic, or other diathesis.
Impoverishment of the blood; increase
of water and diminution of the red
corpuscles.
Found in all periods of life, from ex-
treme infancy to old age.
More frequently, though not necessa-
rily, associated with some organic
disease, as tuberculosis, carcinoma,
Bright’s disease, etc.
Pulse small, weak and compressible.
Murmur at the base of the heart and
over the large arteries, as the ca-
rotid, subclavian, etc.
Very perceptible pallor of the face,
especially of the lips.
Easily fatigued by exertion; physical
labor always more exhausting than
mental.
118
NERVOUS THERAPEUTICS.

Neurasthenia.
General Anaemia.

Insomnia a very frequent complication.
No necessary or constant disturbance of
the circulation.
Habitual mental depression.
Though common to both sexes, not so
relatively frequent in females.
Usually recovers, but gradually, under
the inﬂuence of rest and nutritious
food.
Insomnia not so frequent a complica-
tion; frequently an abnormal ten-
dency to sleep by day as well as by
night.
Disturbance of the circulation, with
habitually cold extremities.
Mental depression not so frequent.
Far more frequent in females.
May be rapidly removed by the removal
of the organic cause.

Neurasthenia.
Hysteria.
No convulsions or paroxysms.
N o globus hystericus, no anaesthesia of
the epiglottis, ovarian tenderness
less common, and attacks of anaes-
thesia far less frequent and less
permanent.
Symptoms more moderate, quiet, sub-
dued and passive.
May occur in well-balanced, intellect-
ual organizations.
Very common in males, though more
common in females.
Is always associated with physical de-
bility.
Never recovers suddenly, but always
gradually, and under the combined
inﬂuences of hygiene and objective
treatment.

Hysterical convulsions and paroxysms.
Globus hystericus, anaesthesia of the
epiglottis, ovarian tenderness and
attacks of general or local anaes-
thesia.
Symptoms acute, intense, violent and
positive.
Usually associated with great emotional
activity and unbalanced mental or-
ganization.
Very rare in males.
In the mental or psychical form, occurs
in those in perfect health.
May recover suddenly and under purely
emotional treatment.

Path0l0g'y.—General neurasthenia was formerly, and by
many still is, regarded pathologically as a form of cerebro-
spinal anaemia.
Its resemblance to spinal irritation, which is
generally regarded as a form of spinal anaemia, is most strik-
ing. The functional disturbances are not only equally great
and varied, but even the characteristic spinal tendency is
sometimes present. I am, therefore, disposed to regard the
NEURASTHENIA. 119
disease as consisting essentially in a ﬂuctuating local or partial
anaemia of the great nerve-centres, in which the quantity and
not, as in general anaemia, the quality of the blood circulating
in the part is at fault.
Clinical Experience.—The favorite remedies for this dis-
ease appear to be; Phosphorus, Chininum sulph., Strychnia, Phos-
phoric ac., Erythroxylon coca, Nux vom., Picric ac., Zincum brom.,
Zincum pic. and Avena sat. Many other remedies, however,
have been employed with beneﬁt in different cases; indeed,
almost every remedy in the materia medica may be called
for at one time or another, so variable and peculiar are the
symptoms.
Therapeutic Indications.-Phosphorus.-Great heaviness
and weariness from the least exertion; extreme mental and
physical prostration; bruised feeling in the back and limbs;
myelasthenia.
Chininum sulph.—Neurasthenia following severe and exhaust-
ing illness, loss of vital ﬂuids, or overexertion, either bodily or
mental; nervous trembling; weakness and trembling of the
lower limbs; coldness of the extremities.
Erythroxylon.-——General nervous debility, the slightest exer-
tion being attended by fatigue; mental depression, with
anxiety and palpitation of the heart; oppression of breathing
arising from nervous debility; sleeplessness and disinclination
to work or move about; constipation, with abdominal disten-
sion; fainting spells from nervous weakness; coldness of the
limbs.
Arsenicum.-—Constant disposition to lie down; sensation of
weakness in the small of the back; weakness of the lower limbs,
preceded or accompanied by copious watery stools; trembling
of the limbs from debility; thirst for small quantities of water;
sleeplessness and restlessness, especially at night.
Galcarea ph0s.——Nervous prostration, with great depression of
spirits; sore, bruised feeling in the back, with inclination to
lie upon it; coldness and weakness of the lower limbs from
defective circulation in them.
Strychnia phos.—Aching pain, sometimes burning, extending
from the back to the front of the chest, causing a feeling of
120 xnnvous THERAPEUTICS.
nausea and anxiety; tenderness on pressure over the dorsal
region; sleeplessness; cold feet, covered with clammy perspira-
tion; great weakness of the lower lirn bs from exhaustion of the spinal
motor nerve-cells ,- myelasthenia.
Avena sat.—Neurasthe/nia of business and professional men,
teachers, and women who have become exhausted by household
cares and worry; coldness of different parts of the body de-
pending on weakness of the circulation from lack of nerve
force; cerebrasthenia.
Nux Vom.—Nervous debility arising from debauchery and
dissipation, late hours, high-seasoned food and abuse of ardent
spirits; mental exhaustion of students and professional men;
insomnia produced by overwork, business cares, etc. Indi-
cated in all cases where there are a. disordered stomach and
constipation.
Zincum.-Chronic cases, attended by great mental and bodily
depression; headache produced by mental exertion; loss of
memory; cold extremities, with paralytic weakness; frightful
dreams.
Staphisagria.-—Nervous exhaustion caused by excessive sexual
indulgence, onanism or loss of vital ﬂuids; great mental de-
pression; nocturnal emissions followed by great prostration;
headache, backache and loss of memory, with inability to per-
form either mental or physical labor.
Epiphegus.-—Nausea and general languor; severe pain in the
forehead caused by any unusual demand upon the system;
aggravated by rising and going about, always better by rest in
a supine position and by sleep.
Zincum brom.— Cerebrasthenia caused by anaemia; mental and
bodily weakness, with tendency to paralysis of the lower ex-
tremities. This remedy is preferable to Zinc alone, as it has a
quicker action and is more readily absorbed.
Picric ac.—Hale regards this as one of our best restoratives of
a wasted and worn-out nervous system; the least mental or
physical effort exhausts the patient and brings on headache;
homoeopathic to the brain-fag of students, school-girls and
literary or business men and women.
Zincum picr.— Cerebrasthenia and nervous exhaustion from
NEURASTHENIA. 121
overworked brain or from sexual excesses; profound neuras-
thenia, when the -nervous exhaustion has passed beyond the
stage of erethism, seminal emissions or erotomania.
Galois hypophos.-—-Neurasthenia attended by profuse night-
sweats; sleeplessness, depression of spirits, loss of appetite,
emaciation; pale and haggard look; habitual coldness and
venus congestion of the limbs from debility; loss of virile
power.
Ignatia.—-Oppression of the chest and breathing from weak-
ness; weakness of memory; depression of spirits; disposed to
weep from the most triﬂing causes; loss of appetite, with feel-
ing of repletion after swallowing a mouthful or two; palpita-
tion of the heart on rising in the morning or after eating;
complete absence of the sexual desire; face wan and pale;
sleepless and full of fanciful apprehensions.
Phosphoric ac.-—General debility, with feeling of extreme
weakness and prostration; cold sweats during the day or on
making any physical exertion; loss of all virile power; profuse
night-sweats, followed by chilliness; mentally as well as
physically depressed.
Zincum phos.—According to Hammond, who ﬁrst introduced
the remedy, it is homoeopathic to mental depression, debility
and nervous weakness, since in large doses it removes these
symptoms when caused by cerebral congestion. Small closes,
on the other hand, have in our experience frequently relieved
these symptoms when dependent on cerebral anaemia.
Pl1ysostigma.——Irritable spine, nervous headache and mental em-
haustion; eyes feel weak and swollen; smarting, sore feeling on
the tip of the tongue which feels as if scalded; aversion to cold
water; mental exertion tends to produce nausea.
Consult, also, spinal anaemia and spinal irritation.
Auxiliary Treatment.-—-One of my city patients who was
gradually recovering from a severe attack of neurasthenia,
attended with aphonia, was induced during the recent Brown-
Sequard craze, to submit to repeated hypodermic injections of
his so-called “vitalizing ﬂuid.” At ﬁrst the patient seemed to
be beneﬁted, as he speedily recovered his voice, but reaction
setting in he again lost it, and his subsequent recovery was
9
122 NERvoUs THERAPEUTICS.
manifestly greatly retarded by the absurd “scientiﬁc treat-
ment” to which he had been thus subjected. This remedy (I),
which at best is nothing more than a mechanical stimulant,
is liable to give rise to septic poisoning or tubercular infec-
tion, and ought never to be sanctioned in these cases even as
an auxiliary proceeding.
As a general rule, patients suffering with this disease will
soonest recover by following closely what is known as the
\Veir Mitchell method of treatment. This consists (1) in per-
fect rest, both mental and physical; (2) the acceleration of
muscular waste, and the consequent ability of assimilating a
greater amount of food, by massage of the muscles by a
trained shampooéér, and by muscular contraction produced by
Faradization; and (3) by supplying the waste so produced by
regular and high feeding, so that the whole system, and the
nervous system in particular, shall be abundantly nourished.
The diet is to be increased and strengthened from day to day
as this process goes on, until at last the patient is able to
take, “in addition to two quarts of milk daily, three full
meals, viz.: breakfast, consisting ‘of a plate of porridge and
cream, ﬁsh or bacon, toast and tea, coffee and cocoa; a luncheon
at 1 P.M. of ﬁsh, cutlets or joints, stewed fruit or cream, or
a pudding; dinner at 7 P.M., consisting of soup, ﬁsh, joint
and sweets; and, in addition, a cup of raw meat soup at
7 A,M. and 11 P.M. Should there be an occasional attack
of dyspepsia, which rarely happens, it is at once relieved
by keeping the patient on milk alone for twenty-four hours.
The raw meat soup is made as follows: Take one pound of raw
ﬁllet of beef, chop it ﬁnely and place it in a bottle with a pint
of water and ﬁve drops of hydrochloric acid. Stand the mix-
ture in ice all night, and in the morning set the bottle in a
pan of water at 110° F., and keep it two hours at this tempera-
ture. It is then to be thrown on a stout cloth, and strained
until the remaining mass is nearly dry. The ﬁltered liquid is
given in two or three doses in the course of twenty-four hours.”
To give the soup the ﬂavor of cooked meat, the beef to be
used may be quickly roasted on one side, and then the process
completed as above described.
CEREBRO-SPINAL MENINGITIS. 123
CEREBRO-SPINAL MENINGITIS.
Synonyms.—-Epidemic Meningitis, Cerebro-spinal Fever,
Spotted Fever, Epidemic Cerebro-spinal Meningitis; Fr., Min-
ingite Cérébro-spinale Epidémigue Méningite Ce’re’bro-rachidienne;
Ger., Cerebral-Typhus, Epidemische-Meningite, Genie/ckrampft Ge-
nickstarre.
Deﬁniti0n.—An acute epidemic febrile disease, depending
on a diffusive inﬂammation of the pia mater of the brain and
spinal cord, and characterized by sudden invasion, with ex-
treme nervous shock, followed by vomiting, fever, violent
headache, extreme prostration, great restlessness, excessive
pain referred to the back of the head and spine, spasmodic
contraction of the spinal extensor muscles, excessive cutaneous
sensibility and frequent delirium, and accompanied by pur-
puric and other eruptions on the face and limbs.
Diag'n0sis.—The disease is liable to be mistaken for typhus
fever, purpura haemorrhagica and malignant scarlatina.
From the ﬁrst it may generally be distinguished by the sudden
appearance of the rash, without any previous mottling of the
skin, and by the nervous symptoms above noted; from pur-
pura heemorrhagica, by the intensity of the fever and the
peculiar nervous symptoms; and from malignant scarlatina,
by the characteristic rash, sore throat and other symptoms of
that disease.
Pathology.--The inﬂammation of the pia results in an
exudation of purulent matter, which is deposited both at the
base and onthe convexity of the brain, in its various depres-
sions, and along the course of its great vessels, on the pons
varolii and cerebellum, and on the posterior surface of the
spinal cord, especially in the lumbar region. The cerebral
membranes are all more or less injected; and the arachnoid is
rendered opaque by the puruloid exudations before men-
tioned, which vary in consistence from a thin.milklike lymph
to thick and dense ﬁbrino-purulent deposits. The brain sub-
stance itself is more or less injected, and sometimes small spots
of secondary softening occur, but in other respects the organ
usually presents a normal appearance. The disease, therefore,
124 NERVOUS THERAPEUTICS.
is a cerebro-spinal meningitis, of a speciﬁc, infective character,
originating probably in a disease-germ, the nature of which is
at present unknown.
Clinical Experience.-—The remedies of greatest clinical
reputation in this disease are Gelsemium and Cimimjuga.
Aconite, Veratrum oir., Belladonna, Opium and Digitalis are also
frequently prescribed. Baptisia, Rhus to:c., Apis, Hyoscyamus,
Stramonium, Bryonia, Nurc vom., Arsenicum, Arum tri., Kali
brom., Amm. brom., Cicuta, Agaricus, Cannabis ind., Caprum
acet., Lachesis, Crotalus, Lachnanthes and Cactus have all been
used with more or less beneﬁt in particular cases.
Therapeutic Indications.— Gelsemium.- Intense cerebro-
spinal congestion, preceded by a severe chill; nausea and
vomiting, followed by great depression, with dulness of speech,
livid cheeks, dilated pupils, icy ‘coldness of hands and feet,
extreme prostration, very weak pulse and laborious breathing;
general muscular weakness, without any impairment of the
mental power; somnolency and coma; sweating relieves.
Cimicifuga.——Pain in the neck, shoulders and spine, also in
the head, but not very violent, except perhaps in the top and
back; low, restless, excitable delirium, like that of delirium tremens;
eyes painful and sensitive to pressure; pupils dilated; general
prostration, accompanied with more or less vomiting; tongue
swollen and throat dry, causing a constant desire to swallow;
muscular twitchings in various parts of the body; profuse
cold sweat and very quick pulse.
Veratrum ViI'.—-Severe pain in the neck and shoulders;
vertigo, with dimness of sight, dilated pupils and vomiting;
loss of consciousness, with coldness of the body, irregular and
feeble pulse and great prostration ; convulsive twitchings;
tonic contraction of the extensor muscles of the spine; pulse
frequent and feeble; trembling of the whole body.
()pium.—Somnolency, or a tendency to stupor, with or with-
out delirium; face bloated and muscles relaxed; head and
limbs feel cold, numb and heavy; eyes ﬁxed and half closed;
opisthotonos, with constrictive feeling in the chest and difﬁ-
culty of breathing; vomiting, colic, diarrhoea or constipation ;
abdomen hard and swollen; spasmodic jerkings of the limbs;
cold perspiration; coma; worse when sweating.
CEREBRO-SPINAL MENINGI'l‘IS. 125
Digitalis.—Stiffness in the back and side of the neck; sharp
stitches and severe cutting pains in the nape of the neck;
heart’s action slow, irregular and labored; head tends to fall
backward when raised up or sitting; violent lancinating pains
in the head, especially in the occiput; delirium resembling
that of delirium tremens (Cimicifuga); depression accom-
panied by faintness and vomiting; convulsions, with retrac-
tion of the head; syncope, with coldness and tendency to
collapse. ‘
Aconite.—In cases where there is well-marked reactionary
fever, attended by chilliness, thirst, restlessness, dryness of the
skin and anxiety of mind.
Baptisia.-—Typhoid symptoms, accompanied by a bruised and
painful feeling in the back of the head and neck; body feels
stiﬁ’ and sore all over ; dark, livid spots on the skin; great rest-
lessness, especially of the head and limbs, which are in con-
stant motion; stomach sore and sensitive to pressure; Vertigo;
weakness and trembling of the limbs.
Apis mel.—Pain and stiffness in the back of the neck;
burning and throbbing in the head; stabbing pains in the
occiput; great mental and bodily prostration, with sense of
suffocation; swelling of the face, giving it an oedematous ap-
pearance; hyperaesthesia of the skin, with stinging pains all
over the surface; great oppression of breathing, feels as though he
would suﬂbcate; pulse variable and intermitting; dimness of
sight; urine scanty or suppressed.
Cicuta.-—Vertigo, with moaning delirium; head retracted;
muscles of the neck sore and stiff; anxious expression of
countenance; dilated pupils; double vision; tonic contraction
of the spinal extensor muscles, especially those of the neck;
opisthotonos ; spasmodic action of the muscles of the face and
limbs; convulsions attended with cries, working of the jaws,
distortion of the limbs, spasm of the muscles of the chest,
painful distension of the abdomen, followed by insensibility
and immobility; pain in the stomach and vomiting; ashy
hue of the skin; diarrhoea or constipation; general pa-
ralysis.
Hyoscyamus.—Drawing pain in the neck when turning the
126 NERvoUs THERAPEUTICS.
head; violent headache, alternating with pains in the back of
the neck; throbbing sensation in the brain; heaviness of the
head, with dimness of vision, palsy of the tongue, and small,
quick and intermitting pulse; stiffness of cervical muscles and
trismus; spasms of the chest, with temporary arrest of breath-
ing; epileptiform convulsions; jerking of the limbs; constant
grinding of the teeth; brown spots, large pustules and gangre-
nous vesicles on the skin; relaxation of the lower sphincters,
with involuntary evacuations.
Cannabis ind.——Pain in the back of the head and across the
shoulders and spine; ﬁxed, staring eyes, with dilated pupils;
vertigo on rising; hearing unusually acute; emprosthotonos or
opisthotonos, with loss of consciousness; face cold, with drowsy
and stupid expression of countenance; great oppression of the
chest; pulse feeble and irregular; collapse, with pale, clammy
and insensible skin.
Hydrocyanic ac.--Malignant cases, attended with immediate
collapse; protruded half-open eyes; dilated and insensible
pupils; bloated and bluish face; eyes insensible to light;
tongue protruded and paralyzed; feeble, irregular pulse and
respiration; general coldness; involuntary evacuations of faeces
and urine. I
Veratrum alb.—-Stiffness of the neck, with bursting sensation
in the head and choking in the throat; violent headache,
with delirium; vomiting, with convulsive shocks in the head
as soon as it is raised up ; head thrown back and rolling from
side to side; face pale, cold and cadaverous looking; convul-
sions, with loss of sense and motion; watery diarrhoea, attended
by collapse; coldness and numbness of the limbs.
Ph0sphorus.——Headache, with burning and stinging pains in
the occiput; laming pains in the spine; dulness of hearing;
frequent fainting; great prostration; petechial and purpuric
eruptions on the surface of the limbs or body; tingling and tearing
pains in the limbs; difficulty of breathing.
Nux Vom.—Hyperaesthetic condition of the cerebro-spinal
system of nerves; shocks in the brain; scalp sensitive to the
touch; loud, reverberating sounds in the ears; oversensitive-
ness to odors; stitching pains through the body; convulsions
CEREBRO-SPINAL MENINGITIS. 127
renewed by the least touch; conscious opisthotonos; bruised
sensation in the head, body and limbs, with feeling of heavi-
ness; numbness and paralytic drawing in the extremities.
Cr0talus.—-Nausea and vomiting, preceded or accompanied
by faintness; extremely violent headache; burning, un-
quenchable thirst; delirium, with staring eyes; anxious breath-
ing; purplish spots on the skin‘; feeble pulse; pallid face;
painful heaviness of the limbs.
Argentum nit.——Cutting pains extending through the head
from forehead to occiput, increasing and diminishing frequently;
vertigo, photophobia, ringing in the ears, double vision;
tongue coated white, or else black, hard and dry; sordes upon
the teeth; lips and nails blue; breathing greatly oppressed;
epileptiform convulsions; jerking and trembling of the limbs;
face pale and emaciated; clouds before the eyes; deafness; in-
continence of faeces and urine.
C0cculus.—Headache, with vertigo, vomiting and feeling as
if the eyes would be torn out; painful stiffness of the muscles
of the neck; epileptiform convulsions; face pale and bloated;
convulsive trembling of the head; miliary eruptions; fainting
ﬁts; constriction of the chest, with heavy and laborious
breathing.
Rhus tox.—Heavy, bruised feeling in the brain, extending
to the ears and back of the neck; bruised feeling in the back
and limbs; vesicular eruptions on the face and upper part of
the body; vertigo, bleeding of the nose and somnolency ; dry
cough, with perhaps bloody sputa; great restlessness, with
intense aching in the limbs.
C11prum.—Nausea and vomiting from cerebral congestion;
nervous trembling, with hyperaesthesia of the senses; con-
vulsions; sad, depressed features, with dim, sunken eyes,
surrounded with blue rings; general paralysis; somnolency
or coma.
Belladonna.—Stupefying headache, worse in the back of the
head and extending to the neck; pain in the neck ameliorated
by bending the head backward; hyperaesthesia of the special
senses; convulsive movements, especially of the muscles of
the face and neck; grinding of the teeth; upper part of the
128 NERVOUS THERAPEUTICS.
body hot, extremities cold; pupils dilated; delirium with or
without coma; retention or inconstancy of urine.
Plumbum.-—Early paralytic symptoms; limbs feel too heavy
to be moved; heavy feeling in the back of the head; retraction
of the abdomen; colic, with obstinate constipation; emaciation;
somnolency.
Lycopodium-—Headache, with pain extending down the neck;
hyperaesthesia of the special senses; dyspnoea, with fanlilce
movement of the nostrils; sense of constriction in the chest and -
abdomen, as though bound with a hoop; numbness and
twitching of the limbs; dreads solitude; melancholy and
irritable.
]Ethusa cynap.-——During dentition, when accompanied by
sudden, excessive, almost continuous vomiting, and attended
by epileptiform convulsions; face pale, eyes staring, pupils
dilated and insensible to light. I
Arsenicum.—-Stiff, sore feeling in the back of the neck; scalp
sensitive and painful; the characteristic thirst for but little
Water frequently repeated; tetanic rigidity; spasmodic grind-
ing of the teeth; great restlessness and prostration; vertigo;
dulness of vision; anxious respiration; tongue dry and trem-
bling; face pale and corpselike; diarrhoea; somnolency.
Gantharides-Lancinating pains in the occiput, extending
deep into the head; spasmodic constriction of the throat;
priapism, with amorous frenzy; tetanic spasms; eyes staring;
face pale, with terror-stricken expression; general coldness,
faintness and trembling.
Agaricus.——Drawing pains in the back of the head; stiffness
and soreness of the nape of the neck and spine; violent pains
all along the spine; delirium; somnolency.
Zincum.-—Convalescence retarded; prostration of the vital
power, with profuse and easy sweating; ﬂushes of heat in head
and face; trembling and twitching of the hands and feet;
weak and watery eyes; weak memory; troubled with ﬂatulent
colic; priapism; dysuria; constipation.
Auxiliary Treatment.—Local measures are usually of
little avail. Ice to the head and spine sometimes has the
effect of allaying the pain, but there is no evidence of its ever
INFANTILE CONVULSIONS. 129
having done any permanent good. The same is true of heat,
except so far as its moderate use during the collapsed state
may help to restore the normal temperature. Stimulants,
carefully administered, may also serve to help bridge over a
dangerous crisis in the disease, but their use under any circum-
stances in this disease is of very doubtful propriety. The
diet during the earlier stage, or while the patient’s stomach is
in a disturbed state, should consist chieﬂy of animal broths,
which, if necessary, may be given by the rectum. At a later
period more substantial food may be allowed, such as milk,
eggs, oysters, ﬁsh and the like, care being taken that it be not
only nutritious and easy of digestion, but acceptable to the
patient’s stomach.
INFANTILE GONVULSIONS.
Synonyms.—'Infanti1e Fits or Spasms, Infantile Eclamp-
sia, Eclampsia Infantum; Fr., Convulsions de l’Enfance; Ger,
Kinderzuclcung, Kinderhrampf.
-Deﬁnition.-—General clonic, epileptiform, acute spasms,
occurring during infancy and childhood, and produced by
transitory causes.
Diagnosis-It is not always easy to distinguish infantile
eolampsia from infantile epilepsy. The chief distinctions are
embraced in the above deﬁnition. Eclampsia is an acute dis-
ease, while epilepsy is chronic; the former depends on some
permanent or hereditary inﬂuence, the latter on some acci-
dental or transient form of irritation.
Pathology.——Whi1e hereditary inﬂuences do not directly
produce simple eolampsia, they no doubt strongly predispose
to their occurrence. Nervous susceptibility is another impor-
tant factor, and this is heightened by the absence of any vol-
untary restraining inﬂuence emanating from the will. But
the most potent factor is believed to be anaemia. In most
cases this is both absolute and relative. The child’s brain
contains more water than that of the adult. An anaemic con-
dition is often induced by the operation of debilitating causes,
such as impure air, insufficient or unwholesome diet, and other
18O NERvoUs THERAPEUTICS.
devitalizing inﬂuences to which infants are far more often
ignorantly or unintentionally than necessarily exposed.
Therapeutic Indications.—Be1ladonna.-—Head hot and
throbbing; face deep red or else pale; eyes injected, tremu-
lous or staring; pupils dilated; intolerance of light; drowsi-
ness, and starting from sleep as if frightened; great vascular
excitement; mouth and tongue dry, with great thirst; pain
in the neck; head drawn backward; great restlessness and
tossing about; when aroused from stupor answers questions
with a jerk; indicated in all cases where there is unmistak-
able evidence of cerebral congestion.
Gelsemium.—Pain, often severe, in the back of the head and
neck; great nervous excitement, or else a stupid, comatose
condition, from which the child is aroused with difficulty ; cere-
bral hyperaemia during dentition; child constantly boring its
head into the pillow; delirious as soon as it falls asleep; excess-
ive irritability; eyes sensitive to light; cramps and spasms
of the extremities; cries ‘out suddenly from time to time;
especially indicated in cases produced by heat, or where there
is marked cerebro-spinal congestion.
Aconite.—Marked febrile excitement; hot, dry skin; child
frets, cries out suddenly, gnaws its ﬁsts and starts as if fright-
ened ; appears to be in great suffering; very restless; twitch-
ing of single muscles; convulsions caused by fright, cold,
teething and inﬂammatory affections, such as otitis, dysen-
tery, etc.
Ignatia.—-—Convulsions return periodically; child screams and
trembles violently; kicks, jerks and has convulsive twitch-
ings of single parts; convulsions extremely violent, with a
predominance of tonic spasm; indicated after fright, during
dentition, after being punished, or during the commencement
of exanthematic fevers.
Camphor brom.—Anaemic subjects, with pale lips, coldness of
the body and extremities; after taking cold; when preceded
or accompanied by a watery diarrhoea; when brought on by a
suppressed catarrh ; when there is great physical prostration.
Kali br0m.—Head hot and body and limbs cold; feet and
hands blue and cold; eyeballs move in every direction; teeth-
INFANTILE CONVULSIONS. 131
ing, accompanied by vomiting and diarrhoea; intestines con-
tracted into a hard ball perceptible to the eye; great excite-
ment of both the nervous and vascular systems; internal as
well as external spasms; grinding of the teeth during sleep,
with moans and cries; indicated where there is cerebral
anaemia.
Veratrum alb.--Anaemic subjects, in whom the convulsions
are attended or accompanied by diarrhoea; face pale, with
cold sweat on the forehead; child trembles all over; especially
valuable when the child is very much prostrated after the
spasm, or when secondary to pneumonia or cholera infantum.
Cuprum.—The spasm begins in single muscles, or in the ﬁn-
gers and toes; is preceded by violent vomiting; is followed
by loud cries; child lies on its face, or turns and twists vio-
lently until the convulsion is repeated; bloated abdomen,
with thin, watery, involuntary discharges; child fairly doub-
lesitself up during the spasm; during dentition in anaemic
cases.
Cina.—Convulsive attacks at night or early in the morning;
spasms of the extensor muscles, the child becoming suddenly
stiff, followed by trembling of the whole body; unusual pallor
about the nose and mouth, with ﬂushing of the cheeks; child
grinds its teeth during sleep; starts and moans during sleep;
child is feeble and whines more or less when awake; very
restless, throwing its arms wildly from side to side; is very
feverish, and sometimes delirious, at night.
0pi11m.—After the spasm the child lies in a deep stupor;
body trembles violently, while the limbs are convulsed; child
screams before or immediately after the spasm ; indicated after
fright of the child or of the nurse, or when there is much
stupor, with retention of urine and faeces.
Stram0nium.—-Heat of the head and body, with red face and
staring eyes; spasms frequently repeated and continually
changing their form; child is frightened by the approach of
strangers and shrinks from them; abdomen swollen; urine
profuse; when caused by the suppression of an eruption, or
when the exanthem fails to make its expected appearance.
Gl0n0in.——Skin hot, face ﬂushed, head drawn back, spasms
/
132 NERVOUS THERAPEUTICS.
unilateral or bilateral; fainting spells, accompanied by diﬂi-
culty of breathing; bowels loose, with greenish, undigested
stools; indicated in cases where there is marked cerebral con-
gestion, attended by palpitations of the heart, dizziness, vomit-
ing and oppression of breathing. _
Gypripedium.—Reﬂex convulsions, occurring in children of
an excitable, nervous temperament, or where there is functional
irritation of the brain, which renders the child sleepless even
at night; child’s humor is very changeable, being playful at
one moment and irritable and fretful at another; in cases of
teething or of intestinal irritation.
Hyoscyamus.—-Congestion of the head; face bloated and
ﬂushed; convulsive jerks of single muscles, or of a ﬁnger or
hand; jerking and twitching of the facial muscles; grating of
the teeth during sleep; eyes red and sparkling; child starts at
every sound; shrieks from fright or fear; sickens after eating,
and perhaps vomits; becomes insensible and froths at the
mouth; spasms violent and last a long time.
Zincum.-—Child starts and screams out in its sleep; has a
startled look when it awakes; the whole body twitches and
jerks; sometimes the convulsive movements are conﬁned to
one side or to single limbs or muscles; body hot; restless and
irritable, especially at night; great appetite; bloated abdomen;
anaemic children during the process of teething.
Nux V0m.—-Spasms very easily renewed, and followed by deep
sleep; when caused by indigestion, or by emotional excite-
ment in the nurse.
Stannum.—Irritative fever from worms, but with more excite-
ment, more cerebral irritation and more fear than in Gina;
convulsions from dentition or intestinal irritation.
Oicuta.——Sudden and unexpected attacks of severe tonic con-
tractions, affecting the whole body, and making it stiff and
straight or bending it backward; clonic convulsions affecting
the head and upper portion of the body; muscular spasms
renewed by the least excitement of the child, or depending on
verminous irritation.
Cham0milla.—Extreme restlessness, child exceedingly cross
and worrisome, can only be pacified by being carried about in
POSTNATAL CONVULSIONS. 133
the nurse’s arms; disordered condition of the stomach and
bowels; muscles of the face‘ and limbs twitch and jerk violently
from intestinal irritation, or from nursing a woman who has
just had a ﬁt of anger and whose milk does not agree.
Helleborus.—C/‘onvulsions of cerebral, or of apparently idio-
pathic origin; intense pain in the head; urine dark, scanty
and frequently emitted; convulsions followed by sudden re-
laxation of the whole body, leaving the body cold and with a
cold sweat on the forehead; tonic spasms of the cervical
muscles.
Ipecacuanha.—Great irritation of the stomach and bowels;
frequent vomiting; convulsive attacks caused by indigestible
food, or by a suppressed exanthem.
Physostigma.—Convulsions caused by reﬂex irritation of the
spinal nerves, especially when preceded by twitching and
trembling of the muscles, dizziness and great weakness in the
lower extremities; intestinal irritation produced by cold,
worms, dentition, etc.
Veratrum Vir.——Gonvulsions secondary to pneumonia, or when
attended by fever, cough or diarrhoea; face pale, or bluish and
cold, or covered with cold perspiration; violent vomiting,
which is immediately renewed on taking the least food or
drink; convulsive twitching of the muscles of the face and
limbs, which are cold and da1np, or covered with a cold per-
spiration.
Auxiliary Treatment.—There is perhaps no disease in
which accessory treatment is of greater importance, in most
cases, than in infantile convulsions. This will be evident by
a moment’s consideration of the fact that the causes are almost
innumerable, and that unless the cause be removed a perma-
nent cure cannot be expected. This suggestion may be all
that is required under this head; if not, the reader will ﬁnd
the whole subject treated at length in the author’s Treatise on
Diseases of the Nervous System, pp. 37-40.
POSTNATAL CONVULSIONS.
Syn0nymS.—Convulsions of the New-Born, Eclampsia
134 NERvoUs THERAPEUTICS.
Neonatorum, Trismus Nascentium; Fr., Trisme de l’Enfance;
Ger., Eklampsie der Neugeboren, Kinderstarrkrampf.
Deﬁnition.—Spasmodic muscular contractions, of a tonic or
clonic character, occurring shortly after birth.
Diag'nosis.—The time of their occurrence, which is usually
on or about the ﬁfth day after birth (very rarely earlier than
the second day, or later than the tenth), is sufﬁcient to dis-
tinguish them from ordinary infantile convulsions, with which
alone they are liable to be confounded.
Pathology.—Out of nine cases, Schuetz found haemorrhages
six times in the intracranial cavity and twice in that of the
spinal cord, while in only two instances did he observe inﬂam-
mation and ulceration of the umbilicus, to which at one time
they were supposed to be due. He therefore thinks that when
by some unknown causes haemorrhages occur in either the
cranial or spinal cavities, and produce sufﬁcient pressure on
certain nervous parts, “reﬂex manifestations and involuntary
motions will follow, attacking larger or smaller complexes of
muscles,” in other words, producing general or partial convul-
sions.
Clinical Experience.——This has been anything but ﬂatter-
ing. Cures, however, have been reported from the use of Hy-
pericum, Passiﬂora, Arnica, Cicuta and Caloarea.
Therapeutic Indications.-—These have already been given
under the head of infantile convulsions, which see.
Auxiliary Treatment.—As the disease very rarely occurs
among infants that are kept dry and clean, in a pure atmos-
phere and with comfortable surroundings, it is evident that
hygienic measures are of primary importance, both in a pro-
phylactic and therapeutic point of view.
PUERPERAL CONVULSICNS.
Synonyms.—Convulsions of Pregnancy and Parturition,
Puerperal Eclampsia, Uraemic Convulsions, Eclampsia Gravi-
darum et Parturientium; Fr., Convulsions des Femmes Enceintes
et en Couche; Ger., Eklampsie in der Schwangerschaft und im
Wochenbett. '
PUERPERAL coNvULsIoNs. 135
Deﬁnition.-—Convulsions occurring during pregnancy, dur-
ing labor, and immediately at or soon after delivery.
Diagn0sis.—This is obvious from the condition of the pa-
tient and the history of the case.
Pathology.—-Albuminuria exists in almost every case of
puerperal convulsions; and as albumen and urea in the urine
are in inverse proportion to each other, that is to say, when
there is much albumen there is little urea, and when there is
much urea there is little albumen, it is a generally accepted
fact that most, if not all, cases of puerperal convulsions are due
to _the poisoning of the blood with urea, either directly or by
the carbonate of ammonia produced by its decomposition.
Clinical Experience.-—The post hoc ergo propter hoe argu-
ment has led to the acceptance of a very large number of rem-
edies as speciﬁcs in this disease. Making proper allowance for
this fact, the following list is entitled to conﬁdence, provided,
of course, the remedies are always given agreeably to their
therapeutic indications: Cuprum, Hydrocyanic ac., Arsenicum,
Hyoscyamus, Bryonia, Stramonium, Digitalis, Pilocarpus, Ascle-
pias syr., Veratrum vir., Gelsemium, Belladonna, Opium, Lachesis,
Ignatia and (Enanthe croc. The following remedies will pre-
vent, it is said, the full development of threatened convul-
sions if given in time: Apis, Helonias, Apocynum can., Eupato-
rium purp., Kalmia and Barosma.
Therapeutic Indications.-— C11prum.—Convulsions alter-
nate with delirium and nervous dyspnoea; are followed by
blindness or deafness, or by apathy and great indifference;
during the paroxysm the face is red and distorted, eyes pro-
truding and staring, tongue and breath cold; spasms chieﬂy
affect the extensor muscles; patient frequently screams out, as
if in great anguish.
Hydrocyanic ac.——Convulsions occurring suddenly, and at-
tended by great depression, slow, moaning breathing and in-
sensibility; spasms, partial or general, with great distortion of
the features and limbs, or with the trunk bent forward; spasm
of the larynx, with symptoms of suffocation; inability to swal-
low; rattling in the trachea; extreme anguish; action of the
heart greatly diminished; extreme prostration.
I
136 NERVOUS THERAPEUTICS.
Arsenicum.—Tonic and clonic spasms, with great distortion
of features, limbs stiﬂ’ and hands clenched; after the parox-
ysm the patient exhibits great exhaustion ; sudden sinking of
strength, with faintness; lies in a stupor like one dead,
breathing imperceptibly.
Hyoscyamus.-—Clonic convulsions, either partial or general,
violent, accompanied by shrieks and great oppression of the
chest; face pale, with cold perspiration, or bluish-purple and
bloated; unconscious and delirious; extensor muscles violently
convulsed.
Bry0nia.——Convulsive jerking of the extremities, beginning
in the ﬁngers and toes and extending to the whole limb;
cramps in the knees and calves of the legs; worse in the morn-
ing and after eating; drawing sensation along the spine, fol-
lowed by violent contraction of the extensor muscles, bending
the body backward like a hoop; face red and bloated; very
apprehensive as to reco.very.
Stram0nium.—Patient very excitable, hysterical, delirious, and
has frightful or agreeable visions, with corresponding moods
and actions, laughing, singing, attempting to escape, etc.; con-
vulsive movements of every muscle, distorting the face, body
and limbs; convulsions easily excited and frequently renewed.
Digitalis.-—Frequent convulsions, with drowsiness and insen-
sibility; heart greatly embarrassed, weak and palpitating, and
frequently intermits. ‘
Pilocarpus pennat.—Puerperal convulsions, attended with high
arterial excitement, hard pulse, heavy blood pressure; perspi-
ration, with free ﬂow of saliva; dyspnoea, threatening suffo-
cation.
Asclepias syI'.—Uraemic convulsions, preceded by severe
headache, with sharp pains through the temples, or with a
sense of constriction across the forehead, full, quick pulse, and
nausea or vomiting; attacks preceded by profuse, then scanty
or suppressed urine.
Veratrum vir.—Oonvulsions attended by high arterial excite-
ment, violent delirium, ﬂushed face, thirst, hot and sensitive
skin, followed by a weak, scarcely perceptible pulse, and cold,
clammy skin, dilated pupils and oppressed breathing.
PUERPERAL CONVULSIONS. 137
Gelsemium.—Passive congestion of the head and face, stupid
look, thick speech, slow, full pulse; labor protracted by rigid
os uteri; apoplectiform convulsions during labor.
Bel1adonna.—Active or passive cerebral congestion; face red
or livid, pupils dilated, speech thick or lost; convulsions par-
tial or general, frequently repeated and attended by loud
cries, contortions of the face and delirious mutterings; parox-
ysms followed by quiet, unconscious sleep, or by disturbing
spasmodic movements and visions.
Opium.-—Uraemic coma following puerperal convulsions; con-
vulsive rigidity of the body; red, bloated face and stertorous
breathing; retention of stool and urine; low, incoherent mut-
tering; apoplectiform convulsions during or after labor.
Lachesis.——Convulsions continue longer and are more severe
about the throat than elsewhere; complains of pains without
being able to locate them ; redness of the face, violent convul-
sions of the facial muscles and jerking of the extremities, most
violent on the left side; trembling of the body and limbs be-
tween the paroxysms.
Ignatia.—Great nervous excitement, manifesting itself in
cries, sobs and paroxysms of laughing; loquacious and then
taciturn; tries to kick the cover off the bed; constantly pull-
ing at her hair; urine turbid and scanty; suffocative ﬁts of
breathing; panting between the spasms, which are often lim-
ited to the muscles of the upper part of the body, the neck and
the face.
(Enanthe croc.——Epileptiform convulsions, with swollen and
livid face, followed by coma or deep sleep, or else with syncope,
insensibility and deathlike coldness; apoplectiform convul-
sions, with convulsive respirations, dilated pupils, insensibility,
feeble pulse and great prostration ; wildly delirious; tetanic
contraction of the limbs.
Auxiliary Treatment.—As a general rule the sooner the
womb is emptied of its contents the better, as this alone often
suﬂices to put an end to the convulsions. When, therefore,
the spasms occur during labor, artiﬁcial delivery should be
speedily effected, unless there is some weighty reason for
deferring the operation. The same is often true when the con-
10
138 NERvoUs THERAPEUTICS.
vulsions set in previous to labor, provided they seriously
threaten a miscarriage. Even when they occur subsequent to
parturition it is important to remove any clot, membrane or
portion of the placenta which may have been retained, as the
convulsions seldom, if ever, entirely cease so long as any of the
contents of the womb remain in the uterine cavity.
TOXJEMIC CONVULSIONS.
Syn0nyms.—Convulsions from Poisoning of the Blood,
Uraemic Convulsions, Cholaemic Convulsions, Convulsions from
Inanition, Eclampsia Toxica; Fr., Convulsions Toxémiques;
Ger, Eklampsie-blutvergiftung, T oxdmische Eklampsie.
Deﬁniti0n.—Convulsions resulting from the introduction
or retention of poisonous substances in the blood.
Diagnosis:-As in other forms of eclampsia, the history of
the case, together with the appearance of the patient, is usually
sufficient to establish the diagnosis. Thus, uraemic convul-
sions occur either in connection with parturition or disease of
the kidneys; cholaemic convulsions result from the introduc-
tion of decomposing products of animal secretions into the
blood; and the convulsions of inanition are induced by the
intoxicating effect of the deteriorated blood upon the nervous
centres.
Pathology.—The pathology of uraemic convulsions occur-
ing in connection with parturition is given in the previous
section, which see. They likewise occur in the course of scar-
latina in consequence of sudden obstruction of the urinary
passages with croupous exudation. They may also be pro-
duced by any affection of the kidney, such ‘as Bright’s disease,
which interferes with the secretion of urine, or by a re-absorp-
tion of urine which has been previously effused into the cellu-
lar tissue, especially after the urine is decomposed and the
blood becomes surcharged with the carbonate of ammonia
(ammoniaemia). Cholaemic convulsions occur most frequently
in acute atrophy of the liver, as on account of the destruction
of the hepatic cells the function of the liver then ceases. In
short, whenever from any cause the blood becomes so impure
EPILEPSY. 139
as to irritate the convulsive centre in the medulla oblongata,
toxaemic convulsions are the result.
Clinical Experience.——A1l worth mentioning will be found
under the heads of cerebral hyperaemia, cerebral anamia and puer-
peral convulsions, which see.
Therapeutic Indications:-See previous sections, especi-
ally those pertaining to convulsions.
Auxiliary Treatment.—Hygienic measures, especially
such as will tend to 'purify the blood, are of the highest im-
portance. Hence pure air, water, and a blood-making diet of
beef and other animal food, are required in all cases. Mas-
sage is also of great benefit by its renewing effect upon the
tissues.
EPILEPSY.
Synonyms.—-The Falling Sickness, Morbus Magnus, M.
Major, M. Daemonius, M. Divinus, M. Deiﬁcus, M. Lunaticus,
etc., Epilepsia, Epilepsis; Fr., Philepsie, Mal Divin, Haut Mal;
Gen, Fallsucht.
Deﬁnition.-—A chronic, non-febrile, nervous affection, char-
acterized by paroxysms of loss of consciousness and, with very
rare exceptions, by tonic and clonic convulsions.
Diagnosis.—Is there any way of positively diagnosing an
epileptic paroxysm, as such, without reference to its history‘?
No! Eclamptic and epileptic convulsions accompanied by loss
of consciousness belong to the same group of symptoms; the
only difference is they occur under different conditions. The
one is acute or transitory, the other chronic, and recurs in
conformity to an established epileptic habit. No doubt there
is such a thing as infantile epilepsy, but such cases are indeed
very rare. Up to about the third year of life the epileptic
habit is not likely to become established, while after that
period local irritations, either internal or external, are not
likely to cause convulsions without the pre-existence of an-
inherited morbid state of the nervous centres.
Epilepsy is liable to be mistaken for hysteria, which is not
only chronic, but often simulates epilepsy very closely. In
epilepsy the loss of consciousness is sudden and genuine;
140 NERVOUS THERAPEUTICS.
there is no recollection of the attack afterward; the eye is
ﬁxed, the features often distorted and the tongue bitten. In
hysteria, on the other hand, the attack is not sudden, con-
sciousness is not entirely lost, and there is no reckless injury
of the tongue or person.
Syphilitic epilepsy may be distinguished from idiopathic
epilepsy by the fact that it occurs in those who have not had
epilepsy in early life and who have reached the age of at least
thirty years; the disease is frequently associated with or is
followed by some form of paralysis, generally partial; the
attacks are frequently preceded by headache, likewise partial,
and the convulsions occur often, that is, many in quick suc-
cession, the interval between the series of attacks being com-
paratively long; the periods of quietude, however, are not free
from headache or other nervous symptoms which exist and
often become aggravated——-conditions contrary to what usually
obtain in simple or idiopathic epilepsy.
Pathology.-—Although no constant anatomical changes
have yet been observed in this disease in any of the great
nerve centres, the fact that it is in most cases an hereditary
affection, and chronic in its nature, renders it almost certain
that it is something more than a mere functional disorder,
and this accords with the latest investigations, which go to
show that it depends, in a measure at least, on certain histo-
logical changes in the medulla oblongata. Cortical epilepsy
is only a peculiar form of peripheral epilepsy, the cortical
irritation being reﬂected upon the convulsive centre or cen-
tres in the medulla, as in other cases of reﬂex epilepsy.
Clinical Experience.-—Notwithstanding the universally
admited fact that genuine epilepsy is extremely difficult of
cure, the number of remedies to which such cures have been
assigned are almost too numerous to mention. I shall there-
fore refer here to only a few of those whose recorded cases are
before me. Indigo is said to have cured a case where the men-
tal symptoms were those of melancholy. Dr. Quezada says
that when he was a boy, aged 13, he had fourteen epileptic
attacks, and that he was permanently cured by the fruit of
Capparis cor., or “simulo,” a plant indigenous in Peru. Dr.
EPILEPSY. 141
Foster prescribed Cannabis ind. in a case of forty years’ stand-
ing—i11 which an unfailing premonition of an approaching
attack was a feeling of extraordinary mental and physical
vigor—-in doses of one-tenth of a drop every hour when she
felt thus “exalted,” with the result that she has had but one
slight seizure since she began the use of it, now nearly three
years, while before she had about thirty annually. Glonoin,
2x dil., is said to have cured many cases. Calcarea ars., rec-
ommended by Dr. Hering, is said to have beneﬁted several,
and entirely stopped a few cases. Dr. Buller claims to have
cured epilepsy with Cotyledon umb. Belladonna is credited
with a large number of cures, but as most of them occurred in
children, I am inclined to regard most of them as cases of
ordinary infantile convulsions. Coceulus, according to Hughes,
has made several undoubted cures. Ouprum acet., 3x, cured a
case where every usual remedy had failed, ﬁfteen years having
since elapsed without any return. Nux vom., 3x, cured a case
of sixteen years’ standing; four years have passed without
any return. Hydrocyanic ac., 3x, has cured, according to Dr.
Hughes, several cases of recent date. Argentum nit., 1x, 2x,
has effected several permanent cures. Thaspium, 3x, has, it is
said, cured two genuine cases. Glnanthe croo. is also credited
with a cure.
Therapeutic Indications.—Indigo.--Exceedingly depressed
and melancholy; great languor and weariness; unusual feeling
of prostration, especially in the lower limbs; convulsions pre-
ceded by a fit of the blues; the aura seems to come from the
abdominal ganglia; sometimes the attack begins with dizzi-
ness.
(lapparis cor.-—Fit occurs suddenly, almost without warning;
convulsions terriﬁc, tonic and clonic, general, with foaming at
the mouth, usually reddened with blood from a bitten tongue;
very stupid for a long time after the ﬁt has passed off.
Cannabis ind.-—Fit immediately preceded by a feeling of ex-
traordinary mental and physical vigor; mind and body in a
state of ecstatic evaltation; on regaining consciousness violent
shocks pass through the brain; some cases are preceded by
active cerebral congestion, throbbing, ringing and buzzing in
the ears, sensitive to light and noise.
142 NERvoUs THERAPEUTICS.
Glonoin.-—Attacks immediately preceded by ﬂushed face,
headache, ringing in the ears and other evidences of cerebral
hyperaemia; increased action of the heart and arteries; nausea
and vomiting, dizziness and oppression of breathing; convul-
sions tend to become more and more frequent.
Belladonna.—Recent cases, with decided brain symptoms;
previous to the attack, headache, throbbing in the temples,
dilated pupils, intolerance of light, redness of the face; after
the attack, anxiety, fear of imaginary things, disturbed sleep,
vertigo, peevishness, ﬂushed face, startings during sleep; con-
vulsions commence in the upper extremities; clutching of the
throat during the ﬁt.
Cocculus.—-Debilitated, nervous subjects; circulation sluggish,
a sort of passive congestion, veins standing out like whip-cords ;
vertigo, with nausea; great lassitude, making it diﬂicult to
stand ﬁrmly; convulsions begin in the ﬁngers and toes.
Cuprum.—Convulsions follow each other in rapid succession,
the convulsive state rather remitting than completely inter-
mitting; aura emanates from the region of the stomach;
patient very restless after the attack, with headache, soreness
of the ﬂesh and prostration; convulsions begin in the extremi-
ties; hands and feet cold, face livid or pale; involuntary dis-
charge of urine; hysterical mood.
Nux vom.—Stomach weak and disordered, tender to the
touch; pressure over the stomach renews the attack; convul-
sive twitching in the limbs and trembling of the whole body;
spinal epilepsy.
Hydrocyanic ac.-—Recent cases, attended by sudden and com-
plete loss of consciousness a11d sensation; body blue and cold;
ﬁt quickly merges into a comatose condition, interrupted only
by a renewal of the convulsive movements, which usually
begin in the extremities and afterward become general; great
drowsiness and prostration after the ﬁt.
Argentum nit.—Pupils dilated a day or two before the attack;
aura rises slowly from the region of the stomach, which feels
oppressed as by a load resting upon it; head feels dull and
stupid; mind exceedingly depressed and melancholy; convul-
sions sometimes preceded by active cerebral congestion.
EPILEPSY. 143
Thaspium aur.——-Flushed cheeks, hot head, visible pulsations
of the carotid and temporal arteries; great exhilaration or
great mental depression; hysterical mood; headache, with
nausea, precedes the attack.
Qlnanthe croc.-Convulsions attended with vertigo, nausea,
vomiting, unconsciousness, coma or deep sleep ; convulsions,
with deathlike syncope, coldness as if dead; tetanic contrac-
tion of the muscles of the jaws and limbs; convulsions epilepti-
form in all cases, pupils dilated, eyeballs turned up, frothing at
the mouth, face swollen and livid; madness with the convulsions.
Chininum ars.—Attack followed by cold perspiration, eructa-
tions and a sense of utter prostration.
Plumbum.-—Convulsions preceded by numbness of the legs;
swollen tongue; consciousness returns slowly and imperfectly;
chronic cases.
Silicea.—-Attack preceded by shaking of the left arm and
great coldness of the left side of the body; slumber, with start-
ing; spasms seem to undulate from the solar plexus toward
the brain; violent screaming, groaning and foaming at the
mouth, followed by warm perspiration, slumber and paralysis
of the right side.
Auxiliary Treatment.—A large proportion of these cases
belong to the reﬂex variety, and depend upon causes which
can be removed during the interval between the attacks. One
case of ﬁfteen years’ standing was accidentally cured in treating
the piles. Another was caused by the larvae of ﬂies in the in-
testines, the removal of which speedily cured the patient.
Many cases depend on some disturbance or irregularity of the
menstrual function, which requires to be corrected. But the
most numerous of those occurring among young persons, of
both sexes, are the result of self-abuse, and require not only
great care and surveillance on the part of parents and guar-
dians, but moral treatment as well.
The fathers of medicine very properly laid great stress upon
the importance of a suitable diet in epilepsy. Celsus and
Aretoeus advise “a soft diet free from crudities.” Boerhaave
says that “great frugality in diet cures epilepsy.” Echeverria
says that “diet and exercise are of more value than medicine.”
144. NERVOUS THERAPEUTICS.
Experience shows, however, that there is no speciﬁc diet suit-
able for all cases of epilepsy. Some recommend a meat, others .
a milk, farinaceous or vegetable diet; but the experiments of
Merson, Gowers and others show that, applied indiscriminately,
neither of these kinds is curative. At the same time there is
no doubt that purely vegetable food and a milk diet has pro-
duced many a lasting amelioration. My own opinion, how-
ever, is that this sort of diet is best suited to full-blooded,
plethoric patients, while meat diet is best adapted to weakly,
anaemic ones. Nocturnal cases are also, as a rule, beneﬁted
by a stimulating meat diet, while those occurring during the
daytime require an unstimulating, milk or vegetable diet.
Excesses in eating and drinking should never be allowed; and
as for alcoholic drinks, smoking, and even coffee and tea, they
had best be entirely prohibited.
TETANUS.
Synonyms. ——Spasm with Rigidity, Lock-jaw, Central
Myelitis, Entasia Tetanos, Trismus; Fr., Tétanos; Gen,
Starrlerampf.
Deﬁnition.—A disease characterized by a rigid contraction
of the voluntary muscles, alternating with a greater or less
degree of relaxation, caused by an irritated or overexcited
state of the medulla oblongata and spinal cord.
Diagn0sis.—Tetanus is not likely to be mistaken for any
other natural disease, unless it be hysteria, which sometimes
bears a slight resemblance to it. The history, duration and
characteristic symptoms of the two diseases are, however,
amply sufficient to distinguish them from each other. Not
so, however, with toxic tetanus, especially that form of it pro-
duced by strychnia ; and as the latter is frequently employed
for purposes of murder and suicide, it is important to be
able to discriminate between the natural and the artiﬁcial
disease. In the former the spasm ﬁrst takes the form of
trismus or lock-jaw, while in the latter the lower extremities
are ﬁrst involved; the hands also are generally affected in
these cases, while in the natural disease the upper extremities
TETANUS. 145
usually escape altogether. Not only so, but the duration of
tetanus is usually much greater than that of the tetanoid
affection produced by strychnia, which generally proves fatal
within less than an hour of its commencement.
Path0l0g‘y.—Various lesions of the spinal cord have been
discovered after death from tetanus, the most important of
which consist in an enlargement of the bloodvessels, together
with granular disintegration of the nerve-tissue; but as many
cases occur in which no pathological changes can be detected,
at least nothing sufficient to account for the convulsions, it is
by no means certain that these alterations are the causes, or
only the effects, of the tetanic manifestations. Indeed, there
are circumstances which seem to indicate that the spinal cord
is not the primary centre of reﬂex action in these cases, but
that the morbid inﬂuence, whatever it may be, that causes the
disease, is ﬁrst transmitted to the medulla oblongata, and
afterward extends to the cord.
Clinical Experience.-—The following remedies have been
used successfully in tetanus in a number of instances: Bella-
donna, Atropine, Narcotin, Cicuta, Passiflora, Gelsemium, Physos-
tigma, Stramonium, Lachesis, Hydrocyanic ac., Angus. vera, Ver-
atrum vir., Arniea and Hypericum. Among the homoeopathic
remedies which have greatly ameliorated cases of tetanus are:
Aconite, Hyoscyamus, Phytolacca, Kali brom., Bryonia, Ouprum,
Arsenicum, Nux vom., Ignatia, Cannabis ind. and Curare.
Therapeutic Indications. — Belladonna. — Cerebro-spinal
congestion; stiffness of the jaws, with convulsive movements,
dilated pupils, diﬂicult deglutition, staring eyes, restlessness,
spasmodic respiration, involuntary discharges of urine; sudden
jerks and shrieks during sleep; opisthotonos; pleurosthotonos,
especially to the left side.
Nicotinum.-—Icy coldness of the limbs; violent tetanic spasms,
succeeded by relaccation and trembling; extreme palor, nausea
and prostration; coldness and shuddering of the whole body;
dry, hot skin, with thirst and quick pulse, succeeded by cold
skin, weak, thready pulse and labored, irregular breathing.
Cicuta ViI'. —Trismus; legs and arms ﬂexed and rigid;
abdomen distended and hard; spasms every half hour; edges
146 NERvoUs THERAPEUTICS.
of the tongue covered with white ulcers; spasms of the oesophagus;
spasms of a tonic character; paleness of the face during the
spasm.
Passiﬂora incar.— Violent tetanus, with opisthotonos, trismus
and convulsions in a child two years old ; ‘produces, it is said,
prompt, perfect and permanent cures in both men and horses,
also in trismus nascentium.
Gelsemium.—Traumatic tetanus; stiffness of the jaws, with pain
and stiffness in the back of the neck; spasmodic feeling in the
pharynx and oesophagus, with difficulty of swallowing; con-
strictive feeling in the chest, with great difficulty of breathing;
pupils dilated; cramps in the legs; convulsive action of the
voluntary muscles; involuntary discharges of faeces and urine;
abdominal muscles rigid; darting pains in the wounded leg,
which jerks and twitches whenever it is touched; hard, feverish
pulse; breathing irregular and hissing.
Physostigma.—Twitching and trembling of the muscles;
trembling, convulsive action of the respiratory muscles;
tendency to fainting; alternate dilatation and contraction of the
pupils, the former corresponding with the period of the spasm, and
the latter with that of quiescence; opisthotonos; no control over
his urine, which is passed invohintarily.
Stramonium.—Traumatic tetanus; opisthotonos; apoplectic
condition, with snoring, red face and deep sleep; body hot;
urine copious; grinding of the teeth; contortion of the hands;
shuddering; spasmodic constriction of the oesophagus; con-
striction of the chest, with difficult breathing; forehead cold;
pulse scarcely perceptible; lower limbs drawn up with great
force, then straightened out and so rigid that they could not
be bent; eyes tightly closed, with occasional twitching;
wounded hand swollen and erysipelatous.
Lachesis.——-Tetanic look, with half-closed eyes and stiffness
of the neck; trismus; opisthotonos; rigors; shooting pains in
the back; throat sensitive to contact and swallowing almost
impossible; two cases cured.
Hydrocyanic ac.—Tetanic spasms, with trismus, protruded
and glistening eyes, bloated face and neck; passive cerebral
congestion.
TETANUS. 147
Angustnra vera-—Violent tetanic paroxysms, with opistho-
tonos; twitching and jerking along the back, like electric shocks;
tetanic spasms excited by the least touch, noise or the drink-
ing of tepid water; thirst, without any desire to drink; pulse
intermittent but rapid. _
Veratrum vir.——Tetanus depending on pneumonia; opistho-
tonos; no relaxation of the muscles of the back for ﬁve days;
heels almost touched the head like a hoop; body covered with
a cold, clammy sweat; remedy not prescribed until after the
febrile reaction had set in.
Arnica.—Traumatic tetanus; internal chilliness with ex-
ternal heat; pulse variable, mostly hard, full and quick;
muscles and limbs twitch and jerk; weary, bruised feeling,
making everything feel too hard; breathing short and panting;
face hot, body cold; jerks and electric-like shocks; tremor of
the limbs.
Hypericum.-—Traumatic tetanus, 'with trismus and opistho-
tonos; swallowing difﬁcult; hardness of the cervical muscles;
face distorted; nostrils dilated; no relapse.
Auxiliary Treatment.-—Warm baths; sweating, produced
by passing hot air inside a covered framework adjusted to the
bed by means of a tube connected with a heated cylinder;
ﬂannel cloths wrung out of hot water, of a temperature just
bearable to the hand, and applied to the nape of the neck and
along the spine; ice, and the spinal ice-bag; and the division
or stretching of any nerve-trunk connecting the wound with
the spinal cord, have all been resorted to with more or less
beneﬁt in different cases.
In order to support the patient during the severe illness
through which he is passing, he should be made to swallow,
if possible, an egg, or half an ounce of raw meat juice, mixed
with three or four ounces of milk, every four or ﬁve hours
during the day. If great exhaustion ensues, or the patient is
unable to swallow, peptones, or beef-tea and brandy, should be
given per annum.
148 NERVOUS THERAPEUTICS.
HYDROPHOBIA.
Syn0nyms.—Dog Madness, Canine Madness, Lyssa, Rabies;
Fr., La Rage, Hydrophobic; Ger, Hundswuth, Tollwuth, Wasser-
scheu.
Deﬁniti0n.—An acute spasmodic disease, allied to tetanus,
produced by the inoculation of a speciﬁc animal poison, usually
through wounds made by animals suffering with rabies, the
symptoms indicating great disturbance of the central nervous
system.
Diagn0Sis.—The diseases most liable to be mistaken for
hydrophobia are tetanus, spurious hydrophobia and acute
mania. In tetanus the result usually follows the injury within
a week or ten days; in hydrophobia it seldom occurs short of
two or three weeks, and is often delayed many months. In
tetanus, again, the convulsions are continuous, and are usually
combined with trismus ; moreover, there is no mental distur-
bance, no increase in the secretion of saliva, and no well-
marked respiratory spasm, as we ﬁnd in hydrophobia.
Spurious hydrophobia, from the great resemblance of its
symptoms to those of the genuine disease, is more diﬂicult of
detection. Such cases, however, usually occur in the hysteric
constitution, present a less serious aspect, are free from any
mental derangement except what arises from fear or anxiety,
and are more easily subdued by treatment.
From acute mania the affection may be distinguished by
the history of the case, the rapid course of the disease, and the
persistency with which the convulsive paroxysms, which are
never absent, return.
Path0l0gy.—The morbid appearances in the medulla ob-
longata and spinal cord, as described by Allbutt, Benedek,
Coates, Gowers and others, consist mainly of changes in the
nerve-cells and vessels——the pressure of round cells; leucocytes
in the perivascular spaces, in the nerve-tissue itself, and among
the nerve-elements; granular degeneration, and even embo-
lism; the changes being most marked about the respiratory
centres in the medulla. None of these lesions, however, are
characteristic; they throw little light on the essential nature
of the disease, as similar changes are observed in other affec-
HYDROPHOBIA. 149
tions. Gower’s opinion, which is substantially that of other
pathologists, is, “that the vascular changes, from their vari-
ability and occasional absence, are probably secondary effects
of the disturbed action of the nerve-centres produced by the
poison carried by the blood.”
Clinical Experience.—'1‘he most interesting, and, in some
respects, perhaps the most important clinical experience in
this disease, is that of M. Pasteur on the protective power of
inoculation. The results, for which alone we have roo1n, are
so far, I am sorry to say, very unsatisfactory. They may be
summed up as follows: (1) Animals which have been inoculated
hypodermically by M. von Frich, after Pasteur’s method, have
not been protected from infection with the fresh virus of street
rabies, and have only exceptionally escaped after intracranial
infection, although inoculated during ten days with virus of
progressive virulence (medulla from ten days to one day).
This result is diametrically opposed to that claimed by Pasteur
himself, who asserts that animals so treated are proof against
any ordinary inoculation. (2) M. Pasteur, having attributed
the unsatisfactory results obtained by M. von Frich to too slow
vaccinations, recommended a more intensive mode of treat-
ment, whereupon M. von Frich instituted a fresh series of
experiments, which he carried out conformably to M. Pasteur’s
instructions, but with no more favorable result; all the ani-
mals died of rabies. (3) Most of the animals which were sub-
mitted to the preventive treatment after subcutaneous inocula-
tion with street rabies died of the disease, even when the
period of incubation was thirty-four days. These experiments
show, as claimed by M. von Frich, that Pasteur’s method of
rendering animals refractory to rabies is not yet either sure or
certain. There is not yet a suﬂicient scientiﬁc basis for the
application in man of a preventive treatment after the bite of
a rabid animal. It is, moreover, quite possible that the pre-
ventive treatment, at any rate the intensive method recently
recommended by M. Pasteur, may itself transmit the disease.
As for the curative power of medicine in hydrophobia, we
can only say that a “prodigious” number of remedies lay
claim to it, as the following list will show:
Xanthium spin.—This remedy has been declared by Dr.
150 NERvoUs THERAPEUTICS.
Grzyvala, of Podolia—-for whose truthfulness Prof. Gubler, of
Paris, vouches—a speciﬁc for hydrophobia. He says that dur-
ing the Crimean war a family of twelve persons had been
bitten by a hydrophobic wolf; six of them entered his wards
at Olschanka, Podolia; they were treated with an infusion of
the leaves of this remedy, and all recovered; the other six, who
were treated by the actual cautery and the daily use of Genista
tinctoria and’ other drugs, died in the course of from twelve to
sixty days. He recounts many other cases, and says that out
of at least one hundred cases he has not failed to save every
one. Out of a herd of thirty oxen bitten by a mad wolf, eight
succumbed to hydrophobia; the commissary of police obtained
the “anti-rabic” powder of Dr. Gr. and gave three ounces daily
to each of the others, saving every one of them.
Hoang-Nan.—M. Perrier, missionary at Tonquin for twenty
years, declares that he has cured a young girl of 14 of hydro-
phobia with this remedy; she afterward grew up, married,
and is now a mother.
Spirma nlmar.——Kuhner, of Russia, says that during a frantic
paroxysm of hydrophobia a patient devoured a piece of the
root of this plant; ﬁfteen minutes afterward he became con-
scious, vomited, and fell into a profound sleep of twenty-four
hours, and was well afterward.
Inula helen.—Dr. Helmuth cites the following cure by this
remedy: In 1858 a policeman, so far gone with hydrophobia
as to have to be held in the carriage in which he was being
driven to Germantown to the residence of Mr. Frye, was
treated exclusively with Inula helenium with success.
Tanacetum vulg.-—M. Hayem, in the name of M. Peyraud, of
Libourne, has shown the resemblance which exists between
true rabies and what he calls tanacetic rabies, that is to say,
rabies caused by the essence of tansy. “If rabbits,” says M.
Peyraud, “ on whom one has previously practiced the injections
of tansy for a period of six, seven or eight days, he submitted
to the action of rabic virus, it will prevent these animals from
developing rabies. All of those to which I have given this
preventive treatment, during the past eight months, have not
been attacked by rabies, while two rabbits which I had inocu-
lated with rabic virus without having previously submitted
HYDROPHOBIA. 151
them to the preventive tanacetic injections, have both of them
succumbed to the true rabies, one very rapidly, the other more
slowly.” This is true homoeopathy, and therefore a great im-
provement 011 Pasteur’s method, even if all that is claimed for
the latter is true, which is very far from being the case.
The following remedies have also been favorably reported
upon in this disease: Scutellaria (Vanderveer), Belladonna
(Adams), Euphorbia (Ruddock), Lachesis (Toothaker), Stramon-
ium (Morgan), Hydrophobin (Berridge), Tabacum (Norton),
Cannabis ind. (Ruxton), Mercurius corr. (De Capua), Gelsemium
(Dubbs), Simaruba Cedron (V allant), Genista lutea (Fox), Can-
tharis (Hartlaub), Hyoscyamus (Hahnemann).
Therapeutic Indicati0ns.—These will be found in previous
sections, especially under the heads of cerebral and spinal
hyperxmia, convulsions and tetanus, which see.
Auxiliary Treatment.—Prophylaxis.—-Immediately after a
person is bitten by a rabid animal the wounded part should
be forcibly sucked, or, if favorably situated for the purpose, a
cupping glass may be applied ;_ then, instead of excising the
wound, which endangers the infection of the freshly cut sur-
face by virus from the blade of the instrument, the pure nitrate
or chloride of silver, or other caustic, should be applied to every
recess of the wounded part, so as to decompose the virus and
destroy the vitality of the affected tissues. This plan is rec-
ommended by Youatt, who was himself bitten several hun-
dred times by rabid dogs without becoming infected after
applying the caustic in this manner. He prefers the chloride
of silver for the purpose, as being a more efficient caustic than
the nitrate. If the patient can be induced to submit to it, and
the case is a very suspicious one, it is safer to use the actual
cautery, in the form of a white-hot iron. A poultice should
then be applied until sloughing of the eschar occurs, after
which, if deemed advisable, the wound may be kept discharg-
ing, by any simple stimulating ointment, until the.period of
greatest danger is passed, or until it ﬁlls up with healthy
granulations.
Among other accessory measures which at different times
have proved of greater or less beneﬁt in these cases, the most
152 NERVOUS THERAPEUTICS.
efficient are the steam bath, ice to the spine, Faradization and
galvanism.
osomia.
Synonyms.-—St. Vitus’s Dance, St. Guy’s Dance, St. J ohn’s
Dance, Chorea Sancti Viti, Chorea Minor; Fr., La Chorée,
Folie Musculaire, Danse de St. Guy, Danse de St. Witt; Ger,
Veitstanz.
Deﬁniti0n.—An affection of the nervous system, character-
ized by a succession of uncoordinated movements of the volun-
tary muscles, occurring almost exclusively in the waking state,
in almost all parts of the body, and either entirely withdrawn
from the sphere of volition, or but little under its control.
Diagnosis:-Partial choreic movements, or local choreas,
are apt to be mistaken for true chorea; they differ from the
latter not only by being deﬁnite spasms located in one part——
as, for example, twitchings on one side of the head or face-
but in being usually incurable. Chorea bears some resem-
blance to tremor, and especially to that form of it called pa-
ralysis agitans, but these disordered movements are usually
conﬁned to adults and the aged, besides being more rhythmical
and restricted. Chorea differs from hysteria by its proneness
to attack children, and by the movements being little if any
under the control of the will, while hysteria is mostly a disease
of adult life, and is ameliorated rather than aggravated by
voluntary exertion. Chorea magna is an entirely different
affection from chorea minor, or what is commonly called
chorea, consisting as it does of a series of complicated move-
ments occurring at irregular intervals, and exactly simulating
voluntary movements—such, for example, as taking three
steps forward and then making a low bow, or rising from a
chair, jumping over it, and then sitting down again as if
nothing had happened—actions which result from an entirely
uncontrollable impulse. These forms of so-called chorea have
at times prevailed as regular epidemics (tarantismus), and par-
take more of the hysterical nature than they do of true chorea.
Path0l0gy.—The fact that ninety-nine out of a hundred
cases of chorea minor are curable, renders it almost certain
CHOREA. 153
that no serious lesion, such as minute emboli, softening, etc.,
exists in either of the great nerve-centres. It is true that in a
few fatal cases post-mortem examination has revealed such
changes, but these are the exception rather than the rule.
Besides, fright is one of the most common causes of the disease,
and surely fright is not capable of producing serious organic
disease. I am therefore disposed to regard the choreas of
childhood as functional neuroses, often associated with the
rheumatic diathesis, or with cardiac disease depending upon
it, together with an enfeebled state of the nervous system, the
result of anaemia impairing the nutrition of the nerve-centres.
Clinical Experience.—The remedies which have received
the strongest indorsement of the profession in this disease are:
Mygale las., Agaricus mus., Oimicifuga, Causticum, Pulsatilla, Coc-
eulus, Nux vom., Ignatia, Hyoscyamus, Tarantula, Calcarea, Gup-
rum, Zincum, Stramonium, Asterias rub., Sulphur, Veratrum vir.
and Cina.
Therapeutic Indications.—Myga1e.-Muscles of the face
jerk and twitch; eyelids and mouth open and close in rapid
succession; in trying to put the hand to the mouth it is
arrested midway and jerked down; gait unsteady; legs in
motion while sitting, and dragged while attempting to walk;
constant motion of the whole body; indicated in all typical
cases 11ot especially calling for some other remedy.
Agaricus.——Marked and frequent nictitation or twitching of
the eyelids; spasmodic movements, from simple involuntary
motions and jerks of single muscles to a dancing of the whole
body; trembling of the limbs; soreness of the spine; redness
of the eyes; involuntary movements cease while asleep; symp-
toms worse during a thunderstorm.
Cimicifuga.—Mind greatly depressed; great nervousness;
muscular twitchings resembling chorea, the left side being
most affected; pain under the left breast; tenderness over the
last cervical vertebra; tenderness over the ovarian regions;
especially suited to cases occurring in young girls at or about
the age of puberty, or when there are present symptoms indic-
ative of menstrual disorder.
Causticum.—Ghoreic movements even in the night; move-
11
154 NERvoUs THERAPEUTICS.
ments involve the right side of the body more than they do
the left; the muscles of the tongue are affected so that the
speech is thick, and the words have to be jerked out; there is
a marked paretic condition of the affected parts; especially
indicated in rheumatic cases, or when resulting from cold or
exposure.
Pulsatilla.——Symptoms due to disease of the genital organs,
such as amenorrhoea, dysmenorrhoea, ovaralgia, etc.; choreic
movements occurring in young girls at or near puberty.
Cocculus.——Movements chieﬂy conﬁned to the right side of
the body, as the right arm or the right leg; menses dark and
scanty; thin, scrawny girls, with irregular periods, and subject
to venous or haemorrhoidal congestions; tendency to paralysis
of the affected parts.
Nux v0m.—Numbness of the affected parts, also formication;
impaired appetite; constipation; vague ﬂying pains about the
chest and legs; movements renewed by the least touch, but
diminished by strong and steady pressure; symptoms worse
early in the morning; chronic cases, especially such as have
been under old-school treatment.
Ignatia.-—Cases which have resulted from depressing emo-
tions, such as grief, fright, etc. ; cases attended by sighing, sob-
bing or a disposition to be alone; most useful when the left
side is affected; worse after eating; better when lying on the
back.
Hy0scyamus.—The twitchings, which are mostly local or con-
ﬁned to certain parts, as the face, the eyelids, the arm, etc.,
are especially violent and jerky; disposed to laugh and be
talkative; is extremely silly and agitated; worse after eating,
which is performed hastly.
Tarantula-—Choreic movements general, or else crossed, as
the right arm and left leg; head drawn downward; involun-
tary discharges of urine; grimaces of the mouth; is in con-
stant motion; can run better than walk; trembling of the body;
movements continue even at night, but subside under the in-
ﬂuence of music.
Calcarea carb.—-Scrofulous habit, light hair, blue eyes, cold,
damp feet; involuntary movements often limited to one side
CHOREA. 155
of the body; apt to stumble or fall down; sore eyes; white
stools; bloated abdomen.
Cuprum.-——Legs and arms in perpetual motion, with constant
motion of the muscles of the face; delicate constitution; face
and tongue pallid; irregular movements commence in one
limb and spread to other parts, sometimes involving the whole
body, at others limited to only one side of it; great mental
exaltation; better when lying down or when asleep, but never
cease altogether.
Zincum.—- Chronic chorea, embracing all the voluntary muscles
of the face, trunk and limbs, so that she was unable to eat,
walk or lie; had had all kinds of treatment, embracing chaly-
beates and other tonics; general health greatly impaired.
Stramonium.-—-Crossed, irregular movements of the voluntary
muscles, as, for example, the right arm and left leg; head and
neck in constant motion; patient leaps about, making the 1nost
grotesque gestures; weeps, laughs, sings, prays, stammers and
does many silly and unusual things; handles the genital or-
gans; is violently agitated by unfounded fears; not disposed
to talk, or unable to do so; the involuntary movements greatest
when awake, but may continue when asleep.
Asterias rub.——Trembling and jerking movements of all the
limbs, rendering her unable to feed herself or to walk; fre-
quent, clear, profuse 1nicturition; from fright and mental de-
pression.
Sulphur. -— Chronic cases, and after suppressed eruptions; in
one case the patient was disposed to admire common objects,
raving over them; she was pale and poorly nourished; had
existed six months; patient is apt to be irritable, peevish and
obstinate.
Veratrum vir.—Choreic movements approach the form of
eclampsia, are very violent and continue during sleep; waked
up by a continual champing of the teeth; lips covered with
foaming saliva; inability to swallow; great sexual excitement.
Cina.—Violent twitching of the muscles, with scintillation of
the eyes, which ﬂash like those of a snake; the choreic move-
ments commence with a shriek; tongue, larynx and oesoph-
agus affected, causing a clucking sound, like that of water
poured from a bottle; when caused by worms or onanism.
156 NERVOUS THERAPEUTICS.
Cicuta.—Twisting, jerking and distortion of the limbs, some-
times accompanied by screams; sudden rigidity of the limbs.
Auxiliary Treatment.--Care should be taken to remove,
as far as possible, all exciting causes of the disease, such as in-
testinal worms, pernicious practices, irregular hours, over-
stimulation of body and mind, etc.; and as the disease is
essentially one of nervous debility, we should aim to strengthen
and build up the system by nutritious diet, Pure air, sunshine,
regular hours, freedom from excitement, and such other hy-
gienic inﬂuences as the casein hand may require. Care should
also be taken not to allow the patient to associate with others
similarly affected; neither should the patient’s mind be allowed
to dwell upon the disease. Choreic patients should never be
scolded, as they have very little, if any, control over their move-
ments, and harsh words will do far more harm than good.
Chorea arising from spinal irritation will be beneﬁted by
the treatment recommended for that disease, which see. Elec-
tricity is highly lauded by some authorities. Benedict says
that out of twenty cases that he treated with the constant
current not one failed to recover; others, however, have been
less successful with it. Hysterical chorea requires the special
treatment recommended for hysteria, which see.
HYSTERIA.
Syn0nyms.——Hysterics, Hysteric Fit, Vapors, Malum Hys-
tericum; Fr., Hystérie, Maladie Imaginaire, Mal de Mere; Gen,
Hysteric, Mutterbeschwerde.
Deﬁnition.—-A disordered state of the nervous system, tend-
ing to chronicity, characterized by acute attacks of functional
spasm and paralysis, anaesthesia and hyperaesthesia, resulting
from irritative impressions, sometimes mental and sometimes
physical, acting on the emotional centres of the brain.
Diagnosis.-—The diagnosis of hysteria, multifarious as are
its symptoms and manifestations, resolves itself simply into
the detection, as such, of a purely emotional disease. This, as
a general rule, is not difficult, provided the observer bears in
mind that the phenomena are, in most cases, imperfect imita-
HYSTERIA. 157
tions of real diseases. In nearly every case there is something
either contradictory or exaggerated about them which betrays
at once their real character. Occasionally, however, owing to
the nature and gravity of the symptoms, it becomes necessary
to distinguish carefully between a ﬁt of hysteria and one of
epilepsy, of hystero-epilepsy or of puerperal convulsions. The
following table gives the differential diagnosis between hys-
teria and epilepsy :

