B49664 3 I 41 t7-; . PAR I. ': r y# - j- r r INRDCINa.9J. DYSD4L,.M.D milli ASCO/72tTUN LS REU O %uM.D. ARI AN B C, M.D. P NTHED KO)H HAHNE1MANN MATERIA MLEEDICA. PARTL19 CONTAINING INTRODUCTION BY J. J, DRYSDALE, M.D. KALI BICHROMICUM BY J. J. DRYSDALE, M.D. ACONITUM NAPELLUS BY R. E. DUDGEON, M.D. ARSENICUM BY FRANCIS BLACK, M.D. 2 PRINTED FOR~ THE0 HAIINEIWANN PUBLISHING SOCIETY; ANDTtTPBLISHE[D BY' H -;BiArILLERE, 219. REGENT STREET; LONDON, AND 290 BROADWAY, NEW YORKC. -PAIZIs: J. B. BA)ILLIERE, LIBRAIRE, RUTE HAUTEFEUILLE. n-sn 1852. - A zPrice foven Sb..lins. LIr L t 7 44, '-;-- W ANo 8,GL1iLT Srauwr, OXFORD STREET. -~r -C t* - -t~~ r A r- -=t: 4' r e WC;;T.aXr ~ ~1, i INTRODUCTION. ACCORDING to the requirements of the fundamental law of Homceopathy a pure Materia Medica should consist simply of a clear and accurate description of the effects of medicinal agents on the living organism. Now as nearly all causes of disease may in their turn become remedies for other diseased states, and in fact the effects of remedies on the healthy body are themselves diseases, it follows that substantially the same method must be followed in observing and describing the effects of medicines as in observing and describing natural diseases. There are however certain obvious technical differences which the nature of the subject demands, and the question is whether we have not given way to these merely technical considerations to an extent injurious to, if not in many cases quite subversive of the main objects which should have been kept in view. To put this point to the proof, let us take an extreme case. Take the example of any disease arising from a morbid poison -a specific cause acting from without, and therefore quite analogous to the effects of medicines. Let any one take a case of such disease and write out the symptoms carefully, but instead of doing so in their natural order and connection in the form of a narrative, let him arrange them in the form of the ordinary schema, or register of symptoms in which our medicines are usually arranged, and then shew it to another person well versed in the diagnosis of the disease. It is almost certain that the latter will fail to recognise it, and will view it with somewhat of the curiosity one would display towards a chinese puzzle, to which we have not the key. Then let the same symptoms in the same words be merely written over again in their natural order and connection and immediately the nature of the case becomes plain and obvious. Or even let one word be pronounced, viz., the name of the disease-thus giving the key to the puzzle-and it becomes equally intelligible; and this mode of arrangement, though a bad way of describing the disease, becomes perhaps a convenient plan for accurately comparing two cases of the same disease in order to find the minuter shades of difference between them. Now this shows us at once the defect and the merit of the ordinary arrangement. On the one hand this arrangement of the symptoms favours that accurate adaptation to the minuter shades of the case of the disease before us which is necessary in Homceopathy, while on the other it deprives us of that general and connected view of the whole action of the medicine which shows in what diseases (or classes of cases) it is to be used at all. Thus in trying to escape the Scylla of a vague generalization, we fall into the Charybdis of an equally unmeaning mass of trivial details. In the first years of Homceopathy this was less, if at all felt, for then we had few medicines, and these were well proved, and the key to the symptoms given by Hahnemann himself. But as the number of proved medicines increased, and these so-called new provings consisted of nothing more than an array of meaningless symptoms without any key, and each year added to the number of such unmeaning lists, to the great embarrassment of our already overburdened memories, and the increasing cumbrousness of our already too cumbrous repertories; then the evil became so painfully felt that the scientific among Homceopathists, and those really anxious for its progress and development, set themselves earnestly to the task of endeavouring to find a remedy for the evil. Foremost of all, and indeed as standing almost alone, we must place the Austrian Proving Society, as the chief representatives of which we may name Drs. Watzke, Gerstel, Mayerhofer, Arneth, and Professor Zlatarovich [professor of Materia Medica in the Joscphinum (an B 6----------------------~II------ I! I i! I -- -- ii INTRODUCTION. Allopathic) School of Medicine]. To the members of this society belong in my opinion the honour of making by far the greatest and most important step that has been made in Homozopathy since the publication of Hahnemann's first volume of the Materia Medica-for the extension and perfecting of our Materia Medica is after all the only true progress which has been, or indeed almost can be made, within the domain of Homoeopathy, and it is therefore to those only who engage in that work that merit, at least of the first order, can be awarded. To men who bear the name of Homoeopathists, but who are content simply to practise it for their own benefit or that of their immediate patients, or who even by writing or lecturing succeed in impressing a few of its truths on persons beyond their immediate sphere, a certain merit is also due as confessors and teachers, but a very inferior order of merit, and we may rest assured that of this generation of homceopathists the only names which have the smallest chance of going down to posterity along with those of Hahncmann and the noble band of men who supported and aided him in the experiments which were the foundation of his Materia Medica, are those of the men of our generation who are engaged in carrying out the same work with the labour, self-denial and even actual suffering which such a work demands. The results of the labours of the Austrian Proving Society have been published under the unassuming title of Materials for the physiological reconstruction of the Hom. Materia Medica, and consist in the re-proving of some of our best known and most valued medicines. The important reason for choosing medicines already so well known was to find out if possible the method by which Hahncmann discovered the specific applicability of these medicines to the diseases for which he recommended them, and for which subsequent experience has amply confirmed the accuracy and value of his recommendation. THahnemann, after making himself acquainted with the general action of medicines, which was afforded by the study of the original provings in their natural order of narrative, did not consider it necessary to publish the individual experiments, but preferred giving them combined into a convenient arrangement for adapting them to individual cases of certain classes of disease which lie indicated in a preface or note to each proving. Without these guides it would be difficult or impossible to find in the mere register of symptoms the peculiar specificity of the medicines to the diseased states for which many of them have become so famous since Hahnemann pointed it out to us. This difficulty has now to a great extent been removed by the re-provings of the Vienna Society, and we are now in a position to demonstrate philosophically the homoeopathic relation between the medicines and the diseases cured by them. But beyond this the Society have not yet been able to advance, for as yet no better plan has been devised of putting the results of the provings in a practically useful form into the hands of homaeopathic practitioners than a well-made Hahnemannic schema with the prefatory directions and notes such as Hahnemann's own earlier medicines appear in. Dr. Watzke has therefore most wisely confined himself to a simple and minute detail of the experiments in his first medicine, viz., Colocynth, followed by analytical and critical remarks on the pathogenetic and curative effects: the whole work being executed in a manner that may be said to exhaust the subject, and to afford to us the materials of a complete study of the properties of the drug. And as such we must all use these materials, making ourselves thoroughly masters of the general character of the action of each medicine. But more than that is required in practice, as we all know, and these provings do not afford us that, viz. the facility for applying the minute symptoms to each individual case. In fact were our Materia Medica arranged only in this form, the practice of Homoeopathy would only exist as far as classes of medicines and diseases are concerned, and there would scarcely be that minute adaptation of the symptoms to individual cases which the proper practice of homoeopathy imperatively demands. This objection has been unanimously felt to be quite fatal to the publication of the Materia Medica which is to be daily or hourly in the hands of the practioner in the form of Watzke's Colocynth. Nevertheless I think it ought to be considered that that work is the commencement of a new epoch in the development of homnoopathy, and that from thenceforth the homoeopathic public can never consent to receive any new proving as having any claims to respect unless the original experiments are published in full, and whatever plan the author may adopt as a fit one for arranging the symptoms for the practitioner, such an arrangement must be given as an addition to the narratives of the experiments, and not in lieu of them. If it has been found expedient and even necessary to re-prove our best medicines, even after Hahnemann, who from hence ii 1 --"~--- ----- - - -I - -~ -- -- - ,I INTRODUCTION. iii forth can expect we are to accept at his hand a mere bald and naked list of symptoms?! In the subsequent reprovings the authors have endeavoured to remedy the defect, but as yet with very partial success. Dr. Mayerhofer, Professor Zlatarovich, and Dr. Watzke himself, in his next medicine, Natr. mur. have added a sort of analysis and summary of the symptoms in the Hahnemannic order, but as these are printed close, and interspersed with physiological, therapeutic and other speculative remarks, they fail to afford a good index-in fact it would be nearly as much trouble to find a symptom in them as in the experiments. Dr. Gerstel has added a schema of his own, which has all the defects of the Hahnemannic one, as far as regards the disjunction of symptoms and the loss of narrative and course; and in addition to these he has introduced a mode of discriminating the therapeutic value of the symptoms, which can only be useful and intelligible to those who adopt a theory of his own, and therefore may for the present be considered practically useless to the great body of homceopathic practitioners, who neither know nor understand his theory; among the latter of whom I am sorry to confess myself. Dr. Muller, who seems to be more a literary than a practical character, has given us a complete old-fashioned schema, with a complacency that is somewhat amusing, when we consider the object of the society. The most useful is that of Dr. Arneth, as he has given a complete index, separate from the pathological remarks. Still, however, the body of the proving remains an unsifted and undigested mass of symptoms. Out of Austria little has as yet been done in this branch of the subject, but as the most notable, I consider, the able and profound writings of Dr. Kurtz, in the Hygea. He has examined and analysed with acuteness and success the relations of the symptoms, and has given a plan of arrangement which is very good for an abridged manual, but would scarcely apply to the Materia Medica in full detail. In this country Dr. Madden has glanced shortly at the subject, and is fully satisfied of