Hysteria.
Epilepsy.
Loss of consciousness gradual and par-
tial or apparent.
Face flushed or unchanged, no froth on
lips, eyelids closed, eyeballs ﬁxed,
no grinding of teeth or biting of
tongue; pupils react readily.
Countenance not distorted.
Sighs, laughs or sobs.
Globus hystericus.
Paroxysm longer than in epilepsy,
usually wakeful and depressed in
spirits.
Rarely occurs at night.
Often connected with uterine or men-
, strual disorders.
Hystero-Epilepsy.
Pressure upon the ovaries will fre-
quently arrest the paroxysm.
Thermometer never rises above 38.5° C.

Sudden and complete.
Livid face, froth at mouth, eyelids half
open, globes rolling, teeth grind-
ing, tongue bitten; more or less
insensibility of pupils to light.
Countenance distorted.
Shows no feeling.
Aura epileptica.
Short paroxysm, followed by heavy,
comatose sleep and dull intellect.
Frequently occurs at night.
Not necessarily connected with the
uterus, though a paroxysm often
occurs at the menstrual period.
Will never modify or stop the attack.
Thermometer always rises above 38.5°
(3., sometimes sev eral degrees
higher.

Hysterical convulsions may be distinguished from puer-
peral eclampsia, not only by the previous history of the case,
but by the presence in the latter of complete unconsciousness
and albuminuria. Hysterical paralysis may be distinguished
from the various forms of cerebral and spinal paralysis by the
symptoms peculiar to the latter. This will sometimes neces-
sitate a continued watching of the hysterical disorder, which
is usually more variable and more inﬂuenced by emotional
excitement than the true disease.
158 NERvoUs THERAPEUTICS.
Path0l0gy.—-Although no constant pathological alterations
have yet been discovered in either the brain or spinal cord,
the symptoms show clearly that both of these great nerve-
centres are involved in every well-developed case of the dis-
ease. The psychical and emotional symptoms point unmis-
takably to the brain as their origin, while various forms of
spasms, paralysis and hemi-anaesthesia can only be explained
by referring the centre of diseased action to the same organ.
In like manner the primary centre of reﬂex action can, in
many cases, be traced directly to the spinal cord, the reﬂex
action gradually spreading from the seat of irritation so as to
involve adjacent groups of muscles under the control of that
organ. That the peripheral nerves are not the primary seat
of the hyperaesthesia is shown by the fact that the symptom
has continued to exist after the affected limbs have been
amputated. These considerations, as well as others equally
conclusive which might be adduced, prove that the cerebro-
spinal centres are the parts especially involved in the irritation
which disturbs the harmonious action of the various parts of
the nervous system in this disease, but what the special condi-
tion of these centres is, whether one of congestion, anaemia or
some change analogous to that which gives rise to insanity or
epilepsy, is as yet undetermined.
Clinical Experience.——Ignatia amara comes so near to
being a universal speciﬁc for hysteria that one seldom has
occasion to resort to any other remedy. Gelsemium, Bella-
donna, Aurum, Uimicifuga, Nux vom., Moschus, Sepia, Aconite,
Lachesis, Chamomilla, Pulsatilla, Phosphorus, Valerian, Platina,
Asafcetida, Stramonium and many other remedies have proved
curative in particular cases.
Therapeutic Indications:-These will be found under the
several diseases simulated by the disorder, especially convul-
sions, spinal irritation, paralysis and neuralgia, which see.
Auxiliary Treatment.-—-Whatever may be one’s opinion
as to the essential nature of this disease, no one will deny that
in the great majority of cases the mind exercises a controlling
inﬂuence over it; it follows, therefore, that moral treatment
is of paramount importance. Many cases have been cured by
HYSTERO-EPILEPSY. 159
one physician which had resisted the treatment of other prac-
titioners equally competent, simply because the former, unlike
the latter, had enlisted the patient’s exertions in her own
behalf. To do this the physician needs, ﬁrst of all, to acquire
the respect and conﬁdence of his patient, after which he has
only to direct and his directions will be obeyed ; but if, on the
other hand, he fails in this regard, either through lack of tact
or otherwise, his directions will most likely be ignored, if not
entirely reversed. Besides, the co-operation of the patient is
all the more necessary in order to successfully overcome the
bad habits and banish the hurtful inﬂuences which are almost
invariably associated with and tend to perpetuate the disease;
such as the various forms of dissipation connected with fash-
ionable life, the use of stimulants, late hours, unwholesome
reading, unsuitable occupations, the injudicious kindness of
home friends, whose mistaken sympathy often leads them to
foster rather than to counteract the natural inclinations and
morbid desires of the patient. We have not the room to
enlarge further upon this fruitful topic, but are free to say that
unless the practitioner has the tact to overcome these difficul-
ties his efforts to cure his patient will, nine times out of ten,
result in utter failure.
HYSTERO-EPILEPSY.
Synonyms.——-Epileptiform Hysteria; Fr., Hysté9'0-l*jp2Ileps’£c,-
Hg/stérie Ep'ileptzf0rme,' Ger, H1/steroepilepsie.
Deﬁniti0n.—An unusually grave form of hysteria, the
violence of the convulsions resembling that of epilepsy, and
characterized by the most intense and remarkable forms of
anaesthesia, paralysis and muscular contraction.
Diagnosis.—Hystero-epilepsy differs from simple hysteria
chieﬂy in the intensity of the symptoms, which give an epilep-'
tiform character to the paroxysms. It differs from pure epi-
lepsy in never, even when of many years’ duration, leading to
dementia; the intellect always remains unimpaired. The epi-
leptic group of symptoms is never complete, and never appears
in connection with, or under the form of, the petit mal; it never
160 NERVOUS THERAPEUTICS.
assumes the form of vertigo-epileptique. Compression of the
ovaries always modiﬁes the attack, and sometimes completely
arrests its effects, which results are never produced in true epi-
lepsy. In hystero-epilepsy, even when the disease lasts a long
time, the thermometer never rises above 385° C.; while in true
epilepsy, under similar circumstances, the thermometer rises
much higher than this, even when the disease is not compli-
cated with cerebral or meningeal congestion, in which latter
case the temperature still continues to rise until it may indi-
cate a fatal termination.
Path0l0g‘y.—As the same causes that give rise to hysteria
operate to produce hystero-epilepsy in certain neurotic consti-
tutions, the pathology of the disease is no doubt of the same
general character; the only difference, so far as our present
knowledge extends, is that the ovaries constitute the special
primary centres of reﬂex irritation, whence originate the
cerebral and spinal symptoms. The blood, also, may be more
or less depraved, as in simple hysteria, but this point has not
yet been deﬁnitely settled.
Clinical Experience.—The remedies which have so far
given the best results in hystero-epilepsy are: Cannabis ind., Ig-
natia, Gelsemium, Amyl ‘nit., Moschus, Tarantula and Hyoscyamus.
Therapeutic Indications.—— The same as in convulsions,
spinal irritation, epilepsy and hysteria, which see.
Auxiliary Treatment.—MM. Charcot and Bourneville
have obtained curative results by the continuous application
of the ice-bag compress over the ovarian region. Whenever
there is an ovarian aura the breaking out of the ﬁt can be
prevented by it.
Dr. Petit has treated the disease successfully by metallo-
therapy. He gives Aurum chlor. internally, and places disks of
gold on the limbs, causing in one case a complete cure, so that
within a year after the commencement of treatment the patient
married. In this case the left arm was contracted during two
years, there were general amyosthenia and anaesthenia, and the
patient suffered intensely from ovarian pain, vomiting and
spasmodic contractions of various muscles, including those of
the oesophagus and vagina.
CATALEPSY. 161
GATALEPSY.
Synonyms.—Morbus Attonitus, Carus Gatalepsia, Hysteria
Cataleptica; Fr., Catalepsie; Gen, Convulsivische Starrsucht.
Deﬁnition.—A peculiar form of nervous disease, allied to
hysteria, occurring in paroxysms, and characterized by a loss,
more or less complete, of consciousness, sensibility and volun-
tary motion, during which the limbs are rigid and remain in
the exact position in which they chanced to be at the moment
of attack, or in that in which they are afterwards placed.
Diagnosis.—The above deﬁnition is sufficiently precise to
prevent the possibility of mistaking this disease for any other,
unless it be some other hysteroid affection, such as ecstasy,
hysteric unconsciousness, etc., a matter of no practical impor-
tance, as these conditions are all of a similar nature and fre-
quently pass from one into the other.
Path0l0g'y.—As in hysteria there appears to be a partial
loss or diminution of will power, so here the controlling power
of the will appears to be completely lost; in other words, there
is not only loss of consciousness and sensibility, but complete
paralysis of the will. “My sensations,” said one who had
recovered, “ were too feeble .to call forth an exercise of will.”
That this is the true explanation is proved by the fact that
the condition can be produced artiﬁcially. Gharcot and others
have shown that when thrown into the hypnotic state the
cataleptic condition can at any moment be brought about by
the mere suggestion that the subject no longer has any power
to move his own limbs.
Clinical Experience.—The only remedies I can ﬁnd to
which cures have been attributed are: Cannabis ind., Artemisia
vulg. and Aranea diad.
Therapeutic Indications.—Same as in hysteria, which see.
Auxiliary Treatment.—According to Prof. Bosenthal,
Faradization of the face by metallic conductors not only re-
stored the consciousness, but brought about complete recovery
from a cataleptic attack in a woman whose death had already
been certiﬁed by a country practitioner.
162 NERvoUs THERAPEUTICS.
MULTIPLE CEREBRO-SPINAL SCLEROSIS.
Syn0nyms.—Disseminated Cerebro-spinal Sclerosis; Fr.,
Sclérose en Plaques Disséminées ; Ger., Multiple Cerebro-spinale
Sklerose.
Deﬁnition.——A disease characterized by overgrowths of neu-
roglia, in the form of plates or nodules, of varying size and
shape, disseminated throughout the spinal cord, and also
through different parts of the brain.
Diagnosis.—The most characteristic mark of this form'of
sclerosis is the universal trembling which ensues on voluntary
movements, and the fact that the trembling of the head, of
the upper and lower extremities, as well as of the whole body,
is considerably increased with every motion. Even the tongue
trembles when the patient is requested to protrude it, while
disturbances of speech are a constant characteristic clinical
symptom.
Pathology.—In describing other forms of sclerosis we have
repeatedly stated that the essential morbid process consists in
hypertrophy or proliferation of the neuroglia, at the expense
of the proper nerve-tissue. In this form the sclerosed tissue
appears, as above stated, in the form of plates or nodules in
different parts of the brain and spinal cord.
Treatment.—See the various forms of cerebral and spinal
sclerosis, including locomotor ataxia, pp. 42, 102-107.
SECONDARY CEREBRO-SPINAL SCLEROSIS.
Syn0nyms.—Secondary Cerebro-spinal Degenerations, Sec-
ondary Degenerations of the Spinal Cord, Ascending and
Descending Degenerations; Fr., Dégenérations Secondaires de la
Moelle lfpiniere ,' Ger., Secondiire Erkrankung Einzelner Rilcken-
marksstrcinge, Seconddre Cerebro-spinale S klerose.
Deﬁniti0n.——Sclerotic degenerations affecting certain por-
tions of the cerebro-spinal axis, resulting from trophic lesions
situated either in the brain or spinal cord; if in the former
they give rise to descending degenerations, if in the latter to
ascending ones.
/
GENERAL, PARALYSIS. 163
Dia,gnosis.——Secondary cerebro-spinal sclerosis may be diag-
nosed by the concurrent existence of the foot phenomenon, the
tendon reﬂex and the phenomena of associated movements.
Pathology-The degenerative changes are usually conﬁned
to the white substance, and consist in atrophy and degeneration
of nervous ﬁlaments, the formation of granular corpuscles and
the characteristic proliferation of the neuroglia. When the
gray matter is involved the nerve-cells undergo more or less
disintegration and wasting; muscular atrophy is then asso-
ciated with the rigidity and contraction resulting from de-
generation of the white substance.
Treatment.—(3onsult the various forms of cerebral and spinal
sclerosis already given, especially locomotor ataxia, pp. 42, 102-
107.
GENERAL PARALYSIS.
Syn0nyms.—General Paresis, Paralysis of the Insane, De-
mentia Paralytica; Fr., Paralysie Générale Incomplete, Périen-
céphalite Chronique Diﬂ'use; Ger, Allgemeine Progressive Gehirn-
lélhmung, Paralytischer Bl5clsirm.
Deﬁnition.—-A general paretic condition, accompanied by
gradually increasing mental disturbance, incoiirdination of
movement and loss of physical power.
Diagnosis.—The diagnosis is based upon the presence of
convulsive tremors in the muscles of articulation at the com-
mencement of the disease, the general and progressive paresis
and loss of coordination, and the peculiar mental manifestations
of aberration and extravagance.
Path010gy.—There are usually more or less congestion and
inﬂammatory thickening of the cerebral membranes, atrophy
and degeneration of the cortical substance, especially of the
anterior lobes, and wasting and amyloid degeneration of the
ganglion cells, with hypertrophy of the neuroglia. Similar
changes also occur in the posterior columns of the spinal cord,
the cerebral nerves and the posterior roots of the spinal nerves.
In some cases there are signs of granular myelitis; large
masses of fat globules, with hypertrophy of the septa of the
cord. It thus appears that the disease is a diffuse inﬂamma-
164 NERVOUS THERAPEUTICS.
tion of the brain and spinal cord, leading ﬁnally to destruction
of ganglion cells and atrophy of the nerve-centres.
Clinical Experience.—/irgentum nit. and Plumbum are
entitled to the distinction of having arrested the degenerative
process. Belladonna, Physostigma, Cocculus ind., Badiaga, Oxalic
ac., Causticum, Gelsemium, Rhus ton, Phosphorus and a number
of other remedies have ameliorated many of the symptoms.
Treatment.——See meningitis, encephalitis and the several
forms of paralysis and sclerosis already described, especially
locomotor ataxia.
PARALYSIS AGITANS.
Syn0nyms.—Shaking Palsy; Fr., Paralysie Agitante, Para-
lysie T remblante; Gen, Schilttelldhmung.
Deﬁnition.—A disease of the nervous system, characterized
by tremor of the voluntary muscles, followed by paralysis of the
same, both being progressive in their course.
Diag'n0SiS.—Paralysis agitans is liable to be mistaken for
chorea, senile tremor and multiple sclerosis. From the ﬁrst it
may be distinguished by the age of the patient and the history
of the case; fro1n tremor senilis, from being a disease of middle
life instead of old age, and by its beginning on the head
and attacking successively the lips, tongue and extremities;
and from multiple sclerosis, by the latter being a disease of
youth, and the tremor appearing only when motions are
intended, whereas, in paralysis agitans, the tremor, though it
may be increased from an intention to motion, or from mental
excitement, is also observed during perfect rest. ‘
Very rarely a case is seen, and it may even run its course,
without any tremor being present. In these cases the disease
is recognized by the other characteristic symptoms, such as
ﬁxed attitude, slow, delayed movements, diﬂiculty in rising
from the sitting posture, retropulsion, apropulsion, monotonous
and mumbling speech, etc. ‘
Path0l0gy.—No characteristic pathological changes have
yet been observed sufficient to account for the symptoms of
this disease. Various coarse lesions have not infrequently
been met with in both the brain and spinal cord, but those
PARALYSIS AGITANS. 165
hitherto observed have been such only as are frequently pres-
ent in those who die of old age where no such symptoms are
present. Although in many cases, however, the results have
been negative, the fact that some observers have found sclerosis
in various parts of the brain and spinal cord renders it highly
probable, I think, that a certain degree of hypertrophy of the
neuroglia constitutes the essential element of the disease.
Clinical Experience.—-I can ﬁnd none of‘ our remedies to
which cures of this disease have been attributed except Plum-
bum, Mercurius and Tarantula. Good results, however, have
followed the administration of Argentum nit., Baryta carb.,
Hyoscyamus, Physostigma and Zincum.
Treatment.—-Compare the various sections devoted to pa-
ralysis and sclerosis, especially multiple cerebral and posterior
spinal sclerosis, pp. 42, 107.
PART IV.
DISEASES OF THE PERIPHERAL NERVOUS SYSTEM.

NEURITIS.
Syn0nyms.——-Inflammation of a Nerve; Fr., Névrite; Ger.,
Entzilndung der Ncrven, Nerventzilndung.
Diagnosis.—The pain does not intermit as in neuralgia,
neither is it excessive, except in traumatic acute neuritis. The
disease may also be distinguished from neuralgia by the in-
creased temperature of the part to which the nerve is distrib-
uted, and by the history of the case. Anaesthesia, spasm and
paralysis, which are common symptoms of neuritis, are absent
in neuralgia. From cerebro-spinal diseases, in which these
symptoms are present, it may be known by the circumscribed
limits of the disease and by the absence of central symptoms.
Pathology.—The pathological changes are chieﬂy conﬁned
to the neurilemma or connective-tissue sheath of the nerve,
which is found to be more or less injected and hyperaemic.
Microscopical examination reveals, in addition to the increased
vascularity, inﬂammatory proliferation of new tissue-elements
with migrated leucocytes. These changes necessarily produce
either irritation, or arrest or disturbance of nerve function,
through compression of the nerve tubules by swelling of the
nerve-sheath.
Clinical Experience.——/lconite, Belladonna and Hypericum
have proved curative in the early stages of acute cases; trau-
matic cases usually yield promply to the internal and external
use of Hypericum perf. and Calendula.
Auxiliary Treatment. -—-The wet compress, hot fomenta-
tions and ice, locally applied, all have their advocates in this
disease. The new operation of nerve-stretching may be of
beneﬁt in chronic cases.
(166)
NEURALGIA. 167
NEURALGIA.
(IN GENERAL.)
Syn0nyms.—Nervous Pain, Neurodynia; Fr.,, lVéoralgie;
Ger, Neuralgie.
Deﬁnition.—A functional disease of the nerves, almost
always unilateral, usually conﬁned to the origin, course or
termination of one or more nervous trunks or branches, and
unaccompanied by fever, inﬂammation or any appreciable
organic lesion.
Diagnosis.—The diagnosis of neuralgia is not usually at-
tended with any difficulty. When the pain takes the course
of a nerve we know at once that it is neuralgic, but when it
is conﬁned to an organ, space or spot, other circumstances have
to be considered: (1) the pain is always more or less paroxys-
mal; (2) it usually begins suddenly, is of a darting, lancinating
or boring character, and is conﬁned to the course of the nerve
and its several branches; (8) the paroxysm develops sponta-
neously or without any marked exciting cause; (4) puncta do-
lorosa are observed in the majority of cases somewhere in the
course of the nerve; and (5) vaso-motory, trophic and other
disorders are occasionally associated with it.
PM3h0l0gy.——The disease, per se, is a purely functional
affection, but many cases occur in which there is reason to
think that inﬂammation of the nerve-sheath is the starting
point and proximate cause of the disease. This is often the
case in sciatica, which is more frequently, perhaps, a peri-
neuritis than a pure neuralgia. In these cases the pain is
much more constant, that is, less paroxysmal than usual, and
is more apt to be attended by paretic symptoms.
Clinical Experience.—In order to avoid undue repetition,
we shall defer giving the usual therapeutic indications until
we come to consider more in detail the leading varieties of the
disease, substituting here a 1 general resurné of clinical ex-
perience.
Spige1ia.—-Sharp and cutting pains, extending over the tem-
ples and forehead, with profuse flow of water from the eyes; sharp
pain in the left side of the face and head, with intense pain in
the eyeball.
168 NERVOUS THERAPEUTICS.
Ammonium picr.—Violent boring pain in the right side of the
head, spreading to the supraorbital and superior maxillary
region, intermittent, commencing at 10 A.M., increasing till
2 P.M., and disappearing about 9 P.M.
Hamamelis.-—Neuralgia of the internal saphcnal nerve in the
ascending form; severe pain on the internal side of the right
knee, radiating from the internal condyle of the femur to the
crural arch; lancinating and burning pains piercing the knee
and extending to the groin.
Magnesia. phos.—Typical facial neuralgias; pains intermittent,
darting, lightning-like, suddenly appearing and disappearing,
relieved by heat and pressure.
Kalmia.——Neuralgia facialis, nocturnal; sharp, shooting and
twitching pains, commencing in the neck, going to the top of
the head, then to the temples and right side of the face; re-
lieved by cold, aggravated by heat.
Pulsatilla.—-Right side of head and face; worse at night, with
throbbing in the head; face ﬂushed; external soreness; always
occur when nursing..
Aco11ite.——Congestive forms of triy”acial neuralgia; pains lan-
cinating and burning; great agitation.
Arsenicum.--Neuralgia of the ﬁfth ncrvc, acute; violent attacks
of tearing, burning pain, occurring every ﬁve minutes both
day and night, in the second branch of the trigcminus, chronic ,-
lumbo-abdominal neuralgia.
Rhododendron.—-Violent prosopalgia, spreading over the right
side of the face from the teeth, and radiating over the mouth,
eyes and ears, equally violent day and night; pains drawing,
tearing, jerking; ameliorated by warmth, when eating, and for
some time afterward.
Mezere11m.—Dull, gnawing, sometimes severe boring pain all
along the jaws and gums; cutting, shooting pain, returning
every night on the left side, extending from the face to the ear,
temple and neck, worse when warm in bed; severe supra-
orbital, intermittent, circumscribed, diurnal pain, beginning
at 9 A.M., increasing until noon, subsiding about 4 P.M., of a
heavy, aching character, sometimes extending into the left eye,
causing a ﬂow of tears.
NEURALGIA. 169
Lachesis.—Dull, heavy, severe pain, commencing at 9 A.M. in
the inner canthus of the right eye and extending outward and
upward above the superciliary ridge, going off in the afternoon;
skin extremely sensitive to touch; worse after sleeping.
Tartar emet.-—Severe neuralgic pains in the right leg, follow-
ing the sciatic nerve, pain running from above downward;
muscles of the leg felt tense.
Bryonia.——Trigeminal neuralgia of the left side; pain acute,
the motion necessary to speak or eat aggravated it to such an
extent as to provoke a free ﬂow of tears; severe pain in the
right side of the head, face and jaws, worse in the morning,
occurring during pregnancy.
Gelsemium.—Severe orbital neuralgia, occurring frequently,
and accompanied by heaviness and drooping of the upper eye-
lids and great muscular weakness; severe paroxysms of right
facial neuralgia, lasting six months; neuralgia of the anterior
crural nerve, pain extending up to the iliac crest and down to
the inner side of the knee, accompanied by tenderness between
these points.
Iris Ver.—Trifacial neuralgia in the left temporal region, ex-
tending down the ramus of the lower jaw into the teeth, pain
sharp and cutting.
Veratrum alb.—-Neuralgia palpebrares of the right upper lid,
greatly aggravated by pressure, the most delicate touch feeling
as if hundreds of needle points were penetrating the cuticle of
the lid; colic-like pains, followed by diarrhoea.
Sabina.——Facial neuralgia depending on paramenia; general
neuralgia, occurring one week prior to menstruation, accom-
panied by frequent shudderings, burning heat in the whole
body and great nervous irritability.
Bismuthum.——Severe facial neuralgia ; pains burning, and
greatly aggravated by warmth; relieved by holding cold water
in the mouth.
Natrum mur.—Facial neuralgia of malarial origin; pains begin
about 8 P.M. in the region of the right eye, the right side of
the nose and the right frontal region, accompanied by high
fever, great thirst and some nausea, subsiding with the abate-
ment of the fever, and returning again the next evening.
12
170 NERvoUs THERAPEUTICS.
Zincum phos.--General neuralgia depending on nervous de-
bility; neurotic constitution; loss of memory; loss of sleep
from continued mental anxiety.
Kali cyan.—-Left supraorbital neuralgia, beginning daily at
9 A.M., reaching its height in less than an hour, and gradually
declining just before noon, the decline being accompanied with
considerable nasal discharge.
Aranea diad.—I/umbo-abdominal neuralgia of a remittent
character, exacerbation occurring between 8 and 11 A.M., and
continuing until evening, attended at its height by excessive
yawning, and at times by vomiting. '
Plumbum met.—Neuralgia of the rectum; pain of a drawing,
gnawing character, worse toward evening and at night.
Kali bich.—Infraorbital neuralgia; pain aggravated by mo-
tion, and especially by cold.
Conium.—Infraorbital neuralgia; tearing, cramplike pains,
occurring in the evening and at night; mastodynia.
Nux V0m.—Supra0rbital neuralgia of an intermittent char-
acter; sudden, agonizing, lightning-like pains, coming on in
the morning and aggravated by pressure and motion.
Colchicum.—Facial neuralgia, involving especially the infra-
orbital nerve ; pains of a tearing character, and accompanied
with trembling and twitching of the lips and muscles of the
face.
Auxiliary Treatment.—-Special attention should be given
to nutrition, especially in obstinate cases. Romberg’s theory
that “ neuralgia is the prayer of the suffering nerve for healthy
blood and more of it,” has been abundantly veriﬁed. Hence
patients suffering from debility (and nearly every such patient
is more or less debilitated), scrofula, tuberculosis, or any other
dyscrasic condition, should push the nutritive process to the
utmost. One of Pretz’s patients ate twelve times in twenty-
four hours and improved under it. Tuberculous cases are
usually beneﬁted by a course of cod-liver oil. Phenacetine and
other analgesic palliatives may prove more or less useful in
obstinate cases.
Electricity, nerve-stretching, compression, sea-bathing, hot
fomentations and the local application of Aconite, Menthol
TRIGEMINAL NEURALGIA. 171
and other stimulating and rubefacient applications have all
done good in special cases. Gussenbauer ascertained that the
great majority of trifacial neuralgias are due to reflex irritation,
While some cases follow from sexual disease, malaria, tobacco
poisoning, etc., ninety per cent. of trigeminal neuralgias result,
he says, from habitual constipation, and may be treated suc-
cessfully by cold water enemata and hydrotherapy.
TRIGEMIN AL NEURALGIA.
Syn0nyms.——Neuralgia of the Fifth Nerve, Facial Neu-
ralgia, Prosopalgia, N euralgia Trigemini; Fr., Tie-Doaloureux;
Ger, Neuralgie des Filnftenerven, Neuralgie der T rigemirms.
Deﬁniti0n.—Neura.lgia of one or more branches of the tri-
facial or ﬁfth nerve.
Diagn0Sis.—Trigeminal neuralgia is most likely to be con-
founded with hemicrania. It may be readily distinguished
from it, however, by the transient and shooting character of the
pains.and by their corresponding with the course and distri-
bution of the different branches of the nerve. It is important,
also, to distinguish trigeminal neuralgia fro1n odontalgia, as
many a sound set of teeth have been needlessly sacriﬁced to
cure a supposed neuralgia which did not exist. In toothache
the pain is usually continuous, or it is made worse when some
of the teeth are subjected to pressure or to cold, and if closely
examined defective places may be found in them.
Pttth010gy.—The most diligent search has often failed to
ﬁnd anything abnormal about the trunk of the nerve or any
of its branches. It is quite certain, however, that the sym-
pathetic nerve is sometimes implicated-in the attacks, for in
no other way can we explain such symptoms as contraction of
the pupils, conjunctival injection, ﬂushing of the face and the
constitutional disturbances sometimes met with ; but it is not
always certain whether these phenomena originate in the sym-
pathetic system or are secondary to the trigeminal disease.
Clinical Experience:-See the preceding section.
Therapeutic Indications. —— Arsenicum. — Severe burning
pains, as if made with hot needles; pains appear toward night
172 NERVOUS THERAPEUTICS.
and reach their greatest intensity near midnight; the anguish
is sometimes so great as to compel the patient to get up and
walk about; aggravated by noise and motion, also by cold
water, which at ﬁrst relieves; ameliorated by hot applications.
Mezere11m.—Pains appear suddenly on moving the jaws, espe-
cially on eating hot things; stiffness of the muscles of the neck;
aggravated by the lightest touch, but diminished by hard press-
urc; may affect any or all three of the trifacial branches.
Kali carb.-—Burning pains, with twitching of the muscles, affect-
ing preferably the mental and infraorbital branches; pains
accompanied by beating of the temporal arteries; aggravated
by eating sour fruit or by mental excitement.
Nux vom. — Lightning-like pains, with twitchings of the
affected parts; violent, agonizing pains, obliging the patient
to change his position frequently or to walk about ;pains
sometimes diminish on remaining quiet or on lying down.
Guprum-—Lightning pains, with violent throbbing of the
temporal arteries and great anguish; pains aggravated by
touch.
Thuja.—Acute shooting pains throughout the course of the
infraorbital nerve, producing ﬂashes of heat in the face and a
sensation of internal heat; cramping pains, with muscular
twitchings; convulsive movements of the upper lip accompany the
exacerbations of pain ; ameliorated by motion and by the open
air.
Bry0nia.—Severe aching and shooting pains, which may ex-
tend to the ear, involving especially the left inferior dental
branch; teeth and gums sore ; sometimes, but not always, re-
lieved by warmth ; aggravated by chewing and by cold.
Ignatia.——Violent, agonizing pains, affecting especially the
supraorbital nerve, occurring in sudden, short jerks, diminish-
ing or disappearing on moving the affected part, but immediately
returning; usually aggravated by pressure.
Aconite.-—Lancinating and burning pains, accompanied by
painful tingling and prickling, redness of the affected parts
and restlessness; pains sometimes relieved by strong friction, but
aggravated by motion.
Phosphorus. —Lancinating, lightning-like pains, affecting
TRIGEMINAL NEURALGIA. 173
chieﬂy the infraorbital nerve, and accompanied by twitchings
in the affected part; pains excited by the least movement of
the part, especially by mastication, so much so as to cause the
patient to refrain from eating or drinking.
Spigelia.—Pains extend to the eyes, which are more or less
injected, and seem to be compressed in the orbit; pains aggra-
vated by the slightest touch or movement.
Zinm1m.—Lightning pains, with muscular twitchings, affect-
ing any or all three branches; eyes appear sunken, eyelids
bluish, face pale, tongue congested; pain increased by pressure.
Argentum nit.——Pains of a sudden, rending character, extend-
ing into the orbit; globe feels as if it would be pressed out;
face pale, sight impaired, affected parts somewhat anaesthetic.
Belladonna.—Outting, throbbing pains, frequently extending
into the eye and temple, or into the ear; affecting especially
the right side of the face; worse in the afternoon and evening;
aggravated by motion, light and noise.
Sepia.—Drawing, tearing pains, extending to the teeth, ver-
tex and occiput, worse in the left side and at night; pains fre-
quently extend to the ear; aggravated or renewed by either
warmth or cold; suited to delicate, sensitive women, especially
when caused by cold, or when the menstrual function is dis-
turbed.
The following remedies may also be indicated: Uoﬂea,
Glonoin, Causticum, Stannum, Colocynthis, Verbascum, Chamo-
milla, Chininurn sulph., Cimicifuga, Graphites, Rhus tocc. and Lyce-
podium.
Auxiliary Treatment.—Galvanic electricity is frequently of
great beneﬁt during the paroxysm, often relieving the most
intense suffering at one sitting. The best mode of applying it
is to place the wet sponge of the positive pole over the affected
nerve, and that of the negative atany convenient point out-
side the painful area. The current, which should be weak at
ﬁrst, will be most effective by being gradually increased until
a slight sensation of heat is produced. One or two applica-
tions a day, of not over ten minutes each, will be suﬂicient, ex-
cept in chronic cases.
Nerve-stretching l1as been practiced successfully in a number
174 NERvoUs THERAPEUTICS.
of instances, especially in the case of the supraorbital nerve,
sufficient force being applied to liberate the nerve from any
inﬂammatory or other form of compression, which may have
interfered with its normal function.
There.is no better local application in these cases than a
solution of Aconitia, one grain to the ounce, which may be
painted over the painful nerve with a camel’s hair brush when-
ever required; or the strong tincture of Aconite may be rubbed
in along the course of the nerve until the part becomes numb‘,
repeating the process pro re nata.
MASTODYNIA.
Syn0nyms.—Neuralgia of the Mammae, Mastalgia; Fr.,
Névralgie des Mamelles ; Ger., Neuralgie der Brustdrilsen.
Deﬁnition.—Neuralgia and hyperaesthesia of the mammary
glands.
Diagnosis.——The disease is often confounded with inter-
costal neuralgia, which is but one of its various forms. Some-
times the slightest touch causes pain (hyperaesthesia); at others,
the deeper structures are involved, and the affection partakes
more of a neuralgic character.
Pathology:-The pathology of mastodynia is obscure.
Sometimes small points on the glands are sensitive to pressure,
due, probably, to enlargement of nerve-ﬁbres. In other cases
the affection appears to be seated in the dorsal region of the
spine, from which the nerves supplying the mammary glands
are derived. The constitutional conditions which give rise to
it are, in the main, similar to those which favor neuralgia in
other parts, namely, anaemia, chlorosis, hysteria, etc. Its
relation to the sexual sphere is shown by its frequent associa-
tion with disturbance of the sexual organism, especially at the
menstrual period.
Clinical Experience.—-Phytolacca.-When complicated with
hyperaemia of the mammae; the breasts are swollen and very
sensitive to pressure, cannot bear to have them touched;
neuralgic pain in the left ovary; worse during menstruation
and lactation.
t
coccreonvnm. 17 5
Bryonia.-—When every movement of the arm causes pain in
the corresponding mamma; also when complicated with
ovaritis.
Arsenicum.—Periodical attacks, especially when complicated
with malaria; also when the pain is relieved by heat and
aggravated.by cold.
Rhus t0x.—()ongestion of the mammae; the breasts feel hot
and dry; the glands are swollen, and the pain is deep-seated,
of an aching character and relieved by manipulation.
Pulsati1la.—When associated with menstrual derangement,
or when there is a constant feeling of chilliness.
Aconite.-—Cutaneous hyperaesthesia; great restlessness and
irritation, especially in young girls.
Cham0milla.—Breasts hard and painful to the touch; hot
perspiration under the mammae.
Cimicifuga.——-Prickling sensations in the mammae; when
associated with characteristic menstrual symptoms, or with
pain in the head and back.
Compare, also, Conium, Calcarea carb., Kali carb., Nitric ac.,
Caladium, Murex.
Auxiliary Treatment.—- Fomentations, especially when
medicated with the indicated remedy, are of great value in
relieving the paroxysms of pain. Inunction of the breast with
oil and quinine is said to be beneﬁcial when the neuralgia
alternates with neuralgia of other parts. It is also recom-
mended to spray the mammae with cold water two or three
times a day, employing friction afterward until the surface is
brought to a glow.
GOGGYGODYNIA.
Syn0nyms.—Neuralgia of the Coccyx, Coccyodynia, Coccy-
dynia; Fr., Doalear de Coccyx; Ger., Kreuzenclschmerz.
Deﬁniti0n.—Pain, apparently of a neuralgic character, in
the vicinity of the coccyx.
Diagnosis.-—As the disease is almost exclusively conﬁned
to women, and sometimes occurs after difﬁcult parturition, it
is liable to be mistaken for hysteralgia. It may be distin-
guished from the latter by the fact that the patient cannot
176 NERVOUS THERAPEUTICS.
bear the least pressure on the os coccygis, whereas in hysteralgia
the favorite position is one that throws the entire weight of
the body on this very part.
Pathology,—The disease is sometimes due to neuralgia of
the coccygeal plexus, but this is not always the case. On the
contrary, there is reason to believe that it is sometimes of a
rheumatic and sometimes of an inﬂammatory nature.
Clinical Experience. —— The remedies which have been
most frequently prescribed for this affection are: Cicuta,
Acidum fluor., Ruta, Zincum, Rhus rad., T huja, Conium and
Carbo an.
Therapeutic Indications.—Gicuta.—Tearing, jerking pains
in the coccyx; stiffness in the lower limbs; when resulting
from injury or pressure during conﬁnement.
Acidum ﬂuor.—Periodical aching in the coccygeal region;
aching pain in the os sacrum and lumbar region, relieved by
pressure, stretching and bending backward, especially the
former.
Ruta.——Pain extending from the coccyx to the sacrum, as if
caused by a blow or bruise.
Zincum.—-Aching, pinching and lancinating pains in the
coccygeal and sacral regions; pressure, tension and weakness
in the sacral and lumbar regions; back cracks when walking.
Rhus rad.—Pain in the loins and lower spinal region, espe-
cially when moving the hips or when lying in bed at night;
rheumatic cases, attended with a sense of weariness and lan-
guor, with stiffness.
Tarantula.—-—-Burning, smarting and painful uneasiness in the
coccyx after conﬁnement, better when standing, worse from
slightest pressure or motion.
Thuja.—Painful drawing sensation in the coccygeal and sac-
ral regions and in the thighs, when sitting; sudden cramping
pain in the lumbar region after long standing, and when at-
tempting to walk it seems as though he would fall; after being
seated awhile the drawing becomes so great as to hinder stand-
ing erect.
Gonium.—Drawing and stitching pains in the lumbar, sacral
and coccygeal region, followed by great weakness and nausea;
drawing through the lumbar vertebrae when standing.
SCIATICA. 177
Garbo an.—Pain in the coccyx, which burns when the parts
are touched; pain as from subcutaneous ulceration, worse on
sitting or lying down; pressing, bearing-down pain in the
coccyx, as if bruised.
Consult, also, Silicea, Belladonna, Rhus tox., Causticum, Cistus
can., Graphites, Paris quad, Kreosotum, Cantharidis, Petrolium,
Magnesia, Phosphorus, Lachesis, Muriatic ac. and Cannabis sat.
Auxiliary Treatment.—Extirpation of the coccyx has been
resorted to in very obstinate and painful cases, also subcuta-
neous section of the attached muscles and ligaments. Such ex-
treme measures, however, are seldom necessary, as the homoeo-
pathically indicated remedy, aided, if necessary, by electricity,
will cure the most rebellious cases. We have the testimony
of Rosenthal that electricity alone cured a case of twelve years’
standing.
SCIATICA.
Synonyms.-——Ischias, Femero-popliteal Neuralgia ; Fr.,
Névralgie Sciatique; Ger., Hitftweh.
Deﬁniti0n.—Neuralgia of the parts supplied by the great
sciatic nerve and its posterior cutaneous branches.
Diag'n0sis.—Sciatic neuralgia is liable to be mistaken for
rheumatism and for inﬂammation seated in and about the hip-
joint. In the former case the pain is not spontaneous as in
sciatica, but is always dependent on muscular action. Hip-
joint disease is common in childhood and youth, while sciatica
is seldom noticed under thirty years of age. But a slowly-
developed chronic inﬂammation, usually called chronic rheu-
matism, occurring in elderly people, is what is most frequently
miscalled sciatica. If the pain is not increased by pressing
the surfaces of the joint together, or by gently rotating the
limb, it may be, and probably is, sciatica; but it cannot be
hip-joint disease. On the contrary, if the pain is made worse
by this procedure, if there is great stiffness about the joint, so
that the lower part of the body moves when an attempt is
made to bend the hip-joint, and especially if the muscles in
the vicinity of the joint are permanently contracted, then it is
not sciatica, but an inﬂammation of the joint itself.
178 NERvoUs THERAPEUTICS.
Pathology.-—There is little doubt that very many cases of
sciatic neuralgia are due to rheumatic inﬂammation of the
nerve-sheath, yet it has often happened that in cases which
during life have been supposed to be examples of this affec-
tion no trace of neuritis has been discovered. Be this as it
may, sciatica, like every other form of neuralgia, is almost in-
variably associated with a depressed state of the system, and
this, as before stated, has led to the general belief that the nerv-
ous system is not duly nourished. The correctness of this
opinion would seem to be veriﬁed by.the fact that a rich,
nutritious diet, especially one rich in fats, always proves bene-
ﬁcial to the patient. I have an old chronic case now under
treatment in a lady who remains entirely free from suffering
so long as she continues to take cod-liver oil, but whenever she
suspends the use of it for a few weeks the disease always re-
turns with great violence.
Clinical Experience.—See preceding section on neuralgia
in general, pp. 167-171.
Therapeutic Indications.--Nux vom.—Short, tearing and
jerking pains, with trembling of the affected parts; stiffness
of the affected limb, with sensation of paralysis; can lie best
on the sound side; sometimes the pains diminish on lying
down and keeping quiet, also after midnight; although the
pains are aggravated by touch and by motion, they oblige the
patient to move the affected part continually.
Colocynthis.--Lightning-like pains in the course of either
sciatic nerve, but especially the left; aggravated by touch,
motion, pressure or cold, also worse at night or when warm in
bed, but ameliorated during the day by warm applications;
pains accompanied by a sense of constriction; especially suited
to acute cases occurring in the young.
Rhus tox.—Burning and tearing pains, attended by numb-
ness, formication, sensation of cold and paralytic stiffness of
the affected limb; pains aggravated by rest, especially rest in
bed and at the beginning of motion, but ameliorated by the con-
tinuance of motion; has also cured cases aggravated by pro-
longed motion.
Bryonia.-—Twitching pains extending from the lumbar region
SCIATICA: 179
to the thigh, with sweating; pains attended with shocks in the
affected limb; pains aggravated by touch and motion, but
often ameliorated by hard pressure or by lying on the affected
part, also by cold water; is suited to both acute and chronic
cases, even when there is atrophy of diseased limb.
Gham0mil1a.——Tearing, boring pains, occurring in young and
nervous persons, especially when the pain is worse at night and
is accompanied by a sensation of paralytic weakness; great
irritability of mind and temper.
Plumbum.—Gonstant drawing and lancinating pains, in-
creased by motion, heat and sudden pressure, but ameliorated
by steady pressure; pains always worse at night, suited especially
to chronic cases, or when there is a tendency to atrophy and
paralysis.
A1'senic11m.—Tearing and burning pains, with nightly aggrava-
tions; ameliorated by warm applications or by rubbing the
affected part; aggravated by touch and motion; sometimes
relieved by motion, especially at night, when the patient has
to get up and walk the ﬂoor for relief; cannot lie on the affected
side, and is very restless even on the sound side; is suited to
both acute and chronic cases, especially when there is marked
periodicity in their recurrence or aggravation.
Ignatia.—-Throbbing, intermitting pains, with fever, preceded
by chilliness, with thirst; paroxysms at ﬁrst tertian, afterward
quotidian; chronic cases, better in summer, worse in winter;
suited also to acute cases where the patient is obliged to con-
stantly change his position to relieve the pain.
Bellad0nna.——Severe lancinating pains, coming on in the
afternoon or evening, or else worse from noon till midnight;
aggravated by the lightest touch, but frequently relieved by
steady pressure; worse from motion or mental excitement;
better from warmth, after perspiring, when erect, or when
letting the limb hang down.
Kali iod.—Pain in the hip, causing the patient to limp ;
nightly tearing pains in the right limb, aggravated by lying
on the affected side; muscles of the affected limb spasmodi-
cally contracted: pains ameliorated by rnotion; chronic cases,
with nocturnal aggravation, or when caused by mercury or
syphilis.
NERVOUS THERAPEUTICS.
Mercurius.—-Nocturnal pains in the course of the sciatic nerve,
attended by nocturnal aggravation, chills, numbness, formication
and tendency to sweat, the perspiration giving no relief;
patient restless and constantly changing his position; syphilitic
cases.
Va.leria.n.—-Pains so intense that it seems as though the thigh
would break; unendurable when at rest, or when sitting or
standing, but relieved by walking about.
Compare, also, the following remedies: Terebinthina, Lycopo-
dium, Vcratrum alb., Sepia, Fcrrum, Tellurium, Nitric ac., T huja,
Ranunculus, Lcdum, Gnaphalium, Argcntum nit., Calcarca carb.,
Coﬂea, Hcpar sulph., Kali bich., Arnica, Cimicifuga, Iris vcrs.,
* Causticum, Lachesis, Phytolacca, Gclscmium, Ruta, Stillingia, Men-
yanthes, Pulsatilla, Polygonium, Natrum mur., Natrum salic. and
Mczcrcum. For indications see the two preceding sections.
Auxiliary Treatment.-—In addition to the accessory treat-
ment given in the last two preceding sections (which see), we
add the following: As regards electricity, a strong galvanic
current will generally relieve those cases in which ﬁrm press-
ure over the affected part causes no pain; but where there is
so much sensitiveness that slight pressure produces pain, strong
galvanic currents usually do more harm than good. On the
other hand, those cases which are aggravated or unrelieved by
the galvanic current are almost always beneﬁted by the Far-
adic or induced current, or by the static current.
Hypodcrmic injections of ether have cured some cases of
sciatica, three drops of ether being injected at intervals of
twelve hours. Debove claims to have succeeded in all his
cases, both acute and chronic, by applying along the track of
the nerve a spray of methyl-chloride, the degree of cold thus
produced being as low as 22°; the line of congelation soon
becomes red and warm, erythema and blisters usually develop-
ing, but a true eschar seldom.
In cases where pressure gives relief much beneﬁt has been
derived from the application of roller bandages. The bandage
should commence at the toes and extend up to the middle or
upper part of the thigh. If the pain is relieved by it, it
should not be removed for several days, or until a cure is
effected.
PARALYTIC APHONIA. 181
Extension and suspension have relieved several obstinate cases.
The diet should be of the most mltritious character, con-
sisting of fresh meat, mutton, beef, grime, poultry, fresh vege-
tables, and a liberal supply of cream; butter and other animal
fats. As in neurasthenia, “the hungry nerve cries out for
food,” and if, owing to lack of power to assimilate, digestion
becomes embarrassed, or if for any reason the amount of food
taken is insufficient to satisfy this hunger, so that the “ cry”
is repeated, we cannot do better than to supply the deﬁciency
with maltine, or some similar preparation.
PHARYNGEAL PARALYSIS.
Synonyms.—Paralysis of the Pharynx; Fr., Paralysie Pha-
ryngée; G'er., Schlundlcopfldhmung.
Deﬁniti0n.—Paralysis of the pharyngeal branches of the
pneumogastric nerve.
Diagnosis.-—Paralysis of the pharynx is usually associated
with paralysis of neighboring parts, as in labio-glosso-laryngeal
paralysis (which see). This is the case whenever the disease
is located at the origin of the nerve in the medulla and in-
volves adjacent nuclei. But the simple form may result from
meningeal disease outside the medulla, from disease of the
bones at the base of the skull, and is occasionally associated
with diphtheria. A careful examination is usually sufficient
to distinguish it from organic disease, with which alone it is
liable to be confounded.
Pathology.—This is suﬂiciently indicated under the above
head.
Treatment.—Remove the cause, if possible; if not, give
Causticum, Gelsemium, Cocculus, Lachesis, Silicea, Cuprum, or
such other remedy as may be indicated.
PARALYTIC APHONIA.
Syn0nyms.—Paralysis of the Larynx ; Fr., Paralysie du
Larynx ; G’er., Kehllcopflélhmung, Stimmlosigheit.
Deﬁnition.—Loss of voice from paralysis of the laryngeal
muscles.
182 NERvoUs THERAPEUTICS.
Diagnosis.-—A laryngoscopic examination will show that
one or both vocal cords exhibit diminished motion, though no
mechanical impediment exists. When both crico-arytenoid
muscles are paralyzed the breathing is obstructed, and even
when it is deep and prolonged the edges of the vocal cords are
closely approximated. When the transverse arytenoid mus-
cles are paralyzed, the posterior part of the rima glottidis opens
in the form of a triangle. If only one vocal cord is paralyzed
the voice is weak, deﬁcient in timbre and volume, and some-
times limited to only a few notes. Some forms of paralytic
aphonia may be diagnosed withoutthe aid of the laryngoscope,
as the reﬂex, the intermittent and the form caused by severe
mental shocks; in this last form, although unable to articulate
words, the patient is able to cough.
Pathology.-—M. Bernard has shown by numerous experi-
ments that while the spinal accessory specially inﬂuences the
vocal muscles, and is therefore the true vocal nerve, the
respiratory muscles of the larynx are under the control of the
inferior and superior laryngeal nerves. He has shown, also,
that paralysis of these nerves, instead of dilating the vocal
ligaments, approximates them, so that every effort at inspira- -
tion tends to render the passage of air through the glottis
more and more difficult by obstructing the laryngeal aperture.
Hence any interference with the function of the recurrent or
inferior laryngeal nerve-—which is the nerve animating all the
laryngeal muscles except the crico-thyroid—or with the func-
tion of the pneumogastric nerve itself, or of one of its branches,
may produce aphonia.
Clinical Experience.-—The principal remedies for pure
paralytic aphonia have been found to be Antimonium crud.,
Lachesis, Phosphorus, Baryta carb., Causticum, Kali bich., Cuprum
met. and Gelsemium. Hysterical and nervous cases usually
yield to Ignatia, Stramonium, Nux mosch., Belladonna, Nux vom.,
Rhus tox. and Platina. Catarrhal aphonia, which is not truly
paralytic, is successfully treated with Aconite, Belladonna, Arum
tri., Causticum, Gelsemium, Antimonium tart., Argentum met.,
Spongia, Iodatum, Mercurius, Bromium, Ammonium brom., Kali
bich., etc., etc.
FACIAL PARALYSIS. 183
Therapeutic Indicati0ns.—See cerebral and spinal paralysis,
pp. 54, 92.
Auxiliary Treatment.-—Paralytic aphonia will sometimes
yield to a single application of the galvanic current; in most
cases, however, several operations are required for the gradual
restoration of the lost voice. As in other kinds of paralysis,
the best form, usually, is the induced or secondary current
(Faraclic), but complicated cases sometimes do better with the
primary current. Massage, the magnetic pad and other local
' measures have sometimes proved curative, and, though seldom
necessar ma be tried in obstinate cases.
7
FACIAL PARALYSIS.
Synonyms.—Bel1’s Paralysis, Paralysis of the Portio Dura,
Histrionic Paralysis; Fr., Paralysie Faciale, Diplegie Faciale;
Ger, Diplegia Facialis, Gesichtslcthmung.
Deﬁniti0n.—Paralysis of the facial muscles from disease or
injury of the portio dura or of its nucleus.
Diagn0sis.—As -facial paralysis is often associated with
hemiplegia, it is important to distinguish it from that disease.
In facial palsy it is impossible for the patient to close his eye
on the paralyzed side, which is not the case in the cerebral
form. If the ﬁfth nerve is paralyzed, and the patient be re-
quested to close the jaws ﬁrmly, the muscles of the sound side
will contract more energetically and promptly than those of
the affected side; and if the third nerve is implicated there
will be ptosis, with dilatation of the pupil and divergent stra-
bismus.
Pathology.—In all cases lasting 1nore than a few days
evidences of defective nutrition may be detected in the nerve-
trunk as it emerges from the stylo-mastoid foramen. The
ﬁbres within the pons, and the nucleus beneath the fourth
ventricle, are sometimes damaged by tumors, haemorrhage,
softening, etc. The nerve sometimes becomes inﬂamed from
the extension of inﬂammation from the neighboring tissues;
and occasionally its function is interrupted by pressure, caused
by proliferation of the connective tissue of the neurilemma.
184 NERVOUS THERAPEUTICS.
Clinical Experience—Facial paralysis has yielded to Gelse-
mium, Causticum, Aconite, Kali chlor., Kali iod., Mercurius, Bella-
donna and Arnica.
Therapeutic Indications.—Ge1semium.-Bruised pain be-
hind and above the eyes; heaviness in the lids; impossible to
close the eye or to raise the lid; paralysis of the facial muscles
of the left side.
Causticum.—Twitching of the lids and eyebrows, especially
the left; sensation of heaviness in the upper lid, with inability
to close the eye ﬁrmly; especially suited to cases caused by
exposure to cold.
Aconite.—Recent cases of a catarrhal or rheumatic origin;
also when due to injury or to inﬂammation; anaesthesia of the
affected muscles.
Kali chlor.—Paralysis of the facial nerve, especially when
affecting the muscles of the cheek ; pressure and tension in the
face; cramplike drawing in the cheek; inability to puff out
the checks or to blow with the mouth; especially adapted to
idiopathic cases. ‘
A1'nica.—Facial paralysis due to injury, especially when there
is much soreness of the affected parts; also when there are in-
ﬂammation and hyperaesthesia of the facial nerve.
Kali iod.—Facial paralysis due to syphilitic disease in any of
its forms.
Mercurius.—This remedy is also indicated in syphilitic facial
paralysis, whether caused by pressure of nodes, inﬂammatory
exudations, neuritis or syphilitic disease of the brain.
Belladonna.-—Acute cases, attended with inﬂammation of the
nerve, redness of the face, hyperaesthesia, throbbing and ex-
tension of inﬂammation from neighboring parts, as from the
tonsils, parotid gland, etc.
Compare, also, Ignatia, Graphites, Pulsatilla, Cocculus, Nux
vom., Cadmium, Stramonium, Barium, Opium.
Auxiliary Treatment.—Hammond, Butler and other elec-
tricians highly recommend electricity in this disease, the former
saying that the affection cannot be cured without it. One pole
of the galvanic current should be placed opposite the stylo-
mastoid foramen, and the other passed over each of the affected
muscles in succession, every day. The weakened muscles may
mrnrnnnrrrc PARALYSIS. 185
be supported, and the mouth drawn toward the centre of the
face, by means of a double wire hook, curved at the ends and
of the required length, one end of which should be placed in
the angle of the mouth and the other over the ear of the
affected side. '
DIPHTHERITIC PARALYSIS.
Synonyms.—Postdiphtheritic Paralysis, Asthenic Paraly-
sis; Fr., Paralysie Diphthéritique; Gen, Diphtheritische Ltihmung.
‘Deﬁnition. ——Paralysis associated with, or secondary to,
diphtheria.
Diagnosis.-—Although diphtheritic paralysis resembles that
which is observed after other acute diseases, and also that
which occurs in hysterical women, the simple fact that it was
immediately preceded by an attack of diphtheria is sufﬁcient
to establish the diagnosis.
Pathology. —The fact that the nervous centres are not
always implicated has led to the conclusion that the paralysis
is peripheral rather than central in its origin. The affection
appears to extend from the peripheric extremities of the nerves
toward the nerve-centres; hence, when the nerve-centres are
involved their implication is probably secondary.
Clinical Experience. — Gelsemium seldom fails to cure
promptly all recent cases. Argentum is a good general remedy
in these cases. Antimonium tart. acts promptly in patients
suffering from oedema of the lungs. Causticum has cured cases
of crossed paralysis following diphtheria, one arm and the
opposite leg being affected; Arsenicum, where the paralysis
was conﬁned to the lower extremities; and Nua: vom., Lachesis,
Cocculus, Arniea and Rhus tor. when limited to one side of
the body.
Therapeutic Indications.——See paralysis in general, pp. 54, 92.
Auxiliary Treatment.—Most cases of diphtheritic paralysis
will yield to the methodical use of electricity; indeed, it may be
laid down as a rule that when the muscleswill respond to
either the primary or secondary current recovery will speedily
follow its application. When this is not the case the fault
usually lies in the constitution, and we should endeavor, by
13
186 NERvoUs THERAPEUTICS.
generous diet, fresh air, salt-water baths, exercise, etc., to revo-
lutionize and build it up ; the paralysis will be found to grad-
ually disappear as the health improves.
GLOSSOPLEGIA.
Syn0nyms.——Paralysis of the Hypoglossal Nerve, Paralysis
of the Tongue; Fr., Paralysie de la Langue; Ger., Zungenldhmung.
Deﬁniti0n.—-Paralysis of the hypoglossal or motor nerve of
the tongue.
Diagn0sis.—As the hypoglossal nerve is the motor nerve,
not only for the tongue, but for all the other muscles attached
to the hyoid bone, with the exception of the stylo-hyoid, the
mylo-hyoid and the middle constrictor of the larynx, we
should, in estimating the character and position of the lesion,
take into consideration the origin, course and distribution of
the entire nerve. In disease of the nucleus of origin the pa-
ralysis, which is commonly bilateral, is associated with pa-
ralysis of the throat and lips, and there is usually more or less
atrophy. If the disease is seated in the motor tract above the
nucleus, that is, in the pons, crus or hemisphere, there is hemi-
plegic weakness on the side corresponding to the paralysis of
the tongue. When the disease is at the surface of the medulla
the paralysis, which is commonly unilateral, is associated with
paralysis of the corresponding half of the palate and vocal
cord; and when theﬁbres of origin within the medulla are
diseased, the paralysis of the tongue is associated with paralysis
of the opposite limbs, so that the tongue deviates from the par-
alyzed side.
Path0l0g'y.——The disease is seldom, if ever, a primary affec-
tion; hence the pathological condition is that of the associated
disease or of the causal condition on which the paralysis de-
pends.
Clinical Experience.—As in all secondary affections, the
treatment should be that of the causal disease. Where no
speciﬁc disease can be assigned the‘ remedies which usually
prove most beneﬁcial are: Argentum, Causticum, Plumbum,
Baryta carb., Opium, Nux mosch., Dulcamara, Stramonium, Bel-
ladonna and Hyoscyamus.
TORTICOLLIS. 187
Auxiliary Treatment.—-The occasional application of elec-
tricity to the tongue is useful in some cases. The most con-
venient way of applying it is by means of Tiirck’S tongue de-
- pressor, the blade of which should be insulated, where it comes
in contact with the lips, by a coating of sealing-wax.
FACIAL SPASM.
Syn0nyms‘.—Spasm of the Facial Muscles, Mimetic Spasm,
Convulsive Tic; Fr., Spasme Faciale, Tic Oonvulsif; Ger, Ge-
sichtshrampf.
Deﬁniti0n.——Tonic or clonic contractions of one or more of
the muscles supplied by the facial nerve.
Diagnosis.—A1l spasms of the facial muscles not consti-
tuting a part of a wider convulsive movement, as in epilepsy,
hysteria, etc., are to be regarded as facial spasms.
Path0l0gy.—Some cases are purely functional, such as
nictitation, or involuntary winking. Others are due to irritation
of the trunk of the nerve by pressure of foreign growths, caries
of the temporal bone, etc. But the majority are of reﬂex
origin, and are due to cold, intestinal worms, etc.
Treatment.-If possible, remove the cause; if not, consult
indications under the head of convulsions.
\
TORTICOLLIS.
Syn0nyms.—Spasm of the Sterno-mastoid Muscle, Wry-
neck; Fr., T orticolis ,' Ger, Steifer Hats, Halsstarre.
Deﬁnition.——A tonic contraction of the sterno-cleido-mastoid
muscle, producing a twisting of the neck to one side.
Diagnosis.—It is scarcely possible to mistake the affection
where there is no tumor or organic lesion to account for the
deformity.
Path010g'y.——Wry-neck is a true neurosis, due ‘in many
cases to irritation of the spinal accessory nerve, conjoined with
a want of proper antagonization, the latter resulting from
fatigue or some similarly acting cause.
Clinical Experience.——Aconite and Oimicifuga will promptly
188 NERVOUS THERAPEUTICS.
cure the large majority of recent cases, especially those depend-
ing on cold and exposure. Belladonna, Rhus to:c., Nucc vom.,
Dulcamara, Bryonia, Lachnanthcs, Cuprum and Mercurius some-
times relieve in the early stages, but when fully developed
medicine has very little power over it.
Auxiliary Treatment.— Galvanization of the affected mus-
cle and F aradization of the opposite one often give speedy relief
in recent cases, but neither electricity, nerve-stretching nor
any other procedure seems to materially beneﬁt chronic cases.
WRITER’S GRAMP.
Synonyms. Scrivener’s Palsy, Anapeiratic Paralysis; Fr.,
Crampe des Ecrivains ; Ger., Schreibelcrampf.
Deﬁnition.—A loss of power to perform certain muscular
movements required in writing, telegraphing, instrument play-
ing, etc., correctly, owing to a spasmodic action of the mus-
cles concerned in the movements, due to their long-continued
use in an unnatural and constrained position.
Diagnosis.—The history of the case, aided by the location
of the spasm, will in most cases render the diagnosis sufficiently
clear.
Pathology--As in facial paralysis, torticollis and other
allied diseases, the paralysis proceeds from the periphery
toward the centre, whence we infer that the disease is not
central, but peripheral. What the molecular or anatomical
changes in the affected parts, or in the nerves supplying them,
are, is not known.
Clinical Experience.-—But three or four remedies are
known to have any marked curative power over this affection,
namely, Gelsemium, Argentum, Strychnia, Arnica and Zincum.
Recent cases will generally yield to the ﬁrst of these remedies,
provided the writer will give the affected muscles suﬂicient
time to recover their lost tone, but not without; the other
remedies mentioned are less certain.
Auxiliary Treatment.—-Rest, galvanism and gymnastic exer-
cise of the affected muscles constitute the most effective treat-
ment in the majority of cases. Rest of the affected muscles,

SPASM on THE GLOTTIS. 189
that is, rest from the particular muscular movements that have
caused the trouble, is essential, whatever other treatment may
be instituted. Dr. Poore’s plan of directing the continuous
galvanic current down the muscles of the forearm, at the same
time requiring the patient to continuously open and close his
ﬁngers, appears to give good results. The gymnastic treatment
is similar, so far as the ﬁngers are concerned, but the patient is
required to execute three or four times a day a series of vigor-
ous movements of the whole extremity while opening and
closing the ﬁngers. In this way the old habits are broken up,
and the nutrition of the affected parts at the same time pro-
moted.
SPASM OF THE GLOTTIS.
Synonyms.—-Spasm of the Larynx; Spasmodic Oroup,
Laryngismus Stridulus; Fr., Spasme de la Glotte; Ger., Kahl-
lcopfhrampf.
Deﬁnition.—Spasmodic closure of the glottis, depending on
tonic spasm of the adductor muscles of the larynx, producing
a sudden arrest of inspiration, and ending in a shrill crowing
sound as the inspiratory act is resumed and concluded.
Diagnosis.--The disease may be distinguished from acute
laryngitis, with which it is often confounded, by the absence
of fever, the greater affection of the breathing, and by the
absence of the croupy cough, which is the distinguishing
symptom of the inﬂammatory affection. A foreign body in
the larynx closely simulates spasm of the glottis, but the his-
tory of the case will prevent any error of diagnosis.
Pathology.—The disease is a pure neurosis, there being no
anatomical change in the larynx. Excessive reﬂex irritability,
arising from constitutional weakness or from some affection
of the brain or medulla oblongata, is no doubt the chief factor
in its production.
Clinical Experience.—The most successful remedies for
relieving the spasm are: Gelsemium, Sambucus, Belladonna,
Chlorine, Corallium rub., Lobelia, Ipecacuanha and Kali brom.
More or less beneﬁt has also been derived from Moschus, Cup-
rum, Arsenicum, Spongia, Iodine, Lachesis, Aconite, Nux vom.,
190 NERvoUs THERAPEUTICS.
Ignatia, Phosphorus, Carbo veg., Plumbum, Phytolacca and
Bromine.
Therapeutic Indications.-—Gelsemium.-Long, crowing in-
spirations, followed by sudden and forcible expirations. This
is perhaps the most reliable remedy we have for promptly
relieving the spasms.
Sambucus. — Inspirations less labored than expirations;
awakes from sleep with symptoms of suffocation; face livid;
gasps for breath; alternation of perspiration and dry heat;
attacks usually occur between midnight and morning.
Belladonna.——Red face; great arterial excitement; cerebral
congestion; paroxysms occur during the day or evening;
excited by drinking.
Chlorine.—Crowing inspiration, expiration greatly impeded ;
cyanotic and partially unconscious; chest inﬂated by a succes-
sion of crowing inspirations to a painful extent.
Iodium.-—Attacks provoked by enlarged cervical, bronchial
and other glands; rachitic and scrofulous children; clayey
stools; circulation feeble and easily disturbed by motion.
Phytolacca.—Frequent spasmodic closure of the larynx; con-
traction of the thumbs and toes; distortion of the face; eyes
move independent of each other.
Plumbum.-—Spasm of the glottis; asphyxia, with sudden
arrest of breathing; mucus rattling in the throat.
Cuprum.—Convulsive breathing, with cough ; blueness of the
face and lips; cough relieved by swallowing cold water; when
produced by fright.
Ipecacuanha.——Blue face and cold extremities at the com-
mencement of the attack; accumulation of mucus in the
bronchia.
Kali brom.—Often relieves night attacks, or when excited by
the irritation of teething or of worms.
Corallium rub.—Spasmodic closure of the larynx, with painful
dyspnoea; face red, cheeks hot and feet cold.
Auxiliary Treatment.—The warm bath, with cold water
dashed on the head and face, usually puts an immediate end
to the spasm; afterward cold sponging of the chest, with out-
of-door exercise, tends to prevent its recurrence. Reﬂex cases
FACIAL ATROPHY. 191
require the special treatment appropriate to each condition.
Thus, if there is phimosis it should be immediately relieved
by surgical operation ; if the child is teething the gums should
be lanced; if the stomach is overloaded an emetic should be
given; and if worms are present they should be dislodged, or
the virminous irritation allayed, by appropriate treatment.
FACIAL ATROPHY.
Syn0nyms.——Neurotic Facial Atrophy, Unilateral Facial
Atrophy, Progressive Facial Atrophy, Progressive Facial He-
miatrophy; Fr., Atrophie Partielle de la Face, Aplasie Lamineuse
Progressive, Trophonévrose Faciale; Ger., Prosopodysmorphia.
Deﬁnition. —An affection in which one side of the face be-
comes notably smaller than the other, owing to an atrophic
condition of the cutaneous, subcutaneous and other tissues of
the affected side.
Diagn0sis.—Progressive facial atrophy may be readily dis-
tinguished from progressive muscular atrophy, by the fact
that, when the latter is seated in the face, it is not conﬁned to
that part, nor to one side of it, as in facial atrophy. In its
early stages it is liable to be mistaken for facial paralysis, but
the latter occurs suddenly, while facial atrophy is developed
very gradually; moreover, the electro-excitability of the mus-
cles is always diminished in facial paralysis, which is not the
case in this disease.
Path010gy.——Microscopical examinations of the affected
muscles exhibit no degenerative changes of any kind, so that,
so far as the muscles are concerned, there is simply atrophy
without degeneration—a condition essentially different from
what exists in other trophic diseases, such as atrophic spinal
paralysis, progressive muscular atrophy, etc. From the fact
that the upper and middle cervical ganglia have been found dis-
tinctly tender on pressure made over them, Bastion and others
attribute the disease to persistent irritation acting upon the
cervical sympathetic; Hammond and others refer it to certain
hypothetical “ trophic nerves;” while Vulpian, who positively
affirms that it cannot be due to vaso-motor inﬂuences acting
1.92 NERVOUS THERAPEUTICS.
on the parts which are the seat of the disease, regards it as an
essential atrophy, due to some intracranial lesion. This opin-
ion is based upon the fact that when the disease results from
traumatic violence inﬂicted on the head or face its develop-
ment is accompanied, in the great majority of cases, for several
years, with pains of greater or less violence seated in the head,
ordinarily toward the fronto-temporal region. Sometimes, also,
there are spasmodic movements of the muscles of the face or
of the jaws; and in some rare cases there has been numbness
in the upper extremity of the opposite side. He, however, in
common with all other authorities, is embarrassed to designate
a seat for the lesion which can reasonably explain all the
phenomena of the disease."<
Clinical Experience.—-The only case of this disease that I
have had an opportunity of treating, though never entirely
cured, was seemingly arrested by Phosphoruse, continued over
a period of nearly two years. The young lady ﬁnally married,
and I lost sight of her.
Therapeutic Treatment.—The remedies most likely to
prove beneﬁcial in this disease are the various preparations of
Phosphorus, Belladonna, Calcarea, Argentum nit., Stramonium,
Gclscmium, Baryta, Causticum and Sulphur.
Auxiliary Treatment.—Bastion claims that marked ame-
lioration has been produced, in some cases, by the long-con-
tinued application of a continuous current of weak tension to
the cervical sympathetic ganglia.
PERIPHERAL ANJESTHESIA.
Synonyms.——Neural, Cutaneous or Local Anaesthesia; Fr.,
Ancsthésic Cutanéc ; Ger , Anaesthesia, Anclsthcsie.
Deﬁnition.-—Loss, more or less complete, of natural, and
especially of tactile, sensibility. ,
Diagnosis.—Cerebral, spinal and cerebro-spinal anaesthesia
—that is, anaesthesia of central origin——has already been con-
sidered in connection with the several diseases on which it de-

* See the author’s Intracranial Diseases, p. 153.
PERIPHERAL ANZESTHESIA. 193
pends, while anaesthesia of the special senses does not come
within the scope of this work. The chief point, therefore, in
our diagnosis is to discriminate between peripheral anaesthesia,
properly so called, and anaesthesia due to central causes. In
cutaneous anaesthesia the existence of a peripheral cause will
be suﬂicient evidence of the nature of the affection, while, on
the other hand, anaesthesia of central origin is almost invari-
ably associated with other marked symptoms of cerebral or
spinal disease. In anaesthesia of the trigen1inus, or ﬁfth pair
of nerves, the elements of the diagnosis are given by Romberg
as follows:
“ 1. The more the anaesthesia is conﬁned to single ﬁlaments
of the trigeminus, the more peripheral the seat of the cause
will be found to be.
“2. If the loss of sensation affects a portion of the facial sur-
face, together with the corresponding facial cavity, the disease
may be assumed to involve the sensory ﬁbres of the ﬁfth pair
before they separate to be distributed to their respective desti-
nations; in other words, a main division must be affected be-
fore or after its passage through the cranium.
“ 3. When the entire sensory tract of the ﬁfth nerve has lost
its power, and there are at the same time derangements of the
nutritive functions in the affected parts, the Gasserian gan-
glion, or the nerve in its immediate vicinity, is the seat of the
disease.
“ 4. If the anaesthesia of the ﬁfth nerve is complicated with
disturbed functions of adjoining cerebral nerves, it may be as-
sumed that the cause is seated at the base of the brain.”
Pathology.--The pathology has been, for the most part,
sufficiently indicated under the above heading. As cold ap-
pears to be the principal cause of peripheral anaesthesia, it is
highly probable, as pointed out by Rendu, that in the major-
ity of cases neuritis lies at the bottom of the trouble.
Therapeutic Treatment.—The most important point in the
treatment is the removal of the cause. Until this is effected medi-
cine can be of no permanent beneﬁt, while afterward it is
seldom required. When caused by external injuries, Arnica
and Hypericum are indicated. Exposure to cold calls for Rhus
194 NERvoUs THERAPEUTICS;
tox., Dulcamara, Causticum, Mercurius, Colchicum, Nux vom., etc.,
in prescribing which the accompanying symptoms and condi-
tions should also be taken into account.
Auxiliary Treatment.—Friction, massage and electricity are
among the various means employed to restore the lost sen-
sibility, the last of which is by far the most efficient. As a
general rule, the secondary current is to be preferred, and this
may be rendered still more effective by employing the wire
brush, as one of the electrodes, upon the affected part.
PART V.
DISEASES OF THE SYMPATHETIC NERVOUS SYSTEM.