the evil, and convinced of the necessity of re-arrangement, though he has not suggested any plan as yet. In France, as in this country, little or nothing has been done in the Materia Medica, except the publication of translation abridgements and repertories of the already existing provings, without any attempt to add to or improve them. In America, besides the publication of abridgements and repertories, a good deal has been done in the north, led on by Dr. Hering, and in the south, by Dr. Mure, to add to the stock of our medicines, but the subject of a general re-arrangement does not seem to have attracted attention yet. In England hitherto our numbers have not been great enough to allow much attention to be given to the scientific development of the Materia Medica, but now that we form a considerable body, and that fair translations and abridgements of medicines are in the hands of those not conversant with foreign languages, it is our duty to direct our attention to the more profound and scientific labours that are going on in the Materia Medica, and either lend our aid, or at the least, render to the English medical public an account of the results of these labours. With this view the Hahnemann Publishing Society has been founded; and besides undertaking a complete repertory has deputed to Dr. Black, Dr. Dudgeon, and myself, the task of bringing out the first vol. of the Materia Medica, which is to consist chiefly of those medicines re-proved by the Austrian Society. To the execution of tids task several difficulties of no ordinary magnitude have presented themselves in limine. To furnish a simple translation of the experiments in their original state would, as above said, be a small boon to the practitioner, and a poor substitute for Hahnemann's own schemas, which are excellent of their kind. Again, to ignore completely all the Austrian re-provings, and publish simply a translation of Hahnemann, would be, in the first place, almost uncalled for, as there exists already an American translation, though it is inconveniently printed, and, in the second place, would be a lamentable confession of ignorance and incapacity, and a virtual acknowledgment that we were unable to profit by Hahnemann's discovery, except where he had not only shown us the way but done the work himself. Or, again, are we merely to pick out all the fresh symptoms and incorporate them with Hahnemann's schemas, and thus overwhehn them with a fresh load of details which would put the finishing stroke to the already almost insuperable difficulty of learning the general action of the medicine when described in that way? These considerations have weighed much on my mind during the past two years, and have been one cause of the retardation of the work. I have done a considerable part of some medicines in the way last described with faint hope of being useful to others, and increasing dissatisfaction to myself, and have at last thrown all aside, and begun -- -- -----~ __ I _ ___ ____ iv INTRODUCTION. on a new plan, which I now submit to the Society with this remark, that it is not by any means intended to supersede the publication of the literal narrative of all new provings, but these being once published, and thus recorded in the Archives of Homccopathy, as the source for the scientific study of the medicine, this plan is offered as one to convey, in a practical form, those parts that are most necessary for the physician in active practice. Nor is this plan in the least meant to bind other fellow-labourers in this work, but each is expected to follow his own plan, and as far as possible, improve upon that of his predecessor. As before said the fundamental objects in a materia mcdica are two, viz., to give a faithful narrative and description of the effects of each medicine, and arrange that in such a form that each symptom may be found at once. These two objects tend to counteract each other, and therefore a special machinery must be devised if we are to secure them both. Now, in considering natural diseases or natural groups of the effects of medicines, we observe that certain symptoms belong evidently to the organ primarily affected, viz., idiopathic symptoms; others again depend merely on the sympathetic derangement of some other organs or part, viz., the symptomatic symptoms. Both these classes of symptoms belong evidently to the same group, and cannot be separated without destroying the unity and fidelity of the picture; but, in that case, how fares it with the second object of the schema, viz., the index function? It is evidently lost, and we have no guide to the symptoms. Hitherto in hand-books the first object has been sacrificed to the second, and the symptoms have all been cut up and arranged under the organs where they occur, and no intimnation given whether they originated there or not. To obviate thLis evil, I propose, a very simple remedy, viz., to separate the index function from the descriptive, and then in each division we shall have two classes of symptoms: one those belonging to the organs under consideration, and the other merely references to other parts where similar symptoms also occur. By adopting this plan we at once get over all difficulty whlich the size of natural groups would throw in our way. To give an example, let us takc awell-known disease or natural group of symptoms, viz., Jaundice, composed of yellow skin and conjunctiva, pale stc,,ls,. dark-coloured urine, drowsiness, bitter taste, &c. To convey a correct idea of the disease these symptoms must of course all be given together: but in that case, how is any one to find it among many pages of similar groups? He must begin by looking for some one of the individual symptoms; and to help him he will find in the hand-books the symptoms arranged in all the different parts where they occur, but no intimation as to whence they are derived. Thus under eyes