HEMIGRANIA.
Synonyms.—l\/Iegrim, Nervous Headache, Sick Headache,
Cephalalgia Periodica; Fr., Migraine; G’er., Migrdne.
Deﬁnition.-—A periodical headache, usually conﬁned to one
side or one half of the head, and frequently attended with
more or less nausea and bilious vomiting.
Diag'n0sis.——The periodicity of the headache, its unilateral
form, and the gastric disturbances associated with it, sufficiently
distinguish it from every other affection.
Path0l0gy.—Formerly the disease was regarded as a pecu-
liar form of neuralgia, dependent on gastric or hepatic de-
rangement; but since Du Bois Raymond, who was himself a
sufferer from it, made a careful study of the phenomena, it has
generally been held to be due to an affection of the cervical
portion of the sympathetic nerve, or of its centre in the medulla
oblongata, giving rise to spasm of the cranial vessels and dis-
turbances of the sensory nerves of the affected side of the head.
Clinical Experience.—The remedies which have most fre-
quently given relief to sick headache are: Sepia, Stannum,
Belladonna, Sanguinaria, Iris vers., Arsenicum, Calcarea carb.,
Gelsemium, Pulsatilla, Veratrum, Spigelia, Kali bich., Bryonia,
Oyclamen, Bromine, Niccolum sulph. and Natrum mur. The fol-
lowing have beneﬁted particular cases: Silicea, China, Nux vom.,
Ignatia,' Caﬁein, Coﬂea, Carbolic ac., Aurum mur., Aconite, Cimici-
fuga, Phosphorus, Ualcarea acet., Sticta, Zincum valer., Asafoetida
and Sulphur.
Therapeutic Ind.ications.—Sepia.—Boring, outward-press
ing headache, or when caused by mental emotion, especially
vexation, and attended with nausea, vomiting, shivering, pale
(195)
196 NERvoUs THERAPEUTICS.
face and ﬂying heat; ameliorated by pressure, darkness and
sleep; periodicity is a marked symptom, especially in females,
to which this remedy is especially suited.
Stannum.--One-sided headache in the morning, attended
with nausea and ill humor; stupefying pain over the eye and
in the temple, feeling as if the part would be crushed; pulsa-
tive pain in the side of the head, with heat; face pale and
sunken; retching and vomiting of bilious matter.
Belladonna.——This remedy is specially indicated in attacks
accompanied by congestion of the brain, heat and redness of
the face, irritation of the sensory nerves of the eye and dilata-
tion of the pupils; it acts best on the right side, and when the
pain is aggravated by light, heat and motion, especially
stooping.
Sanguinaria.—-Hemicrania, which increases in violence with
the sun’s ascent, decreases as it declines, and is preceded by
scanty urine, passing off with a profuse flow of urine; also when
the attacks occur periodically every week or at longer inter-
vals; or when the attacks are most severe on the right side,
and are followed by chills, nausea, vomiting of food or bile,
and aggravated by the least movement, relieved only by sleep.
Iris vers.--Attacks commencing with a blur before the eyes;
dull, heavy, throbbing pains, with nausea, vomiting and great
depression of spirits.
Arsenicum.—-Hemicrania associated with bilious colic, bilious
vomiting or some affection of the liver; great depression of
spirits, thinks he will die; aggravated by cold; ameliorated
by warmth; attacks renewed by going into the open air; great
prostration; feels chilly and is very restless.
Galcarea carb.-—-Hemicrania occurring in delicate or scrofulous
constitutions, with irritable and obstinate dispositions, and
attended with nausea and vomiting; aggravated, and fre-
quently induced, by mental and bodily exertion, by exposure
to the sun, or to cold and damp weather.
Gelsemium.—Hemicrania accompanied by double vision or by
dimness of sight, or with great sensitiveness to sounds; dull,
heavy pains extending to the nape of the neck, with throbbing
in the temples, and vertigo on rapid movement.
HEMICRANIA. 197
Pulsatilla.—Semilateral headaches where the pupils are con-
tracted, pulse quick, small and weak, or full and strong, with
feeling of weakness, or else great strength; chilliness, followed
by sweat, sometimes semilateral, nausea and vomiting, no
thirst, alternations of ﬂushing and paleness; worse before mid-
night ; suited to delicate, chlorotic girls and to weakly females
suffering from menstrual irregularities ; also to hemicrania in
the male sex when attended with a feeling of intoxication.
Veratrum alb.——Attacks attended with great anxiety, fear,
coldness, small, rapid, intermitting or slow pulse, nausea and
sometimes vomiting; occasionally attended by a sensation of
both warmth and coldness on the scalp and sensitiveness of the
hairs ; cold sweats on the forehead, weakness, faintness and
profuse micturition ; attacks usually nocturnal.
Spigelia.—Periodical attacks, generally conﬁned to the right
temple or to the left eye and left temple, pulsating, darting or
boring, increasing and declining with the sun, and accom-
panied with paleness of the face, nausea and vomiting; aggra-
vated by motion, stooping, noise, thinking or mental emotion.
Kali bich.-—Hemicrania commencing at the internal angle
of the eye, and gradually spreading over the brow and side of
the head, usually the left ; in many cases there is dimness of
vision, with aversion to light and noise; pains are usually of
a shooting character, extending from the root of the nose to
the external angle of the eye; in other cases the pain is dull,
heavy and throbbing, and conﬁned to small spots on the side
of the head.
Bry0nia.—Deep stitching or throbbing pains in the left side
of the head, with pressure from behind forward, accompanied
by nausea and vomiting; soreness of the scalp and throbbing
over the whole side of the head; aggravation from rising,
stooping or sitting down.
Cyclamen.——Violent left-sided headache, with heat and throb-
bing, glittering before the eyes, dimness of vision, chilliness,
with nausea; aggravated by motion, especially stooping; worse
in the afternoon and evening.
Bromine.—Hemicrania of the left side of the head, usually of
but little use on the right side; throbbing in the forehead and
198 NERvoUs THERAPEUTICS.
temple; pains in the eye, eyelid and eyebrow of the affected
side.
Niccolum sulph.—Periodical attacks accompanied by a sense of
great fulness, heat and stupefaction, setting in on.rising and
increasing until noon, with vertigo and nausea; distress so
great as to make the patient groan in anguish.
Natrum mur.—Hemicrania occurring in scrofulous or scor-
butic constitutions; attacks periodical and attended with
marked weakness, prostration, thirst, palpitation and nausea;
pains increase and decrease with the course of the sun.
Auxiliary Treatment.—Absolute rest, low diet and exclu-
sion from light and noise are efficient means of mitigating the
distress. The inhalation of three or four drops of Amyl. nit.
every ﬁfteen or twenty minutes frequently gives speedy relief.
Morphia, Sulfonal, Antipyrine and Phenacetine, in sensible doses,
are sometimes given as palliatives, especially in obstinate cases.
The constant current of electricity has often proved beneﬁcial,
but is far from being a speciﬁc. Care should be taken not to
make the current too strong, for fear of causing amaurosis.
EXOPHTHALMIC GOITRE.
Syn0nyms.—Exophthalmic Bronchocele, Graves’ Disease,
Basedow’s Disease; Fr., Maladie de Graves, Goitre Exophthal-
migue; Ger., Basedow’sche Krankheit, Glotzaugenkropf.
Deﬁnition.—A nervous affection, characterized by certain
functional disturbances of the circulation, and giving rise to
violent palpitations of the heart, bronchocele and exoph-
thalmos.
Diagnosis.—The. disease is of such a peculiar character as
to render an error in diagnosis impossible.
PathOl0gy.—The true nature of the disease, and the rela-
tion which the cardiac affection sustains to the bronchocele
and exophthalmos, are involved in much obscurity and doubt.
The most rational and generally received theory is that which
refers the disease to functional disturbances of the sympathetic
nervous system. Not only do the general symptoms point to
disturbances of the vaso-motor centres, but the almost number-
MYX(EDEMA. . 199
less complications of the disease, many of which are of an ex-
tremely variable and transient character, appear strongly to
conﬁrm this view of its nature.
Clinical Experience.-—Iodium and its various preparations,
Spongia and Bromine, have eﬂected most of the cures which
have been recorded, though Lycopus, Badiaga, Cactus, Ferrum,
Calcarea carb., Belladonna, Baryta carb., Secale cor. and Natrum
mur. have occasionally been attended with success. The same
is true of Amyl nit., which is administered by olfaction. One
of my cases, after resisting all other remedies, yielded perma-
nently to Bromine 3°.
Therapeutic Indicati0nS.—Although the disease is rich in
symptoms, they are too variable to be studied outside the ma-
teria medica. In addition to the remedies above mentioned,
compare Phosphorus, China, Silicea, Digitalis, Platina, Sepia,
Cimicijfuga, Silicea, Gelsemium and Sulphur.
Auxiliary Treatment.-——Galvanism, applied to the sympa-
thetic nerve, has been employed with success in many cases,
especially in curing the goitre and exophthalmus, and also in
improving the general health; it is also highly useful in regu-
lating the menstrual function, upon the disturbance of which
many cases measurably depend. Whatever tends to invigo-
rate the system and improve the general health usually exerts
a beneﬁcial inﬂuence upon the disease. The patient should
therefore abstain from the use of stimulants, take regular but
gentle exercise in the open air, make use of a plain, but liberal,
nutritious and easily digestible diet, and avoid all emotional
or other excitement.
MYX(EDEMA.
Synonyms,—The Mucoid Disease, Ord’s Cretinoid Affec-
tion, Mucoid Cretinism; Fr., Myxédéme; Ger., Myxddeme.
Deﬁnition.—A disease in which the tissues of the body are
progressively invaded by a mucoid, jelly-like substance, un-
accompanied by albuminuria or other sign of kidney disease.
Diagnosis.-—The disease is not likely to be confounded with
anasarca, which it most resembles, as the oedema does not pit
200 msnvous THERAPEUTICS.
upon pressure, but, on the contrary, is resilient like India
rubber. In scleroderma the surface is hard, there is no per-
manent reduction of temperature, as there is in myxoedema,
and the disease belongs to a much earlier period of life. The
clubbing of the ﬁngers, as well as the mental symptoms and
the history of the case, will also serve to distinguish it from
arsenical or other forms of swelling.
Pathology.-The mucoid deposit is found in almost every
part of the body, both at the surface and in all the great nerve-
centres. The nervous elements undergo yellow degeneration
or are atrophied, the nerve-ﬁbres are more or less wasted, and
the small spaces ﬁlled with hyaline material. The identity of
the pathological process in the nerve-centres and in the other
tissues appears to show that they are not related as cause and
effect, but form parts of some general disturbance of nutrition.
Clinical Experience.— Glonoin, Arscnicum, Jaborandi and
Calcarca carb. are the only remedies that have so far appeared
to materially beneﬁt these cases.
Auxiliary Treatment.-—Dr. Ord says that he has in two
cases found beneﬁt from the use of vapor baths. Friction has
also seemed to beneﬁt some cases.
ANGINA PECTORIS.
Synonyms.—Breast-pang, Cardiac Neuralgia, Neuralgia of
the Phrenic Nerve, Hyperaesthesia Plexus Cardica, Sterno-
cardia, Sternodynia, Sternalgia, Syncope Anginosa: Fr., An-
gine dc Poitrinc; Ger, Brustbrdune.
Deﬁnition.-—A nervous affection, often complicated with
organic disease of the heart, characterized by severe paroxysms
of pain and sense of constriction, commencing in the region of
the sternum or deep in the chest, and extending over the left
side of the thorax and the left arm, more rarely over both
sides and arms; the pain is often associated with faintness
and anxiety, and with various other senso-motor and vaso-
motor disturbances.
Diagnosis.—The diagnosis may be easily made from the
characteristic symptoms, as given in the above deﬁnition,viz.:
ANGINA PECTORIS. 201
great pain, occurring in paroxysms, in the region of the heart,
accompanied by a sense, rather than fear, of sudden death, by
the feeling of faintness, constriction and cardiac oppression, by
the radiation of the pains, etc.
The differential diagnosis between stenocardia, properly so
called, and other forms of angina pectoris is as follows:

Angina Vera.
A6
Angina Spuria.

Most frequent at the age of laterio-
sclerosis, after forty and ﬁfty years.
More frequent in males.
Attack provoked by every act necessi-
tating an effort; spontaneous at-
tacks are rare.
Rarely periodical or nocturnal.
‘The attack isolated from any other
symptom.
The vaso-motor form rare.
Anguish, with sensation of compression
and as in a vise.
Severe substernal pain.
Pain of short duration (2 to 15 min-
utes), ceasing after the effort.
Attitude, silence, absolute immobility
necessary to stop the pain.
Coronary scleroses (of the arteries) the
cause. _
Arterial medication.
At every age, even during childhood.
More in women.
Attacks from efforts rare; the most
attacks come on spontaneously.
Mostly periodical, even at the same
hour, and nocturnal.
Neurotic symptoms frequent.
Vaso-motor form frequent.
Sensation of distension of the heart,
with painful anguish.
The pain more in cardiac region.
Pain lasting one or two hours and not
ceasing with the eﬂbrt.
Incessant agitation, walks about, rest
does not stop the pain.
N euralgia of the nerves and of the
cardiac plexus.
Anti-nervous and anti-neuralgia medi-
cation.

Pathology.—We see no reason for changing the views we
have elsewhere expressed on this subject. Notwithstanding
the fact that organic lesions of the heart are almost always
associated with angina pectoris, the symptoms are such as to
require it to be placed among the neuroses, and such is now
the usual classiﬁcation. Flint, Anstie, Laennec, Eulenberg,
Trousseau and others substantially agree in regarding the
disease as essentially a neuralgia, while Bomberg, Friedrich,
Klapka and others believe it to be a hyperaesthesia of the
cardiac plexus. The author is of the opinion that the spinal
14
202 NERvoUs THERAPEUTICS.
system of nerves is primarily, and the sympathetic system
secondarily, involved in these cases, and that the spasm is a
reﬂex symptom, generally of peripheral, but sometimes of
central origin. The sources of peripheral irritation are found
in suppressed neuralgias, in the various organic lesions of the
heart, and in bronchial, pulmonary and abdominal conges-
tions; the central are chieﬂy, if not wholly, conﬁned to the
various forms of spinal irritation.*
Clinical Experience.—-While Amyl nit. usually gives the
most rapid and certain relief during the paroxysm, the most
successful curative agent is Iodium and its various compounds,
especially Kali iod. and Natrum iod. Spongia, Cactus, Arsenicum,
Glonoin, Spigelia, Aconite, Cuprum, Laurocerasus, Veratrum alb.,
Aurum mur., Agaricus and Lachesis have given relief in special
cases, agreeably to the following
Therapeutic Indications. ——Iodium.--Cramping pressure
in the region of the heart; spasmodic palpitation of the heart;
sensation as if the heart was being squeezed together; pale face;
great oppression of the chest, with inclination to faint; anguish,
physical and mental, with anxiety.
Natrum i0d.—Organic complications, with frequent attacks
of angina; oppressive anguish in the region of the heart, with fear
of sudden death; aching pain in the region of the heart, with
sense of constriction; anxious feeling, as if something dreadful
was about to happen; mind and body greatly depressed.
Kali iod.—Violent pain in the middle of the chest, extending
to the shoulder; extremely violent stitches deep in the chest;
pain in the chest as if out to pieces; irresistible desire to go into
the open air; torturing feeling of anguish, with oppression of
breathing and loss of voice.
Spongia.——Cramping pain in the heart, with great anguish in
the chest; extreme oppression of breathing, with feeling of suffoca-
tion; sudden pain and pressure within the chest, with anxiety;
face pale; nausea; lower part of the body feels numb, upper
part sore and bruised.
Amyl nit.——-Great cardiac oppression and tumultuous action
0
* Hart’s Diseases of the Nervous System, p. 273.
ANGINA PECTORIS. 203
of the heart; aching pain and constriction around the heart, with
precordial anxiety; visible pulsations of the carotid arteries;
very severe pain in the region of the heart, extending to the
right arm; angina pectoris, with great agony; anxiety as if some-
thing might happen, must have fresh air.
Natrum nit.—Oppressive anguish in the chest, with dyspnoea;
aching pain in the region of the heart; cardiac palpitations,
with anguish; moderately severe cases of angina pectoris.
Cactus grand.—Oontinuous palpitation of the heart, both day
and night; worse when walking, at night, and when lying on
the left side; sensation as if the heart was grasped by an iron.
hand, preventing movement; angina pectoris, with organic com-
plications.
Arsenicum.—-Great mental and bodily anguish from severe
pains in the region of the heart, extending down the arm;
great dyspnoea and prostration; surface and extremities cold;
attacks followed by numbness and prostration; periodical
attacks, attended by faintness and extreme weakness; worse
after midnight and from motion.
Glon0in.——Syncopal form, with pale face, disposition to faint,
nausea and extreme anguish of mind and body; crampy pains
in the region of the heart, producing a feeling of faintness and sense
of impending danger; attacks followed by extreme and pro-
longed prostration.
Spigelia.—Palpitation of the heart, with anxious oppression
of the chest; painful constriction in the left side of the chest,
arresting the breathing and producing an anxious feeling of
suffocation; pains increased by leaning forward and by motion.
Ac0nite.—Constant pressure in the left side of the chest, with
dyspnoea, increased by exercise; aching, constrictive pain in
the left side of the chest, with paroxysms of great anguish and
fear of death; heat and ﬂushing of the face; attacks occurring
.in young, strong, plethoric subjects.
Cuprum.—Sudden attacks, attended by intense dyspnoea, faint-
ness and slight convulsions; surface cold and blue; old chronic
cases, in feeble subjects, with slow pulse and but little vitality.
Laur0cerasus.—Violent attacks, attended by extreme suffering,
suﬂocative gasping for breath and loss of speech; surface cold
and moist; recent cases, without serious organic complications.
204 mrnvous THERAPEUTICS.
Veratrum alb.—Functional cases, attended by excessive an-
guish, arresting the breathing, and producing a feeling of im-
pending suffocation; painful constriction of the chest, with
Violent palpitations and cutting pains.
Agaricus mus.——-Cardiac pain and dyspnoea, increased by
walking, with continued pressure at the pit of the stomach; great
precordial anguish, with paralytic pain in the left arm, neck
and nape of the neck; frequent empty cructations.
Aurum mur.-—Palpitation of the heart produced by wallcin g in
the open air, and increased by continuing to walk, until the
anguish becomes so extreme as to compel the patient to desist
from all exercise in the open air, though such patients can walk
for hours in a close room without inconvenience (Kafka).
Lachesis-—Sternal pressure and dyspnoea extending to the
shoulders, and feeling as if the thorax was held by an iron band ;
patient is pale, weak and trembling with anguish; pulse
small, irregular and intermitting; surface covered with cold
sweat; tendency to faint; aggravated by motion.
Compare, also, Naja trip., Gelscmium, Crotalus, Digitalis, Lyce-
podium, Cimicifuga, Dioscorea, Angustura, Moschus, T abacum,
Oxalic ac., Bryonia, Juglans, Asafwtida, Rhus to:c., Tarantula,
Lactuca vir., Arnica, Phytolacca and Sepia.
Auxiliary Treatment.--Any very strong, stimulating or
revulsive impression made upon or over the heart during the
occurrence of a paroxysm will usually put an immediate or
speedy stop to it. Hence we ﬁnd that electricity, both the in-
duced and constant currents, as well as the spraying of ether
or the application of hot bran poultices over the heart, will
generally give relief. Many a victim of angina pectoris now
ﬁnds instantaneous relief by carrying with him for immediate
use a small vial ﬁlled with cotton moistened with a few drops
of Amyl nit., which he can inhale whenever threatened with
a new attack.
GASTRALGIA.
Synonyms.—Neuralgia of the Stomach, Heartburn, Gastro-
dynia, Cardialgia Nervosa; Fr., Gastralgie; Gen, Magenschmerz.
Deﬁnition —A gastric neurosis, characterized by pain,
GASTRALGIA. 205
often severe, in or about the stomach, and, as a rule, uncon-
nected with any other affection of the part.
Diagnosis.——Gastralgia may be distinguished from acute
gastritis by the absence of the fever, the persistent vomiting,
the sensitiveness to hard pressure, and other symptoms belong-
ing only to the inﬂammatory affection. Cancer of the stomach
may be known by the progressive emaciation and steady char-
acter of the pain which accompanies it. In perforating ulcer
of the stomach the painfulness and sensitiveness to pressure
are conﬁned to a small spot, being limited to the seat of the
ulcer. Dyspepsia, and the passage of biliary calculi, may also
be distinguished by the symptoms peculiar to each.
Pathology.——-Nothing is positively known concerning the
pathology of this affection. The symptoms plainly point to
functional disturbances in both the spinal and sympathetic
systems of nerves, in the production of which malnutrition
no doubt constitutes the chief etiological factor. Debility pro-
duces nervous excitability, and gives rise to a great variety of '
functional disturbances, as we see in hysteria, spinal irritation,
anaemia, etc.—conditions frequently associated with gastralgia,
as they are with each other. It is reasonable to infer, there-
fore, that they all have a common basis in malnutrition of the
nervous centres, though no organic changes sufficient to account
for the phenomena are discoverable.
Clinical Experience.-—Nux vom., Ignatia, Arsenicum, Ozcalic
ac., Argentum nit., Bryonia, Carbo veg. and Pulsatilla stand at the
head of the list as curative agents in this disease, though cures
have also been effected by Belladonna, Ferrum, China, Petroleum,
Stannum, Plumbum, Bismuthum, Colocynth, Cocculus, Lachesis,
Hydrastis, Dioscorea, Veratrum, Aurum mur., Sulphuric ac., Iris
ver., Hydrocyanic ac., Ptelea, Cina, Rumex, Sepia, Calcarea carb.,
Nitric ac., Lobelia, Phosphoric ac. and many other remedies.
Therapeutic Indications.-—Nux V0n1.—Clawing, drawing
and cramping pains in the stomach, with tension and pressure
between the shoulder-blades ; the pain extends into the chest,
or downward into the abdomen; epigastrium sensitive to the
touch; pain worse from light pressure and better from hard
pressure; gastralgia brought on by high living, indulgence in
tobacco-chewing and smoking, sedentary habits and habitual
206 NERvoUs THERAPEUTICS.
constipation; pain worse from eating; pressure in the epigas-
trium after meals, as from a stone, from indigestion; heart-
burn. This remedy alone will, if persevered in, cure the ma-
jority of cases.
Ignatia.—Cramping pains in the stomach; sharp, pinching,
pressive pains in the pit of the stomach and in the right hypo-
chondrium ; pressive pain in the epigastrium; a relaxed,
ﬂabby feeling in the stomach, or an all-gone feeling, as if from
fasting, with great exhaustion; hysterical, changeful moods, now
tearful, silent and melancholy, then impatient, irresolute, ill-
humored and angry; burning in the stomach; regurgitation
of food; frequent voiding of large quantities of pale urine;
especially suited to hysterical and nervous persons, especially
females and those addicted to the excessive use of tobacco.
Arsenicum.—-Acute burning, or ‘gnawing, corroding pains,
accompanied by great restlessness, nervous excitability, cold-
ness of the extremities, palpitation of the heart and nightly
aggravations ; feeling as if the stomach was inﬂamed ; pressure
in the stomach as from a lump; vomiting of food as soon as
taken; faint, sickly feeling, with pale face and earthy com-
plexion; induced by eating ice cream, cake, etc.; relieved by
drinking milk.
Argentum nit.-—Severe gastralgia, attended with heartburn,
which is aggravated or excited by eating; feeling as if a stone
lay in the stomach; gnawing, ulcerative, sore pain, seated at
one spot, or radiating to different parts, with spinal irritation;
pains sometimes appear to depend upon an irritable state of
the nerves of the stomach proper; often there are ﬂatulence,
nausea and palpitation ; pain increases and decreases gradually ;
hard pressure in the pit of the stomach sometimes relieves.
Bryonia.——Contractive, pinching pains, relieved by eructa-
tions ; pressure in the stomach after eating as from a stone;
soreness and tenderness in the epigastrium ; bloated feeling in
the stomach, with stitches and oppression of breathing; symp-
toms aggravated by motion and by eating; pains come on in
chronic cases an hour or two after eating and continue for
several hours.
Garbo veg.—Gastralgia, with waterbrash, coming on about
3 P.M., with thirst for cold water; bloating of the stomach,
GASTRALGIA. 207
with burning pains, relieved by eructation; vomiting of large
quantities of mucus tinged with bile, giving relief; suited to
cases complicated with hysteria or dyspepsia, especially if there
is present a hyperaemic and irritable condition of the lining
membrane of the stomach.
Pulsatilla.—Heartburn when the stomach is empty; sour and
bitter vomiting, with absence of thirst; feeling as if food had
lodged in the oesophagus; indigestion provoked or aggravated
by eating rich or fat food.
Bellad0nna.——Cramping or shooting pains in the pit of the
stomach, forcing the patient to bend backward and to hold his
breath; periodical pains in the pit of the stomach, with
tremor; region of the stomach sensitive to the touch; face
bloated and congested; pressing, drawing and clutching pains
extending to the back, with nausea, thirst and vomiting, ag-
gravated by drinking water or by motion, and ameliorated by
eating.
0hina.—Gastralgia, attended with great chilliness or coldness,
constant feeling of weariness and debility, heartburn, with
sour eructations, bloated abdomen and palpitation of the heart;
gastralgia at a certain hour every day or every other day;
gastralgia after natural or artiﬁcial depletions; torpid liver,
with jaundiced hue, and large, undigested stools, worse at
night; pains aggravated or excited by cold, by eating, by
fatigue or by mental emotions.
Oxalic ac.—Gastralgia appearing after eating, with pyrosis
and cold feeling externally between epigastrium and umbilicus.
Veratrum.-—Pain in the epigastrium, coming on gradually,
radiating upward to both sides and to the back between the
scapulae, increasing in violence till it becomes agonizing, then
gradually wearing off; especially adapted to those cases in
which the coeliac plexus and sympathetic are involved; pain
increases and subsides gradually, and is attended with marked
coldness of the extremities.
00cculus.—Cramping pains in the stomach, preventing sleep;
violent pinching, griping and cramping pains in the epigas-
tric region; great distension of the stomach from an accumu-
lation of gases; especially suited to cases where Nux vom.
being indicated fails to cure, and pyrosis is not present.
208 ' NERVOUS amrnnarnurrcs.
Colocynth.-—Pains paroxysmal and extend into the umbilical
region, obliging the patient to bend double; exacerbations re-
cur every few minutes, are not the result of indigestion, but
rather, in some cases, of emotional excitement.
Ferrum.—Anaemic cases, with atony of the stomach; heart-
burn, with feeling of a load in the stomach; vomiting imme-
diately after eating, which usually relieves the suffering; aggra-
vated or induced by coughing and moving about.
Bisml1thum.—Pressure in the stomach as from a load; burn-
ing pain in the stomach, extending to the spine, with water-
brash, ﬂatulence and extreme prostration; pains are sometimes
relieved by bending backward. This is the principal remedy
of old-school physicians.
Stannum.—Heartburn, canine hunger, sinking at the pit of
the stomach, great uneasiness; patient ﬁnds relief by walk-
ing; the pain comes on gradually, extends to the navel, is re-
lieved by pressure and is very obstinate.
Consult, also, the other remedies above mentioned, likewise
the therapeutic indications given under the head of cnteralgia,
p. 212.
Auxiliary Treatment.—Electricity, sinapisms and fomen-
tations over the stomach, and similar measures, may be of
some value during the paroxysms, but careful attention to diet
and the methodical usg of the shower-bath, galvanism, etc.,
during the intervals between the attacks, will, by strengthen-
ing the system, be of much greater beneﬁt in most cases, espe-
cially in weakly, neurotic, hysterical subjects.
OVARALGIA.
Synonyms.—Pain in the Ovaries, Ovarian Neuralgia, Ova-
rian Irritation; Fr., Névralgie des Cvaircs; Gcr., Neuralgie der
Ovarien, Neuralgie der Eierstbclce.
Deﬁnition.-A nervous affection of the ovaries, character-
ized by pain of a neuralgic character, occurring in paroxysms
and unattended with inﬂammation or, necessarily, with en-
largement.
Di‘agnosis.——The pain of ovaralgia is characteristic, being
OVARALGIA. 209
neither burning, as in ovaritis, nor pinching, as in colic, but
sets in suddenly, is attended with distinct remissions, and is
relieved by pressure; sometimes, also, it shifts to other parts,
showing clearly its neuralgic character.
Pathology. — Ovarian hyperaemia, resulting from the
monthly ripening and discharge of the ovum, is the only
known condition, aside from the neurotic constitution common
to neuralgic subjects, capable of producing the disease. Neither
of these conditions, however, are necessary factors in its causa-
tion, though their combination is a fruitful source of the pain,
as testiﬁed to by many women who never complain of it at
any other period. The rheumatic diathesis also fagors it, as
it does other forms of neuralgia. These conditions are calcu-
lated to render the ovaries sensitive to inﬂuences which would
otherwise make no painful impression upon them.
Clinical Experience.—Ignatia is a reliable remedy in cases
occurring in hysterical subjects, especially when the pain is
sharp and irritating, with abundant ﬂow of colorless urine, or
when the neuralgia is caused by grief; Conium, when, with the
ovaralgia, there are sharp twinges of pain in the mammae;
Lilium tig., when the ovary feels as if squeezed in a vise; Naja,
obscure ovarian pains; Ammonium brom., when the pain is a
dull, heavy, persistent ache, and is aggravated by excitement;
Cimiczfuga, patients of a rheumatic diathesis, or who are sub-
ject to menstrual colic and dysmenorrhoea; Ferrum et Strychnia,
anaemic women, in whom the menstrual ﬂow ‘is scanty and
the mucous membranes pale; Zincum val., in cases of pure
neurosis, pain shoots down the limb even to the foot, also in
chronic cases; Chininum ars. or Chininum sulph., when inter-
mittent or of malarial origin ; Gelsemium, when the pains seem
to radiate from the spine, or when there is pain in the back of
the head and neck; Apis, sharp, cutting pains in the left ovary,
or contractive, spasmodic pains in the right ovary; compare,
also, Caulophyllum, Hamamelis and Colocynth.
Auxiliary Treatment.—Dr. Julia Holmes Smith recom-
mends the application of hot sand, well saturated with sea-
water, over the affected ovary; also its exposure, and that of
the surrounding parts, to the direct rays of the sun for an hour
every day, aﬂirming that the heat and vivifying power of the
210 NERvoUs THERAPEUTICS.
sun’s rays make it a valuable curative agent not sufficiently
appreciated by the profession. I can fully conﬁrm this testi-
mony, having witnessed several remarkable recoveries by this
process while in California, where the sun-bath is generally
appreciated by all classes.
HYSTERALGIA.
Synonyms.—-Neuralgia of the Womb, Uterine Neuralgia,
Irritable Uterus, Uterine Colic; Fr., Fortraiture; Ger., Neuralgie
der Gebéirmutter.
Deﬁnition.-—Neuralgic pains in the uterus, sometimes ex-
tending through the pelvis, not connected with any demon-
strable morbid alterations in that organ.
Diag‘n0SiS.——The history of the case, the character of the
pain, the absence of inﬂammation, the periodicity of the attack,
the locality of the suffering, and the fact that the pain is
usually relieved by pressure, when all are combined in the same
case, are sufficient not only to establish its neuralgic character,
but to distinguish it from every other painful affection of the
part.
Patho1ogy.——What is said under this heading in the previ-
ous article applies with equal force to hysteralgia. There is no
doubt that some forms of dysmenorrhoea belong to this cate-
gory. Indeed, most of those uterine pains which occur between
and remote from the menstrual periods are usually due to
some other disorder of the sexual organs, and are seldom cases
of pure primary neuralgia.
Clinical Experience.—Cimicifuga is one of our most reli-
able remedies for uterine neuralgia, especially when it is of
rheumatic origin; Belladonna has long been a favorite remedy
for irritable uterus, especially when the pains are sharp, lan-
cinating and throbbing, and are aggravated by exercise;
Arsenicum is a valuable remedy if the pains are of a burning
character and attended by chilliness, hot, dry skin, thirst, rest-
lessness and anguish; Calcarea, if the patient has ﬂying pains
about the pelvis, perspires easily and is poorly nourished;
Gelsemium, if the patient is hypochondrical, ﬁdgety and com-
plains of vertigo; Sepia, if the pains occur at the climacteric
period; Caulophyllum and Rhus rad., if there is any rheumatic
ENTERALGIA. 211
tendency. Compare, also, Platinum, Xanthoxylum, Ignatia, Pul-
satilla, Nux vom., Veratrum, Zincum val., Coﬂea, Strychnia, Conium,
Helonias, Aconite, Sabina, Bryonia, Sulphur and others.
Auxiliary Treatment. -—The constant current, applied
with an insulator through the vagina, hot vaginal injections,
' hot compresses and similar measures often afford considerable
relief. Hygienic treatment as in other forms of neuralgia,
which see.
ENTERALGIA.
Syn0nyms.——Neuralgia of the Bowels, Enterodynia, Neu-
ralgia Mesenterica, Neuralgia Meseraica; Fr., Névralgie Intesti-
nale; G’er., Neuralgie der Eingeweide, Darmweh.
Deﬁniti0n.——-An affection of the nerves of the intestines,
characterized by paroxysms of sharp, intense pain, without in-
ﬂammation or any discoverable organic lesion.
Diagnosis.—-The disease is very apt to be confounded with
colic; indeed, many authors regard enteralgia and intestinal
colic as essentially one and the same disease. The chief
difference between the two affections lies in the fact that
enteralgia is a true neuralgia, while colic is dependent on
spasm of the muscular walls of the intestines. In the former
the pains are darting or lancinating, in the latter twisting or
griping. An error in this particular is, however, of but little
consequence, since the treatment is essentially the same in
both. Enteritis and other inﬂammatory affections may be
known by the presence of inﬂammatory symptoms, such as
fever, thirst, tenderness on pressure and the stationary char-
acter of the pain, none of which symptoms belong to enteralgia.
Pathology.-—Impaired vitality of the nerve-centres, whether
resulting from hereditary weakness, anaemia, malaria, plum-
bism, or any form of blood deterioration, lies at the foundation
of neuralgia, and enteralgia is no exception to the rule. What
the exact relation between them is, other than that of cause
and effect, is simply a matter of pure speculation; but, consider-
ing the nature of these etiological factors, it is reasonable to infer,
as already pointed out, that the disease is dependent on mal-
nutrition of the nerve-centres, and this view is conﬁrmed by
the apparently central origin of the affection.
212 nnnvous THERAPEUTICS.
Clinical Experience. ——- Enteralgia resembling colic, or
when arising from indigestion, usually yields to Nua: vom., Pul-
satilla, Dioscorea, Colocynth, Arsenicum or Chamomilla; lead
colic, or enteralgia resembling it, Alumen, Alumina, Platina,
Opium, Podophyllum; abdominal hyperaesthesia, Plumbum,
Cuprum, Zincum, Stannum. ~ -
Therapeutic Indications.—Nux vom.—Neuralgia of the
bowels from indigestion or overeating; attacks resulting from
dissipation or from sedentary habits; periodical attacks occurring
after eating or after regular meals; pains relieved by bending
double or by lying on the face; constipation; diurnal drowsi-
ness. .
Arsenicum.——Attacks coming on suddenly after eating and
drinking, especially after partaking of ice water, cake or ice
cream; periodical attacks due to malarial inﬂuence; neuralgic
attacks followed by great prostration, the strength suddenly
sinking; burning, cutting pains, attended by great restlessness
and intolerable suﬂ’ering; paroxysms attended by nausea and
vomiting, or with thin, watery stools; pains worse at night,
also after eating and drinking, better from warm applications.
Colocynth.——Pains appear to radiate from the umbilicus, are of
a sharp, cutting, darting or twisting character, and occur in
paroxysms; relieved by bending double or by hard pressure ;
coffee and smoking relieve, but food and other kinds of drink
usually aggravate.
Dioscorea.——Severe colic-like pains, which do not intermit and
are aggravated by rest; relieved by stretching the body out or
by walking about; hypcrwsthesia of the abdominal nerves; pains
shift their location suddenly and appear in distant parts, as the
ﬁngers and toes; stools bilious and offensive.
Ghamomilla.—Colic-like pains in the region of the navel, also
lower down on both sides, with pain in the hollow of the back
as if broken; abdomen swollen and drumlike; ﬂatus passed in
small quantities without relief; relieved by warm applications.
Podophylll1m.—Lead colic ; frequently recurring attacks, ac-
companied by retraction of the abdominal walls; severe straining
during stool, with escape of ﬂatus; morning aggravations;
attacks renewed by eating and drinking.
ENTERALGIA. 213
Alumina.——Lead colic ; paroxysmal pains, with dyspnoea, worse
when stooping; violent cutting pains, principally in the
evening, succeeded by oppression of the chest; colic-like pain,
followed by diarrhoea and pain in the region of the kidneys;
pinching and lacerating pain, with chilliness in the abdomen,
relieved by heat.
0pium.—Lead colic; violent cutting pains in the abdomen, as
if made with a knife; constipation, with hard and distended
abdomen; pains worse before and after stool; hypochondria
painful when touched.
Plumbum.—Excruciating pains in the umbilical region, shoot-
ing to other parts, and moderated by pressure; recti muscles
hard and knotty; abdomen retracted to the utmost extent;
ameliorated by hard pressure and by friction; obstinate con-
stipation; pains resembling lead colic, but due to some other
cause.
Cuprum.——Violent cutting, drawing, intermittent pains; ab-
domen retracted and sore to the touch ; pains cause the patient
to utter fearful screams; very restless and uneasy, constantly
tossing about; worse by drinking cold water.
Platina.—Lead colic ; severe colic-like pains, with sensation of
burning and writhing around the abdomen, with oppressed
breathing, and with a tremulous sensation through the whole
body; drawing pains, extending from the chest to the groins
and into the genital organs; patient screams and tosses about
in every direction to relieve his suffering.
Bellad0nna.—Violent cutting, clutching, clawing pains in
various parts of the abdomen, constantly shifting about, ap-
pearing and disappearing suddenly; light pressure aggravates,
but hard pressure relieves; thirsty, but drinks little, as drink-
ing aggravates the pains; tendency to cerebral hyperaemia;
worse until evening and after midnight.
Compare, also, Ignatia, Cocculus, Mercurius, Aconite, Phos-
phorus, Rhus tox., Veratrum, Iris vers. and Sepia.
Auxiliary Treatment.—-Hot fomentations, warm or hot
water enemas, frequently repeated, mustard foot-baths, hot
Aconite and Chloroform liniments often give great relief. In
lead colic it is sometimes necessary to resort to Morphia, which
is best given hypodermically.
PART VI.
SYMPTOMATIC DISEASES.

CEPHALALGIA.
Syn0nyms.—Headache; Fr., Cephalalgie, Douleur de T éte,
llfal a Téte; Ger., Kopfschmerz.
Deﬁnition.—Pain in the head, usually symptomatic of some
other affection. '
Diagnosis.—Hemicrania is the only affection liable to be
confounded with it. In hemicrania the pain is more or less
unilateral, is frequently associated with nausea and bilious
vomiting, is generally ushered in by premonitory symptoms,
and is usually of a periodical character—-—peculiarities which
do not characterize ordinary headache.
Path0log'y.——Excluding hemicrania as a separate disease,
headaches, though embracing numerous forms or varieties,
may be conveniently arranged in three separate classes, namely:
(1) structural headaches, or those depending upon disease within
the cranium; (2) congestive headaches, which may be either
active or passive; and (8) toxaemia headaches, which include not
only those of a rheumatic, syphilitic and other dyscracic char-
acter, but all those which attend fevers and inﬂammatory
affections, some of which are also partly congestive. This
classiﬁcation is of itself suﬂiciently descriptive of their nature,
Clinical Experience.—C0ngestive headaches generally yield
to Belladonna, Aconite, Ammonium carb., China, Cactus, Glonoin,
Ferrum, Asclepias syr., Pulsatilla, Digitalis, Cimicifuga, Carbo veg.,
Calcarea carb., Alumina, Atropine, Amyl nit., Chamomilla, Bryonia,
Camphor, Cocculus, G-ratia, Fluoricum ac., Causticum, Caladium,
Arnica, Agaricus, Capsicum and Gelsemium; or else to Kali carb.,
Lycopodium, Mercurius cor., Lachesis, Hamamelis, Magnesia
carb., Silicea, Theridium, Sepia,‘ Nux vom., Sanguinaria, Naja,
(214)
CEPHALALGIA. 215
Kali iod., Ouprum, Lachesis, Lilium tig., Natrum sulph.,
Opium, Stramonium, Veratrum vir., Nitric ac., Phosphoric ac.,
Psorinum, Spongia, Lachnanthes, Sulphur and Phosphorus.
Remedies and indications for nervous headache.—See hemicrania.
Remedies successfully employed in the various forms of sympto-
matic and sympathetic headaches are given below in connection
with the therapeutic indications.
Therapeutic Indications. —Gham0mi1la.-—Pains stinging,
stitching, tearing and pressing; seat, forehead, temples and
vertex; aggravated by mental exertion; ameliorated by mo-
' tion ; especially suited to children; arthritic and rheumatic
headaches, especially when attended by vertigo, nausea and
vomiting. .
Berberis.—Pains lacerating, darting, tensive or aching; face
pale, cheeks sunken, eyes with bluish-black circles; arthritic,
menstrual and rheumatic headaches, especially when complicated
with hepatic troubles; aggravated by motion, stooping, after-
noon; ameliorated in open air.
Ipecacl1anha.—Pains stinging, throbbing, lacerating ; accom-
panied by nausea, vomiting, drowsiness, heaviness of the head;
aggravated by stooping or moving the head; ameliorated out
of doors.
Natrum sulph.—— Characterized by fulness, heat in the vertex,
pressure, vertigo, nausea, vomiting; menses late and scanty;
mood sad and depressed; worse in the forenoon ; menstrual
headache occurring periodically, every spring.
Lachesis.—Pains throbbing, beating, lacerating, pressing;
seat, forehead, temples, vertex, over the eyes; giddiness just
before the menses; nausea and vomiting; pain in left ovarian
region; ameliorated by lying down; headaches catarrhal, hyste-
rical, menstrual and rheumatic. -
Sepia.—Pains pressing, stinging, stitching, often one-sided,
usually the right; nausea and vomiting, with aversion to
food; aggravated by noise and motion; ameliorated by rest,
darkness and sleep; gastric, hysterical and rheumatic headaches,
or headaches depending on derangement of the digestive or
sexual systems.
Belladonna.—- Pains sudden in their appearance and disap-
216 NERVOUS THERAPEUTICS.
pearance, but last indeﬁnitely; often accompanied by stupefac-
tion and vertigo, redness and swelling of the face; aggravated
by noise, light, shock or contact; catarrhal, gastric and rheu-
matic headaches, especially in lymphatic or scrofulous subjects;
cerebral congestion.
Anacardium.— Gastric headache caused by indigestion; nausea,
with retching, soon after drinking cold water; weak digestion,
with fulness and distension of the abdomen; symptoms dis-
appear after dinner and reappear two hours afterward.
Aconite.-—Pains piercing, throbbing, stupefying; headache,
with. fever, especially when produced by exposure to cold,
suppressed perspiration or currents of air; accompanied by
roaring in the ears, chilliness, restlessness, wakefulness; aggra-
vated by noise, light or motion; catarrhal and menstrual head-
aches, especially at the commencement.
Causticum.—Pains throbbing, tearing, stitching; seat, chieﬂy
in vertex, spreading to forehead and temples; accompanied by
nausea and vertigo; aggravated by stooping, reading, looking
up, shaking the head; ameliorated in the open air; arthritic
and rheumatic headaches, especially in the scrofulous.
Nux mosch.—Pains pressing, throbbing, tearing ; conﬁned to
small spots; bloating of stomach and abdomen; scat, chieﬂy in
forehead and temples; aggravated by eating, emotional excite-
ment, menstrual congestion, changes in the weather; hysterical '
headache, especially when complicated with gastric troubles.
Silicea.—-Pains pulsating, pressing, tearing, frequently one-
sided; accompanied by nausea, vomiting, frequent cold sweat
about the head, or vibratory sensations in the head; aggra-
vated by noise, light, motion, even the slightest jar; amelio-
rated by warmth, darkness and sleep; gastric and rheumatic
headaches.
Sulphur.—— Catarrhal and gastric headaches, especially in scrofu-
lous patients; or when associated with constipation, morning
diarrhoea or haemorrhoids; or when caused by abdominal
plethora, suppressed eruptions or mental exertion, or when
beginning, increasing and ending with the daily course of the
sun; aggravated by motion, stooping, wet and cold weather,
heat of the bed or mental exercise; ameliorated by pressure
and moderate warmth.
CEPHALALGIA. 217
Phytolacca.—Pains sharp, shooting, or dull and heavy; seat,
forehead and temples; accompanied by vertigo, dimness of
vision, nausea; aggravated by damp weather; gastric and
rheumatic headaches, especially in syphilitic subjects.
Lycop0dium.—Pains chieﬂy pressing and lacerating ; seat,
forehead and temples; characterised by great restlessness and
disposition to faint; worse in the afternoon; gastric, bilious and
rheumatic headaches.
Colocynthis.—-Pains tearing, aching, drawing, compressive,
often one-sided; accompanied by restlessness, anguish, vertigo,
nausea, or vomiting of bitter, yellowish ﬂuid; aggravated by
motion, stooping, bending the head forward; ameliorated by
pressure; arthritic and rheumatic headaches, especially those of
an intermitting type.
Euphrasia.—Catarrhal headache; headache accompanied by
profuse watery coryza, smarting of the eyes, lachrymation,
photophobia, or sneezing and discharge of mucus; aggravated
by cold in the head.
Iris Vers.—Pains shooting and throbbing, or dull and heavy ;
seat, chieﬂy in the forehead; accompanied by nausea and vom-
iting, ﬁrst of sour, watery ﬂuid, then of bile; paroxysms of pain,
followed by copious emissions of urine and vomiting, with
great burning and distress in the stomach; bilious and gastric
headaches, always beginning with a blur before the eyes.
Arsenicum.—Pains burning, beating, pressing, drawing or
throbbing; sometimes associated with a ﬂuent burning and
excoriating coryza; often attended with a burning nausea and
the characteristic thirst; ameliorated by warmth, wrapping
up the head or by rubbing; cold water only relieves tempo-
rarily; catarrhal, gastric and malarial headaches, especially those
of an intermitting or periodical character.
Bovista.—Menstrual headache, characterized by deep-seated,
stupefying pains; putrid, bitter taste, with nausea and empty
eructations; morning sickness, relieved by eating breakfast;
aggravated by pressure and by sitting up. I
Caulophyl1um.——Pains contractive or pressive, paroxysmal or
intermitting; pressure behind the eyes, with dimness of sight;
menstrual irregularities, with “moth ” spots on the forehead ;
- 15
218 NERvoUs’ THERAPEUTICS.
aggravated by stooping, light and noise; menstrual and rheu-
matic headaches.
Gelsemium.—- Catarrhal and hysterical headaches, appearing
suddenly, with vertigo, dimness of sight and double vision;
often accompanied by slight nausea; ameliorated by shaking
the head; pain in the back of the head and neck, extending
to the shoulders, also across the forehead and temples; relieved
by profuse urination.
Mezereum.—- Catarrhal headache in scrofulous and syphilitic
‘subjects; headache extending from the root of the nose
into the forehead, as if everything would press asunder, with
pain in the temples when touched; heat and perspiration on
the head, with chilliness and coldness of the rest of the body.
Kali carb.--—Catarrhal headache, especially in aged people
inclined to obesity; pains are of a sticking character, worse
when stooping or moving the head, better from raising the
head and from warmth; constipation.
Nux vom.——Pains pressing, drawing, stupefying, affecting the
whole or any part of the head, but especially the forehead;
accompanied by more or less dizziness, nausea and inclination
to vomit; aggravated by motion, stooping, moving the eyes,
noise, light and mental exertion; gastric and bilious headaches,
attended by constipation, and brought on by a debauch, wine,
coffee, sedentary habits, or too close mental application.
Podophyllum.— Gastric, rheumatic and bilious headaches, espe-
cially when associated with torpidity of the liver; or when
alternating with diarrhcea, or when accompanied by bitter taste
and risings, giddiness, glimmering before the eyes; nausea,
bilious vomiting and purging; worse in the morning; better
from pressure and from lying quiet in the dark.
Stramonium.-—Hysterical and rheumatic headaches, especially in
young and plethoric persons; swollen face, with glistening
eyes; vertigo when walking in the dark; heat and pulsations
about the vertex, accompanied by faintness and loss of sight
and hearing; aggravated by cold; ameliorated by warmth
and quiet.
Platina.——Pains drawing, crampy, affecting chieﬂy the fore-
head; face usually red and hot; numb feeling in the brain;
CEPHALALGIA. 219
mood variable, sometimes cheerful, at others depressed ; aggra-
vated by stooping and by being in a warm room ; ameliorated
by going into the fresh air; hysterical headache, especially in
young girls with erotic desires, or who are suffering from
amenorrhoea or from profuse menstruation.
Kali iod.-—Pains tensive, stinging, shooting and tearing;
seat, every part of the head, especially the forehead; head-
ache accompanied with inﬁammation of the frontal sinuses,
nose, eyes and throat; swelling of the cervical glands; violent
sneezing, with running of acrid water from the nose, excori-
ating the skin; catarrhal headache, especially in scrofulous
and syphilitic subjects.
Gymnocladus.— Catarrhal headache, especially during the early
stage, characterized by fulness, throbbing in the forehead
and temples, vertigo, numbness, heat of face and exhaus-
tion; frequent violent sneezing, originating high up in the
nose; dizziness, with dimness of sight, nausea and eructation.
Chelid0nium.—Pains heavy, drawing and pressing; accom-
panied by nausea and bilious vomiting; aggravated by motion;
ameliorated by rest, pressure and closing the eyes; bilious
headaches, affecting especially the right side of the forehead
and the right temple. .
Eupatorium perf.——Pains shooting and throbbing; seat, chieﬂy
in the vertex, temples and occiput; vomiting of food and bile;
tongue coated white or yellow; attacks generally occur in the
morning between 7 and 9 A.M.; aggravated by heat; amelio-
rated by pressure; bilious and malarial headaches.
Asaf(Btida.——Pains darting, stitching, j erking; they sometimes
disappear by the touch, or are transformed into other pains;
hypochondriacal and hysterical restlessness, with anxiety;
ameliorated by walking in the fresh air; hysterical headache in
hypersensitive subjects.
Allium cepa.— Catarrhal headache, with coryza; copious watery
discharge from the nose and eyes; worse in the evening;
better in the open air.
Bismuth11m.— Gastric headache, complicated with gastralgia;
pain comes on immediately after eating and is relieved by
vomiting; pains chieﬂy frontal; aggravated by motion.
220 nssvoos THERAPEUTICS.
Hydra.stis.—Catarrhal headache, especially in debilitated sub-
jects, or when troubled with mucous discharges; pale face,
with worn and weary appearance; myalgic pains in the scalp
and muscles of the neck; discharge of thick white mucus ,
from the nose; cachectic condition, with loss of appetite and
fainting turns ; subacute and chronic cases.
Gossypium.—-Menstrual headache, with drawing and stinging
pains extending from the temples to the centre of the fore-
head; nausea, with inclination to vomit; menses last only
about twenty-four hours, and are scanty and painful.
Merc11riuS.——Pains burning, stitching, tearing, pressing; accom-
panied by catarrhal aﬂections of the head and throat; disposed
to sweat easily; chronic cases, complicated with ozaena, the pain
extending to the root of the nose and frontal sinuses; catarrhal
and rheumatic headaches, especially when occurring in syphilitic
subjects. ‘
Phosphorus.—Pains burning or throbbing, seated in the fore-
head or temples, often semilateral; accompanied by nausea,
vomiting, vertigo, with a tendency to _fainting, especially in
the morning on rising; sudden changes of mood, from grave
to gay, from laughing to weeping; aggravated by stooping,
music, mental and moral disturbances or abuse of stimulants ;
hysterical headache.
Alumina.—Chronic catarrhal headache, especially in scrofulous
subjects; head feels heavy, with oppression in the forehead;
pressive, stupefying pain in the frontal region ; aggravated by
being in a warm room, or by going up stairs or stepping;
ameliorated by pressure.
Bryonia.—Pains throbbing, digging, sticking, burning or
pressing; scat, any portion of the head, but especially the
temples; usually associated with soreness; aggravated by stoop-
ing or by quick motion; gastric and rheumatic headaches,
especially when accompanied by nausea or vomiting, or when
arising from indigestion.
Cedron.—Pains of a shooting character, located chieﬂy in the
frontal region, often extending to the orbits; when severe
they are often accompanied by palpitation and quickened
respiration; malarial headaches, coming on with clocklike
regularity. '
CEPHALALGIA. 221
Gamboge.—Gastric headache, with compressive and heavy
pains in the forehead and temples; accompanied with vomiting,
purging and fainting; drowsy, heavy feeling in the whole
head, with pain in the small of the back; watery diarrhoea,
with colic and tenesmus; ameliorated in the open air.
Natrum m11r.——Menstrual headache, occurring periodically,
during the menses, every spring ; characterized by fulness, heat
in the vertex, pressure, vertigo, nausea, vomiting; menses late
and scanty; sad and depressed mood ; worse in forenoon.
Pulsatilla.—Pains of almost every variety, and often one-
sided; accompanied by more or less vertigo, nausea, bad taste
in mouth, without thirst; worse in bad weather; better from
pressure, also in the open air; gastric, menstrual and rheumatic
headaches, especially when due to menstrual irregularities,
mental exertion, fat food, abuse of coffee or spirits, or exposure
to damp, cold weather.
Stillingia.—- Catarrhal headache in syphilitic and scrofulous
constitutions; dull, heavy, stupefying pains in the frontal re-
gion; dizziness, with throbbing in the head; headache accom-
panied with inﬂamed and watery eyes and general soreness of
the muscles; chronic cases which have been aggravated by
mercurial treatment.
Rumex.—-Pains generally dull, but sometimes sharp and
piercing; aggravatedby motion; catarrhal headache, with great
irritation of the larynx and soreness behind the sternum.
Scutellaria.-——Hysterical headache, especially when caused by
mental emotion; pain worse over the right eye; ameliorated
by moving about in the open air; urine scanty before and
profuse after the headache.
Lilium tig.—-Menstrual headache, especially in cases due to
menstrual irregularity arising from prolapsus or malposition
of the uterus, and causing strangury and ineffectual urging
to stool; pains in the forehead and temples, with vertigo and
depression of spirits; constant bearing down in the lower
part of the abdomen, with severe pressure in the ovaries,
rectum and anus, with constant desire for stool; bearing-down
pressure in the vagina, as if everything would be pressed out ;
worse from rising up and from standing.
222 NERvoUs THERAPEUTICS.
Kali bich.— Catarrhal and rheumatic headaches, the former ac-
companied by ozaena; frontal headache, complicated by a
chronic catarrhal condition of the nasal and other mucous
surfaces; aggravated by moving, stooping or mental exertion;
ameliorated by hard pressure.
Crocus.——Menstrual headache, of a pressive, burning and
throbbing character, aﬂecting the forehead, temples and top of
the head; vertigo, with confusion and webs before the eyes;
headache at the climacteric period, 1nost severe at the time
corresponding to the monthly periods, lasting two or three
days and nights; excitable and variable disposition.
Argentum nit.—Gastric headache in nervous persons; usually
attended with chilliness and trembling of the body, intense
nausea and vomiting; giddy and very restless; worse in the
open air; better from bandaging the head. '
Cocculus.—-Gastric and menstrual headaches, with a feeling of
emptiness in the head; violent headache which compels the
patient to sit up, aggravated by talking, laughing, noise and
bright lights.
Sanguinaria.— Gastric and rheumatic headaches, most severe on
the right side, affecting especially the frontal region and tem-
ples; accompanied by nausea and vomiting; attacks usually
paroxysmal, with more or less chilliness and burning in the
stomach; aggravated by motion, light and noise; ameliorated
by quiet, darkness and sleep.
Antimonium crud.-—Gastric headache, with aversion to food;
tongue coated white; aching of the limbs, nausea and vomit-
ing; anorexia, risings and inclination to vomit; symptoms
ameliorated in the open air.
Carbo an.—Menstrual headache, chieﬂy in forehead and ver-
tex; pains pressing, throbbing, tearing; accompanied by vertigo,
sometimes by nausea; vertigo and nausea on raising the head
after stooping; menses too early and too long, but not too great,
followed by debility and prostration.
Calcarea phos.— Gastric and rheumatic headaches, with fulness
and pressure in the head, and with vertigo when walking or
moving; patient dull, peevish, quarrelsome and forgetful;
aggravated by changes in the weather, eating and mental and
bodily exertion; ameliorated by cold washing.
vnameo. 223
VERTIGO.
Syn0nyms.—Swimming of the Head, Dizziness, Giddiness;
Fr., Vertige; Ger., Schwindel.
Deﬁniti0n.——The consciousness on the part of the patient of
disordered equilibration of the body.
Diagnosis.-—It is impossible to mistake this condition for
any other subjective symptom. It is not always easy, how-
ever, to determine whether labyrinthine vertigo is primary or
secondary. To do this we have to consider the presence or
absence of certain symptoms. Thus, tinnitus and deafness
without vertigo indicate disease of the middle ear; the same
is true of tinnitus and vertigo without deafness. But in order
to clear up the diagnosis in these cases, we should test the con-
dition of the conducting apparatus, ascertain the permeability
of the Eustachian tube, and make an otoscopic examination of
the membrani tympani, since it is not until this is done that
we are prepared to estimate the signiﬁcance of the syncope,
nausea, vomiting and other like indeﬁnite symptoms.
Pathology.—It is not always easy to determine with pre-
cision which of the sensory impressions is concerned in this
or that particular case of vertigo. Sometimes the impressions
are labyrinthine when they appear to be ocular, and vice versa.
Doubtless in some cases the two forms are combined. This is
the more probable from the fact that variations in labyrinthine
tension may be caused by differences in the vascular tension
of the labyrinthine bloodvessels, and a similar cause may, and
often does, operate in the case of visual disturbances. Not
only do labyrinthine, visual and tactile disturbances give rise
to vertigo, but, as is well known, the latter is often caused by
derangement of the stomach and other viscera. This is easily
accounted for by the close and important nervous relations
which the labyrinth sustains to these organs. For example,
the nucleus of the vestibular nerve, which supplies the semi-
circular canals, and which is a branch of the auditory nerve,
is in close relation to the nucleus or internal origin of the
pneumogastric. Finally, those diseases, as well as those medi-
224 rurnvous THERAPEUTICS.
cines, which cause variations in the labyrinthine tension may
also give rise to vertigo.*
Clinical Experience:-We should never forget that vertigo
is a 1nere symptom, indicative of some abnormal condition,
the removal of which is essential to cure. The remedies which,
irrespective of the cause, most frequently relieve are: Phos-
phorus, Nucc vom., Arsenicum, China, Chininum sulph. and Pulsa-
tilla. The following can usually be relied upon in the several
conditions named :
Nervous Vcrtigo.—Nux vom., China, Chininum sulph., Arseni-
cum, Ferrum, Phosphorus, Phosphoric ac., Pulsatilla, Ignatia,
Zincum, Silicea.
Gastric Vcrtigo.——Nux vom., Bryonia, Arsenicum, Ipecacu-
anha, Pulsatilla, China, Carbo veg., Sepia, Ignatia, Phosphorus,
Calcarea, Tarantula, Sulphur and Natrum mur.
Epileptic Vcrtigo.——Belladonna, Stramonium, Hyoscyamus,
Arsenicum, Amyl nit. and Glonoin.
Ocular Vertigo.—Causticum, Gelsemium, Argentum nit., Phos-
phorus, Physostigma, Nux vom., Rhus tox., Spigelia, Paris
quad., Senega, Euphrasia and Cuprum acet.
Auditory or Labyrinthine Vertigo.-—-Natrum sal., China, Chini-
num sulph., Rosa damas., Colchicum, Aconite, Kalmia, Sali-
cylic ac., Conium and Cicuta.
Therapeutic Indications.—Ph0sphorus.—Vertigo accom-
panied by reeling, nausea, vomiting; vertigo occurring in the
morning, with an empty stomach, after eating or sleeping,
during or after the menses, or with fainting and trembling;
ocular, gastric or nervous vertigo, especially when caused by
nervous debility, sexual abuse, spermatorrhoea or haemorrhoids;
worse after eating.
Nux Vom.—Vertigo, with tendency to faint, worse during and
after meals; vertigo associated with dyspepsia and constipa-
tion; vertigo brought on by mental exertion, sedentary habits,
high living or haemorrhoids; vertigo in nervous and hysteri-
cal subjects; ocular, ncrvous or gastric vertigo, or when caused

* From the author’s work on Intracranial Diseases, pp. 269-271, where this sub-
ject is treated somewhat at length.
VEBTIGO. 225
by paresis of the ocular muscles from the use of stimulants or
tobacco; worse after dinner.
Silicea.—Vertigo accompanied by nausea, and aggravated by
motion or by looking upward; dizzy sensation from the nape
of the neck into the head ; vertigo during sleep, or when rising
from a recumbent position ; nervous or ocular vertigo, especially
when brought on by severe physical or mental labor, reading,
writing or sewing.
Natrum sal.—Vertigo, with inclination to fall toward the left
side; labyrinthine vertigo, with tendency to fall to the affected
side, while surrounding objects appear to move in the opposite
direction; noises in the affected ear, with defective hearing;
worse on raising the head 'or sitting up.
Natrum carb.—Vertigo, with great lassitude; weakness of
digestion, with nausea in the morning and inclination to
vomit; gastric and nervous vertigo, the latter from the effects of
exposure to the sun.
Lachesis.'—-Frequent momentary vertigo, especially on closing
the eyes, sometimes with paleness, nausea and vomiting; ver-
tigo, with headache, cerebral congestion and cold extremities;
epileptic vertigo, with reeling, falling and loss of consciousness.
Veratrum-Vertigo, with sensation as if everything in the
head was loose; loss of appetite, with burning stomach, dis-
tended abdomen, ﬂatulency, vomiting and diarrhoea; gastric
vertigo, with cold perspiration on the forehead.
Senega.— Ocular vertigo, especially when caused by paresis or
paralysis of the superior rectus or superior oblique muscle of
the eye, or when the vertigo and double vision are relieved by
bending the head backward.
Ignatia.—Vertigo followed by nausea and vomiting of slimy,
sourish ﬂuid; burning in the stomach; abdominal distension,
with ﬂatulency and constipation; restless, changeable disposi-
tion; vertigo caused by mental emotion; gastric, nervous or
epileptic vertigo ; worse from stooping or moving the head.
Cupr11m.—Vertigo when looking up, with loss of sight, as if
gauze were before the eyes; vertigo, with sensation of turning
round, or revolving vertigo; vertigo from cerebral congestion;
extreme weakness, especially of the lower extremities; ocular
vertigo caused by paralysis of the nervus abducentis. '
226 NERvoUs THERAPEUTICS.
China.—Vertigo from nervous weakness or from general
debility; vertigo from anaemia, with pale face, ringing in the
ears, nausea, vomiting or fainting; vertigo with an empty
stomach; gastric, nervous or auditory vertigo, especially when
caused by debility from loss of animal ﬂuids.
Chininum sulph.—Vertigo occurring periodically, with chills
and fever, especially when due to malarious inﬂuence; vertigo,
with headache, cerebral congestion and deafness; auditory ver-
tigo, with hammering and humming in the ears and partial
deafness.
Conium.—Vertigo caused by looking steadily at an object, or
on rising up or going down stairs, or when lying down or
turning over in bed; great debility and inclination to sleep-;
ocular or auditory vertigo, with sensation as if turning in a
circle.
Arsenicum.—Vertigo, with inclination to fall, especially when
closing the eyes; nausea and disposition to vomit in a recum-
bent position, less when sitting up; burning in the stomach,
with vomiting; vertigo coming on periodically, with coldness,
followed by fever, loss of appetite and vomiting; gastric, nerv-
ous or epileptic vertigo, with reeling, as if intoxicated.
Bryonia.——Gastric vertigo, with nausea and disposition to
faint ; weakness and distension of the stomach, ﬂatulence and
constipation; burning in the stomach, with vomiting; aggra-
vated by rising from a recumbent position and by motion;
ameliorated by rest and by lying down.
Apomorplﬂa.-—-Labyrinthine or gastric vertigo, attended with
tinnitus and slight deafness; nausea, with retching and vomit-
ing, coming on at intervals; sudden vomiting, almost without
nausea; syncope, with lessening of blood pressure.
Bellad0nna.——Vertigo accompanied by luminous vibrations
before the eyes, especially when stooping or bending the head;
vertigo, with vanishing of sight, and a tendency to fall back-
ward or to the left side; epileptic vertigo, ‘caused by rush of
blood to the head, with heat and redness of the face. buzzing
in the ears, dimness of vision and loss of consciousness; aggra-
vated in a warm room; ameliorated in the open air. '
Euphrasia.— Ocular vertigo from paralysis of the ocular mus-
VERTIGO. 227
cles, especially when caused by taking cold, or when associated
with coryza; blurring of the eyes, relieved by winking.
Stram0ni11m.——Vertigo followed by stupefaction of all the
senses and by complete insensibility; vertigo accompanied by
strange fancies; epileptic vertigo, especially when walking in the
dark, day or night.
0pium.—-Vertigo, with stupefaction of the senses, or after
fright; vertigo, with apoplectic symptoms; pale or bloated
face, with dimness of sight and tendency to faint; ameliorated
by rest; ocular vertigo, depending on paralysis of the accommo-
dation.
Tarantula.—Vertigo after breakfast, with a bad taste in the
mouth; vertigo from ﬁxing the sight on" any object; gastric,
nervous or epileptic vertigo, so severe as to cause him to fall, but
without losing consciousness; nausea, bloating of the stomach
and disposition to vomit.
Sepia.-Vertigo, with ﬂatulency and constipation; worse
‘when drinking, while looking upward, or while looking from
a great height, a large assemblage of people or an extended
plain; gastric or nervous vertigo, especially when caused by a
dyspeptic condition; worse when drinking.
Hy0scyamus.——Epileptic or ocular vertigo, with reeling, loss of
sight, hearing and consciousness; double vision; red, spark-
ling, staring and distorted eyes.
Kali i0d.—— Ocular vertigo, especially in syphilitic patients;
dimness of vision, with twitching of the eyeballs; burning in
the eyes, with sensation of a ﬁlm before the eyes, relieved by
winking; glandular swellings on neck.
C0ccul11s.——Vertigo aggravated by noise, motion, smoking, cof-
fee, sitting up in bed and riding in a carriage; epileptic vertigo,
with nausea, reeling, loss of consciousness and sudden falling,
tq the ground.
Argentum nit.—— Ocular vertigo, caused by weakness or paraly-
sis of the ciliary muscle; transitory blindness, nausea and con-
fusion of the senses; sensation of expansion when looking high
up in the street; trembling weakness when walking with shut
eyes, or when walking in streets with high houses, as though
they would fall upon him.
228 NERVOUS THERAPEUTICS.
Gicuta.——Auditory vertigo, associated with aural disease, dis-
charge of blood from the ears, loud sounds when swallowing,
and hardness of hearing; tinnitus aurium; worse in the room
than in the open air.
Ipecacuanha.—Vertigo, with loss of appetite, empty retching
and qualmishness; gastric vertigo, with nausea and vomiting;
abdominal distension, with ﬂatulency, colic and diarrhoea.
Golchicum-—Vertigo, with roaring and stoppage of the ears;
ameliorated by rest; auditory vertigo, with chronic discharge
from the ears and hardness of hearing.
Kalmia.—Vertigo while stooping or looking downward; pal-
pitation of the heart; auditory vertigo, with sensation when
turning as of something loose in the head.
Natrum mur.——Vertigo, with nausea and heartburn after eat-
ing; gastric vertigo, with reeling and dimness of sight; sensa-
tion of everything turning in a circle when walking; nausea
and sudden sinking of strength ; burning and feeling of press-
ure in the stomach; want of appetite and aversion to food.
Physostigma.— Ocular vertigo from partial or complete paraly-
sis of the ciliary muscle; has been applied with beneﬁt as a
local application in such cases.
Sulphur.—Chronic vertigo, especially if preceded by a sup-
pressed eruption; gastric vertigo, especially in the morning
after breakfast, with nausea; dimness of vision, with inclina-
tidn to fall to the left.
Phosphoric ac.—Vertigo, with great disposition to sweat dur-
ing the day; night-sweats, with vertigo; vertigo from onanism,
loss of animal ﬂuids, or mental exertion, anxiety or’ over-
work; nervous vertigo, especially when caused by cerebial or
nervous exhaustion.
Gelsem1'um.—Vertigo, with reeling and staggering even to
falling; heaviness of the head, with imperfection of sight and
dulness of mind; ocular or nervous vertigo, the former from
paralysis of the ocular muscles; aggravated by smoking.
Gausticum.—Ocular vertigo caused by paralysis of any of the
ocular muscles; congestion of blood to the head, with heat;
vertigo brought on by taking cold; sudden and frequent loss of
sight, with sensation of a ﬁlm before the eyes; inclination on
COMA SOMNOLENTUM. 229
stooping to fall backward, and on looking up to fall toward
the left side.
Amyl nit.—Vertigo, with sensation as if a vapor spread from
her through her head, rendering her powerless; slight nausea,
with uncomfortable feeling in the stomach; precordial anxiety;
she turned deadly pale, felt very giddy, then became partially
unconscious, remaining so for ten minutes; mental confusion
and a dreamlike state; auditory vertigo, with a bursting sensa-
tion in the ears, as if the drums would be forced out with each
beat of the heart; great throbbing in the ears and head, with
confusion.
Calcarea carb.—-Vertigo, with stupefaction of the head; sensa-
tion of coldness in the brain; vertigo, with tinnitus and
nausea, especially when stooping or rising up suddenly; ver-
tigo caused by cerebral congestion; distension of the stomach
and bowels, ﬂatulence and constipation; gastric or epileptic
vertigo.
Aconite.—Vertigo on raising the head, or on rising from a
recumbent position; vertigo, with sensation of intoxication, the
patient staggering like a drunken man; nausea; great fear of
falling; auditory vertigo, with reeling; worse when bending
forward or going down stairs.
Compare, also, Graphites, Iodium, Chamomilla, Bovista, Cy-
clamen, Ruta, Mezereum, Lycopodium, Secale, Platina, San-
guinaria, Thuja, Staphisagria, Tartar em., Mercurius, Hepar,
Coffea, Boracis, Arnica, Spongia, Asterias rub., Agaricus, Sam-
bucus, Theridium, Spigelia, Apis.
Auxiliary Treatment.--The application of the galvanic
current is usually of great service in all forms of vertigo, either
as central galvanization, or 'by the application of both poles on
each side of the sixth and seventh cervical vertebrae, using
from ten to ﬁfteen cells, as the case may require.
COMA SCMNOLENTUM.
S,ynonyms.——-Stupor, Sopor, Somnolency, Lethargy, Carus,
Somnolentia, Lethargia, Carus Lethargus; Fr., Stupeur; Ger.,
Stumpfsinn.
230 NERvoUs THERAPEUTICS.
Deﬁnition.—A greater or less degree of insensibility, arising
from a partial or complete loss of consciousness, due to an
abnormal amount and kind of sleep.
Diagnosis.—It is not always easy to distinguish the various
degrees of insensibility, or unconsciousness, due to abnormal
sleep, from similar conditions resulting from other causes.
For example, coma is a state of complete insensibility, but
complete insensibility is not always coma, and the same is true
of minor degrees of unconsciousness. As a general rule, how-
ever, we will ﬁnd, in addition to the comatose state, certain
characteristic symptoms belonging to the primary affection,
the presence of which will serve to distinguish the condition
from that of simple coma. Thus in syncope there is fainting;
in asphyxia, deﬁcient respiration; in narcosis, the peculiar
effects of the agent or drug producing it; and in uraemia, con-
vulsive movements, vomiting, etc.
Pathology.—Natural sleep is a physiological, not a patho-
logical condition; but stupor, lethargy, coma, etc., denote
different degrees of insensibility somewhat allied to sleep, but
in which the loss of consciousness is more profound than in
any form of true sleep. The terms stupor, sopor, lethargy, etc.,
are employed to designate various degrees of insensibility and
unconsciousness from that of sleep properly so called, up to
that of profound anaesthesia, in which there is complete loss of
consciousness and true coma. Not only does stupor vary in
degree, but coma also. Thus we have what is known as the
comatose state, coma and profound coma, the last of which was
designated by the older writers carus, the gravest of the graver
states of unconsciousness and inserisibility. These are all
pathological conditions or, rather, symptoms of such conditions,
the pathology of which corresponds with that of the primary
diseases to which the symptoms belong.
Clinical Experience.—The chief clinical distinctions are
as follows:
For stupor manifesting itself in the morning: Nux vom., Natrum,
Hepar, Phosphoric ac., Sulphur, Natrum mur.
For somnolency coming on early in the evening: Pulsatilla,
Lachesis, Calcarea, Silicea, Phosphoric ac., N ux vom.
COMA SOMNOLENTUM. 231
For coma somnolentum: Belladonna, Opium, Laurocerasus,
Barium carb., Crocus, Ledum, Veratrum. '
For profound coma: Opium, Belladonna, Lachesis, Lyce-
podium.
Therapeutic Indications.—Bryonia.——Moanings and start-
ings in sleep, with fever, and sometimes with loud cries; great
drowsiness or heavy stupor, with or without delirium.
PulSatilla.—Deep sleep, with snoring inspirations; charac-
teristic symptoms, cerebral, gastric, intestinal and urinary;
valuable in cases complicated with erysipelas.
Veratrum.-—Protracted stupor, especially when accompanying
the collapse of diarrhoea or cholera; coldness of the whole body.
Stram0nium.——Deep sleep, with stertorous respiration and
bloody froth at the mouth ; epileptic coma.
Belladonna.—One of the most reliable remedies for stupor
arising from cerebral congestion; stupor, with snoring, dark
red face, dilated pupils; drowsy, yet unable to sleep; delirious
sleep ; eyes half open, but insensible to light.
Lachesis.—Comatose symptoms, especially when resulting
from erysipelas of the head and face; constant sopor, with
moaning and tossing about, especially in children.
Rhus tox.—Especially valuable in the coma of typhoid fever
and erysipelas; sopor, with snoring, muttering and grasping at
ﬂocks.
0pium.—Profound coma, such as occurs in apoplexy, with
stertorous breathing, dilated pupils, dark red, bloated face, and
feeble, irregular pulse; mouth open, eyes half closed, pupils
insensible to light.
0hamomilla.—Soporose condition in children, with feverish
restlessness; snoring and starting in the sleep; delirium, with
moaning, talking or screaming; comatose condition during
dentition, especially when associated with diarrhoea.
Tartar emet.—Coma, with constant yawning and stretching;
especially indicated when the symptom is caused by irritation
or congestion of the brain; great prostration, with trembling
of the limbs; coma of delirium tremens.
Camphora.—Sopor and delirium, with chilliness and coldness
of the body; talking and snoring in the sleep; cerebral con-
gestion; face red, but sometimes pale.
282 rznnvous THERAPEUTICS.
Phosphoric ac.-—Sopor, especially in the daytime; being
roused, he answers correctly, but immediately falls asleep
again; typhoid fever, especially when attended by profuse
sweating.
HelleboI'11s.—Sopor, especially when resulting from an attack .
of hydrocephalus, either acute or chronic; fever, with hot head
and cold hands and feet; urine suppressed.
Secale cor.—-Long-continued stupor, with startings and de-
lirium; cold, viscid sweat; face red or pale; foetid and colliqua-
tive diarrhoea; suppression of urine.
Nux mosch.—Sopor, with or without delirium; valuable in
low forms of fever, especially when accompanied by putrid or
colliquative diarrhoea; also in children during_the diarrhoea
of teething. ,
Lycopodium-—Very drowsy during the day, with yawning;
sleep disturbed by loud screams; starting and jerking of the
limbs during sleep; great nervous irritation, with peevish
mood; fevers.
Compare, also, Ignatia, Arsenicum, Cuprum, Sepia, Arnica,
Carbo veg., Ledum, Conium, Capsicum, Alumina, Colocynth,
Crocus, Sambucus, Antimoniu1n, Cannabis, Hydrocyanic ac.,
Lactuca and Asafoetida.
INSOMNIA.
Synonyms.—Sleeplessness, VVakefulness, Pervigilium ; Fr.,
Insomnie; Gen, Schlaﬂosiglceit.
Deﬁnition.—./in unnatural deﬁciency or loss of sleep.
Diag‘nosis.—Healthy sleep varies within certain limits in
different individuals; and this variation is occasionally so
great, that what would be a normal amount of sleep in one
would constitute an excess or a deﬁciency of sleep in another.
The diagnosis therefore must be based on the average or nor-
mal habit of the patient himself, and not on that of others.
Pathology:-As in other symptomatic affections, insomnia
is a mere symptom of some other abnormal condition or dis-
ease. It may be partial, as when the patient is able to obtain
only a portion of his usual allowance of sleep; or it may be
INSOMNIA. 233
complete, in which case he may be unable to obtain any sleep
whatever for several successive nights, as in acute mania,
violent fevers, or when suffering from severe pain, profound
grief or great mental disturbance. In these cases the primary
disease is the one to be chieﬂy considered.
Clinical Experience.—In the absence of other indications,
the following clinical distinctions will be of service:
Sleeplessness before midnight.—-Passiﬂora incar., Gelsemium,
Belladonna, Mercurius, Phosphorus, China, Ignatia, Pulsatilla,
Spigelia, Graphites, Valerian, Conium, Carbo veg., Calcarea
-carb.; Sulphur, Bryonia, Cyclamen, Selenium, Moschus, Staph-
isagria, Aconite, Opium.
Sleeplessness after midnight.—Passiﬂora, Rhododendron, Asa-
foetida, Platina, Rhus tox., Mercurius, Arsenicum, Coffea, He-
par, Nux vom., Kali carb., Aurum, Nitric ac., Thuja, Hyoscy-
amus, Sambucus, Capsicum.
Waking freguently.—Passiﬂora, Gelsemium, Belladonna,
China, Fluoric ac., Teucrium, Manganese, Digitalis, Bismuth,
-Causticum, Calcarea carb., N ux vom., Pulsatilla, Phosphorus)
Zincum, Arnica, Rhus tox., Nitric ac.
Waking too early.——Ranunculus bulb., Muriatic ac., Dulca-
mara, Sepia, Asafoetida, Phosphoric ac., Silicea, Natrum carb.
Retarded sleep.-—Passiﬂora, Gelsemium, Belladonna, Pulsa-
tilla, Nux vom.,- China, Ignatia, Sepia, Causticum, Graphites,
Phosphorus, Selenium, Lachesis, Carbo veg., Caladium, Mer-
curius, Rhus tox., Sulphur, Creosotum, Aconite, Moschus,
Opium, Veratrum vir.
Therapeutic Indications.—Passiﬂora incar.—Sleeplessness,
with great restlessness; suicidal mania; neuralgia, preventing
sleep. This is one of the most reliable remedies for insomnia,
the patient falling into a quiet slumber, from which he usually
awakes in a natural and rational condition.
GelsemiuIn.——Drowsy and sleepless, or else wide awake and
unable to get to sleep; insomnia from cerebral irritation and
congestion; insomnia from overwork or debauch; insomnia
of college professors, authors or business men.
Belladonna.-—Insomnia, with drowsiness; cerebral congestion.
One of the most reliable remedies for insomnia when properly
16
234 NERVOUS THERAPEUTICS.
given, the higher potencies being required in all cases where
the brain is oversupplied with blood or actively congested,
and the lower ones when it is overpowered by the intensity
of blood pressure, pupils widely dilated and convulsions
threatened.
Aconite.—Sleeplessness from febrile and inflammatory condi-
tions; anxiety, with great restlessness and tossing about; sleep-
lessness of infants and aged people; sleeplessness due to mental
excitement, especially when there is active cerebral congestion,
with intense anxiety and fear of death or disaster.
Gimicifuga.——-Sleeplessness associated with pain in the base of
the brain, extending to the nape of the neck, and sometimes
over the shoulders; extreme prostration, both physical and
mental. An invaluable remedy in the insomnia of drunkards,
especially when it takes the form of delirium tremens, and also
in that of opium-eaters, or those who are trying to abandon
the use of it.
Nux vom.-—Sleeplessness from overwork, both mental and
bodily; too close study, especially at night; abuse of stimu-
lants; especially useful in cases of recent debauchery and
gluttony.
Phosphorus:-Gets to sleep too late or not at all; insomnia
from nervous debility, especially when caused by onanism or
sexual excesses; sleeplessness following intense mental strain,
overwork or anxiety, or when associated with pain and con-
fusion in the head; wakens frequently during the night, and
can get no sound and refreshing sleep.
Opium.—Great wakefulness or drowsiness, with inability to
get to sleep; insomnia, with acuteness of hearing, the ticking
and striking of the clock, cock-crowing and other noises keep-
ing the patient awake. This remedy, used somewhat high, also
mitigates the stupor of cerebral congestion, especially where
there is a tendency to apoplexy; particularly suited to the
sleeplessness of old people.
Veratrum vir.—Sleeplessness from cerebral congestion, or
from a general febrile ‘condition; particularly useful in the
insomnia of acute fevers, puerperal mania and the excitement
attending attacks of epilepsy.
INSOMNIA. 235
Hy0scyamus.——Sleepless from nervous excitement; wild, star-
ing eyes; tendency to delirium; especially suited to nervous
and overworked persons, particularly women suffering from
undue lactation, household cares, etc.
Ignatia.-——Sleepless from grief or depressing emotions; in-
somnia caused by nervous exhaustion, loss of health, property
or friends.
Pulsatilla.-—Sleeplessness arising from late suppers or from
indigestion; determination of blood to the head and surface of
the body, rendering the patient restless, sleepless and very
uncomfortable; particularly suited to insomnia occurring in
mild and tearful young women, especially if there happens to
be any derangement of the menstrual function.
Cocculus.—-Sleeplessness arising from mental activity or from
night-watching; sleep retarded, and frequently interrupted by
wakings and startings.
Zincum val.-—-Insomnia, with pains in the head, particularly
in children; frequent waking in the night; drowsy, with pale
and tired expression of countenance.
00ffea.—Sleeplessness of infants; sleeplessness arising from
joy, long watching and overexcitement of mind; acute nerv-
ous erethism, preventing sleep.
ll/Iosclms.-—Nervous excitement preventing sleep ; is awakened
by sense of heat, rendering the covering uncomfortable; re-
lieved by throwing off the covering.
Stramonium.—Sleepless from intense nervous excitement;
sleep interrupted by frightful screams; restless sleep full of
dreams; tendency to delirium; best suited to cases attended
with unusual mental disturbances, or where there is a tendency
to maniacal excitement.
Silicea.—Sleeplessness arising from extreme physical and
mental prostration; great depression of spirits; sleeplessness
from inanition.
C0ca.——Sleeplessness from mental exhaustion or from anae-
mia; patient sometimes awakened after going to sleep by a
sense of shock in the brain ; suited to weak and nervous women,
worn-out brain-workers, night-watchers and those who have
lost much sleep.
236 mravous THERAPEUTIOS.
Sulphur.—Sleepless from nervous excitement, cutaneous irri-
tation and external heat; sleepy in daytime, sleepless at night.
Arsenicum.—Insomnia from nervous exhaustion caused by
general anaemia; will seldom beneﬁt cases not due to blood
degeneration, and hence must be given with a view of over-
coming this condition.
Auxiliary Treatment.——The three principal causes of
sleeplessness are, imperfect circulation, indigestion and anaemia.
Much may be done in the way of accessory treatment to remedy
these difﬁculties, and thus secure sound sleep. Thus imperfect
circulation, whether it take the form of cerebral hyperaemia,
-cold feet, or both combined, as is usually the case, may be cor-
rected by a warm bath or by a brisk rubbing just previous to
retiring for the night. Sometimes a cold douche just after the
bath will be still more effective. Massage and gymnastic excr-
cises are also useful for the same purpose, though as a general
rule the latter had best be practiced in the morning, unless
the patient leads a sedentary life, in which case the evening
practice is the most suitable.
The effects of indigestion in preventing sleep may usually
be remedied by partaking of very early and very light suppers,
but this is a matter in which every individual is a law unto
himself; experience alone can determine what form, character
and amount of food will best agree with any one patient, and
the same is true as to the time of eating.
Sleeplessness arising from general anaemia may be success-
fully combated by the administration of liquid food, such as
hot milk, beef-tea and broths, an hour or so before bedtime.
In these cases, also, the patient should sleep with his head
low, whereas in cases of hyperaemia the head should be well
elevated.
As for the bed, the bed-clothing, etc., the aim should be to
secure perfect comfort to the patient. No part of the body
should be chilled, nor should any portion of it be overheated.
Plenty of fresh air should be supplied to the sleeping room,
while at the same time the sleeper should be protected from
draughts, even moderate ones, as they always have a tendency
to disturb the circulation, which is inimical to sound sleep.
PART VII.
MENTAL DISEASES.