he will find yellowness, under skin the same, under urine dark color, and so on; and he is left to put them together as he may. Now, this way not only renders nugatory the knowledge we had of the group, but, unless counteracted by knowledge derived fraom other sources, must infallibly mislead; for, suppose we wanted some medicine for drowsiness, for example, depending on idiopathic disease of the brain, and totally unconnected with jaundice, how are we to know that the drowsiness mentioned in that medicine belongs to the jaundice group, and not to any of the numerous other groups belonging to the medicine? But it is quite unnecessary to enlarge on a matter self-evident. I would then lay it down as a rule never to separate the symptoms of the original group, but put it down as a whole in its proper place; and, in addition, put a mere reference to it under the different parts to which its symptoms extend. In the above example, for instance, we put the whole group in its proper place and number it, say 365. Then under the eyes, after the part allotted to the symptoms belonging to those organs, would come yellowness, see Sympt. 365, wand so on under mouth, bitter taste, see 365, &c. The next -consideration is the order of arrangement we are to adopt. On this head we have very little to say, for as long as- we keep the groups together and do not lose their course and connection, it is a matter of comparative indifference what order we follow in describing them; and, as the Hahnemannic order is familiar to us all, it is on that account incomparably preferable to any other. But now comes the grand difficulty, in fact the only real difficulty in the matter. It is to determine what are the natural groups, and which are idiopathic, and which symptomatic symptoms. It may be thought that by a careful study of the medicine and the application of the principles of pathology and diagnosis, we may arrive at that knowledge, and thus place the action of the medicine on a sure and intelligible basis; but a little further reflection will show the futility of that hope, as well as the incompatibility of the attempt with INTRODUCTION. v the proper functions of the author of a pure Materia Medica. To make the matter clear, we may compare his duties with th6se of a messenger despatched by a scientific body to a distant country where some unknown disease was prevailing, for the purpose of obtaining accurate information on that disease. If the messenger, after observing a sufficient number of cases, were to cut them up into separate symptoms and arrange them into an arbitrary list and hand in that as his whole report, he would be deservedly regarded as wholly imcompetent. If, again, instead of bringing back cases he contented himself with forming his opinions of the pathological nature of the disease, and gave in that without any details, then he would be met with the answer-We do not want your theories, but simply a report of facts and observations, and upon these we can theorize at home as well or better than if we travelled ourselves. So it is with the proving of a medicine: the author of it must confine himself to the office of a faithful reporter of facts and observations, for otherwise how could he convey to others information of greater value than he himself is aware of? If it was confined to that, therapeutics would be in a sad plight indeed. For granting that the author of the proving united in his own person the sum of all the knowledge of the day bearing on pathology, and explained the action of the medicine, and described the diseases to which it was applicable in the most complete manner the science of the day allowed, without the actual narrative of the symptoms, yet still what is that? In the course of a few years, one generation, or even ten years, all will be changed, and the scheme then deemed so perfect will have become antiquated and unintelligible. And yet the effects of drugs on the body are immutable and unchangeable, and a plain and faithful description of them can never become antiquated or other than correct. Though, therefore, it may become necessary to have theoretical disquisitions and lectures on the nature of the action of the medicines in each generation, yet these must be kept totally distinct from the facts, and cannot be accepted as the principle on which these facts are to be arbitrarily arranged. While we thus reject all pathological speculations as the basis of arrangement of the Materia Medica, it must not be supposed it is because we undervalue pathological knowledge, or that homceopathic practitioners individually are ignorant of the subject, or could suc cessfully practise medicine as a whole without being at least on a par with their medical brethren of other schools. All that is meant is, that as yet pathology is by far too imperfect to form the said basis, and in many respects may be said to be centuries in the rear of therapeutics; in short, we can cure with tolerable case and certainty a vast number of easily recognized and described diseases, of whose ultimate pathological nature we are wholly ignorant. For example, physicians have for long been able to cure with Peruvian Bark certain forms of disease easily described and recognized by others, called intermittent fevers, of the ultimate pathological nature of which they all along have been and still are almost wholly ignorant. If the first observers of the power of Peruvian Bark, instead of narrating cases of disease actually cured, had merely given us their theories of its pathological nature, the use of the Bark would either never have become general or would have been speedily lost from the impossibility of knowing what disease was actually meant. We must in consequence fall back on a more empirical formula. The plan I propose is this; that our schema should consist only of groups of symptoms, however large or however small even if consisting of one single symptom, which occurred independently, so that whenever we have a symptom or a group of symptoms to which a number is attached, we shall know that it occurred alone (with certain exceptional limitations); and otherwise, the individual was in perfect health as far as could be ascertained. The advantage of this may be best shown by analyzing the sources of fallacy contained in a badly constructed Hahnemannic schema, many of which are mere parodies of Hahnemann's own good provings. Some persons, having found that they could make up a group of symptoms from the single ones in Hahnemann's provings and with that cure a case of disease that exactly corresponded to it, have imagined, that in order to get such another proving, you have merely to throw together all the separate symptoms of the several morbid states a medicine will produce, and then it is of no use to discriminate which symptoms belong to each morbid state, for as it produces them all you cannot go wrong in any combination you may form with these symptoms. There arc two obvious sources of fallacy here:-one is, I think, that it is forgotten, that it is, in many cases, the order and connection alone of the symptoms that give them any diagnostic *F i vi INTRODUCTION. value at all, and that once lost it is impossible to put them together again into any likeness of the original morbid state they signified. The second is, that the effect of the degree of intensity of the morbid state is overlooked; for it is plain that the lowest degree of intensity of a morbid action will only give rise to the most essential symptoms, but, in proportion as the degree increases, will be superadded symptoms less and less peculiar, and less fit to be cut away from their connection. For example, certain pains in the chest occurring quite isolated may indicate the lowest degree of the kind of pleurisy or pneumonia to which Bryonia is homoeopathic, and may, therefore, usefully stand isolated in the proving: but, supposing the action of the drug carried farther so as to produce intense and extensive inflammation, then there would be superadded distinct symptoms, such as dyspncea, general fever, prostration of strength, &c., which are, properly speaking, not direct symptoms of Bryonia at all, and can only appear in combination in this group where they speak to the intensity of the degree merely of the inflammation of the chest. The error of using these latter symptoms in making up any other group is too plain to require further notice. In fact the best illustration of my meaning is afforded by the description of an epidemic disease, which is the action of the same cause on a great variety of different organisms. In one, a portion of its effects, possibly a small fragment, or even a single symptom, may be manifested; in another, a similar fragment but of different nature; in others, the full disease in different degrees of intensity. In a faithful description we would not only give the complete cases but likewise the fragments, and it would be perfectly proper to combine these fragments together to form a complete picture of the disease. But it would, of course, never do to disintegrate the separate symptoms of these groups or fragments and re-combine them in an arbitrary manner. Now a great many of the,symptoms in a proving are independent, isolated symptoms,- and may with propriety be used for combining together to give a faithful picture of the whole action of the medicine, as they are in fact the characteristic symptoms of the lowest degree of the morbid state. But it may be said, No doubt we often get only one symptom or a small group of symptoms, owing to the feeble dose of the medicine given, but if more was given, or it acted more powerfully, and the morbid state was more developed, many more symptoms would make their appearance. Why therefore put down that single symptom by itself so conspicuously, which may after all be only a sympathetic symptom of no importance, and may have appeared accidentally rather than another? In short, the more superficial and incomplete the proving, the more such symptoms will appear.-To this the answer appears to me, that the appearance of one symptom or small group alone is not at all likely to be accidental, but that it is precisely because that is a most characteristic or peculiar symptom that it appears alone. However this may be, it is still a fact that some symptoms do appear alone in the provings of substances in sufficient dose to cause undoubted effects, and therefore in any faithful representation of these effects such symptoms must be noted as having appeared in that manner. Doubtless as the provings are more complete and the morbid action more intense and completely shewn, these symptoms will take their place in the larger groups. Still there will always be a utility in keeping the record of the fact that they also appeared alone. In the cholera a fully developed case will serve quite well to describe the stools, but it is also a matter of great importance in the history of the disease and of the value of the symptoms to know that in some cases the peculiar stools seem to occur as a fragment of the disease in some individual cases during the epidemic. Another advantage of this plan of never dividing independent natural groups is, that we avoid the difficulty of discriminating between primary and secondary and alternative symptoms and the after-effects, as they are called. For if we take care to give the course and termination of each morbid state in the same group, it is easy enough to see which is the primary action.