MELANCHOLIA.
Synonyms.-—Melancholy; Fr., Lypémanie, Mélancolie; G'er.,
Schwermuth, Melancholie.
Deﬁnition.—A form of mental alienation, characterized by
excessive gloom, despondency and apprehension.
Diagnosis.—Although formerly regarded as a species of
monomania, or partial insanity, it may be distinguished from
it by the fact that there is in simple melancholy little or no
disorder of the intellect, the emotion is disproportioned to the
cause, and hence there is often associated with it a suicidal
tendency. But melancholy with delusions, constituting hypo-
chondriasis, is most frequently met with, and is the form we
are usually called upon to treat (see hypochondriasis).
Pathology.-—The physical state with which nearly all cases
of melancholia are associated is one of anaemia, but just what
relation the anaemia sustains to the mental condition is not
fully determined. We know that powerful moral emotions,
associated with great mental depression, will, if long con-
tinued, derange the bodily functions and lead to inanition
and exhaustion. On the other hand, when, as in these cases,
there is a strong predisposition to the disease, there is no
doubt that defective blood nutrition affords a sufficient ex-
planation of simple melancholy, which is a state of mere
depression. 1
Clinical Experience.—The remedies of greatest repute in
melancholia are: Aurum, Ignatia, Arsenicum, Kali phos., Lyco-
podium, Pulsatilla, Nux vom., Belladonna, Natrum mur., Cimi-
cifuga, Phosphorus, Platina, Ambra, Plumbum, Iodium, Kali
brom., Agnus cast., Amyl nit. and Veratrum.
(237)
288 NERVOUS THERAPEUTICS.
Therapeutic Indications.—Aurum.—Extreme melancholy,
fearful, taciturn, mistrustful; suicidal tendency, has a great loath-
ing of life; anaemia, vertigo, vascular and nervous depression;
hypochondriasis; religious melancholy.
Ignatia.-—Silent grief; desires solitude that he may nourish
his sorrow; aversion to every form of amusement; anxiety,
with taciturnity; sexual impotency; hypochondriasis.
Arsenicum.—Very despondent; does not wish to recover, as
she thinks she is in the way, and her family would be better
off without her; poor appetite; says she is getting weak and
cannot control her mind ; tongue red; has an intense desire for
small quantities of water at short intervals; persistent burning
pains in the stomach and bowels ; hypochondriasis.
Kali pl10s.;Melancholic, depressed mood, with excitement
and sleeplessness; no appetite; weeps a great deal from religious
melancholy ; constant lamentations, self-reproaches and crying;
staring, unconscious look; irritable, fretful, timid, distrustful,
weeping mood, with disgust of life and fear of death; hypo-
chondriasis.
Lycopodium.—Weeps the whole day; cannot calm herself;
worse from 4 till 8 o’clock P.M.; full of ungrounded fears ,-
pusillanimous.
Pulsatilla.—Religious melancholy; greatly concerned about his
worldly and eternal well-being; weeps, prays and laments; early
in the morning, depression of spirits and full of cares about
domestic affairs; pale face, cold hands, ﬂushes of heat; pre-
cordial anguish, with thoughts of suicide.
Nux vom.—Taciturn and fond of solitude; easily vexed and
disposed to quarrel with every one; afraid of coming to want ,-
has a kind of fainting feeling, with nausea and ﬂushes of heat,
going off when lying down; pale, sunken countenance; lack
of appetite, slow pulse and constipation; involuntary sighing
and moaning; hypochondriasis.
Be1lad0nna.—C’erebral congestion; restlessness which drives
him from place to place, and will not allow him to sit or lie
down for more than a few minutes at a time; full of mistrust
and apprehension; starts easily; extremely low-spirited, with
disposition to take his own life; great irritability, with mental
anguish.
MELANCHOLIA. 239
Natrum mur. — Excessive despondency; full of gloomy
thoughts; will not listen to consolation; likes to dwell on past
unpleasant occurrences; sallow complexion; loses ﬂesh, though
living well ; hypochondriasis.
Cimicifuga.—Puerperal melancholy ; imagines the whole world
is against her and that she will become insane; cries, sobs,
feels perfectly helpless, and believes her case is beyond medical
skill; puerperal hypochondriasis ; bowels costive, tongue furred,
spine sensitive to pressure.
Ph0sphorus.—Extreme melancholy ; gloomy, taciturn, anxious,
discontented and irresolute; loathing of life, but anxious for the
future; cold feet and hands, with trembling of the limbs;
frequent empty eructations; constipation; impotence.
Platina.—-Melancholy, with dread of death; weeping mood;
anorexia; anxiety, with trembling; disorder of the sexual
system.
Ambra gris.-—Extreme depression of spirits; sits day after
day weeping, with great muscular debility and pain in small
of the back; feels worse from the presence of other people; sleep—
less and constipated.
P1umbum.—Religious melancholy ; great weakness of the sexual
organs; extreme constipation; frequent attacks of colic; restless,
hopeless and indifferent to everything.
I0dium.—-llfelancholy and discouraged; has no ambition;
wishes to be left alone; shuns every one, especially the
physician; is very apprehensive, restless and thinks that he
will become insane.
Kali br0m.—Mental depression from cerebral exhaustion;
suicidal tendency; religious melancholy, with sense of moral
unworthiness; nervous system all unstrung; sheds tears and
gives way to her feelings in a childish manner; indifferent to
life.
Agnus cast.- -Extremely low-spirited, with sense of approach-
ing death; vertigo, with loss of memory; starts in sleep, as if
from fright; great physical debility, with prostration of mind
and body; puerperal melancholy.
Amyl nit.—Coldness and chilliness, followed by fever; great
depression of spirits, with heat of head and burning of the
240 NERVOUS THERAPEUTICS.
hands and feet; features contracted, face pale, eyes lustreless,
and mind dull and obtuse. This remedy is best administered
by inhalation, two or three drops, on cotton, three or four
times a day.
Veratrum.—Great anxiety, despondency and despair; religious
melancholy; distrusts every one; cold sweat all over; moaning
during sleep; frightful dreams; fearfulness, with tendency to
start at every new sight or person; frequent eructations;
puerperal melancholia. '
Compare, also, Helleborus, Cannabis inal., Abrotanum, Colocynth,
Lachesis, Indigo, Stramonium, Bromine, Lithium, Kali iod.,
Lobelia, Sulphur, Leptandra, Hepar, Causticum, Calcarea, Alumina
and Hyoscg/amus.
Auxiliary Treatment.—This may be summarized as fol-
lows: (1) Rest as a means of mental and physical recupera-
tion; (2) exercise, amusement and occupation as stimulants
in the renewal of health; (3) nourishing diet and, where
necessary, artiﬁcial feeding; (4) sanitary hygiene, including
the warm bath, massage, etc.; and (5) mental and moral
hygiene, especially such as is calculated to divert the mind of
the patient from his own troubles, furnish an adequate motive
for his exertions and, at the same time, produce little or no
fatigue; in short, the chief aim should be to impart vigor of
body and cheerfulness of spirit to the patient, not only in the
ways above mentioned, but, if necessary, by change of scene,
travel, cheerful society, and such other measures as the exigen-
cies of the case may require.
HYPOOHONDRIASIS.
Synonyms.—Hypo, Spleen, Morbus Hypochondriacus; Fr.,
Hypochonolrie; Gen, Milzhranlcheit, Milzsucht.
Deﬁnition.—-A form of melancholia, characterized by hallu-
cinations relative to the state of the patient’s physical health.
Diagnosis.——The diagnosis between hypochondriasis and
simple melancholy is usually evident enough, since the pecu-
liar hallucination which characterizes the former is always
absent in the latter. Moreover, in the former there is no ten-
MORAL INSANITY. 241
dency to suicide. On the contrary, the chief concern of the
patient has regard to the prolongation of his life, and this
impels him to endless search for the cure of his ailments,
whether real or imaginary.
Pathology.—As there are no anatomical characters peculiar
to the disease, the pathology does not essentially differ from
that of simple melancholia, which see.
Treatment.—See previous section, as the clinical experience,
therapeutic indications and accessory treatment given under
the head of melancholia apply equally to hypochondriasis,
which is but a special form of melancholy.
MORAL INSANITY.
Synonyms.—Emotional Insanity, Impulsive or Affective
Insanity; Fr., Manic sans Délire, Folie Raisonnante, Monomanie
Aﬂective; Gen, Gemiithswahnsinn.
Deﬁnition.—A species of insanity in which the intellect is
apparently unimpaired, but the moral and emotional part of
the brain is disordered.
Diagnosis.—Moral insanity differs from every other form
of the disease in the absence of delusion. Notwithstanding this,
the morally insane can scarcely be considered of sound intel-
lect, as their conduct is not only odd, peculiar and unlike that
of other people, but is often foolish and very unwise, the
patient, for example, spending his capital as if it were income,
or approving acts which admit of no justiﬁcation.
Another diagnostic point is, that they seldom, if ever, are
insane on more than one point. If, for example, they are pos-
sessed of a suicidal tendency, they have no desire to kill others;
if they have a propensity to steal, they have no disposition to
commit acts of violence; in other words, they are true mono-
maniacs.
Pathology.—Whether caused by hereditary transmission,
as is usually the case, or by physical disease, there is in both
instances some abnormal condition of the moral portion of the
nervous centre. Pathology shows that, as the intellectual
functions are not materially disturbed, the disease must be
242 NERVOUS THERAPEUTICS.
seated in the cells of the cortical portion of either the lateral
and posterior portions of the cerebrum, or in those of the cor-
tical portion of the cerebellum and medulla oblongata. The
former is probably the true seat of the malady, as disease or
irritation occurring in the cerebellum and medulla oblongata
produces a want of controlling power over the muscles, and
not over the mind.
Clinical Experience.—The homoeopathic materia medica
is exceedingly rich in emotional remedies, but we shall merely
indicate here a few of those which experience has shown can
generally be relied upon to meet the special symptoms that
characterize the most common forms of emotional insanity.
For angry mood: Nux vom., Ignatia, Bryonia, Arsenicum,
Veratrum, Staphisagria.
For quarrelsome disposition: Calcarea, Aconite, Chamomilla,
Ignatia, Lycopodium, Coffea, Aurum, Nux vom., Alumina.
For malice: Belladonna, Lycopodium, Stramonium, Verat-
rum, Hyoscyamus, Nux vom.
For jealousy: Hyoscyamus, Lachesis, Pulsatilla, Gausticum,
Cicuta, Baryta.
For audacity: Ignatia, Aconite, Opium, Pulsatilla, Berberis.
For rvindictiueness: Aurum, Agaricus, Lachesis, Anacardium.
For artfulness : Nux vom., Lachesis, Chlorum, Drosera, Coca.
For obstinacy: Belladonna, Sulphur, Ignatia, Silicea, Lyco-
podium, Calcarea, Nitric ac.
For greediness : Bryonia, Sepia, Arsenicum, Pulsatilla, Lyco-
podium, Calcarea, Natrum carb.
For ﬁtful mood: Ignatia, Platina, Sulphuric ac., Aconite,
Belladonna, Graphites, Zincum.
For suicidal disposition: Aurum, Arsenicum, Belladonna,
Antimonium crud., Pulsatilla, Nux vom., Derris pin.
For disposition to kill : Stramonium, Arsenicum, Hepar, China,
Lachesis.
For disposition to commit acts of violence: Belladonna, Stra-
monium, Hyoscyamus, Veratrum, Cocculus, Platina, Cuprum,
Lycopodium.
Therapeutic Indications.--See melancholia and mania for
both indications and auxiliary treatment.
MANIA. 243
MANIA.
Syn0nyms.——Madness, Insanity, Furor Mania; Fr., Fureur,
Manic Aiguéi; Ger., T obsucht, Wuth, T ollheit.
Deﬁniti0n.—Disorder of the intellect, characterized by
hallucinations or delusions which impel to acts of violence.
Diagnosis.-—The violence which characterizes acute mania
is such as to prevent any error of diagnosis in cases of that
character; but there are many varieties of simple mania, aris-
ing from numerous causes, in which the excitement is not very
great, nor the delusions, if any, very manifest, especially in
the early stages; but they are all attended by more or less
excitement, there is no gloom or depression, the conduct is
more or less noisy and irrational, and, sooner or later, de-
lusions, coinciding with the temper and bodily condition,
manifest themselves. Moreover, the will-power is usually
1nore or less impaired, perception, reason and volition are all
to a greater or less extent defective, and if any motive actuates
the patient, there is such a want of correspondence between it
and the act that there cannot be said to be any adequate mo-
tive for it.
Pathology.—The physical changes in the brain which char-
acterize insanity are best seen in chronic cases, where we ﬁnd
degeneration of the cerebral nerve-cells, producing condensa-
tion and atrophy of the gray substance, increased weight, di-
minished volume and chronic inﬂammation, with softening.
Now, although such changes are not observed to any such ex-
tent in acute cases, it cannot be doubted that material altera-
tions do exist in all cases of insanity, whether acute or chronic.
Even with our inadequate means of demonstration, Balfour,
who analyzed seven hundred post-mortems, found tissue alter-
ations in ninety-one per cent. of his cases. Hence the con-
census of opinion among alienists now is, that insanity is an
actual morbid condition of the brain itself, and not a mere
functional disturbance, as was once thought. Indeed, so evi--
dent is this truth, that the eminent physiologist, Van der Kolk,
asserts that he never failed to discover pathological changes
where there was abnormal mental function manifested ; as, for
244 NERVOUS THERAPEUTICS.
example, where mania existed he found the cortical layer
under the frontal bones darkened, more closely adherent to the
pia mater, or softened.
Clinical Experience.—Acute or Furious Mania.—Stramo-
nium, Opium , Tarantula, Hysocyamus, Belladonna, Gelsemium,
Cuprum.
Suicidal Mania.—Aurum, Nux vom., Pulsatilla, Rhus tox.,
Belladonna, Sepia, Platina, Zincum, Carbo veg., Alumina,
Mercurius, Staphisagria, China, Sulphur, Nitric ac., Arsen-
ioum.
Religious Mania.—-Stramonium, 'Baryta, Aurum, Crocus,
Lachesis, Veratrum.
Mania, with Fear.—Aconite, Opium, Veratrum.
Mania, with Aversion.—Conium, Aurum, Calcarea carb., Ci-
cuta, Ammonium mur.
Gay Manial—Stramonium, Hyoscyamus, Belladonna, Au-
rum, Platina, Crocus, Lycopodium, Veratrum, Anacardium.
Apathetic Mania.—Argentum, Antimonium crud., Coca.
Antagonistic States of Minol.——Phosphorus, Anacardium,
Staphisagria, Sepia, Capsicum.
Puerperal Mania.—Platina, Cimicifuga, Belladonna, Pulsa-
tilla, Ignatia, Aurum, Hyoscyamus.
Therapeutic Indications—Stramonium.—Acute mania, char-
acterized by furious rage; gay mania, dances, gesticulates,
laughs and sings, has paroxysms of constant talking, or breaks
out into low laughter, or is in ecstasy, ﬁlled with pleasant
fancies, expresses his wishes _by signs, exceedingly busy with
his fancy and quite cheerful ; religious mania, kneels down,
stretches his hands out with pious look, starts up from the least
opposition, with wild cries and violent gestures; puerperal
mania and ng/mphomania, with obscene gestures and language ;
desires light and company, being afraid to go alone; very
loquacious, in a prayerful, beseeching, inciploring language;
face often red and bloated.
0pium.—-Furious mania, with rage, fear, distortion of face,
protruding and conjested eyes, bluish redness and swelling of
the lips; paroxysms of rage, with rolling on the floor and
threats against his own relatives, whom he does not seem to
recognize.
MANIA. 245
Hyoscyamus.-—Acute and subacute mania, with or without de-
lusions, where the patients are destructive, tearing up and
breaking everything, and ﬁlthy in their habits; talks incessantly
and does not sleep ; noisy, shouting and walking about inces-
santly; wants to go naked, will wear no clothes, tears them into
tatters; hallucinations, but little or no cerebral congestion ; gay
mania, dances, laughs in an absent manner, makes ridiculous
gesticulations like a clown, and performs funny tricks like a
monkey ; religious mania, alternately ludicrous, solemn or
furious, dresses in some fantastic way, as in a priest’s gown
over his shirt with fur boots, wants to go to church in this
guise in order to preach or ofﬁciate at mass, and ferociously at-
tacks all who try to oppose him; puerperal mania, thinks she
has killed her child, and that her chin has become a duck’s
bill; sleepless, unwilling to remain in bed, delirious, but not
violent, or else furious, with indescribable rage and horrid an-
guish ; does not know her own relatives; complains of having
been poisoned; complete loss of modesty, throws off the bed-
clothes; hyperaesthesia of cutaneous nerves; melancholy, with
muttering, starting and twitching.
Belladonna.——Acute, ‘subacute and chronic mania, with conges-
tion of the brain, headache, ﬂushed face, hallucinations, intol-
erance of light and noise, desire to suicide by drowning ;
chronic, with occasional exhibitions of silly laughing during
agreeable intervals ; unsteadiness of purpose, with almost con-
stant tendency to move some part of the body, especially the hands,
indisposition to converse, especially with strangers, to whom she
makes determined answers; opposition excites rage and de-
structive tendencies; walks hurriedly, sings, dances, laughs
and waves her hands; worse in the afternoon, evenings and
at the approach of the menstrual period; desire to bite, strike
and run away ; gay mania, a merry craziness, with laughing and
singing, tries to compose songs, and sings merry but senseless
tunes, or whistles occasionally, but refuses to eat or drink, or
sings or hums different airs, or smiles a long time to himself,
or is disposed to sing or whistle, with frequent bursts of laugh-
ter, or is wild and wantonly merry, with inclination to quarrel
"without cause, or will tear off clothes, run out into the street
246 NERVOUS THERAPEUTICS.
partially or wholly naked, gesticulating in a strange manner,
crying, laughing, muttering and demanding foolish things;
suicidal mania, with distaste for life and desire for death ;
wishes some one to kill him; attempts to jump out of the
window; alternating with paroxysms of fury; puerperal mania,
merry but quarrelsome; strikes and bites ; starts in affright at
the approach of others; tries to escape or hide ; insomnia, fear
of ghosts, moaning; begs those around her to get her out of
the way and kill her.
Aurum.——Sleeplessness, anguish of mind, seems to have no
friends; ﬁts of anger, rashness and fury ; desperate actions and
thrashing about; speaks continually in questions and is quar-
relsome; great depression, with suicidal tendency; suicidal
mania, great desire to commit self-destruction, seeking every
opportunity to do so; excessive desire for water, with melan-
choly notion that he was not intended for this world ; anxious
desire to take his own life, attended with derangement and
cramps in stomach and bowels; religious mania, he imagines
he is irretrievably lost, with desponding shouts and screams ;
puerperal mania, with preoordial anguish, driving her from place
to place ; unhappy, with continual thoughts of suicide ; prays all
the time; imagines she is not fit for this world ; weak memory
and intellect.
Nux v0m.—Obstinate and quarrelsome, increasing to violence;
suicidal mania, desire for death, because ‘his agony of mind
allows him no repose, because present pain and misfortune
seem insupportable to him ; inclined to take his own life, with
palpitation of heart and great anxiety; morose and taciturn;
disposed to quarrel if disturbed; giddiness, with reeling; con,-
stipation; gastric disturbances; nymphornania.
Anacardium.—Sensation of being possessed of two opposing
wills; is inclined to laugh when he ought to be serious, and
does not incline to laugh when tempted by what is ludicrous;
actions stupid and childish; rapid loss of self-reliance, memory
and mental vigor; incipient dementia.
Mercurills.-—Insomnia, with peevishness, irritable temper,
great restlessness, apathy, sensation as if the head would burst;
suicidal mania, with disgust for life, from want of courage to
MANIA. 247
meet trials and mortiﬁcation, or desire for death, from an in-
supportable dislike for every person and thing, even those
which are most loved.
Aconite.——Acute mania, attended with fear, despondency and
apprehensions of future calamity; anxious lamentations ac-
companied by disheartening apprehensions; anxiety, attended
with heat of the face and head, palpitation of the heart and
coldness of the extremities; apprehensions of approaching
death; puerperal mania, with great fear of death; ailments from
fright or anger; fear of strangers, of not getting up; inconsol.-
able anxiety; reproaching others for mere triﬂes.
Gelsemium.—/lcute mania, attended with cerebral congestion;
head hot, face ﬂushed, eyes red and protruding; surface and
extremities cold, or cold and hot alternately; wild demeanor;
puerperal mania, with great depression of spirits, pain in the
back of the head and neck, congestion of the base of the brain,
dilated pupils, blur before the eyes, lochia arrested or very
scanty.
Arsenicum.—Restless, sleepless and in constant mental agony;
poor appetite, eats only under compulsion; pain in occiput, '
running up over the head to forehead; eyes have a blur over
them so that she can scarcely see; says she cannot control her
mind; tongue bright red and seamed; hands and feet cold;
bowels constipated; suicidal mania, attempts to strangle herself
with a string at night, though constantly watched.
Crocus.—Fickle, changeable disposition; cheerfulness, mirth,
joy, sadness, despair all follow each other in rapid succession;
religious mania, gloomy, sad mood, with great anxiety about
the future.
Sepia.——Imagines things he does not want to imagine; uses
wrong expressions, knowing them to be wrong; proposes to him-
self things contrary to his intentions; is in contradiction with
himself; has paroxysms of laughter and weeping in alterna-
tion, without either of them resulting from a corresponding
frame of mind; gastric disturbances, with constipation.
Cuprum.-—Acute, furious mania, attended with full, quick pulse,
red and inﬂamed eyes, wild looks, incoherent speech and rage,
every paroxysm terminating in perspiration.
248 NERVOUS THERAPEUTICS.
Tarantula.—Restlessness of the hands and legs, constant
movement, cannot remain in one place; great and constant
heat about the epigastrium ; disposition to joke and laugh and
play tricks, with impulsive movements; sudden, foxlike and .
destructive efforts, requiring the utmost vigilance to prevent
damage, followed by laughter and then apologies; all the symp-
toms relieved by music; screams, sings, bites, throws things
violently about, springs out of bed, destroying whatever she
can get hold of; sleeps two days, then awakes with screaming;
soils the bed with urine.
Compare, also, Cimicifuga, Veratrum, Platina, Ignatia, Can-
nabis ind., Phosphoric ac., Iodium, Pulsatilla, Zincum, Staph-
isagria, Alumina, Nitric ac., China, Rhus tox.
Auxiliary Treatment.——The patient should, if possible, be
removed from his own home to a sanitarium, or place where
the surroundings are such as to lead him to forget his malady,
or at least to so occupy his mind by /new objects as to divert it
from the old, and not to call up, by sight or otherwise, any of
those ideas or objects which occasioned, or are liable to renew
or aggravate, the malady. Moral rather than physical restraint
should be employed, the patient being at all times encouraged
to exercise his own self-control. Hence his attendant should
be a person of great discretion, self-control, kindness and
watchfulness, the latter being exercised in such a manner as
not to attract the patient’s attention. Everything about the
patient should be made to appear as cheerful as the circum-
stances of the case will admit. Thus the room ordinarily
occupied should be light, well ventilated and ornamented with
pictures, flowers and everything calculated to gratify the inno-
cent tastes of the patient. Employment, recreation and vari-
ous forms of amusement, suited to the capacity of the patient,
should be provided for him, both as stimulants in the renewal
of health and to prevent the mind reacting on itself. As the
patient improves, his attention should be gradually, but cau-
tiously, directed to former objects and associations, until all
danger of shock or relapse has passed. The diet should always
be generous and such as is suited to an anaemic or debilitated
state of the system. Many a threatened attack of mania may
DIPSOMANIA, 249
be prevented by the timely administration of a warm bath,
stimulants and a generous diet.
DIPSOMANIA.
Syn0nyms.—Oinomania; Fr., Manic Ebrieuse, Manic Crapu-
lease ; Ger, T ranlcsacht.
Deﬁnition.—A morbid condition of the nervous system,
characterized by an inordinate craving, generally periodic, for
alcoholic stimulants.
Diagnosis.—-This disease is liable to be confounded with
habitual drunkenness. In the former, however, the craving
exists independent of external circumstances of temptation,
while in the latter it consists mainly in a desire to maintain a
condition of stimulation to which the patient has become
accustomed.
Pathology.-—This form of insanity, like that of others, can
generally be traced in the family history. The pathological
changes are marked in all cases, but they vary greatly, accord-
ing to the stage of the disease. There is always more or less
atrophy of the cortical substance, with degeneration of the
ganglion cells. As the tendency is to dementia, very few
organs of the body escape disease, of which fatty degeneration
of the heart, liver, kidneys and voluntary muscles is the most
constant. Permanent intellectual and moral degradation
characterizes the disease, and if the patient lives long enough
he is almost certain, sooner or later, to become hopelessly
demented.
Clinical Experience. — This is not very encouraging.
Sulphuric ac., Tartar emet., Angelica, China, Arsenicum, Nux vom.,
Pulsatilla, and especially Strychm'a gr. of the nitrate, three
times a day for six weeks), have helped and sometimes cured
individual cases; but unless the dipsomaniac can be secluded
in an asylum long enough to work a change in the nutrition
of the brain, the morbid tendency is not likely to be eradicated
by any treatment, however judicious or prolonged it may be.
Therapeutic Indications.—See the following section, mam'a
a potu.
17
250 NERVQUS THERAPEUTICS.
MANIA A POTU.
Synqnyms.—De1irium Tremens, Trembling Delirium; Fr.,
Délire Ebrieuse, Délire Crapuleuse; Ger, Zitterwahnsinn.
Deﬁnition.—A form of delirium, characterized by great
mental agitation and muscular tremor, peculiar to persons ad-
dicted to the immoderate use of alcoholic stimulants.
Diagnosis.——It is scarcely possible to mistake the disease
for any other, as, in addition to the history of the case, we have
the characteristic symptoms, such as complete insomnia,
tremor of the voluntary muscles, and, above all, the mental
symptoms, such as imaginary fears, visions of snakes, insects,
monsters, etc.
There are two forms, the acute (mania a potu proper), without
trembling, and the chronic (delirium tremens proper), with
trembling, after which the disorder is named.
Patho1ogy.—The most recent observations and experiments
conclusively prove that, contrary to the old notion, the phe-
nomena of delirium tremens do not arise from the sudden
withdrawal of an accustomed stimulus, but from the effects of
its accumulation in the system, just as mercurial tremors arise
from the inhalation of mercurial fumes. After a time, depend-
, ing on the susceptibility of the drinker, the system becomes, so
to speak, saturated with alcohol, and after that no more can be
taken without producing the trembling and other nervous
symptoms peculiar to the disease. No characteristic morbid
changes are observed after death in the acute form; in the
chronic they resemble, when present, those of dipsomania,
which see.
Clinical EXperience.—Belladonna, Stramonium, Hyoscyamus,
Opium, Cimicifuga, Cannabis ind., Capsicum and Tartar emet. are
all effective remedies, while Arsenicum, Agaricus, Nux vom., Digi-
talis, Scutellaria and Cypripedium are also of much benefit in
particular cases.
Therapeutic Indications. —- Bel1adonna.- Delirium, with
visions of rats, mice, etc. ; imagines he sees water running over
the table and window panes; tries to extract one of his teeth;
smiles and stammers; dry feeling in the throat, with diﬁiculty
MANIA A POTU. 251
of swallowing; fever, with thirst; cerebral congestion; restless,
anxious and unsteady in his walk and actions; trembling of
the hands.
Stramonium.——-Delirium, with frightful visions and hallucina-
tions; sees animals and strangers attacking him from all sides;
hides himself, or tries to escape; hears imaginary voices; face
red and swollen; eyes glistening and staring; manner hurried
and ﬁtful; limbs in a constant tremor; talks absurdly, laughs,
starts at every sound and movement and looks greatly fright-
ened; complete insomnia.
Hyoscyamus.—-Starts and trembles as if by fright; wants to
hide from the light and from company; fears persecution; con-
stantly tossing about at night, cannot sleep; derangement of
the stomach, with loss of appetite; disposed to laugh at his
own fears, yet trembles in every limb.
0pium.—Stupor, from which the patient starts in great fright
or mutters in his sleep, talking deliriously; dreams of animals
glaring at him with their ﬁery-red eyes; trembles, looks fright-
ened and tries to escape; becomes comatose, with loud, snoring
respiration, dilated pupils and half-closed eyes; reduced vital
power.
Cimicifuga.-—Complete insomnia; imagines he sees rats, mice,
lizards and other strange objects; talks incessantly, changing
from one subject to another without any good reason; pulse
full and quick; eyes wild and staring; stomach disordered;
cross and taciturn; tremor scarcely visible, but apparent to
the touch; occipital headache.
Cannabis ind.——Illusions of a spectral character and of strange
sounds at night; wakes before midnight overcome with fright;
imagines he is going to be choked; all objects appear double
their natural size; talks incoherently, stammering and stut-
tering; everything, even his own hand, appears monstrously
large.
Capsicum.—Prostration extreme, tremor excessive, delirium
bland; thinks the ceiling is about to fall and crush him, caus-
ing him to jump from the bed as quickly as his weak condition
would allow; tongue coated, pulse small and irregular, skin
moist, forehead constantly bedewed with a cold,-clammy sweat;
252 NERVOUS THERAPEUTICS.
voice‘ feeble, husky and tremulous; complete insomnia for
three successive nights.
Antimonium tart.—Fearful delirium ; constantly throwing
pillows at imaginary demons; eyes red and injected; pulse
quick and irritable; has neither eaten nor slept for more than
a week; gastric derangement from drinking beer; low states of
the system, with profuse, cool sweats.
Arsenicum.—Muscular tremors, with great prostration; fear,
with great anguish and sweat, dread of ghosts, of thieves or of
death, and especially of vermin crawling over the bed or over
the hands; gastritis.
Gelsemium.—-Delirium, with great nervous excitement, head-
ache, fear and wakefulness; had not slept for ten nights;
kicked off the footboard struggling with his attendant, con-
stantly calling for more whisky; produced sleep after morphia
had failed.
Compare, also, Nux vom., Gratiola, Coffea, Kali brom., Ran-
unculus bulb., Nux mosch, Digitalis, Calcarea.
Auxiliary Treatment.—Conﬁnement always irritates the
patient and increases his fears; no more restraint, therefore,
should be placed upon his movements than is necessary to pre-
vent accidents. The chief danger to be guarded against is ex-
haustion; hence care should be taken to provide for the nutri-
tion of the impoverished brain and nerve-centres, by the free
administration of food which can be easily digested and
assimilated. Beef-tea, raw eggs and milk or warm coffee, coca,
warm milk and egg-emulsion will usually give satisfactory
results. Aitken recommends Cayenne pepper. The stimulus
of such a spice, he says, given in soup, on the atonic stomach,
will have a favorable inﬂuence on absorption. Lilienthal ad-
vises us to keep our patients on an exclusive milk diet, as it
antidotes alcohol and sometimes causes a disgust for it.
DEMENTIA.
Synonyms.—-Mental Decay; Fr., Démence; Ger, Bliidsinn.
Deﬁnition.—A gradual decay of the mental faculties.
Diagnosis.-Acute primary dementia, which does not come
DEMENTIA. 253
under the above deﬁnition, sets in rapidly without any preced-
ing disorder, affects only young people, usually girls, and is
amenable to treatment. Chronic primary dementia, though
sometimes a sequel of the acute, usually comes on gradually,
and when not caused by disease of the brain generally results
from years of hard drinking, its chief symptom being loss of
memory. Secondary dementia, which is the form to which the
term is usually applied, is a sequel to previous mental disorder,
such as melancholia and mania. These distinctions are suﬂi-
cient for diagnostic purposes.
Path0l0gy.—The pathological condition, in most cases of
dementia, is one of diffuse interstitial inﬂammation of the great,
nervous centres, which results eventually in destruction of
ganglion cells and atrophy of the nervous structures. Indeed,
the degree of imbecility is generally pretty accurately measured
by the amount of atrophy and destruction of ganglion cells
Which the cerebral nerve-centres have undergone.
Treatment.—On this point little can be said. The same >
careful tending and nursing are required as in infancy, the
weakness and helplessness being equally great. Although,
with the exception of the acute primary form, a cure is not
to be expected, medicines are often of great utility. Such
remedies as Arsenicum, Acidwm nit. and phosph, Carbo veg.,
China, Digitalis, Phosphorus, Nux vom., Pydophyllin, etc., are
frequently required to render the patient more comfortable
and to prolong his life; while during the earlier stages the
decay of the mental faculties may be greatly retarded, and in
some cases arrested, by Anacardium, Ignatia, Phosphoric ac., etc.,
the selection being determined, as in all other cases, in accord-
ance with the symptoms presented by the patient at the time
of prescribing.*

* From the author’s work on Nervous Diseases, p. 379.
INDEX.
SEo'rIoN I.—DIsEAsEs.
Abnormal growths, cerebral, 48 .
—- —- spinal, 111
Abscess, cerebral, 32, 35
Acute ascending paralysis, 94
— hydrocephalus, 67
Adults, spinal paralysis of, 95
a
Alkaline solvents, 29
Amyotrophic lateral sclerosis, 102
— paralysis, 101
Anaemia, cerebral, 9
— antero-lateral columns, 78
— cerebro-spinal, 117
— general, 117
— posterior columns, 81
— posterior spinal, 81
— spinal, 78
Anapeiretic paralysis, 188
Anaesthesia, 27, 192
—— peripheral, 192
Antero-lateral columns, anaemia of, 78
Anterior horns, inﬂam. of, 95
Angina pectoris, 200
Antero-spmal paralysis of infancy, 97
Aphasia, 37
Aphemia, 37
Aphonia, paralytic, 181
Apoplectic stroke, 21
Apoplexy, cerebral, 21
— spinal, 84
Apoplexia sanguinia, 21
Arachnitis, cerebral, 60
—- spinal, 85
—- traumatic 60
Artiﬁcial dehvery in puerperal convulsions, 137
Ascending and descending degenerations, 162
Asthenic paralysis, 185
Ataxia, locomotor, 107
Atrophia cerebri, 40
— musculorum lipomatosa, 98
Atrophic spinal paralysis, 95
Atrophy, cerebra , 42
- facial, 194
— Cruveilh.ier’s, 101
— progressive muscular, 101
facial, 191
Athetosis, 44, 56
Bandages in sciatica, 180
Basedow’s disease, 198
Baths, salt, 26, 185
—- sea, 168, 170
-— shower, 208
— steam, 152
—— sun, 209
- vapor, 200
— warm, 111, 147, 190, 240
Bowels, neuralgia of, 211
Brain, anaemia of, 9
—— arachnoid, inﬂam. of, 60
— atrophy of, 40
-— concussion of‘, 50
— congestion of, 14
— dropsy of, 73
Brain, haemorrhage of, 21
— hyperzemia of, 14
— hypertrophy of, 39
—- p1a mater, inﬂam. of, 60, 62
— softening of, 34
— sup urative inﬂam. of, 32
— syp ' itic disease of, 45
— tumors of, 48
— water on, 73
Brain-fag, 9, 117
Breast-pang, 200
Bronchocele, exophthalmic, 198
Brown-Sequard on cerebral syphilis, 46
—— — “vitalizin ﬂuid,” 122
Bumpf's treat. 0 locomotor ataxia, 111
Bulbar paralysis, 99
Canine madness, 148
Cardiac neuralgia, 200
Cardialgia, 204
Carus, 229
— catalepsia, 161
Catalepsy, 161
Cauterization, prophylactic, 151
Central myelitis, 144
Cephalal a, 195, 214
— perio ‘ca, 195
Cerebral anaemia, 9
— abscess, 32
— apoplexy, 21
—— arachnitis, 60
—— atrophy, 40
— concussion, 50
-— congestion, 14
-— embolism, 30
— haemorrhage, 21
— hyperaemia, 14
-— hypaemia, 9
— hypertrophy, 39
— leptomeningitis, traumatic, 61
meningeal haemorrhage, 59
meningitis, chronic, 71
—- granular, 67
-- simple acute, 62
—- tubercular, 67
pachymeningitis, acute, 58
—- chronic 59
-- external, 58
-— internal, 59
—— secondary, 58
— traumatic, 58
paralysis, 54
-— infantile, 56
sclerosis, diffused, 40
—— multiple, 42
softening, 34
syphiloma, 71
syphilis, 45, 71
t ombosis, 27
—- tumors, 48
Cerebro-spinal hyperwmia, 116
anaemia, 117
meningitis, 123
fever, 123
Illllllllllllllllll
(25
256 INDEX.
.000.
0''’
0.,‘
on...
.I..
Cerebro-s inal sclerosis, 162 Differential cerebral concussion, 50
Cerebras enia, 10, 117 — — embolism, 27
Cerebritis, 32 — — epilepsie, 157
Coccygodynia, 175 —— —- hyperaemia, 9
Cold applications, 20, 54, 57, 84, 85, 175, 180, — -- paralysis, infantile, 59
190 — - thrombosis, 27
— douche, 54, 175 — -- paralysis, cerebral, 56
Childhood, essential paralysis of, 97 -— — — spmal, 56
Chorea, 152 -- — — infantile, 97
— minor, 152 -— hysteria, 118, 157
— Sancti Viti, 152 — progressive muscular atrophy, 97
Chronic cerebral meningitis, 71 — neurasthenia, 117, 118
-- inﬂam. of brain, 32 — peripheral neuritis, 96
— hydroce halus, 73 — poliomyelitis, 96
Columns 0 Burdach, sclerosis of, 107 — simple meningitis, basilar, 63
Coma somnolentum, 229 -— —- — tubercular, 67
Compression, in neural ' , 168, 170 -— typhoid fever, 67
— in chronic hydrocep lus, 75 Diffused cerebral sclerosis, 40
— in hystero-epilepsy, 160 Diplegia facialis 184
Commotio medulla spinalis, 112 Diphtheritic paralysis, 185
-— cerebralis, 50 Dipsomania, 249
Congestion, cerebral, 14 Disseminated sclerosis, cerebro-spinal, 162
— cerebro-spinal, 116 -- — cerebral, 42
— spinal, 76 -— — multilocular, 103
Concussion, cerebral, 50 —- — spinal 103
- spinal, 112 Dizziness, zés
Convulsions, cholaemic, 138 Dog-madness, 148
— infantile, 129 Douche, cold, 54, 98, 115
— of pregnancy and parturition, 134 — salt-water, 115
— of the new-born, 134 - spray, 90
— postnatal, 133 Dowse, Dr., on cerebral syphilis, 46
— puerperal, 134 Dro )sy of the brain, 73
— toxaemic, 138 Due enne’s disease, 99
— urmmic, 134, 138
Convulsive tic, 187
Cretinism, mucoid, 199 Eclampsia gravidarum et parturientium, 134
Croup spasmodic, 189 — mfantum, 129
Cruve1lhier’s atrophy, 101 — neonatorum, 134
Cutaneous anaesthesia, 192 — toxica, 138
Electricity in angina pectoris, 204
— athetosis, 45
Debility, nervous, 117 -- bulbar paralysis, 100
Degeneration, cerebral, diffused, 40 catalepsy, 161
— — multiple, 42 cerebral anaemia, 13
— spinal, primary, 104 — —— atrophy, 41
— — secondary 206 — -— haemorrhage, 44
— cerebro-spinal, 160 — -— hyperaemia, 20
Delirium tremens, 250 — -— sclerosis, 44 \
Dementia, 163, 252 — — tumors, 49
— paralytica, 163 — chorea, 156
Diet in athetosis, 45 coccygodynia, 177

— anaemia, 13 diphtheritic paralysis, 185
— bulbar paralysis 101 -— facial paralysis, 184
— meningitis, cerebral, 60 -- glossoplegia, 187
— — cerebro-spinal, 129 - hydrophobia, 152
— convulsions, toxic, 139 - hysteralgia, 210
— cerebral thrombosis, 29 — locomotor ataxia, 111
— delirium tremens, 252 — muscular atrophy, 96
- epilepsy 144, 157 — neuralgia, 168, 170, 173
—- encephalitis, 34 — neurasthenia, 121
—— ext. pachymeningitis 59 — peripheral anmsthesia, 194
— haemorrhage, cerebra , 26 — paralytic aphonia, 181
-— hemicrania. 198 -— sciatica, 180
— insomnia, 236 - spinal hyperaemia, 78
— mania, 248 -- -— irritation, 84
— melancholia, 240 -— - meningitis, 88
— neuralgia, 168, 170, 181 -— —- paralysis of adults, 97
— neurasthenia, 122 -- — - infantile, 97
-— sciatica, 181 -— — pseudo-hypertrophic, 99
— spinal anaemia, 80 —- — sclerosis, 104
— -— meningitis, chronic, 88 Electric brush, 111, 194
— tubercular meningitis, 71 Electro-cautery, 88
— tetanus, 146 Electro-massage, 97
— the Weir Mitchell, 122 Embohc dust 31
Differential diagnosis, in Embolism, solvents in, 29
— anaemia, cerebral, 9 Emotional insanity, a41
— — general, 117, 118 Encephalitis, 32
-— angina pectoris, 201 Enemata, 168
— cerebral compression, 50 Entasia tetanus, 144
g 0
0... 2 :
.0’. ' :
INDEX. 257
Enterodynia, 211
Enteralgia, 211
Epidemlc meningitis, 123
Epilepsia, epilepsis, 139
Epileptiform hysteria, 159
Epilepsy 139
Essential paralysis of childhood, 97
Ether-spray,180, 204
Exhaustion, nervous, 117
-— spinal, 78
Exophthalmic goitre, 198
Exercise, 20, 27, 115, 185, 190, 240
External cerebral pachymeningitis, 58
Extirpation of the coccyx, 177
Facial atrophy, 191
— neuralgia, 171
-— paralysis, 184
-— spasm, 187 '
Falling-smkness, 139
Femero-popliteal neural ‘a, 177
Functional paralysis of t e cord, 78
Furor mania, 243
Galvanism in
-— athetosis, 45
— cerebral atrophy, 41
— — hsemorrhage, 26
— — hyperaemia, 20
— — sclerosis, 44
— -— tumors, 49
— exophthalmic goitre, 199
— facial aralysis, 184
— astra ‘a 208
— ydrop 0 ia, 150
-— locomotor ataxia, 111
— infantile spinal paralysis, 98
— neuralgia, 173, 180
— paralytic aphonia, 184
- progressive muscular atrophy, 102
— sciatica, 180
— sclerosis, 104
— spinal concussion, 115
-— — irritation, 84
— — menin 't1s, chronic, 88
— vertigo, 2 9
—- writer’s cramp, 188
— wry-neck, 188
Gastral ‘a, 204
Gastro ynia, 204
General paralysis, 163
paresis, 163
Glossoplegia, 186
Glosso-labio-laryngeal paralysis, 99
Glottis, spasm of, 189
Giddiness, 223
Goitre exophthalmic, 198
Granular cerebral meningitis, 67
Grave’s disease, 198
Gumma syphiliticum cerebri, 45
Gussenbauer on trifacial neuralgia, 171
Gymnastic exercise, 15, 188
0
Haematoma clurae matris, 59
Haematomyelia, 84
Haematorrhagia medulla spinalis, 84
Haemorrhagic pachymeningitis, 59
Haemorrhage, cerebral, 21
— meningeal, 59
—- spinal, 84
Heartburn, 204
Heat-stroke, 52
Hammond’s athetosis, 44
Headache, 195, 214
Hemicrania, 195

Heat, artiﬁcial, in
— -’— cerebral hyperaemia, 2)
—- — paralysis, 57
— — meningitis, 67
— -— softening, 36
-— cerebro-spinal meningitis, 129
— enteral ‘a, 213
— hystera gia, 210
— mastodynia, 175
— neuralgia, 168, 170
— neuritis, 166
— ovaral a, 208
—- spinal yperaemia, 78
—— -— irritation, 84
— tetanus, 145
Hemiplegia, 54
-— cerebmlis spastica, 56
Hot douche, 78
Hydrocephalus, acute, 67
— acutus sine tuberculosis, 62
— chronic 73
— internal, 67-
Hydrops capitis, 73
Hydrophobia, 148
Hyperaesthesia plexus cardica, 200
Hypertrophia cerebri, 39
Hypo, 240
Hypochondriasis, 240
Hypoglossal nerve, paralysis of, 186
Hyperaemia, cerebra , 14
— cerebro-spinal, 116
— spinal, 76
Hysteria, 118, 156
— cataleptica, 161
-— epileptica, 157
Hysteric ﬁt, 156
Hysterics, 156
Hystero-epilepsy, 159
Hysteralgm, 210
Hyperplasia, cerebral neuroglia, 39
Hypertrophy, cerebral, 39
Ice and ice-water applications, 54, 57, 66, 83, 88,
115, 129, 147 152, 160, 166.
Idiopathic cerebral leptomeningitis, 62
— latent spinal sclerosis, 104
— softening of the cord, 90
Impulsive insanity, 241
Infantile cerebral paralysis, 56
- convulsions, 129
— spinal paralysis 97
Inﬂammation of the anterior horns, 95
— lateral columns, 102
— nerve 166
— spina cord, 88
Inﬂammatory softening of the cord, 88
Inhibitory paralysis, 78
Inanition, convulsions from, 138
Insane, paralysis of, 163
Insanity, affective, 241
— common, 243
— emotional, 241
— impulsive, 241
— intellectual, 243
— moral, 241
Insolation, 52
Insomnia, 232
Insolatio, 52
Internal cerebral pachymeningitis, 59
Insular spinal sclerosis, 103
Irritable uterus, 210
Irritation, spinal, 84
Ischias, 177
Karl Pauli on locomotor ataxia, 111
Labio-glosso-laryngeal paralysis, 99
258
INDEX.
'||||||||||
Lan ’s paralysis, 94
Later co umns, inﬂam. of, 102
—- sclerosis, idiopathic, 104
— —— amyotrophic, 102
—- — primary, 104
Laryngismus stridulus, 189
Larynx, paralysis of, 181
— spasm of, 189
Leptomeningitis, cerebral, 61, 62
— infantile, 62
— idiopathic, 62
— spinal, 85
—- traumatic, 61
— tubercular, 67
Lethargia, 229
Lethargy, 229
Lipomatosis musculorum luxurians, 98
Local anaesthesia, 192
Lockjaw, 144
Locomotor ataxia, 107
Lyssa, 148
Madness, 148, 243
Malum hystericum, 156
Mammae, neuralgia of, 174
Massage, 13, 26, 97, 120, 139, 184, 194, 240
— electro 9
Melancholia, 237
Mania, 243
—- a potu, 250
Mastal ' , 174
Masto ynia, 174
Megrim, 196
Meningeal haemorrhage, cerebral, 59
-— tumors, spinal, 112
Menin es, spinal, inﬂam. of, 85
— cere ral, inﬂam. of, 60, 62
Menin 'tis, basilar, 62, 71
cere ml, 60, 62, 71
cerebro-spinal, 121
chronic, 71
convexital, 71
epidemic, 121
spinal, 85
simple acute 62
subarachnoid, 60
syphilitic, 71
tubercular, 62, 67
Mental decay, 252
Metallotherapy in hystero-epilepsy, 160
Mimetic spasm, 187
Moral insanity, 241
— treatment, 159, 240, 248
Morbus attonitus, 161
— hypochondriacus, 240
— ma us, major, daemonius, divinus, deiﬁcus,
unaticus etc., 139
Mollities medulla: spinalis, 90
Mucoid cretinism, 199
Muscular atrophy, 96, 101
— — progressive, 96
—— paralysis, progressive, 101
—- seudo-hypertrophic, 98
Mu tilocular sclerosis, disseminated, 103
Multiple sclerosis, cerebro-spinal, 162
-— — cerebral, 42
— — spinal, 103
Myelitis, acute, 88
— bulbi, 99
— central, 144
Myelasthenia, 78, 117
Myelomalasia, 90
Myopathic paralysis, 101
Myxoedema, 199
Nerves, inﬂam. of, 166
Nerve-stretchin , 73, 110, 146, 166, 168, 170, 173

Nervous exhaustion, 117
-— headache, 195
-— pain, 167
Neuralgia, in general, 167
—— of the bowels, 211
— cardiac, 200
— of the coccyx, 175
— femero-po liteal, 177
— intercos , 177
— ischiatic, 177
— of the mammae, 174
— meseraic, 211
— ovarian, 208
—— phrenic 200
-— spinal, 1
-— of the stomach, 204
— trifacial, 171
— uterine, 210
Neural anaesthesia, 192
Neuritis, 166 ,
Neurod nia, 167
Neurog ia, hyperplasia of, 39
Neurasthenia, 9, 78, 117
— cerebralis, 9 '
— spinalis, 78 117
Neurotic faci atrophy, 191
Nutrition, 168, 170
Oinomania, 249
Ovaralgia, 208
Ovarian irritation, 208
—- neuralgia, 208
Ovaries, pain in, 208
Ord’s cretinoid affection, 199
Pain, neuralgic, 167
— ovarian, 208
Paralytic aphonia 181
Paralysis, cerebral, 54
— acute ascending, 94
— — progressive, 94
— antero-spinal, of infancy, 97
— anapeiretic, 188
— agitans, 164
— atrophica, 101
— ascendens acuta, 94
— amyotrophic, 101
— asthenic, 185
— Bell’s, 184
— Cruveilhier’s, 101
— diphtheritic, 185
—- facial, 184
— functional 78
— general, of the insane, 163
—- losso-labio-laryngeal, 99
— istrionic, 183
—- infantile, 97
- inhibitory, 78
— Landry’s, 94
— myo athic, 101
— Of a ults, 95
— of the hypoglossal nerve, 186
—- of the larynx, 99, 181
—- of the pharynx, 99, 181
—- of the portio dura 183
— of the tongue, 186
—- progressive bulbar, 99
— pseudo-hypertrophic, 98
— reﬂex, 93
— spasmodic, 104
—- spinalis spastica, 104
— spinal, 92-107
— — of adults, 95
— toxic, 93
Palsy, common cerebral, 54
—- shaking, 164
— Schrivener’s, 188
- spinal, 78, 92
mnnx. 259
Paralytic aphonia, 181
Paraplegia, 92
-— reﬂex, 78
Paraplexia, 92
Parr’s treat., Writer’s cramp, 188
Pasteur on hydrophobia, 149
Pachymeningitis, acute cerebral, 58
-— chronic 59
—- external, 58
-- haemorrhagic, 59
— internal, 59
— secondary, 58
— spinal, 85
-- traumatic, 58
Peripheral anaesthesia, 192
— neuritis, 96
Pervigilium, 232
Pharynx, paralysis of, 99, 181
Pia mater, cerebral, inﬂam. of, 62
Phrenic nerve, neuralgia of, 200
Poliencephalitis acuta, 56
Poliomyelitis anterior, 95
Polymyositis, progressive, 101
Posterior spinal anaemia, 81
— — sclerosis, 107
Post-diphtheritic Paralysis, 185
Postnatal convulsions, 133
Primary sclerosis, lateral, 104
— — cerebral, 42
— —-— spinal, 104
-— softening, spinal, 90
Progressive bulbar paralysis, 99
— facial atrophy, 191
- — hemiatrophy, 191 _
-- locomotor ataxia, 107
— muscular atrophy, 101
—- polymyositis 101
Prophylaxis in hydrophobia, 151
Prosopalgia, 171
Pseudo-hypertrophic spinal paralysis, 98
Puerpera convulsions, 134
Pyzemia, in cerebral pachymeningitis, 58
Babies 148
Rachi gia, 81
Reﬂex paraplegia, 78, 93
— para ysis spinalis, 78
Rest, in cerebral thrombosis, 29
hemicrania, 198
melancholia, 240
neurasthenia, 122
spinal haemorrhage, 85
— irritation, 84
-— concussion, 115
writer’s cramp, 188
Restraint in delirium tremens, 252
—- mania, 250
Salt-bath, in cerebral anaemia, 13
—- hmmorrhage, 28
St. Guy’s dance, 152
—- J ohn’s dance, 150
— Vitus’s dance, 150
Sciatica, 17 7
Schrivener’s palsy, 188
Sclerosis, cerebral, 41, 42
-— diffused, 41
disseminated, 42
idio athic, 42
insu ar 42
multiple, 42
— pnmary, 42
columns of Burdach, 107
spinal, 103, 104, 106
—- amyotrophic lateral, 102
-— glrsiénary, 104
' eminated, 103
— — multiple, 103
lllllllll
Sclerosis, spinal, secondary, 106
— cerebro-spinal, 162, 165
- — disseminated, 162
— - secondary, 162
Sea-bathing in neuralgia, 168, 170
—'cerebra1 anaemia 13
Secondary spinal sclerosis, 106
—— cerebro-spinal sclerosis, 162
Shaking palsy, 164
Shower-bath, in gastralgia, 208
Sick-headache, 195
Simple acute cerebral meningitis, 62
Sleeplessness, 232
Softenin , cerebral, 34
— spina , 90
Somnolentia, 229
Somnolency, 229
Sopor, 229
Spasmodic croup, 189
— spinal paralysis, 104
Spasm, facial, 187
-- laryngeal, 189
-— mimetic, 187
—— of the glottis, 189
— —- mastoid muscle, 187
— with rigidity, 144
Speech loss of, 37
Spott fever, 123
Spinal anaemia, 78, 81
— apoplexy, 84
— arachnitis, 85
—— concussion, 112
— congestion, 76
— exhaustion, 78
— haemorrhage, 84
-— hyperzemia, 76
— inﬂammation, 88
— irritation, 81
—- leptomemngitis, 85
— meningitis, 85
- neuralgia, 81
-— pachymeningitis, 85
— paralysis, 78, 92
— — of adults, 95
— -— atrophic, 95
— —- functional, 78
— -— infantile, 97
—- -— simple, 92
— —- spasmodic, 104
—— —— pseudo-hypertrophic, 98
-— sclerosis, disseminated, 103
— -— multiple, 103
— -- primary, 104
— -— posterior, 107
— -- secondary, 106
—— tumors, 112
Spinal cord, anaemia of, 78, 81
—- concussion of 112
— hyperaemia o , 76
—- inﬂam. of, 88
— inﬂammatory softening of, 88
— non-inﬂammatory softening of, 90.
- paralysis of, 78
— sclerosis of, 103, 104, 160
Spleen, 240
Spotted fever, 123
Steam-bath, in hydrophobia, 151
Sternalgia, 200
Sternodynia, 200
Sternocardia, 200
Stomach, neuralgia of, 204
Stupor, 229
Subarachnoid meningitis, 61
Sun-bath, in ovaralgia, 209
Sunstroke, 52
Sus ension, in locomotor ataxia, 111
Syp ' ‘s, cerebral, 45
Syphiloma, 45
Syncope anginosa, 200
260
INDEX.
Swimming of the head, 223
Syphilitic meningitis, chronic, 71
Tabes dorsalis, 107
Tapping, in chronic hydrocephalus, 75
Tetanus, 144
Thermic fever, 52
Thrombosis, cerebral, 27
—- solvents in, 29
Tongue paralysis of, 186
Tortico ‘s, 187
Toxaemic convulsions, 138
Traumatic cerebral arachnitis, 60
—- — leptomeningitis, 61
— — pachymeningitis, 58
Trembling delirium, 250
Tremors, s inal, 111
Trigemina. neuralgia, 171
Trismus, 144
— nascentium, 134
Tubercular cerebral leptomeningitis, 67
— —— meningitis, 67
Tumors, cerebral, 48
-— spinal, 112

SECTION II.-REMEDIES.