* SThe meaning Hahnemann httached to his different kinds of symptoms may be best gathered from the Fragmenta de viribus medicamentorum positivis, in the preface to which we read as follows: " Medicina quovis alias vires citius edit, alias serius, qum ambsi sibi utcunquNc oppositm sunt ct dispares, immo e diametro opposite; illas vires primarias vol primi ordinis nuncupo, has secondarias vel secundi ordinis." "Que reliquias nominavi symptomata, ea non occurrunt nisi ubi cnormis dosis enormes suscitavit tumultus, tumque diutius justo aliqum, vel primm classis vires vel secundarisa remanent, ham vel ille, ut fort cujuslibet hominis natura, vcl in hanc morbositatem vel in illam potissimum prona." There is no mention in this work of alternating symptoms, nor in fact does the expression (wechselwirkung) appear, except in one or two volumes of the Mat. Med., and disappears again in subsequent volumes. In fact there was no need of any name for them at all, as it merely means that two symptoms which might stand to each other in the - - -- --- INTRODUCTION. vui Another recommendation I would make is to arrange by themselves all the immediate local effects, the chemical and physical effects, and in short all those that Dr. Madden has included in the term genico-dynamic. If a medicine is an evacuant, an emetic for example, and we know by increasing the dose to a certain amount we can always produce vomiting and its necessary train of symptoms, which either stop or prevent all the other effects, I would not arrange these among the more specific effects of the drug, but all such by themselves. Also of the after-effects, after giving a few examples in their proper place in the individual groups, it is quite unnecessary to multiply instances, as they are of no use as characteristics of the drug, but merely the effects of excessive action, however produced, such as constipation following purgatives, sleeplessness and nervous exhaustion following naxcotics, &c., all which depend merely on exhaustion of irritability firom previous overstimulation, of whatever nature. The next addition I would recommend to the schema is the Concordance, similar to that of Hartlaub's Tabellen, for as the main object of the whole schema is the saving of labour to the practitioner, it will be an inumense saving of time to him if, while he finds that the medicine in question will not suit the case, he will at the same time be directed to the next most likely medicine, without having to go back to the Repertory. The Concordance would of course only apply to the most important and peculiar symptoms, and thus it would at the same time point out in a most accurate manner the related medicines. Finally, as a most important consideration, I would direct especial attention to the mode of printing the Materia Medica. The object to be sought is that as large a portion of the essentials should strike the eye at once. For this purpose there must be as little turning over of pages as possible; I would therefore recommend it to be printed in quarto, or some such large size, in double colunms, with a narrow space for the Concordance. Also that great care be taken to have the headings and numbers in distinct types; and in a group of symptoms the merely narrative and less important portions should be printed close, while the peculiar symptoms should be widely printedl and in separate lines. On the details of the arrangement of the Schema.On endeavouring to apply the foregoing general principles to practice, we encounter a number of difficulties wlhich require great pains and assiduity to surmount, and which in the end still leave the schema in a more or less imperfect state, but nevertheless we must not be discouraged on that account as we cannot expect perfection in any work of the kind, and however well it may be done there will still remain something to be learned by the study of the original narratives alone. Of course each one is left to meet these difficulties in his own way, but as a guide so far, I may detail the mode of proceeding that I adopted after many unsuccessful trials.-The thing sought is the discovery of the natural groups and isolated symptoms. Now on taking up a proving in any one individual which extended over several days or weeks, the aspect it presents is that of a complete labyrinth of symptoms, which appear and disappear fr'om day to day without any apparent connection with each other, except that they occurred in the same individual and from the same cause. These two circumstances were therefore taken as the basis of the first procedure, and having careftlly looked through each person's experiments, they were divided into portions at which any natural break occurred by leaving off the medicine till all effects subsided, and. then renewing with a different dose, or even the same dose. This brought the experiments into more manageable compass. Thex,. to get rid of repetitions, the whole experiments were written out with the narrative of the course and progress of each symptom, brought together instead of scattered tlu'ough the several days, and thus repeated over and over again. This brought down the size of the groups very greatly. This cannot however always be done without injtuy, for when there is a distinctly marked course of groups of symptoms, all these must be given in the order of their occurrence day by day, or at least week by week if the duration is very long. Thus we must give together the symptoms of the first day, and next all those of the second day together, and so on, though several of the symptoms may be repeated many times. in fact,,as the plan of drawing together the symptoms in each paragraph is only adopted for the sake of convenfience, int order to save space and allow a more condensed and easily comprehended view of the group of whfich each paragraph is composed, it must not be used in any case where it would cause any sacrifice of distinctness of the I.;-I relation of primary and secondary actions, such as constipation and diarrhoa, may both occur as parts of different primary groups produced by the same medicine. viiil INTRODUCTION. course of the symptdms. Then all