Unilateral facial atrophy, 191
Uraemic convulsions, 133, 136
Uterine colic, 210
— neuralgia, 210
Vapor baths, in myxoedema, 200
Vapors, 156
Vertigo, 223
Wakefulness, 232
Warm baths, in insomnia, 236
— mania, 250
— melancholia, 240
—- spasm of glottis, 190
-— tetanus, 145
Wasting palsy 101
Water on the brain, 73
Weir Mitchell treat. in neurasthenia, 122
— spinal irritation, 84
White softening, spinal, 90
Womb, neuralgia of, 210
Writer’s cramp, 188
Wry-neck, 187
Abrotanum in treatment of cerebral soften-
ing 3
Acidum tluor. in coccygodynia, 176
Aconite in treat. of acute myelitis, 89
— —- angina ectoris, 203
— —- cerebra haemorrhage, 23
-— — —- hyperaemia, 16
—- -— —— meningitis, 64
— —— cerebro-spinal meningitis, 125
— — facial paralysis, 184
-— headache, 216
— infantile convulsions, 130
-— insomnia, 234
— mania 247
— mastodynia, 175
— neural ‘a, 168, 172
—— spinal yperaemia, 77
— -— meningitis, 86
—— sunstroke 53
-— -— vertigo, 2 9
Eculus hip., in treat. of locomotor ataxia, 110
Ethusa in treat. of cerebral meningitis, 66
— — cerebro-spinal meningitis, 128
— —— chronic hydrocephalus, 74
Agaricus in treat. of angina pectoris, 304
— — cerebro-spinal meningitis, 128
— — chorea 153
—- — spinal hyperaemia, 77
Agnus cast. in treat. of melancholia, 239
Alumina in treat. of enteralgia, 212
—— -— headache, 220
— -— locomotor ataxia, 108
— — spinal anaemia, 80
Allium cepa in treat. of headache, 219
Aluminum in ascending paralysis, 94
Ambra gris. in melancholia, 239
Ammon. picr. in neuralgia, 168
—- brom. in ovaralgia, 209
Amyl nit. in treat. of angina pectoris, 202
— — cerebral hyperaemia, 16 _
— -— hemicrania, 197
— — melancholia, 239
— — sunstroke, 53
— — vertigo, 229
Anacardium in treat. of cerebral meningitis, 66
— - headache, 216
— - mania, 246
Angustura in treat. of acute myelitis, 90
Angustura in treat. of locomotor ataxia, 110
— -— myelitis, 89
—— — tetanus, 147
Antimonium crud. in treat. of headache, 222
—— — sunstroke, 50
Antimo. tart. in treat. of delirium tremens, 252
— — diphtheritic paralysis, 184
Apis mel. in cerebral hyperaemia, 17
— cerebro-spinal meningitis, 125
— — hydrocephalus, 74
— -— menin'gitis, 65, 69
—- ovaralgia, 209
Apocynum can. in treat. of chronic hydro-
cephalus, 73
Apomorphia in vertigo, 226
Aranea diad. in neuralgia, 170
Artemesia vulg. in tubercular meningitis, 69
Argentum nit. in treat of
— — cerebro-spinal meningitis, 127
— — epilepsy, 142
—— — astral a, 206
— — eadac e, 222
— —— locomotor ataxia, 109
— -— multiple cerebral sclerosis 43
— -- pseudo-hypertrophic paralysis, 100
— -— neuralgia, 173
— —- spinal hyperaemia, 77
— — vertigo, 227
Arnica in treat. of acute myelitis, 90
— — aphasia, 38
— — cerebral haemorrhage, 24
— — hyperaemia, 17
— paralysis, 57
concussion, cerebral, 51
facial paralysis, 184
myelitis, 90
spinal concussion, 114
— — hyperaemia, 78
sunstroke, 53
tetanus, 147
Arsemcum in treat. of angina pectoris, 203
- — acute myelitis, 89
— —— cerebral anaemia, 10
— -— -— softening, 37
-— — cerebro-spinal meningitis, 128
llllllllll
— chronic hydrocephalus, 74
— delirium tremens, 252
— — encephalitis, 34
INDEX.
261
Arsenicum in treat. of enteralgia, 212
— —— astral ‘a, 206
-— — eadac e, 196, 217, 222
— -- hemicrania, 196
—- —- hysteralgia, 210
— — insomnia, 236
- -— mania 247
-— -— mastod nia, 175
-— — melanc olia, 238
— -- myehtis, 89
—— —- neuralgia, 168, 171
— -— neurasthenia, 119
-- -— puerperal convulsions, 136
— — sciatica 179
— -— spinal anaemia, 80
-- -— vertigo, 226
Asafoetida in treat. of headache, 219
Asclepias syr. in treat. of cerebral hyperzemia, 19
— — puerperal convulsions. 136
Asterias rub. in treat. of chorea, 155
Aurum in treat. of angina pectoris, 204
— —- cerebral hyperaemia, 18
— — — s hilis, 47
—- - locomotor ataxia, 108
— — mania, 246
— — melancholia, 238
Avena sat. in treat. of neurasthenia, 120
—- — -— cerebral anaemia, 11
Baptisia in treat. of cerebro-spinal meningitis,
125
Baryta carb. in treat. of aphasia, 38
— -— cerebral heemorrhage, 23
— — -— tumors, 49
— - locomotor ataxia, 110
-— -- multiple cerebral sclerosis, 43
Belladonna in treat. of acute myelitis, 89
— -— cerebral concussion, 51
- - — haemorrhage, 23
— hypersemia, 16
—— meningitis, 64
—— softening, 36
—- tumors, 49
cerebro-spinal meningitis, 127
coma, 231
delirium tremens, 250
epilepsy, 142
enteralgia, 213
facial paralysis, 184
astra ‘a, 207
eada e, 215
hemicrania, 196
hysteralgia, 210
infantile cerebral paralysis, 57
— convulsions, 130
insomnia, 233
locomotor ataxia, 109
mania, 245
melancholia, 138
myelitis, 89
neuralgia, 173
puerperal convulsions, 137
sciatica, 17 9
spasm of glottis, 190
spinal hyperaemia, 77
—- irritation, 83
—- meningitis, 86
sunstroke, 55
-— tetanus, 145
- — tubercular meningitis, 70
— -— vertigo, 226
Berberis in treat. of cerebral syphilis, 47
- -- headache, 215
— —- spinal hyperaemia, 77
Bismuthum in treat. of gastralgia, 208
— — headache, 219
-- —- neuralgia, 169
Bovista in treat. 1' headache, 217
lllllllllllllllllllllllllllll
"llllllllllllllllllllllllllllll

Bromides in treat. of cerebral hyperaemia, 21
Bromine in treat. of hemicrania, 197
exophthalmic goitre, 199
B1-yonia in treat. of cerebral hypereemia, 16
—— —- coma, 231
astral ia, 206
eadac e, 220
- — hemicrania, 197
— — mastodynia, 175
— — meningitis, cerebral, 65, 69
— — —— spinal, 86
— — — tubercular, 69
— - neuralgia, 169,172
— —- puerperal convulsions, 136
-- — sciatica, 178
—— — vertigo, 226
_—
Cactus grand. in treat. of angina pectoris, 203
Calcarea carb. in cerebral tumors, 49
—- — chorea, 153
— -— hemicrania, 196
— -— hydrocephalus, 74
— —- hysteralgia, 210
—- — tubercular meningitis, 69
— -— vertigo, 229
Calcarea phos. in cerebral anaemia, 12
—— — chronic hydrocephalus, 75
- — headache, 222 '
— —- neurasthenia, 80, 119
— - spinal anaemia, 80
— —- tubercular meningitis, 69
Galois hypophos. in treat. of neurasthenia, 121
Camphor in treat. of cerebral anaemia, 11
— — coma, 231
-— — concussion, 51
— —- sunstroke, 53
Camphor brom. in treat. of infantile convul-
sions, 130
Calendula in treat. of spinal concussion, 114
Cannabis ind. in treat. of cerebro-spinal men-
in 'tis, 126
- — de irium tremens, 251
— - epilepsy, 141
Cantharis in treat. of cerebro-spinal menin-
gitis, 128
Capparis cor. in treat. of epilepsy, 141
Capsicum in treat. of delirmm tremens, 251
Carbo veg. in treat. of gastralgia, 206
— - sunstroke, 53
Carbo an. in treat. of headache, 222
— — cocc godynia, 177
Caulophyl um in treat. of headache, 217
-- — hysteralgia, 210
Causticum in treat. of acute myelitis, 89
-— — aphasia, 38
— — chorea, 153
— — diphtheritic paralysis, 185
—— -— facial paralysis, 184
—- - headache, 216
— — myelitis, 90
— — ocular paralysis, 72
— -- vertigo, 228
Cedron in treat. of headache, 220
Chamomilla in treat. of aphasia, 40
— -— coma, 231
— —- enteralgia, 212
— - headache, 215
— — infantile convulsions, 132
— — mastodynia, 175
— — sciatica, 17 9
Chelidonium in treat. of headache, 219
China in treat. of cerebral anaemia, 10
-— - gastralgia, 207
— -— spinal anmmia, 80
- — verti o, 226
China ars. 1n treat. of e ilepsy, 143
China sulph. in treat. 0 neurasthenia, 119
-— - vertigo, 226
262
INDEX.
Chlorine in treat. of spasm of glottis, 190
Cicuta in treat. of cerebral concussion, 51
— — cerebro-spinal meningitis, 125
—- -‘— coccygodynia, 176 '
—— — chorea, 154
— -- infantile convulsions, 132
—— — spinal concussion, 114
—- —- -— meningitis, 87
— — tetanus, 145 ,
-— — vertigo, 228
Cimicifuga in treat. of cerebral hyperaemia, 18
—- — -— meningitis, 66
—— — cerebro-spinal meningitis, 124
—- — chorea, 153
— — delirium tremens, 251
— -— hysteralgia, 210
—— — insomnia, 234
—— -— mastodynia, 175
—— — melancholia, 239
—— — ovaralgia, 209
—— — spinal irritation, 82
Gina in treat. of cerebral anaemia, 12
-— — chorea, 155
—- — infantile convulsions, 131
—— — tubercular meningitis, 70
Cinnabaris in treat of cerebral syphilis, 47
Coca in treat. of insomnia, 235
Cocculus in treat. of acute ascend. paralysis, 94
—- — cerebro-spinal meningitis, 127
—- — chorea, 154
—— —- epilepsy, 142
—- — gastralgia, 207
—- —- headache, 222
— —— insomnia, 235
—- -— spinal irritation, 82
— — vertigo, 227
Coffea in treat. of cerebral hyperaemia, 18
—- — insomnia, 235
Colchicum in treat. of aphasia, 38
-- —- neural ‘ , 170
—- — spinal yperaemia, 77
—- — vertigo, 228
Colocynthis in treat. of enteralgia, 212
—- -— gastralgia, 207-
— -— headac e, 217
— — sciatica, 178
Conium in treat. of aphasia, 38
— -— cerebral concussion, 52
- — —- tumors, 50
—— -— coccyggodynia, 176
—- — neur gia, 170
—— -— ovaralgia, 209
—- — spinal concussion, 114
-- -— vertigo, 226
Corrallium rub. in treat. of spasm of glottis, 190
Crotalus in treat. of cerebro-spinal meningitis,
1
Crocus in treat. of headache, 222
—- —- mania, 247
Cuprum in treat. of angina pectoris, 203
-— — cerebral hyperaemia, 18
—- —- -- meningitis, 65
-— -— cerebro-spinal meningitis, 127
— —— chorea, 155
—- —- epilepsy, 142
-— -- enteralgia, 213
- - infantile convulsions, 131
- -- mania, 247
- — neuralgia, 172
— — puerperal convulsions, 135
— — spasm of glottis, 190
-— -- spinal meningitis, 87
— — vertigo, 225
Cyclamen in treat. of hemicrania, 197
Cypripglium in treat. of infantile convulsions,

Digitalis in treat. of cerebral meningitis, 65
— —— chronic hydrocephalus, 74
— — cerebro-spinal meningitis, 125
— — puerperal convulsions, 136
— —- sunstroke, 54
Dioscorea in treat. of enteralgia, 212
Epiphegus in treat. of neurasthenia, 120
Ergot in treat. of cerebral hyperaemia, 21
Erythroxylon coca in treat. of neurasthenia,
80,119
— — spinal anaemia, 80, 119
Ether in treat. of sciatica, 180
Eupatonum perf. in treat. of headache, 219
Euphrasia in treat. of vertigo, 226
— —— headache, 217
Ferrum in treat. of cerebral anaemia, 11
— —- gastralgia, 208
Ferrum et strych. in treat. of ovaralgia, 109
Fluoric acid in coccygodynia, 176
Gamboge in treat. of headache, 221
Gelsemmm in treat. of acute ascending paral-
ysis, 94
—- — myelitis, 89
—- cerebral concussion, 51
— — hyperaemia, 17
— — meningitis, 66
—- cerebro-spinal meningitis, 124
-—- delirium tremens, 252
—- diphtheritic paralysis, 186
— facial paralysis, 184
— headache, 218
— hemicrania, 196
— hysteralgia, 210
- infantile convulsions, 130
-— — cerebral paralysis, 57
—- insomnia, 233
-— locomotor ataxia, 109
—- mania, 247
— neuralgia, 169
— ocular paralysis, 73
—- ovaralgia, 209
-— puerperal convulsions, 137
—- spasm of glottis, 190
— spinal hyperaemia, 77
— -— -— irritation, 82
— — tetanus, 146
— -- vertigo, 228
Glonoin in treat. of angina pectoris, 203
—- — aphasia, 38
—- — cerebral concussion, 51
— -— -— hyperaemia, 15
—- -- —— meningitis, 65
— — epilepsy, 142
—- — infantile convulsions, 131
— — sunstroke, 53
Gossypium in treat. of headache, 220
Graphites in treat. of cerebral tumors, 49
Gymnocladus in treat. of headache, 219
llllllllllllllllllllll
Hamamelis in treat. of neural ' , 168
Hepar sulpb, in treat. of spina concussion, 114
Helleborus in treat. of cerebral meningitis, 66
— — chronic hydrocephalus, 74 ,
-— — coma, 232
— —- infantile convulsions, 133
— — locomotor ataxia, 109
-— — tubercular meningitis, 69
Helonias in treat. of cerebral anaemia, 12
Hoang Nan in treat. of hydrophobia, 150
Hydrastis in treat. of headache, 220
Hydrocyanic ac. in treat. of cerebro-spinal men-
ingitis, 126
INDEX.
263
Hydrocyanic ac. in treat. of epilepsy, 142
-— —- puerperal convulsions, 135
~— — tetanus, 146
Hyoscyamus in treat. of cerebral concussion, 51
— — hyperaemia, 16
— — meningitis, 67
— — cerebro-spinal meningitis, 126
— — chorea, 154
— — delirium tremens, 251
—- — infantile convulsions, 132
— -- insomnia, 235
— — mania, 245
— —— puerperal convulsions, 136
— — vertigo, 227
Hypericum in treat. of cerebral concussion, 51
— — spinal concussion, 114
—- — — irritation, 83
—- —— —— meningitis, 86
— — tetanus, 147
Ignatia in treat. of cerebral anaemia, 11
—- — chorea, 154
— — gastral ia, 206
— — infanti e convulsions, 130
— — insomnia, 235
— —- locomotor ataxia, 110
— — melancholia, 238
— -— neuralgia, 172
— -— neurasthenia, 121
—— — ovaralgia 209
— — puerperal convulsions, 137
— —— sciatica, 179
-— — spinal irritation, 83
— — vertigo, 225
Indigo in treat. of epilepsy, 141
Inula helen. in treat. of hydrophobia, 150
Iodine in treat. of angina pectoris, 202
— — encephalitis, 34
— — melancholia, 239
— —- spasm of the glottis, 190
Ipecacuanha in treat. of cerebral anaemia, 12
-— — headache, 215
— — infantile convulsions, 133
— — spasm of glottis, 190
— -— vertigo, 228
Iris vers. in treat. of headache, 217
-— — hemicrania, 196
—— — neuralgia, 169
Kali bichr. in treat. of headache, 222
— — hemicrania, 197
— -— neuralgia, 170
Kali brom. in treat. of infantile convulsions, 130
— — melancholia, 239
— — spasm of glottis, 190
Kali carb. in treat. of cerebral tumors, 49
— — headache, 218
— —- neuralgia, 172
Kali chlor. in treat. of facial paralysis, 184
Kali cyan. in treat. of neuralgia, 170
Kali iod. in treat. of angina pectoris, 202
-— — aphasia, 38
— — cerebral syphilis, 47
-— —— chronic hydrocephalus, 75
— — facial paralysis, 184
-- — headache, 219
—- — ocular paralysis, 73
— — sciatica, 179
—- — spinal meningitis, 87
— — tubercular meningitis, 70
—- — vertigo, 227
Kali phos. 1n treat. oi melancholia, 238
—- — spinal anaemia, 80
Kalmia in treat. of neuralgia, 168
— — vertigo, 228
Lachesis in treat. of angina pectoris, 204
-— — aphasia 3
—— — cerebral concussion, 51
-— — — haemorrhage, 24

Lachesis in treat. of coma, 231
—- —- headache, 215
— — neuralgia, 169
-— — puerperal convulsions, 137
— — spinal hyperaemia, 77
— — tetanus, 146
—- - vertigo, 225
Lachnanthes 1n treat. of cerebral hyperaemia, 18
Lathyrus in treat. of locomotor ataxia, 109
-— — spinal hyperaemia, 78
Laurocerasus in treat. of angina pectoris, 203
— — cerebral haemorrhage, 25
—— —- -— concussion, 51
Ledum in treat. of paralysis, 94
Lilium tig. in treat. of headache, 221
-— -- ovaralgia, 209
Lycopodium in treatment of aphasia, 37
—— —- cerebro-spinal meningitis, 128
— — coma, 232
—- - headache, 217
— — melancholia, 238
— — spinal anaemia, 80
— — tubercular meningitis, 70
Magnesia phos. in treat. of neuralgia, 168
Mercurius in treat. of acute myelitis, 89
— — cerebral syphilis, 47
—- — facial paralysis, 184
— — headache, 220
-—— — mania, 246
— — myelitis, 89
—- —- ocular paralysis, 73
—- — sciatica, 180
—- —— spinal meningitis, 87
Mercurius iod. in treat. of encephalitis, 34
Mezereum in treat. of headache, 218
— - neuralgia, 168 172
Moschus in treat. of insomnia, 235
Mygale in treat. of chorea, 153
~ .--~
Naja in treat. of ovaralgia, 209
Natrum carb. in treat. of vertigo, 225
Natrum iod. in treat. of angina pectoris, 202
Natrum mur. in treat. of cerebral anaemia, 13
— —- headache, 221
- — hemicrania, 198
— — melancholia, 239
— — neural ia, 169
— — spinal irritation, 83
— — vertigo, 228
Natrum nitrite in treat. of angina pectoris, 203
Natrum salicyl. in treat. of vertigo 225
Natrum sulph. in treat. of cerebra anaemia, 13
— - headache, 215
Niccolum sulph. in treat. of hemicrania, 198
Nicotinum in treat. of tetanus, 145
N ux mosch. in treat. of coma, 232
-— - headache, 216
Nux vom. in treat. of acute ascending paral-
ysis, 95
— cerebral anaemia, 11
— —- haemorrhage, 24
-— —— hyperaemia, 17
— cerebro-spinal meningitis, 126
— chorea 154
— enteralgia, 212
— epilepsy, 140
— gastral ia, 205
- headac e, 218
-— infantile convulsions, 132
— insomnia, 234
- locomotor ataxia, 110
—- mania, 246
— melancholia, 238
— neuralgia, 170, 172
— neurasthenia, 120
- ocular paralysis, 73
264
INDEX.
Nux vom. in treat. of sciatica, 178
— —— spinal anaemia, 79
— — — meningitis, 86
—- —- vertigo, 224
CEnanthe cr0. in treat. of epilepsy, 143
— —- puerperal convulsions, 137
Opium in treat. of cerebral haemorrhage, 23
-- -— — hyperaemia, 17
— — — meningitis, 66
-— — cerebro-spinal meningitis, 124
-— — coma, 231
—- — delirium tremens, 251
— — enteral ’ , 213
—- — infanti e convulsions, 231
— — insomnia, 234
—- — mania, 244
— — ocular paralysis, 73
-— — puerperal convulsions, 137
— — vertigo, 227
Oxalic acid in treat. of acute myelitis, 90
— —- gastralgia, 207
— — locomotor ataxia, 110
— — multiple cerebral sclerosis, 43
— — myelitis, 90
Passiﬂora in treat. of insomnia, 233
—— — tetanus, 146
Phosphorus in treat. of acute ascending paraly-
sis, 95
— —- acute myelitis, 90
-— —— aphasia 38
—- — cerebral haemorrhage, 23
—— — — hyperaemia, 18
—— — cerebro-spmal meningitis, 126
-— — headache, 220
— — insomnia, 234
— — locomotor ataxia, 108
— — melancholia, 239
— —- multiple cerebral sclerosis, 43
— —— myelitis, 90
— —- neuralgia, 172
—— —- neurasthenia, 119
— — pseudo-hypertrophic paralysis, 100
— -— spinal anaemia, 79
— — vertigo, 224
Phosphoric ac. in treat. of coma, 232
— -— neurasthenia, 121
—— — vertigo, 228
Physosti a in treat. of locomotor ataxia, 109
— —— in antile convulsions, 133
— — spinal meningitis, 87
—- -- neurasthenia, 120
-— — tetanus, 146
— — vertigo, 228
Phytolacca in treat. of headache, 127
— —— mastodynia, 174
— -- spasm of glottis 190
Picric acidé treat. of acute ascending paraly-
SIS,
— — acute myelitis, 90
—- -— cerebral softening, 35
— — myelitis, 90
—- — neurasthenia, 120
Pilocarpus in treat. of pueliperal convulsions, 136
Platina in treat. of entera gia, 213
-— —- headache, 218
-— — melancholia, 239
Plumbum in treat. of acute myelitis, 89
— —— cerebro-spinal meningitis, 128
— —- chronic hydrocephalus, 75
— - encephalitis, 34
— —- enteralgia, 213
-— — epilepsy, 143
— — locomotor ataxia, 108
— — melancholia, 239

Plumbum in treat. of multiple cerebral sclero-
SIS’
— — myelitis, 89
— — neuralgia, 170
—- -— sciatica, 179
—- — spasm of glottis, 190
—- — spinal meningitis, 87
Podophyllum in treat. of enteralgia, 212
— — headache, 218
Pulsatilla in treat. of cerebral anaemia, 12
—- — -- haemorrhage, 24
—- — —- hyperwmia, 19
—— — chorea, 154
—~ — coma, 231
-— — encephalitis, 34
—~ -— ﬁastralgia, 207
— — eadache, 221
— — hemicrania, 197
—- — insomnia, 235
— - mastodynia, 175
— -- melancholia, 238
— — neuralgia, 168
Rhododendron in treat. of neuralgia, 168
— — spinal hyperaemia, 77
Rhus rad. in treat. of hysteralgia, 210
—— — coccygodynia, 176
Rhus tox. in treat. of acute ascending paral-
ysis 95
—- -— cerebral haemorrhage, 24
—- -— — hyperaemia, 18
—~ — cerebro-spinal meningitis, 127
—— -- coma, 231
—— — mastodynia, 175
—- — multiple cerebral sclerosis, 44
—— —— sciatica, 178
—~ -— spinal concussion, 114
—— — — hyperaemia, 77
—- — — irntation 83
—- — — meningitis 87
Rumex in treat. of headache, 221
Ruta in treat. of coccygodynia, 176
Sabina in treat. of neuralgia, 169
Sambucus in treat. of spasm of the glottis, 190
Sanguinariaintreat. of cerebral haemorrhage, 24
—- — headache, 222
— — hemicrania, 196
Scutellaria in treat. of headache, 221
-— — sunstroke, 53
Secale in treat. of acute ascending paralysis, 95
— — acute myelitis, 89
— — cerebral anmmia, 13
— —- hyperazmia, 21
— — coma, 232
— — myehtis, 89
—- —- spinal hyperaemia, 77
—- —— — irritation, 83
— — — meningitas, 87
Senegain treat. of vertigo 225
Sepia in treat. of cerebral haemorrhage, 25
— — — tumors, 49
—- — headache, 215
— — hemicrania, 195
—- —- hysteralgia, 210
— — mania, 247
— — neuralgia, 173
—- — vertigo, 227 .
Silicea in treat. of cerebral syphilis, 47
— — epilepsy 143
-— — enceph 'tis, 34
— — headache, 216
-- — insomnia, 235
—- — locomotor ataxia, 110
-— — spinal h eraemia. 77
— — tubercu r meningitis, 71
— — vertigo, 225
INDEX. 265
Spigelia in treat. of angina pectoris, 203 Thuja in treat. of neuralgia, 172
— —- hemicrania, 197 —— —— coccygodynia, 176
- -- neuralgia, 167, 173 ‘
—- — ocular paralysis, 73
Spiraea ulm. 1n treat. of hydrophobia, 150
Spongia in treat. of angina pectoris, 202
— — tubercular menin itis, 70
Staphisagria in treat. 0 neurasthenia, 120 . . . .
Stannum in -treat. of gastralgia, 208 _ — cerebr°'SP1na1menmg1t1s’ 126
-— — hemicrania, 196 '~_ _ coma’ 2.31 9
— — infantile cerebral paralysis, 57 _ _ asttalglaz "07
—- —— — convulsions, 132 _ _ . em1°¥ama: 197 _
Stillingia in treat. of headache, 221 — "' mfantlle c9nVu1s1°nSa 131
Stramonium in treat. of aphasia, 38 _ " melapqhoha’ 240
-— — cerebral hyperaemia, 16 _ _' myelmss 90 ,
— — —- meningitis, 65 "' _ neuralgla, 169 . . .
_ _ chorea, 155 — — tubercular meningitis, 70
__ __ _ _" V6I't1g_0, .
_ _ delirium tremens, 251 Veratrum V11‘. 1n tr_eat. of cerebral concussion , 55
- - headache, 218 — — —- hyperzemla. 11 _ , _
— - infantile convulsions, 131 — _ °e1'eb1'°'S_P_1na1men1ng1t1S, 124
— —- insomnia, 235 "' _ Phoreag 19° _
_ __ mania, 244 —— — lIIfH.DtII_B convulsions, 133
-— — ocular paralysis, 73 — _ msommai 234 .
-- — puerperal convulsions, 136 — _ Puerperzfl convulslonsr 13
— — spinal meningitis, 87 " _ Sllnstroke, 53 '
- - tetanus, 146 - -, — t<?t=\11\1S,147 _
__ __ vertigo’ 227 V1pera 1n treat. of cerebral concussion, 53
Strychnia in treat. of cerebral softening, 36
Strycl1s%1§1£,hg3ée1§1itareg8- of neurasthemaa 80,119 Xanthium spin. in treat. of hydrophobia, 150
—— — — irritation, 82
Valerian in treatment of sciatica, 180
Veratrum alb. in treat. of acute myelitis, 89
— —— angina pectoris, 203
— -— cerebra anaemia, 12
Sulphur in treat. of cerebral anaemia, 13 Zinc brom. in treat. of cerebral anaemia, 12
—- — -- hyperaemia, 19 — — neurasthenia, 120
— — chorea, 155 Zinc oxyd. 1n treat. of multiple cerebral scle-
— — chronic hydrocephalus, 74 rosis, 43
— — headache, 216 Zinc phos. in treat. of cerebral anaemia, 12
-— — insomnia, 236 — —— — softening, 36
-— —— multiple cerebral sclerosis, 44 -— — neuralgia, 170,
—- —— vertigo, 228 — — neurasthenia, 121
Sulphuric ac. in treat. of spinal concussion, 114 Zinc picr. in treat. of cerebral anaemia, 12
—— — neurasthenia, 120
Zinc val. in treat. of insomnia, 235

Tanacetum in treat. of hydrophobia, 150 -— — ovaralgia, 209
Tartar emet. in treat. of coma, 231 Zincum in treat. of cerebral anaemia, 12
— -— neuralgia, 169 — — cerebro-spinal meningitis, 128
Tarantula in treat. of chorea, 154 —- — chronic hydrocephalus, 75
-— — coccygodynia, 176 — — chorea, 155
- -— mania, 248 — -— coccy odynia, 176
-- —- multi le cerebral sclerosis, 44 — — encep alitis, 34
-- -- spina irriration, 83 — — infantile convulsions, 132
—- — vertigo, 227 — — locomotor ataxia, 109
Tellurium in treat. of spinal irritation, 83 — — neuralgia, 173
Thaspium aur. in treat. of epilepsy, 143 — — neurasthenia, 120
SECTION III.—-FRENCH SYNONYMS.

Abcw cérébrale, 32 Catale sie, 161
— du cerveau, 32 Cepha algie, 214
— dc l’encephale, 32 Commotion cérébrale, 50
Anemie cérebrale, 9 -— du cerveau, 50
—- cerebro-spinale, 117 -- de la moe'lle épiniere, 112
—- du cerveau, 9 —— spinale, 112
Anesthésie cutanée, 192 Congestion cérébrale, 14
Angine de poitrine, 200 -— cérébro-spinale, 116
Aphasie 37 —- du cerveau, 14
Aplasie iamineuse progressive, 191 Coup de soleil, 52
Apodplexie cérébrale, 21 Convulsions de 1’ enfance, 129
— e la moe'lle épiniere, 84 — des femmes encientes et en couche, 134
— méningée, 59 — toxémiques, 138
Arachnite spinale, 85 Crampe des écrivains, 188
Ataxie locomotrice, 107
Athetose, 44
Atrophie cérébrale, 40 Danse de St. Guy, 152
— du cerveau, 40 —- de St. Witt, 152
-— muscularie raisseuse progressive, 101 Degenerations secondaires de la moelle épi-
—- partielle de a face, 191 niere, 162
266
INDEX.
Délire crapuleuse, 250
— ebrieuse, 250
Démence 252
Diplegie faciale, 184
Douleur de téte, 214
-— de coccyx, 175
Embolie cérébrale, 30
Encephalite chronique, 32
Epilepsie, 139
Fievre cérébrale, 67
Folie musculaire, 152
—- raisonnante, 241
Fortraiture, 210
Fureur, 243
Gastralgie, 204
Goitre exophthalmique, 198
Haut mal, 139
Hématomyéle, 84
Hemorrhagie cérébrale interstitielle, 21
— des méninges, 59
— du cerveau, 21
— méningée cérébrale, 59
— intrarachienne, 84
Hydrocéphale, 73
Hydrophobie, 148
Hydropsie du cerveau, 73
Hyperémie cérébrale, 14
— cérébro-sginale, 116
— de la. moe le épiniere, 76
Hygértrophie cérébrale, 39
—- u cerveau, 39
Hypochondrie, 240
Hystérie, 156
— épileptiforme, 159
Hystér0~épi1epsie, 159
Inﬂammation de Parachnoide, 60
— de Pencephale, 32
— de la moelle épiniére, 88
Insomnie, 232
La chorée, 152
La rage, 148
Leptoméningite spinale, 85
Les dé enérations secondaires de la. moelle
— épinlere, 106
Lypémanie, 237
Maladie de Graves, 198
— imaginaire, 156
Mal 5 téte, 214
— de mere, 156
— Divin, 139
Manie aigue, 243
—- era uleuse, 249
—— ebneuse, 249
-— sans déhre, 241
Mélancholie, 237
Ménin 'te oérébrale chronique, 71
— céré ro-rachidienne, 123
—; cérébr inale, épidémique 123
— consec-ut1fs 51a carie du roclmr, 61
— épidémique, 123
— granuleuse, 67
— simple, 62
— spinale, 85

Méningite tuberculeuse, 67
Mlgraine, 195
Monomanie affective, 241
Myélite 88
Myxédéme, 199
Névralgie, 167
— des mamelles, 174
— des ovaires, 208
— intestinale, 211
— sciatique, 177
Névrite, 166
Pachyméningite cérébrale, 58
— -— chronique, 71
— secondaire, 58
— spinale, 85
Paraplégie, 92
— functionelle, 78
— hypertrophique de Penfance, 98
— reﬂexe, 78, 93
Paralysie agitante, 164
— ascendante aigue, 94
— atrophique graisseuse de l’enfance, 97
— cérébrale, 56
— — de1’enfance, 56
—- de la lanque, 186
— diphthéritique, 185
— dn larynx, 99, 181
— du phartxinx, 99, 181
— essentie e de1’enfance, 97
—- faciale, 184
— générale incomplete, 163
- losso-labio-laryngée, 99
-— aryngée, 181 _
-— musculaire progressive atrophique, 101
— myosclérosique, 98
—- pharvn ée, 181
-— pseuElo- ypertrophique, 98
— spinale, 92
— — atrophi ue, 95
— — de Padu te, 95
— tremblante, 164
Perieneéphalite chronique diffuse, 163
Rachialgie, 81
Ramollissement cérébrale, 34
— de la moelle épiniiare, 88, 90
— spinale, 88, 90
Sclérose en plaques disséminées, 42, 103, 162
— latérale amyotrophique, 102
Spasme de la glotte, 189
- faciale, 187
Stupeur, 229
Syphilis du cerveau, 45
Tabes dorsal spasmodique, 105
Tétanos, 144
Thrombose cérébrale, 27
Tic-convulsif, 187
— douloureux, 171
Torticollis, 187
Trisme de Penfance, 134 '
Trophonévrose faciale, 191 '
Tumeurs de la moélle épiniére, 112
— du cerveau, 48
— rachidiennes, 112
Vertige, 223
INDEX.
267
SECTION IV.—-GERMAN SYNONYMS.
Akute Convexitzits Meningitis, 61
— Spinallaihmung bei Erwachsenen, 95
—- und Chronische Enkephalitis, 32
All emeine Akute Hirnhautentzundung, 65
—- %’rogressive Gehirnlahmung, 163
Amyotrophique Lateral—sklerose des Riicken-
mark
Anaesthesia, 192
Anéimie des Gehirns, 9
Analsthesie, 192
Aphasie, 37
Apoplexie, 21
Athetose, 44, 56
Atrophie des Gehirns, 40
Basedow’scbe Krankheit, 198
Blcidsinn, 252
Brustbraune, 200
Cerebrale Abscess, 32
-— Eiterbeule, 32
— Geschwiir, 32
-— Kinderléihmung, 56
— Pachymeningitis, 58
— Typhus, 123
Cerebro-spinale Anéimie, 117
— — Hyperéimie, 116
Ghronische Convexitzits Meningitis, 71
— Hirnhautentziindun , 71
Convulsivische Starrsuc t, 161
Darmweh, 211
Der Wasserkopf, 73 .
Diphtheritische Léihmung, 185
Diplegia Facialis, 184
Eiterbeule des Gehirns, 32
Eklampsieblutvergiftung, 138
— der Neugeborenen, 134
— in der Schwangerschaft und im Wochen-
bette, 134
Embolie der Hirnarterien, 30
Enkephalentziindung, 32
Entziindung der Arachnoidea, 60
- der Nerven, 166
Epidemische Menin 'tis, 123
Erschiitterung des ehirns, 50
~ des Riickenmarks, 113
Erweichung des Gehirns, 34
— des Riickenmarks, 85, 88, 90
Fallsucht, 139
Gehirnaniimie, 9
Gehirnatrophie, 40
Gehirnblutungen, 21
Gehirnerweichung, 34
Gehirnhypertroplne, 39
Gehirnléihmung, 54
Gehirnhyperalmie, 14
Gehirnapoplexie, 21
Geisteskrankheit, 243
Gemiithswahnsinn, 241
Genickkrampf, 123
Genickstarre, 123
Geschwiilste des Gehirns, 48
- des Rilckenmarks, 111
Gesichtkrampf, 187
Gesichtliihmung 184
Glotzaugenkrop , 198
Graue Degeneration der Hinterstriinge des
Riickenmarks, 107

I-Ialsstarre, 187
Hiimatome der Dura Mater, 59
Hemicranie, 196
I-Iirnarterienversperrung, 27, 30
Hirnblutung, 21
Hirngeschwiir, 32‘
Hirn eschwiilste, 48
Hirn autentziindung, Akute, 65, 95
Chronische, 71
Hirnlabmun , 54
Hirnlustseuc 1e, 45
Hirnschlag, 21
Hirnwassersucht, 73
Hundswuth, 148
Hiiftweh, 177
Hyperamie des Gehirns, 14
Hypertrophie des Gehirns, 39
Hypochondrie, 240
Hysteric, 156
Hystero-Epilepsie, 159
Kehlkopfkrampf, 189
Kehlkopﬂithmung, 99, 181
Kinderzuckung, 129
Kinderkrampf, 129
Kinderstarrkram f, 134
Kinderlréihmung es,Gehirns, 56
'Kopfschmerz, 214
Krankhafte Geschwiilste des Gehirns, 84
— — des Riickenmarks, 112
Kreuzendschmerz, 175
Magenschmerz, 204
Melancholie, 237
Mi rane, 195
Mi zkrankheit, 240
Milzsucht 240
Multi le (lerebro-spingle Sklerose, 162
—- S erose des Gehirns, 42
— — des Riickenmarks, 103
Muskelatrophie, 98, 101
— mit Interstitieller Lipomatose, 98
Muskellahmung, 98, 101
Mutterbesohwerde, 156
Myxiideme, 199
Nerventziindung, 166
Neuralgie, 167
— der Brustdrtisen, 174
—- der Eierstocke, 208
— der Eingeweide, 211
— des Fiinftennerven, 171
— der Gebairmutter, 210
— der Ovarien, 208
— der Trigeminus, 171
Neuritis, 16:1
Paralytischer Blcidsinn, 163
I1:riIaI11a'.1'(_% I:3ateral€kler:)&se des 9Raiziickenmarks, 105
ar ysis seen ens cuta
Poliomyelitis Anterior, 95 ’
Primalre Sﬁerogg der Seitenstriinge des Riicken-
mar , 1
Progressive Bulbéirparalysie, 99
Prosopodysmorphia, 191
Reﬂex Paralysis Spinalis, 78
Riickenmarksapoplexie, 84
Riickenmarkshautentziindung, 85
Riickenmarksentziindung, 88
Ruckenmarkshyperamie, 76
Rimkgratschmerz, 81
268
INDEX.
Schlaﬂosigkeit, 232
Schlagﬂuss, 21
Schlundkopﬂiihmung, 181
Schreibekrampf, 188
Schiittelkihmung, 164
Schwermuth, 237
Schwindel 223
Secundﬁel3rkrankungEinze1ner Riickenmarks-
strange, 106
— Cerebro-spinale Sklerose, 162
— Pachymeningite, 58
-— Leptomeningite, 61
Sonnenstich, 52
Spatische Spinalparalgsie, 105
Spinale H eréimie,
-- Meningitis, Spinalmeningitis, 85
Spinalhihmung, 92
—- i Erwachsenen, 95
Spinalparalysie, 92
Sprachlahmung, 37
Starrkram f, 144
Steifer H s, 187
Stimmlosigkeit. 181
Stumpfsinn, 229
Syphﬂitische Gehirn Erkrankung, 45
pinalhyperalmie, 76
— Kinder 5 ung, Spinalkinderlahmung, 97

Thrombose der Hirnarterien, 27
- Cerebralis, 27
Tobsucht, 243
Tollheit 243
Tollwu , 148
Toxiimische Eklampsie, 138
Trunksucht, 249
Tuberculdse Hirnhautentziindung, 67
Unsinnigkeit, 243
Veitstanz, 152
Wasserko i, 73
Wassersc eu, 148
Wuth, 243
Zitterwahnsinn, 250
Zungenlaihmung, 186
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an avoidance of abstract theorizing on one side, and of mere empiricism on the other, which
is most satisfactory.”———From the British Journal of Homoeopathy.
BELL, DR. JAMES B. The Homoeopathic Therapeutics
Of Diarrhoea, Dysentery, Cholera, Cholera Morbus, Cholera Infantum,
and all, other Loose Evacuations of the Bowels. By JAMES B. BELL,
M. D. Third edition. Pp. 191. 8vo. Cloth, . . . . . . . . . 31.50
“‘Bell on Diarrhoea’ is a well-known classic that has for years been the daily com-
panion of careful scientiﬁc prescribers. . . . Practitioners who have much to do with
diarrhoea cannot afford to do without it. . . . The help afforded by this work has
been the means of saving a great number of lives.” —The Homoeopathic World, London.
STANDARD IIOMCEOPATHIO Punucnrrons. 5
“This little book, issued in 1809 by Dr. Bell, has long been a standard work in Homoe-
opathic Therapeutics. \Ve feel quite within bounds in asserting that it has been the means
under our law of saving thousands of lives. Than this no greater commendation could be
penned. . . . . In this second edition, Dr. Bell has been assisted by Dr. Laird, of
Maine; also by Drs. Lippe, William P. \Vesselhoeft, and E. A. F arrington. Thirty-eight
new remedies are given; the old text largely rewritten ; many rubrics added to the reper-
tory; anew feature, the‘ black type,’ for especially characteristic symptoms, introduced.
“This is a typical homoeopathic work, which no homoeopathic physician can afford to
be without. The typographical setting is worthy of the book.”—From the Ifomceopathic
ystctan.
BERJEAU, DR. J. PH. The Homoeopathic Treatment of
Syphilis, Gonorrhoea, Spermatorrhoea, and Urinary Dis-
eases. Revised, with numerous additions. By J. H. P. FROST, M. D.
Pp.25G.12mo. Cloth, ..................$l.50
This valuable little book, compiled from the results of the experience of
the best homoeopathic authorities, by Dr. Berjeau, of London, in 1856, has
since been revised and enlarged by J. H. P. Frost, M. D., and is now perhaps
the best and most concise presentation of the subject to be had.
“ This work is unmistakably the production of a practical man. It is short, pithy, and
contains a vast deal of sound practical instruction. The diseases are brieﬂy described ; the
directions for treatment are succinct and summary. It is a book which might with proﬁt
be consulted by all practitioners of homoeopathy.” -—-North American J ournul.
BOERICKE and DEWEY, DRS. WIVI. A. and W. A. The
Twelve Tissue Relnedies of Schiissler, comprising the Theory,
Therapeutical Application, Materia Medica, and a Complete Repertory of
these Retnedies. Arranged and compiled by WILLIAM BOERICKE, M. D.,
Professor of Materia Medica, and W. A. DEWEY, M. D., Professor of
Anatomy, in the Hahnemann Medical College of San Francisco. Pp. 303.
8vo.Cloth,.........................$2.50
This is the most recent and most complete of all the works on the
Schussler Remedies. Its superiority to previous books on the subject is
attested by its rapid sale and the wide attention it has attracted.
“This work is not a padded reprint of Schiissler’s Therapy, nor a mere compilation from
the journals of additional cures by the Tissue Remedies; but is, in large part, original work,
with the materials presented by Schiissler. The section on ‘The Relations of the Biochemic
(Schiissler’s word) to the Homoeopathic Treatment,’ although short, is one of the most
instructive we have read for a long time/’—DR. J. T. O’CONNOR in Htmoeopctthic Recorder.
“The rapid strides which the use of the Tissue Remedies of Scluissler has made in the
homoeopathic profession since their introduction, entitles this book to the closest attention.
It is by far the most comprehensive and the fullest in every particular yet published on this
subject.’ ’—The Homoeopathic News.
6 STANDARD HOMCEOPATHIC PUBLICATIONS.
“The work is systematically arranged, the main point being devoted to the therapeu-
tical application of the remedies, followed by a complete Materia Medica of the same, to
which is added a carefully prepared repertory, which embraces every characteristic of the
Twelve Remedies.’ ’--The Medical Visitor.
BREYFOGLE, DR. W.‘L. Epitome of Homoeopathic Medi-
cines. Pp. 383. 12mo. Cloth, . . . . . . . . . .s1.25
We quote from the author’s preface:
“It has been my aim throughout to arrange in as concise form as possible, the leading
symptoms of all well-established provings. To accomplish this, I have compared Lippe’s
Materia Medica, the Symtomen-Codex, J ahr’s Epitome, Boenninghausen’s Therapeutic
Pocket-Book, and Hale’s New Remedies.”
BRIGHAM, DR. GERSHAM N. Phthisis Pulnionalis, or
Tubercular Consumption. Pp. 224. 8vo. Cloth, . . $2.00
This interesting work on a subject which has been the “ Opprobium Med-
icorum ” for generations past, has met with a favorable reception at the hands
of the profession. It is a scholarly work and treats its subject from the stand-
point of pure Homoeopathy. .
“Our author’s work must be pronounced as decidedly able, and its principal defects
are those of the subject itself in its present state of development. In our opinion the
whole question is still involved in too much doubt and diﬁiculty to admit of its being
handled very lucidly at present. Dr. Brigham tries very hard to clear the deck of all no-
tions that might be in the way of handling the subject scientiﬁcally, but he does not quite
succeed even in deﬁning clearly one single form of phthisis. Why? Because in the present
state of the subject it is impossible for any man to do so, and we question whether a much
better book on phthisis is possible at present.”—From the Homoeopathic IVorlcl.
BRYAN T, DR. J. A Pocket Manual, or Repertory of Ho-
II1(B01)€tl3l1i(3 Medicine, Alphabetically and N osologically arranged,
which may be used as the Physicians’ Vade-mecum, The Traveler’s Med-
ical Companion, or the Family Physician. Containing the Principal
Remedies for the most important Diseases; Symptoms, Sensations, Charac-
teristics of Diseases, etc.; with the Principal Pathogenetic Effects of the
Medicines on the most important Organs and Functions of the Body, to-
gether with Diagnosis, Explanation of Technical Terms, Directions for
the Selection and Exhibition of Remedies, Rules of Diet, etc. Compiled
from the best Homoeopathic authorities. Third edition. Pp. 352. 18mo.
Cloth,
BURNETT, DR. J. COMPTON. Essays: Ecce Medicus; Natrum
Muriaticum; Gold; The Causes of Cataract; Curability of Cataract;
Diseases of the Veins; Supersalinity of the Blood. Pp. 296. 8vo.
Cloth,
STANDARD HOM(EOPATHIC PUBLICATIONS. 7
Dr. Burnett’s essays were so favorably received in this country that
they would undoubtedly have commanded a very large sale, had they not been
so high in price. As it was, the six essays would have cost over ﬁve dollars,
and in order to bring them within reach of the many we reprinted them, by
special arrangement with the author, who contributed a new essay, “The
Causes of Cataract,” not hitherto published, and a general introduction to the
volume.
The book is printed in good style, on heavy toned paper and well bound,
and we are able to furnish it at less than half the price of the imported
volumes.
“This brilliant little book . . . forms by far the fullest record of the life of Hahne~
mann, as it gives also the best estimate of his character and of his work, with which we are
acquainted. Rarely, if ever, have we met with a more sparkling, more attractive piece of
reading. . . . It is the work of a master in literature.”——From a notice of Ecce Medicus in
Jllonthly Homceopathic Review.
BUTLER, DR. JOHN. Electricity in Surgery. Pp. 111. 12mo.
Cloth,
This interesting little volume treats of the application of Electricity in
Surgery. The following are some of the subjects treated of: ENLARGEMENT
or THE PROSTATE; STRICTURE; OVARIAN CYsTs; ANEURISM; NAEVUS;
TUMORS; ULCERS; HIP DISEASE; Sranms; Bnmrs; GALVANO-OAUTERY;
HEMORRHOIDS; FISTULZE; PROLAPSUS or RECTUM; HERNIA, ETC., ETC.
The directions given under each operation are most explicit and will be heartily
welcomed by the practitioner.
BUTLER, DR. J OHN . A Text-Book of Electro-Therapew
tics and Electro-Surgery. FOR THE USE or STUDENTS AND
GENERAL PRACTITIONERS. By J OHN BUTLER, M. D., L.R.C.P.E., LR.
C.S.I., etc., etc. Second edition, revised and enlarged. Pp. 350. 8vo.
Cloth,..........................$8.00
“ WVe have nothing to add in hearty commendation of this work to our notice of the ﬁrst
edition. . . . It is undoubtedly the best book on uterine surgery, and the only scientiﬁc
one on elcctro-therapeutics now before the public.”——The Homceopathic Times.
“Among the many works extant on Medical Electricity, we have seen nothing that comes
so near ‘ﬁlling the bill’ as this. The book is sufficiently comprehensive for the student or
the practitioner. The fact that it is written by an enthusiastic and very intelligent homoe-
opathist, gives to it additional value. It places electricity on the same basis as other drugs,
and points out by speciﬁc symptoms when the agent is indicated. The use of electricity is,
therefore, clearly no longer an exception to the law of similia, but acts curatively only when
used in accordance with that law. We are not left to conjecture and doubt, but can clearly
see the speciﬁc indications of the agent in the disease we have under observation. The
author has done the profession an invaluable service in thus making plain the pathogenesis
of this wonderful agent. The reader will ﬁnd no diﬁiculty in following both the pathology
8 STANDARD HoMcEoPATnIo PUBLICATIONS.
and treatment of the cases described. Electricity is not held up as the cure-all of disease,
but is shown to be one of the most important and valuable of remedial agents when used in
an intelligent manner. We have seen no work which we can so heartily recommend as
this.’ ’ — Cincinnati Jlfedical Advance.
CLEVELAND, DR. 0. L. Salient Materia Medica and
Therapeutics. By C. L. CLEVELAND, M. D.,Lecturer on Materia
Medica in the Homoeopathic Medical College, Cleveland, Ohio. Pp. 160.
Small8vo.Cloth,................ .3125
The object of this book is to furnish the homoeopathic physician and
student with a simple, salient, practical, and thoroughly reliable work on
Materia Medica and Therapeutics. The one hundred and ninety-seven drugs
presented are those most commonly used.
“The monograph is very suggestive, and will be found a useful aid in the selection of
remedies.”—New York llledical Times.
“It would be diﬁicult to choose between Guernsey’s ‘Keynotes’ and Cleveland’s
‘Salient Materia Medica.’ Both are of pocket size; both are quite reliable. They will
scarcely take the place of Johnson’s ‘ Key ’ in the pockets of the students. They ought not
to replace a full symptomatology on the table of a physician, and still they refresh our
minds, and will serve as companions in studying larger works. The truth is that Cleveland
contains much that Guernsey lacks and vice versa; one needs them both.”—— * * * in
North American Journal of Homoeopathy.
DUNHAM, CARROLL, A. M., M. D. Homoeopathy the
Science Of Therapeutics. A collection of papers elucidating and
illustrating the principles of Homoeopathy. Pp. 529. 8vo. Half morocco,
$4.00;Cloth,.............. .......$3.00
“More than one-half of this volume is devoted to a careful analysis of various drug-
provings. It teaches us Materia Medica after a new fashion, so that a fool can understand,
not only the full measure of usefulness, but also the limitations which surround the drug.
. . We ought to give an illustration of his method of analysis, but space forbids. VVe
not only urge the thoughtful and studious to obtain the book, which they will esteem as
second only to the Organon in its philosophy and learning.”—-The American Homaeopathist.
DUNHAM, CARROLL, A. M., M.D. Lectures on Materia
Medica. Pp. 858. 8vo. Half morocco, $6.00; Cloth, . . . l$5.()O
“Vol. I is adorned with a most perfect likeness of Dr. Dunham, upon which stranger
and friend will gaze with pleasure. To one skilled in the science of physiognomy there will
be seen the unmistakable impress of the great soul that looked so long and steadfastly out
of its fair windows. But our readers will be chieﬂy concerned with the contents of these
two books. They are even better than their embellishments. They are chieﬂy such
lectures on Materia Medica as Dr. Dunham alone knew how to write. They are preceded
quite naturally by introductory lectures, which he was accustomed to deliver to his classes
on general therapeutics, on rules which should guide us in studying drugs, and on the
therapeutic law. At the close of Vol. II we have several pages of great interest, but
the most important fact of all is that we have over ﬁfty of our leading remedies pre~
STANDARD HOMCEOPATHIC PUBLICATIONS. 9
sented in a method which belonged peculiarly to the author, as one of the most successful
teachers our school has yet produced. . . . Blessed will be the library they adorn, and
the wise man or woman into whose mind their light shall shine.”—Oinc'imzat'i llledical
Advance.
EDMONDS, DR. W.‘ A. A Treatise on Diseases Peculiar to
Infants and Children. By ‘V. A. EDMONDS, M. D., Professor of
Paedology in the St. Louis Homoeopathic College of Physicians and Sur-
geons, etc., etc., etc. Pp. 300. 8vo. Cloth, . . . . . . . . . . $2.50
“The most concise and practical treatise on this very important subject yet given to
the profession. It is not an exhaustive work, but a most plain and readily useful one. It
contains in brief what Duncan and others have elaborated without necessity or advantage.
. . We heartily commend the book as the cheapest and best extant.”-—T/ze llledical Gall.
EGGERT, DR. W. The Homoeopathic Therapeutics of
Uterine and Vaginal Discharges. Pp. 543. 8vo. Half mo-
rocco,..................... .$3.50
The author has here brought together in an admirable and comprehensive
arrangement everything published to date on the subject in the whole homoe-
opathic literature, besides embodying his own abundant personal experience.
The contents, divided into eight parts, are arranged as follows :——PART I.
lllenstmtation and Dysvnenorrhcea. PART II. Zllenorrhagia. PART III. Amen-
orrhwa. PART IV. Abortion and Miscarriage. PART V. illetrorrhagia. PART
VI. Fluor albus. PART VII. Lochia, and PART VIII. General Conoomitants.
FARRINGTON, DR. E. A. A Clinical Materia Medica. By
E. A. FARRINGTON, M.D., Late Professor of Materia Medica in the Hahne-
mann Medical College of Philadelphia. Edited by CLARENCE BARTLETT,
M.D. Pp.752. Cloth,. . . . . . . . . . . . . . . . . . .$6.0()
Halfmorocco, The great book for the student.
“There is scarcely a practitioner in our school but will ﬁnd a hint in every lecture worth
the cost of the book . . . . We think it the best book published in our school in
1887 .”-—The Medzcat Advance.
“The volume thus presented to the profession is a worthy monument to the originality,
the enthusiasm and the indefatigable energy of the author. As a work on Materia Medica
it is of such unique arrangement, that it can hardly enter into competition with, while it
may invaluably supplement the present occupants of that important ﬁeld. .
The work, as a whole, is a possession on which homoeopathy may congratulate itself.”-—
The New England Medical Gazette.
GUERNSEY, DR. H. N. The Application of the Principles
and Practice of Homoeopathy to Obstetrics and the Dis-
orders Peculiar to Women and Young Children. By
HENRY N. GUERNSEY, M.D.,Professor of Obstetrics and Diseases of Women
10 STANDARD HOMCEOPATHIC PUBLICATIONS.
and Children in the Homoeopathic Medical College of Pennsylvania, etc.,
etc. With numerous Illustrations. Third edition, revised, enlarged, and
greatly improved. Pp. 1004. 8vo. Half morocco, . . . . . . $8.00
In 1869 this sterling work was ﬁrst published, and was at once adopted as a
text-book at all homoeopathic colleges. In 1873 a second edition, considerably
enlarged, was issued; in 1878 a third edition was rendered necessary. The
Wealth of indications for the remedies used in the treatment, tersely and suc-
cinctly expressed, giving the gist of the author’s immense experience at the
bedside, forms a prominent and well-appreciated feature of the volume.
GUERNSEY, DR. H. N. Key-Notes to the Materia Medica.
As taught by HENRY N. GUERNSEY, M. D. Edited by J os. C. Guernsey,
A. M., M. D. Pp. 267. Small 8vo. Cloth, . . . . . . . . . . $2.25
“If we are not mistaken, this will prove one of our best and most convenient books for
0fﬁce reference. The most serious defect is its brevity. We could wish there was more of
it.”—Medical Advance.
“ This work will no doubt receive a hearty welcome at the hands of the many admirers
-of the late and lamented author. Of his conscientious labors in homoeopathic therapeutics
‘we need not speak, for his name stands as almost synonymous with pains-taking study of
symptomatology. In the character of ‘ Key-Notes.’ . . . [it] . . . will prove service-
able to the student and busy practitioner.”—The Hahnemannian Monthly.
“ N 0 man ever was more ﬁtted to compile awork of this sort than the late Dr. Guernsey ;
keen and critical in observing symptoms, enthusiastic in reporting the successful use of the
remedy, he was ever on the alert to catch the genius of the drug and to ﬁnd its similitude
in the patient.”—North American Journal of Homoeopathy, March, 1887.
GUERNSEY, DR. E. Homoeopathic Domestic Practice.
With full Descriptions of the Dose to each single Case. Containing also
Chapters on Anatomy, Physiology, Hygiene, and abridged Materia Medica.
Tenth enlarged, revised, and improved edition. Pp. 653. Half leather,
Price,..........................$2.5O
HAGEN, DR. R. A Guide to the Clinical Examination of
Patients and the Diagnosis of Disease. By Rrcrman HAGEN,
M.D., Privat docent to the University of Leipzig. Translated from the
second revised and enlarged edition, by G. E. GRAMM, M.D. Pp. 223.
12mo.Cloth,............. .. ..$1.25
“ This is the most perfect guide in the examination of patients that we have ever seen.
The author designs it only for the use of students of medicine before attending clinics, but
we have looked it carefully through, and do not know of 223 pages of printed matter any-
where of more importance to a physician in his daily bedside examinations. It is simply
invaluable.”—From the St. Louis Clinical Review.
HAHNEMANN, DR. S. Organon of the Art of Healing. By
SAMUEL HAHNEMANN, M.D. Aude Sapere. Fifth American edition.
STANDARD HOMGIOPATHIC PUBLICATIONS. 11
Translated from the ﬁfth German edition, by C. WESSELHOEFT, M.D.
Pp.244. 8vo. Cloth,...................$1.75
" “ Every homoeopathic physician and undergraduate should be owner of a copy of this
wonderful work, should read it very carefully and often, and ponder over its contents. Our .
word for it, gentlemen, you will be the better for it as physicians and homoeopathists, and .
you will be often surprised to ﬁnd that on subjects which to your minds were obscure
Hahnemann sheds a perfect ﬂood of light which renders them so bright and well deﬁned, -
that even he who runs may read.
“ To insure a correct rendition of the text of the author, they (the publishers) selected
as his translator Dr. Conrad Wesselhoeft, of Boston, an educated physician in every respect,
and from his youth up perfectly familiar with the English and German languages, than
whom no better selection could have been made. That he has made, as he himself de-
clares, ‘an entirely new and independent translation of the whole work,’ a careful compar-
ison of the various paragraphs, notes, etc., with those contained in previous editions gives
abundant evidence; and while he has, so far as possible, adhered strictly to the letter of
Hahnemann’s text, he has at the same time given a pleasantly ﬂowing rendition that avoids
the harshness of a strictly literal translation.”—Hahneanannian lllonthly.
HALE, DR. E. M. Lectures on Diseases of the Heart. In
three parts. Part I. Functional Disorders of the Heart. Part II. In-
ﬂammatory Aﬂ'ections of the Heart. Part III. Organic Diseases of the
Heart. Second, enlarged edition. Pp. 248. 8vo. Cloth, . . . . $1.75
“After giving a thorough overhauling to the lectures of Dr. Hale, with the full inten-
tion of a close criticism, I acknowledge myself conquered. True, there are text-books on
the same subject of thrice the number of pages—-more voluminous, but not so concise; and
in this very conciseness lies the merit of the work. Students will ﬁnd there everything
they need at the bedside of their patients. It ﬁlls just a want long felt by the profession.”—-
North American Journal of .Homoeopathg/.
HALE, DR. E. M. Materia Medica and Special Thera-
peutics of the New Rernedies. By EDWIN M. HALE, M. D.,
Professor of Materia Medica and Therapeutics of the New Remedies in
Hahnemann Medical College, Chicago, etc., etc. Fifth edition, revised
and enlarged. In two volumes—Vol. I. Special Symptomatology. With
new Botanical and Pharmacological Notes. Pp. 7 70. 8vo. Half morocco,
$6.00;Cloth,.......................$5.00
5‘ Dr. Hale’s work on New Remedies is one both well known and much appreciated on’
this side of the Atlantic. For many medicines of considerable value we are indebted to
his researches. In the present edition the symptoms produced by the drug investigated,
and those which they have been observed to cure, are separated from the clinical observa-
tions, by which the former have been conﬁrmed. That this volume contains a very large
amount of invaluable information is incontestable, and that every effort has been made to
secure both fullness of detail and accuracy of statement is apparent throughout. For these
reasons we can conﬁdently commend Dr. Hale’s fourth edition of his well-known work
on the New Remedies to our homoeopathic colleagues.”—From the London Homoeopathir:
Review.
12 STANDARD HOMCEOPATHIC PUBLICATIONS.
HALE, DR. E. M. Materia Medica and Special Thera-
peutics of the New Remedies. By Enwm M. HALE, M. D.
Vol. II. Special Therapeutics. With illustrative cases. Pp. 901. 8vo.
Half morocco, $6.00; Cloth, . . . . . . . . . . . . . . . . .$5.00
“Hale’s New Remedies is one of the few works which every physician, no matter how
poor he may be, ought to own. Many other books are very nice to have and very desir-
able, but this is indispensable. This volume before us is an elegant specimen of the
printer’s and binder’s art, and equally enjoyable when we consider its contents, which are
not only thoroughly scientiﬁc, but also as interesting as a novel. Thirty-seven new drugs
are added in this edition, besides numerous additions to the effects of drugs, previously
discussed. . . . We must say and reiterate, if necessary, that Dr. Hale has hit the nail on
the head in his plan for presenting the new remedies. It does well enough to tabulate and
catalogue, for reference in looking up cases, barren lists of symptoms, but for real enjoyable
study, for the means of clinching our information and making it stand by us, give us vol-
umes planned and executed like that now under consideration.”-—Fr0m the New England
Medical Gazette.
HALE, DR. E. M. Medical and Surgical Treatment of the
Diseases of Women, especially those causing Sterility. Second edi-
tion. Pp. 378. 8vo. Cloth, . . . . . . . . . . . . . . . . $2.50
“This work is the outcome of a quarter of a century of practical gynaecological experi-
ence, and on every page we are struck with its realness. It is one of those books that will
be kept on a low shelf in the libraries of its possessors, so that it may be found readily at
hand in case of need. . . .
“In many obstinate uterine cases we shall reach this book down to read again and
again what this clinical genius has to say on the subject. We have never seen Professor
Hale in the ﬂesh, but we have had scores of consultations with him in the pages of his
New Remedies, and he has thus fearlessly helped us cure many an obstinate case of disease.”
--From the Howzceopathie World, London.
HART, DR. C. P. Diseases of the Nervous System. Being a
Treatise on Spasmodic, Paralytic, Neuralgie, and Mental Affections. For
the use of Students and Practitioners of Medicine. By CHAS. PORTER
HART, M.D. Pp. 409. 8vo. Cloth, . . . . . . . . . . . . . $3.00
“This work supplies a need keenly felt in our school——a work which will be useful
alike to the general practitioner and specialist; containing, as it does, not only a condensed
compilation of the views of the best authorities on the subject treated, but also the author’s
own clinical experience; to which is appended the appropriate homoeopathic treatment of '
each disease. lt is written in an easy, ﬂowing style, at the same time there is no waste of
words. . . . We consider the work a highly valuable one, bearing the evidence of hard
work, considerable research and experience.”—Medico-Chirurgieal Quarterly.
HART, DR. 0. P. A Treatise on Intracranial Diseases. By
CHAs. PORTER HART, M.D., Honorary Member of the College of Physi-
cians and Surgeons of Michigan, etc. Pp. 312. 8vo. Cloth, . . . $2.00
The Author’s Nervous System, with above as Supplement, bound in one.
Price,
SPANDARD HOMCEOPATHIG PUBLICATIONS. 13
“Well bound, beautifully printed, up to the times in pathology, replete with homoeo-
pathic therapeutics, supplemental and completory of the author’s work on Nervous Diseases
-—these are its qualiﬁcations.”——H'ahnemannian Monthly, April, 1884.
“ It is written in Dr. Hart’s elaborate manner, clear and unambiguous, and will prove a
valuable guide to the proper understanding and treatment of imﬂammatory, organic, and
symptomatic affections of the brain and its membranes.”-—American Observer.
“ We are glad to observe how closely our author adheres to the rigid (and hence suc-
cessful) homoeopathic method of prescribing. Even in insomnia, where the temptation to
use chloral, etc., is so pressing we have given us the truth—to the exclusion of empirical
nonsense.”-—Homa;opathic Physician, April, 1884.
HELMUTH, DR. W. T. A System of Surgery. By WM. Ton
HELMUTH, M.D. Fifth edition. Enlarged, re-arranged, revised; many
parts re-written, and much new matter added. Illustrated with 718 wood-
cuts. Bound in full leather. Ppfllll. Royal octavo, . . . . . $9.00
Whether he like it or not, every doctor will at some time be called upon to
do a little surgery, in view of which no homoeopathiaphysician can afford to be
without Dr. Helmuth’s great work, which is admirably adapted to the needs of
the general practitioner. It is the work also for the special student, and him
we would remind that surgery of to-day is not what it was ten years ago, and
the difference between the preceding and our author’s present edition is one of
great importance.
The work has for many years been used as a standard text-book in all
homoeopathic colleges, and will long maintain its rank as the best work on the
subject ever brought out by our school. Ever since it was issued the necessity
for student or practitioner to invest in allopathic works on the subject ceased to
exist, and now that this new ﬁfth edition, which is up to date, abounding in
valuable hints, and giving the results of the author’s ripe and extensive ex-
perience in homoeopathic medication in connection with surgery-now that all
this, in our author’s forceful, elegant diction is placed before the profession, it
is certainly to be doubted if a work better adapted to the needs of the practi-
tioner can be found anywhere.
“ We gladly welcome the ﬁfth edition of this standard work, without which no homoeo-
pathic physician can consider his library complete. The author has succeeded in his endeavor
to make it ‘an exponent of the surgery of the present,’ and a volume suited alike to the
requirements of student and surgeon; moreover, it is written in so interesting a manner
that its perusal is a matter of pleasure as well as proﬁt.’ ’——B. W. J'., in the Hahnemannian
Monthly.
“ This is THE homoeopathic work on surgery. The author stands in the front rank as
a skilled operator. He has few equals and no superiors. The book is a marvel.”—St. Louis
Periscope.
“For years Dr. Helmuth’s Surgery has been the pride of every Homoeopath; both
practitioner and student have looked to it for guidance and direction as authority in all
surgical matters. We had thought it almost impossible to improve the work, bu‘ we
14 STANDARD HOMGSOPATHIC PoBLrcAT1oNs.
really think this edition now before us is the best that has appeared. There has been
so much new matter added that any one who now possesses a. former edition will . . . re-
quire this issue in order to be up with the times.”—-The Medical Advance, January, 1887.
HELMU TH, DR. W. T. Supra-Pubic Lithotomy. The High
Operation for Stone—-Epicystotomy-—Hypogastric Lithotomy ——“ The
High Apparatus.” By WM. TOD HELMUTH, M. D., Professor of Surgery
in the N. Y. Horn. Med. College; Surgeon to the Hahnemann Hospital
and to Ward’s Island Homoeopathic Hospital, N. Y. 98 quarto pp.-—-8
lithographic plates. Cloth, . . . . . . . . . . . . . . . . . $4.00-
A superb quarto edition, with lithographic plates, printed in ﬁve colors,
and illustrated by charts and numerous wood-cuts.
“ Here is a handsome folio volume, beautifully bound in gray muslin, with red edges,
ﬁne paper, handsome type, illustrated by artistic lithographic plates and numerous wood-
cuts, that at once attracts the eye of the lover of books. The name of the author is a cer-
tain guarantee of its literary and scientiﬁc value. . . . The book commends itself, not so
much on account of the thoroughness with which it has been prepared, as from the fact
that it is a masterly plea for a form of operation that it would seem has long been unjustly
under the ban of surgical censure. . . . In this bold and original work Helmuth has
opened up a new ﬁeld for study, ably and abundantly fortiﬁed his positions, and given en-
couragement for the hope that even the low ratio of mortality from lithotomy operations
that modern methods have secured, will in the future be still further reduced.”—ll[edical
Counselor.
“One can see on every page that Professor Helmuth worked here can amore, that his
whole soul was in it. . . . The work is so practical that any one can understand its mean-
ing.”—-North American Journal of Homoeopathy.
“Dr. Helmuth is well known as a skillful, bold, and successful operator. . . . The
work redounds greatly to his honor on account of its highly scientiﬁc character. . . . We
are proud to ﬁnd that our homoeopathic school has contributed such a valuable treatise to
surgery, and trust it will receive the attention it merits.”——British Journal of Homoeopathy.
HEINIGKE, DR. CARL. Pathogenetic Outlines of Homoeo-
pathic Drugs. By Dr. CARL HEINIGKE, of Leipzig. Translated
from the German, by EMIL TIETZE, M. D., of Philadelphia. Pp. 576. Svo.
Cloth,..........................$3.50
“The reader of this work will gain more practical knowledge of a given drug from its
pages in the same space of time than from any other book on the same subject.
“ To the English-reading portion of our colleagues this book will be a boon to be
appreciated in proportion that it is consulted, and will save them many weary researches
when in doubt of the true homoeopathic remedy.”-—American Homoeopath.
I-IERING, DR. CONSTANTINE. Condensed Materia Med-
ica. Third edition, more Condensed, Revised, Enlarged, and Improved.
Edited by Dr. E. A. FARRINGTON, Professor of Materia Medica. Pp. 960.
Large8vo. Halfmorocco, . . . . . . . . . . . . . . . . . $7.00
STANDARD HoMcEoPATH1c PUBLICATIONS. 15
Having stood the test of time, this well-known and standard work on Con-
densed Materia Medica needs no ﬂattering array of press notices to recommend
it anew to the rising homoeopathic profession. We need only call attention to
the work done by the able editor in his revision of the text for this, the third
edition, and to this end we quote from his preface: _
“In the preparation of this . . . edition . . . additions have been made, and a few
typographical errors corrected, but, in justice to the lamented author, no alterations have
been made in the substance of the text as he left it.
“ More than twenty new remedies, arranged after the plan of the book, are given in
full, and over forty partially proved drugs, with brief but distinctive indications, are added
to the sections on ‘Relationship.’ Besides all this, about six hundred choice and well-
attested symptoms have been incorporated in their proper place in the text. All the late
works have been drawn upon for the new material, and even private sources have been
unsparingly taxed; but still, great caution has been used in making selections. The plans
and purposes of the work demand clinical as well as pathogenetic symptoms. But of the
former sort only those have been employed which agree with the provings, and which show
every evidence of Igenuineness. Such discrimination demands the exercise of one’s best
judgment and the expenditure of much time. But it is believed the beneﬁts to be derived
far outweigh the trouble. The book is now offered to the profession and to students, not as
a rival of other works, but as a rich treasury full of information common to homoeopathic
literature, and also of gleanings from the vast collection which Dr. Hering made during a
busy half century of medical study and labor.”
HERING, DR. CONSTANTINE. Domestic Physician. By
‘CoNsTANTINE HERING, M.D. Seventh American Edition. Pp. 464.
Price,..... ...s2I50
The present editor, Claude R. Norton, M.D., a former assistant of Dr.
Hering, undertook, at his desire, the task of superintending the publication of
the work. Some additions to the text have been made, a few remedies intro-
duced, and, at times, slight alterations in the arrangement effected, but the well-
known views of the author have been respected in whatever has been done.
“ Hering’s Domestic Physician was loaned to me some thirty years ago to investigate
homoeopathy, and throughout these long years it has remained my valued companion.”—-
Dr S’. Lilienthal in the North American Journal of Homwopathy.
“In the country or in a locality where no good homoeopathist lives, this book is in-
valuable. As a case in point, we remember hearing of a lady who prescribed for her mother
in Paris in a case so serious that two allopathists gave a gloomy prognosis. The lady care-
fully studied the case, gave the remedy and in the morning the two regulars were very much
surprised to see the improvement.”——T he Hornoeopathic Physician.
HOLGOMBE, DR. W. H. ,HoW I became a Homoeopath.
An interesting pamphlet of 28 pages. 8vo. Paper cover. Price, $0.15
Perdoz.,......................... 1.25
]:IOM(EOPATHIC POULTRY PHYSICIAN (Poultry Veteri-
narian); or Plain Directions for the Homoeopathic Treatment of the
most Common Ailments of Fowls, Ducks, Geese, Turkeys, and Pigeons,
l8 STANDARD HoMo.=:o1>ATRIo PUBLICATIONS.
based on the author’s large experience, and compiled from the IIIOSL reli-
able sources, by DR. FR. SCHR6TER. Translated from the German. Pp.
86.l2mo.Cloth,.....................$0.50
H()M(EOPATH1C COOKERY. Second edition. With additions by
the wife of an American Homoeopathic Physician. Designed chieﬂy for the
Use of such Persons as are under Homoeopathic Treatment. Pp. 176.
Price,..........................$0.50
‘HULL’S J AHR. A New Manual of Homoeopathic Practice.
Edited, with Annotations and Additions, by F. G. SNELLING, M.D. Sixth
American edition. With an Appendix of the New Remedies, by C. J.
HEMPEL, M.D. In two volumes. Vol. I, price $5.00. Vol. II, price,
$4.00. The complete work, 2,076 pages, . . . . . . . . . . . . $9.00
The ﬁrst volume, containing the symd/otomatology, gives the complete patho-
genesis of two hundred and eighty-seven remedies, besides a large number of
new remedies added by Dr. Hempel in the appendix. The second volume
contains an admirably arranged Repertory. Each chapter is accompanied by
copicns clinical remarks and the concomitant symptoms of the chief remedies
for the malady treated of, thus imparting a mass of information and rendering
the work indispensable to every student and practitioner of medicine.
JAHR, DR. G. H. G. Therapeutic Guide; the most important re-
sults of more than Forty Years’ Practice. With Personal Observations re-
garding the truly reliable and practically veriﬁed Curative Indications in
actual cases of disease. Translated, with Notes and New Remedies, by
C.J.HEMPEL,M.D. Pp.546,. . . . . . . . . . . . . . . $3.00
“With this characteristically long title, the veteran and indefatigable Jahr gives us
another volume of homoeopathics. Besides the explanation of its purport contained in the
title itself, the author’s preface still further sets forth its distinctive aim. It is intended, he
says as a ‘guide to beginners, where I only indicate the most important and decisive points
for the selection of a remedy, and where I do not offer anything but what my own individual
experience, during a practice of forty years, has enabled me to verify as absolutely decishe
in choosing the proper remedy. The reader will easily comprehend that, in carrying out
this plan, I had rigidly to exclude all cases concerning which I had no experience of my own
to offer.’ . . . We are bound to say that the book itself is agreeable, chatty, and full of
practical observation. It may be read straight through with interest, and referred to in the
treatment of particular cases with advantage.”——British Journal of Homcropatky.
J AHIR, DR. G. H. G. The Homoeopathic Treatment of Dis-
eases of Females and Infants at the Breast. Translated
from the French, by C. J . HEMPEL, M. D. Pp. 422. Half leather, $2.00
This work deserves the most careful attention on the part of homoeopathic
practitioners. The diseases to which the female organism is subject are de-
scribed with the most minute correctness, and the treatment is likewise indi-
STANDARD HoMcEoPATHIo PUBLICATIONS. 17
cated with a care that would seem to defy criticism. No one can study this
work without deriving both proﬁt and pleasure.
JONES, DR. SAMUEL A. The Grounds of a Homoeopath’s
Faith. Three lectures, delivered at the request of Matriculates of the
Department of Medicine and Surgery (Old School) of the University of
Michigan. By SAMUEL A. JONES, M.D., Professor of Materia Medica, Thera-
peutics, and Experimental Pathogensy in the Homooepathic Medical Col-
lege of the University of Michigan, etc., etc. Pp. 92. 12mo. Cloth (per
dozen,$3),”........................$0.30
The ﬁrst Lecture is on The Law of Similars; its Claim to be a_ Science in
that it enables Precision. The second Lecture, The Single Remedy a Necessity
of Science. The third Lecture, The illinimnm Dose an Inevitable Sequence. A
fourth Lecture, on The Dynamization Theory, was to have ﬁnished the course,
but was prevented by the approach of ﬁnal examination, the preparation for
which left no time for hearing evening lectures. The Lectures are issued in a
convenient size for the coat-pocket.
JOHNSON, DR. I. 1). Therapeutic Key. Sixteenth Edition. Pp.
400. Bound in ﬂexible leather cover, . . . . . . . .8225
Boundincloth, 1.75
Again we have the pleasure of announcing a new edition of the above,
which, since its ﬁrst appearance, has been a leading work of reference for the
clinical student and busy practitioner of the homoeopathic school. Notwith-
standing the many editions through which it has passed, there is still a de-
mand for the book; and each time it appears, it is found laden with newer and
more valuable material. In this edition the author has reproduced the Com-
parative Materia Medica, which was omitted in the previous. This will no
doubt be very acceptable to many, as its nonappearance in the last edition
gave rise to expression of disappointment from various quarters. Besides this,
the author has introduced other new matter and further indications for the use
of remedies, which makes the book still more desirable.
“ This is a wonderful little book, that seems to contain nearly everything pertaining to
the practice of physio; and all neatly epitomized, so that the book may be carried very com-
fortably in the pocket, to serve as a source for a refresher in a case of need.
“It is a marvel to us how the author has contrived to put into 347 pages such a vast
amount of information, and all of the very kind that is needed. N o wonder it is in its
tenth edition.——Homoeopathic World, London-—notice of tenth edition.
JOHNSON, DR. I. D. A Guide to Homoeopathic Practice.
Designed for the Use of Families and Private Individuals. Pp. 494.
Cloth,.................... $2.00
This is the latest work on Domestic Practice issued, and the well and favor-
2
18 STANDARD HoMcEoPATHIo PUBLICATIONS.
ably known author has surpassed himself. In this book ﬁfty-six remedies are
introduced for internal application, and four for external use. The work con-
sists of two parts. Part I is subdivided into seventeen chapters, each being de-
voted to a special part of the body, or to a peculiar class of disease. Part II
contains a short and concise Materia Medica. The whole is carefully written
with a view of avoiding technical terms as much as possible, thus insuring its
comprehension by any person of ordinary intelligence.
“Family Guides are often of great service, not only in enabling individuals to re-
lieve the triﬂing maladies of such frequent occurrence in every family, but in the graver
forms of disease, by prompt action to prepare the way for the riper intelligence of the phy-
S1C1&I'l.
“The work under notice seems to have been carefully prepared by an intelligent phy-
sician, and is one of the handsomest specimens of book-making we have seen from its pub-
lisher.”--—Homoeopathic Times.
JOHNSON, DR. I. D. A Guide to Homoeopathic Practice.
Designed for the Use of Families and Private Individuals. Translated into
German. Pp.463. Price, . . . . . . . . . . . . . . . . . $2.00
This valuable domestic homoeopathic guide, which has become so popular
in English, has now been published in German, under the belief that in time
the translation will be equally in demand. A work of such practical usefulness
cannot fail to win its way to the German homoeopathic household.
LAURIE and McCLATCHEY. The Homoeopathic Domestic
Medicille. By Josnrn LAURIE, M. D., Ninth American, from the
Twenty-ﬁrst English edition. Edited and revised, with numerous and im-
portant additions, and the introduction of the new remedies. By R. J.
MOCLATCHEY, M. D. Pp. 1044. 8vo. Half morocco, . . . . . $5.00
“ We do not hesitate to indorse the claims made by the publishers, that this is the
most complete, clear‘, and comprehensive treatise on the domestic homoeopathic treatment
of disease extant. This handsome volume of nearly eleven hundred pages is divided into
six parts Part I is introductory, and is almost faultless. It gives the most complete
and exact directions for the maintenance of health, and of the method of investigating the
condition of the sick, and of discriminating between different diseases. It is written in the
most lucid style, and is, above all things, wonderfully free from technicalities. Part II
treats of symptoms, character, distinctions, and treatment of general diseases, together with
a chapter on casualties. Part III takes up diseases peculiar to women. , Part IV is devoted
to the disorders of infancy and childhood. Part V gives the characteristic symptoms of
the medicines referred to in the body of the work, while Part VI introduces the repertory."
-—-Ha/memannian Monthly.
LILIENTHAL, DR. S. Homoeopathic Therapeutics. By S.
LILIENTHAL, M. D., Editor of North-American Journal of Homoeopathy,
Professor of Clinical Medicine and Psychology in the New York Homoe-
opathic Medical College, and Professor of Theory and Practice in the
STANDARD Ho1\IoaoPATHIc PUBI.IcATIoNs. 19
G
New York College Hospital for Women, etc. Second edition. Pp. 835.
8vo. Half morocco, $6.00; Cloth, . . . . . . . . . . . . . $5.00
“Certainly no one in our ranks is so well qualiﬁed for this work as he who has done
it, and, in considering the work done, we must have a true conception of the proper sphere
of such a work. For the fresh graduate this book will be invaluable, and to all such we
unhesitatingly and very earnestly commend it. To the older one, who says he has no use
for this book, we have nothing to say. He is a good one to avoid when well, and to dread
when ill.”—Prof. Samuel A. Jones in American Observer.
“ . . . It is an extraordinarily useful book, and those who add it to their library will
never feel regret, for we are not saying too much in pronouncing it the best work on thera-
peutics in homoeopathic (or any other) literature. With this under one elbow, and Hering’s
or Allen’s Materia Medica under the other, the careful homoeopathic practitioner can refute
Niemayer’s too conﬁdent assertion,‘ I declare it idle to hope for a time when a medical
prescription should be the simple resultant of known quantities.’ Doctor, by all means buy
Lilienthal’s Homoeopathic Therapeutics. It contains a mine of wealth.”—Prof. Chas. Gatchel
in Ibid.
LUTZE, DR. A. Manual of Homoeopathic Theory and
Practice. Designed for the use of Physicians and Families. Trans-
lated from the German, with additions by C. J. HEMPEL, M. D. From
the sixtieth thousand of the German edition. Pp. 750. 8vo. Half
leather,.........................$2.50
MALAN, H. Family Guide to the Administration of Ho-
moeopathic Remedies. Pp. 112. 32mo. Cloth, . . . . $0.30
MANUAL OF HOM(EOPATHIC VETERINARY PRAC-
TICE. Designed for all kinds of Domestic Animals and Fowls, prescrib-
ing their proper treatment when injured or diseased, and their particular
care and general management in health. Second and enlarged edition.
Pp. 684. 8vo. Half morocco, . . . . . . . . . . . . . . . $5.00
“ In order to rightly estimate the value and comprehensiveness of this great work, the
reader should compare it, as we have done, with the best of those already before the
public. In size, fullness, and practical value it is head and shoulders above the very best
of them, while in many most important disorders it is far superior to them altogether, con-
taining, as it does, recent forms of disease of which they make no mention.” ——-.Hahneman-
niun Monthly.
MARSDEN, DR. J. H. Handbook of Practical Midwifery,
WITH FULL INsTRUoTIoNs FOR THE HOMCEOPATHIO TREATMENT on THE
DIsEAsEs OF PREGNANCY, AND THE AocIDENTs AND DIsEAsEs INCIDENT
To LABOR AND THE PUERPERAL STATE. J. H. MARsDEN, A. M., M. D.
PP‘ I D O I O O O O I O O I l I O U I I I O I I “ It is seldom we have perused a text-book with such entire satisfaction as this. The
author has certainly succeeded in his design of furnishing the student and young prac-
titioner, within as narrow limits as possible, all necessary instruction in practical midwifery.
20 STANDARD HOMCEOPATHIO PUBLICATIONS.
The work shows on every page extended research and thorough practical knowledge. The
style is clear, the array of facts unique, and the deductions judicious and practical. We are
particularly pleased with his discussion of the management of labor, and the management
of mother and child immediately after the birth, but much is left open to the common
sense and practical judgment of the attendant in peculiar and individual cases.”—Hbmoeo-
patlric Times.
MORGAN, DR. W. The Text-book for Domestic Practice;
being plain and concise directions for the Administration of Homoeopathic
Medicines in Simple Ailments. Pp. 191. 32mo. Cloth, . . . . $0.50
This is a concise and short treatise on the most common ailments, printed
in convenient size for the pocket; a veritable traveler’s companion.
NEIDHARD, DR. C. Pathogenetic and Clinical Repertory
of the most Prominent Symptoms of the Head, with
their concomitants and conditions. By Dr. C. NEIDHARD, formerly
Professor of Clinical Medicine in the Homoeopathic Medical College of
Pennsylvania. Pp. 188. 8vo. Cloth, . . . . . . . . . . . $1.50
“We trust that the volume will ﬁnd its way into the library of a large number of
physicians, and we have no doubt it will be found worthy of a place. The salient advan-
tages of the book are as follows:
“ 1. It furnishes us with the most essential head symptoms of the Materia Medica. 2.
It gives the conﬁrmation of these, as well as other symptoms, from the experience of an ex-
tensive practice covering a period of ﬁfty years. 3. To these are added the concomitants in
other parts of the body, produced by the same remedy, and the conditions under which
these symptoms are aggravated or ameliorated. It is the author’s experience that if the
symptoms of the head are most similar to any remedy, this remedy is also most eﬂicacious
to the corresponding symptoms in other parts of the body. 4. The different parts of the
head affected are divided and classiﬁed in diﬁ'erent chapters, for the purpose of affording
easy reference to the student or practitioner. To all of them the concomitants and condi-
tions are appended.”—-New York Medical Times.
._ “The Repertory, as a whole, is excellently planned and executed, and is doubtless des-
tined to prove of genuine usefulness ”-»New England Medical Gazette.
NORTON, DR. GEO. S. Ophthalmic Therapeutics. By Gno.
S. NQRTON, M. D., Professor of Ophthalmology in the College of the New
York Ophthalmic Hospital, Senior Surgeon to the New York Ophthalmic
Hospital, etc. With an introduction by PROF. T. F. ALLEN, M. D. Sec-
ond edition. Re-written and revised, with copious additions. Pp. 342. 8vo.
Cloth,.........................$2.50
The second edition of Allen and Norton’s Ophthalmic Therapeutics has
now been issued from the press. It has been re-written, revised, and consider-
ably enlarged by Professor Norton, and will, without doubt, be as favorably re-
ceived as the ﬁrst edition—-out of print since several years. This work embodies
the clinical experiences garnered at the N. Y. Ophthalmic Hospital, than which
STANDARD HOMCEOPATHIC PUBLICATIONS. 21
a better appointed and more carefully conducted establishment does not exist in
this country. Diseases of the eye are steadily on the increase, and no physician
can afford to do without the practical experience as laid down in the sterling
work under notice.
PERKINS, DR. D. C. The Homoeopathic Therapeutics of
Rheumatism and kindred Diseases, with Notes, Suggestions,
andaComplete Repertory. By D. C. PERKINS, M. D. Pp. 180. 8vo.
Cloth,..........................1.50
This is a work which presents, in a most distinct and interesting manner,
the symptoms which should guide in the selection of the remedy for all forms
of rheumatism; and its excellence has been heartily acknowledged by our
medical press.
“ It is seldom that we can say, with truth, that a long-felt want has been supplied; but
in reference to Dr. Perkins’ book we do say it.”—--The Homoeopathic Physician.
PETERS, DR. J. C. A Treatise on the Principal Diseases of
the Eyes. Based on Th. J. B.1'ickert’s Clinical Experiences in Homoeop-
athy. Pp. 29l. 8vo. Cloth, . . . . . . . . . . . . . $1.50
RAUE, DR. C. G. Special Pathology and Diagnostics, with
Therapeutic Hints. By. Dr. C. Cr. RAUE. Third edition, re-
written and enlarged. Pp. 1,094. Large 8vo. Half morocco or
sheep, . . . . . $8.00
This is a book which has made for itself a name and a place in the litera-
ture of our homoeopathic school of medicine, and, in connection with this Third
Edition, it is enough to say that the work has been greatly improved and con-
siderably enlarged, and, as Homoeopathy now stands, is doubtless as near. as
possible to all that can be desired. Practitioners who own the ﬁrst and second
editions will ﬁnd it to their interest to own also the third, with its new and
valuable features.
“The third edition of this classical work will be welcomed by every homoeopathic
practitioner. . . . We know of no book in either school of medicine at once so concise and
accurate.” -—-Calijfornia Homoeopath.
“ By the revision and enlargement of this excellent work the author has again con-
ferred aboon upon the entire homoeopathic school. As a work on practice, this book is
undoubtedly the best representative of Homoeopathy to be found in our literature. Its aeti-
ology, pathology, diagnosis, are clear and concise, and the ‘ Therapeutic Hints,’ with ‘ Di-
gest,’ enable the practitioner to cure his patient. . . . The oﬁice of every homoeopath will
be incomplete without this work for reference. It will repay its cost many times a year.”
—Medical Advance.
“The young physician of limited means, and consequent limited library, would ﬁnd it
to his special advantage to possess it, as it really stands as a fair equivalent to many mono-
graphs on many subjects ordinarily considered desirable possessions ”~—Medical Era:
22 STANDARD HOMCEOPATHIC PUBLICATIONS.
“Prof. Raue, as a teacher, was always noted for his practical conciseness in stating
things, and his statements have always been looked upon as eminently reliable, hence it is
no wonder that his work should reach a third edition.”-—-N. Y. Medical Times.
“ To the general practitioner, no matter how ‘ busy,’ to the student, to those who are
seeking light in this new and rapidly enlarging ﬁeld of medicine, and to the old school phy-
sician we recommend this work as one far superior to any now in existence, taking the size
into consideration.”-—.Physicians’ and Surgeons’ Medical Investigator.
REIL, DR. A. Monograph on Aconite. Its Therapeutic and
Physiological Effects, together with its Uses, and Accurate Statements de-
rived from the various Sources of Medical Literature. By A. REIL,
M. D. Translated from the German by H. B. Millard, M. D. Prize essay.
Pp.168,........ .......$0.60
RUSH, DR. JOHN. Veterinary Surgeon. The Handbook to
Veterinary Homoeopathy; or, the Homoeopathic Treatment of Horses,
Cattle, Sheep, Dogs, and Swine. From the London edition. With nu-
merous additions from the Seventh German edition of Dr. F. E. Gunther’s
“ Homoeopathic Veterinary.” Translated by J. F. SHEEK, M. D. Pp. 150.
18mo.Cloth,........ . ......$0.50
SCHZEFER, DR. J. C. New Manual of Homoeopathic Veter-
inary Medicine. An easy and comprehensive arrangement of Diseases,
adapted to the use of every owner of Domestic Animals, and especially de-
signed for the farmer living out of the reach of medical advice, and show-
ing him the way of treating his sick Horses, Cattle, Sheep, Swine, and
Dogs in the most, simple, expeditious, safe, and cheap manner. Trans-
lated from the German, with numerous additions from other veterinary
manuals, by C. J. HEMPEL, M. D. Pp. 321. 8vo. Cloth, . . . . $2.00
SCHUSSLER, DR. MED. An Abbreviated Therapy; The
Biochemical Treatment of Disease. By DR. MED. Scniissrmn,
of Oldenburg. Translated from the Twelfth German edition by DR. J.
‘ T. O’CONNoR. Pp. 94. 12mo. Cloth, . . . . . . . . . . . . $0.90
This translation of Schiissler’s Twelve Tissue Remedies is altogether new,
and the rendering is as close to the original as possible. Dr. O’Connor has also
added a very useful repertory, which greatly enhances the value of the work,
and many who already possess the old edition will ﬁnd it to their advantage to
procure also the new.
SHARP’S TRACTS ON HOMUEOPATHY, each,’ 5 cents; per
hundred,................ ."'...$3.00
N o. 1. What is Homoeopathy? No. 7. The Principles of Homoeopathy.
N 0. 2. The Defense of Homqeopathy. £0. 8. Controversy on c:
6 ° 6
i812: i’tZ§lf.‘;‘l‘i{....r “ i.::i’i.1if::§§;;:§§ “
No. 5. The Difficulties of L‘ N 0. 11. Single Medicines of :
No. 6. Advantages of N 0. 12. Common Sense of
STANDARD HOMCEOPATHIC PUBLICATIONS. 23
SHARP’S TRACTS, complete set of 12 numbers, $0.50; Bound, $0.75,
SMALL, DR. A. E. Manual of Homoeopathic Practice, for
L"? tlFiTs‘e of FaTnilies em&Priva1eindividna1s. Fifteenth enlarged edition.
Pp. 831. 8vo. Half leather, . . . . . . . . . . . . . . . . $2.50
SMALL, DR. A. E. Manual of Homoeopathic Practice. Trans-»
lated into German by C. J. HEMPEL, M.D. Eleventh edition. Pp. 643.
8vo. Cloth, . ‘ . . . . . . . . . . . . . . . . . . . . . . . $2.50
STAPF, DR. E. Additions to the Materia Medica Pnra.
Translated by C. J. HEMPEL, M. D. Pp. 292. 8vo. Cloth, . . . $1.50
This work is an appendix to Hahnemann’s Materia Medica Pura. Every
remedy is accompanied with extensive and most interesting clinical remarks,
and a variety of cases illustrative of its therapeutical uses.
Taschenbuch der Homoeopathic zum Familien-Gebrauch.
Pp. 233. 12mo. Cloth, . . . . . . . . . . . . . . . . . . $0.75
This is an excellent little work on homoeopathic domestic practice in the
German language.
TESSIER, DR. J. P. Clinical Remarks concerning the
Homoeopathic Treatnlent of Pneumonia, preceded by a Re-
trospective View of the Allopathic Materia Medica and an explanation of
the Homoeopathic Law of Cure. Translated by C. J. HEMPEL, M. D. Pp.
131. 8vo. Cloth, . . . . . . . . . . . . . . . . . . . . . $0.75
TESTE. A Homoeopathic Treatise on the Diseases of Chil-
clren. By ALPH. TESTE, M. D. Translated from the French by EMMA
H. COTE. Fourth edition. Pp. 345. 12mo. Cloth, . . . . . . $1.50
Dr. Teste’s work is unique, in that in most cases it recommends for certain
aﬁ'ections remedies that are not usually thought of in connection therewith;
but, embodying the results of an immense practical experience, they rarely fail
to accomplish the desired end.
VERDI, DR. T. S. Maternity, a Popular Treatise for Young
Wives and Mothers. By TULLIO SUZZARA VERDI, A. M., M. D.,
of Washington, D. C. Pp. 450. 12mo. Cloth, . . . . . . . . $2.00
“N 0 one needs instruction more than a young mother, and the directions given by Dr.
Verdi in this work are such as I should take great pleasure in recommending to all the
young mothers, and some of the old ones, in the range of my practice.”—-George E’. Ship-
man, M. D., Chicago, Ill.
“Dr. Verdi’s book is replete with useful suggestions for wives and mothers, and his
medical instructions for home use accord with the maxims of my best experience in, prac-
tice.”--Jolm F. Gray, M.D., New York City.
24 STANDARD HOMCEOPATHIC PUBLICATIONS.
VERDI, DR. T. S. Mothers and Daughters; Practical Studies
for the Conservation of the Health of Girls. By TULLIO SUZZARA
VERDI, A. M , M. D. Pp. 287. 12mo. Cloth, . . . . . . . . . $1.50
“ The people, and especially the women, need enlightening on many points connected
with their physical life, and the time is fast approaching when it will no longer be thought
singular or ‘ Yankeeish’ that a woman should be instructed in regard to her sexuality, its
organs and their functions. . . . Dr. Verdi is doing a good work in writing such books,
and we trust he will continue in the course he has adopted of educating the mothers and
daughters. The book is handsomely presented. It is printed in good type on ﬁne paper,
and is neatly and substantially bound.”——-Hahnemannian Monthly.
VERDI, CIRO DE SUZZARA, M. D. Progressive Medi-
cine: AScientiﬁc and Practical Treatise on Diseases of the Digestive
Organs and the Complications arising therefrom. By CIRO DE SUZZARA
VERDI, M. D., late Acting Assistant Surgeon at Balfour Hospital, Profes-
sor of Physiology and Pathology in the Cleveland Homoeopathic College
for \Vomen. Pp. 349. 12mo. Cloth, . . . . . . . . . . . . $2.00
VON TAGEN. Biliary Calculi, Perineorrhaphy, Hospital
Gangrene, and its Kindred Diseases. Pp. 154. 8vo.
Cloth, ..s1.25
WILLIAMSON, DR. W. Diseases of Females and Chil-
dren, and their Homoeopathic Treatment. Third enlarged
edition. Pp. 256. Cloth,. . ' ' ' . . . . . . . . . . . . .$l.00
This work contains a short treatise on the homoeopathic treatment of the
diseases of females and children, the conduct to be observed during preg-
nancy, labor, and conﬁnement, and directions for the management of new-born
infants.
WILSON, DR. T. P. Special Indications for Twenty-ﬁve
Remedies in Intermittent Fever. By T. P. W1LsoN, M. D.,
Professor of Theory and Practice, Ophthalmic and Aural Surgery, Uni-
versity of Michigan. Pp. 53. 18mo. Cloth, . . . . . . . . . $0.40
This little work gives the characteristic Indications in Intermittent Fever
of twenty-ﬁve of the mostly used remedies. It is printed on heavy writing
paper, and plenty of space is given to make additions. The name of the drug
is printed on the back of the page containing the symptoms, in order that the
student may the better exercise his memory.
WINSLOW, DR. W. H. The Human Ear and its Diseases.
A Practical Treatise upon the Examination, Recognition, and Treatment
of Atfections of the Ear and Associate Parts, Prepared for the Instruction
of Students and the Guidance of Physicians. By W. H. VVINSLOW, M.D.,
Ph. D., Oculist and Aurist to the Pittsburgh Homoeopathic Hospital, etc.,
STANDARD HOMCEOPATHIC PUBLIcA'rIoNs. 25
etc., with one hundred and thirty-eight illustrations. Pp. 526. 8vo.
Cl0th,i............ ...$4.50
“It would ill become a non-specialist toIpasIs iudgméit hpoh the intrinsic merits of
Dr. Winslow’s book, but even a general reader of medicine can see in it an author who has
a ﬁrm grasp and an intelligent apprehension of his subject. There is about it an air of self-
reliant conﬁdence which, when not offensive, can come only from a consciousness of know-
ing the matter in hand, and we have never read a medical work which would more quickly
lead us to give its author our conﬁdence in his Ministrations. This is always the conse-
quence of honest and earnest and inclusive scholarship, and this author is entitled to his
meed.”—Dr. S. A. Jones in American Observer.
WIN TERBURN, DR. GEO. W. The Value of Vaccination:
A N on-Partisan Review of its History and Results. By GEORGE WILLIAM
WINTERBURN, Ph.D., M. D. Pp. 182. Price, bound in paper, $0.50;
bound in cloth, . . . . . . . . . . . . $0.75
The MS. of this little work was placed in the hands of two physicians
directly opposed on the question of vaccination. The ﬁrst, who was in agree-
ment with the position taken by the author, pronounced it a most interest-
ing and exhaustive treatise; the second, while he did not assent to the con-
clusions drawn, declared it to be a scholarly effort, and one that would be
read with interest by many in the profession—“ Not a dull page in it,” he
said. Such comment from two physicians of opposite views on this question
is proof that the book is well worthy of the attention of those interested in
the subject.
WORCESTER, DR. S. Repertory to the Modalities. In
their Relations to Temperature, Air, Water, Winds, Weather, and Sea-
sons. Based mainly upon Hering’s Condensed Materia Medica, with
additions from Allen, Lippe, and Hale. Compiled and arranged by
SAMUEL WORCESTER, M. D., Salem, Mass., Lecturer on Insanity and its
Jurisprudence at Boston University School of Medicine, etc., etc. Pp.
160. 12mo. Cloth, . . . . . . . . .$l.25
WORCESTER, DR. S. Insanity7 and its Treatment. Lec-
tures on the Treatment of Insanity and Kindred Nervous Diseases. By
SAMUEL WoRoEsTER, M. D. Pp. 262. 8vo. Cloth, . . . . $3.50
Dr. Worcester was for a number of years assistant physician of the But-
ler Hospital for the Insane, at Providence, R. I., and was appointed shortly
after as Lecturer on Insanity and Nervous Diseases to the Boston University
School of Medicine. This work, comprising nearly ﬁve hundred pages, will
be welcomed by every homoeopathic practitioner, for every physician is called
upon sooner or later to undertake the treatment of cases of insanity among
his patrons’ families, inasmuch as very many are 10th to deliver any aﬁiicted
member to a public institution without having ﬁrst exhausted all means
26 ISTANDARD Homcsorarnro Punnroarroris.
within their power to effect a cure, and the family physician naturally is the
ﬁrst to be put in charge of the case. It is, therefore, of paramount importance
that every homoeopathic practitioner’s library s_hould’contain such an indis-
pensable work. '
“ The basis of Dr. Worcester’s work was a course of lectures delivered before the senior
students of the Boston University School of Medicine. As now presented, with some alter-
ations and additions, it makes a very excellent text-book for students and practitioners.
Dr. Worcester has drawn very largely upon standard authorities and his own experience,
which has not been small. In the direction of homoeopathic treatment he has received
valuable assistance from Drs. Talcott and Butler, of the New York State Asylum. It is
not, nor does it pretend to be, an exhaustive work; but, as a well-digested summary of our
present knowledge of insanity, we feel sure that it will give satisfaction. We cordially
recommend it.”-—New England Medical Gazette-
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