these groups were carefully compared one with another, and all those symptoms or groups not in harmony with those of other provers were rejected as doubtful, or plainly accidental and not the effect of the medicine at all. This is especially necessary, and it is precisely here of course where a good proving differs most in reality from a bad one, but it is also the point on which the least apparent diffelrence exists between a good and a bad proving, and in which the greater the labour and fidelity of the author the less is the apparent result, for the greatest portion of his labour may be spent in determining on thi rejection of certain symptoms, and the value of that rejection will only be discovered by the anxious practitioner after repeated experience that the positive results given have not deceived him. We have now arrived at a point where the groups have become of a more intelligible size, and many will consist of single symptoms. In some medicines with a very small and circumscribed sphere of action it will perhaps not be necessary to proceed any further in subdivision; but in those nmedicines which have a more extensive action the groups will still be found too large and unwieldy for practical use, and are still susceptible of further subdivision without injury. In this however we must proceed very carefully, and not upon any speculative principle, but solely as the result of observation and comparison with each other, for we shall soon find several marked and distinct spheres of action which have obviously no connection with each other, at least as far as mutual dependence goes. For example, we may find certain symptoms of the eyes which appeared in some persons to a considerable degree of intensity, though those persons exhibited no sym)pto(ms belonging to the digestive organs; again, we may meet with others who had symptoms belonging to the digestive organs, and also those same eye symptoms in the same or a lesser degree. It would be quite admissible to separate these two classes of symptoms in the latter case. Biut we may also meet other symptoms of the eyes which never occurred alone, but only in perons who exhibited a certain degree of symptoms beI.Inging to the digestive organs: these latter I have considered it would be quite imnproper to separate. The same proceedlg is to be applied throughout in subdividing the groups, keeping in mind the general principle that we must have a distinct ground, derived from observation alone, for separating any symptom or class of. symptoms, and without that sufficient ground we must leave all symptoms in the original group, however unintelligible and unwieldy. Having proceeded in this direction as far as the pathogenetic experiments with each medicine extant will allow, doubtless there will still remain in many provings groups of symptoms which include a good many symptoms that have no special connection with the group, but are present merely accidentally from occurring in the same individual: this can only be determined by further experiments, and till then I see no other mode than to leave them where we found them, without opening the door to error of all kinds. To endeavour to escape the difficulty by breaking up the whole group into individual symptoms would, as said before, be equivalent to the destruction of nearly all the results of the experiments themselves. The schema will now present the appearance of a numnber of individual cases of all the varieties of the morbid states produced by the drug, as concise as possible, and varying in size from one symptom to large groups. Our next step will be, where possible, to proceed to draw together several of these groups, where they are very similar and produced by the same dose given for about the same length of time: we shall thus further save repetitions, and be able to point out the more important and essential elements of the group, just as we do with the more complete cases of any disease. When the same symptom or group of symptoms occurs very often it is, of course, not necessary to give it more than once, but at the end of each section some remarks are given, pointing out the comparative frequency and value of the different groups. We must give (when possible) the morbid appearance with each group, and also all those symptoms which can be derived from chemical and physical means of diagnosis,-such as, analysis of the se- and excretions, auscultation and percussion, the use of the microscope, &c. Where we have only morbid appearances derived from animals or cases of human poisoning of which we have not the symptoms, it will be better, probably, to arrange them at the end of the proving, as we do not know exactly which symptoms they illustrate. As it becomes more complete the schema now assumes more and more the appearance of a good Hahnemannic schema, with this difference, that each separate morbid state or sphere of action has a complete schema to itself, ji I I INTRODUCTION. ix subarranged in the Hahnemannic order, and the whole is formed of a congeries of such schemas rendered accessible by an index at the end of each section, and in addition to that, of an analysis of the section itself when it is large. Now it may be thought there is no need of the index and analysis, as both these functions may be discharged by having a good general repertory for all the medicines. To this I have nothing to object theoretically, but practically, everything. For the chief object of such a schema at all being to save time and labour to the practitioner, that object could not be attained if he had to refer to another vast work in several large volumes to discover the locality of any symptom in each medicine. Besides that, a common repertory would not do; for the number of the symptom must be given, and therefore such a repertory could not be begun till the Materia Medica on this plan was finished; while, on the other hand, the Materia Medica on this plan could not be used till the index and analysis were given; therefore they must appear simultaneously. I object even to printing the index at the end of each proving, because to save time all the symptoms of each part should be so arranged as, if possible, to catch the eye at once, without turning over pages; and it may often happen that the most striking and characteristic symptom of the group we are studying may really be among the sympathetic symptoms. For example-in a case of gastric or bilious disorder something in the character of the headache may seem to us the most peculiar and striking feature; on turning up that symptom in a general repertory, we are referred to a medicine arranged in this form: we first look among the independent head symptoms, and not finding it there, run the eye further down and find it among the connected symptoms with the number attached; we have then merely to turn to that, and we find not only the headache we want, but if the medicine suits, at the same time the greater part of the rest of the symptoms of our case: while if the index were at the end we should have a great deal more turning over of pages. As a further saving of labour I would, in many cases, in the index put not merely the number of the symptom, but, in a short abbreviation, the sphere of action it occurs in so that we may be often saved the trouble of looking for it, as this tells it will not suit. On the Therapeutic Action.-It seems to me the wisdom of Hahnemann was conspicuously shown when he declined, except very sparingly, to incorporate with his provings any speculations as to the diseases they would cure, and, in fact, simply referring any one to the pathogenetic effects for information on that point. In fact, we give best the indications for cure when we describe best the pathogenetic action; and if any one asks me what a medicine will cure, I can only point to the symptoms and groups, and say it will cure any cases similar to them, but what these groups exactly mean, either when I meet them as idiopathic disease or as symptoms of a medicine, I must frankly confess I cannot tell. How can it be otherwise, unless we have attained absolutely to the ultimatum of pathological science? When we say a medicine will cure such and such groups, it must always be with the proviso that both the symptoms of the case of disease and of the medicine that fit together, give sufficient information to enable us to conclude that the proximate causes of the two states are very similar, for otherwise the symptoms of a medicine and of a disease may quite correspond as far as they go and yet the medicine not be homceopathic at all, the reason of which would be quite plain if both morbid states were further developed, for then the divergence would become manifest. It is never to be forgotten that in homoeopathy we always treat the proximate cause alone, and, in fact, cannot if we will treat anything else; we have no power over mere symptoms, and our constant endeavour is to get so complete a view of the morbid state as to be sure that our unknown proximate cause, which is recognized by certain symptoms of a medicine, should be as similar as possible to another equally unknownx proximate cause, which is recognized by the assemblage of symptoms before us which we name the disease. Now we do not know yet the ultimate nature of the action that produces the healthy functions, and scarcely even the seat of many of the sensations familiar to us in perfect health; how then can we expect to understand and fully account for all those slight aberrations of healthy sensation and function which we meet with in our provings? And if pathology is called in to the aid of physiology to explain the natural sensations and functions by exhibiting the effects of their exaggeration or interruption by disease, so much the more is the usus in morbis necessary for throwing light on certain symptoms in medicines as the lowest elements of the disC -'t - ___qT-CIIY-LI-_ -I ------~ - -- --i I _ _ _ __.__ x INTRODUCTION.; cased states they cure. Therapeutic use becomes thus the I magnifying glass of the pathogenesis. And the'reason why we cannot fill up the chapter of therapeutic use Ilbeforehand is, that the more refined methods of diagSnosis are as yet little employed, and we are not able iin lmot cases to recognize the incipient signs or lowest Sdegree of natural diseases themselves; but when all the improvel d means of diagnosis afforded by chemistry Sand physics, including light, electricity and magnetism already known and ere long about to be discovered, are;iiplied both to the incipient stages of disease and to the i'provings of medicines, then we shall have less and less Ij edi of the,usus in morbis as the complement of patho1 genetic experiments to display the truly homcopathic relation of all dynamic specifics. Biut, in the meantime, the author of a proving must Iabstainl from speculations on therapeutic use in the body ) of tlhe 1roving, though he may with propriety add a se.parate' chapter, containing the results of past experience,M that head, and any speculations of his own for the Sfu'tulre, and also a few general remarks on the chief spheres of action of the medicine which may guide the practitioner to certain large classes of cases where it is,mio.st likely to be found suitable. Fi nallyi, it. may be objected that if the Hahnemannic ScNhema is so defective, how is it that we have got on so S well witlh Iahnemann's own early provings? To this [ reply: 1st.-They are good provings, and the sympSoms were really produced by the medicines. 2nd.-A great many of his numbered paragraphs consist of single iRPOL ULY,. i 1 I,VR:nrOL, JULY, 1831. symptoms and small groups of symptoms, which really occurred in an independent and isolated form from the action of moderately small doses. They are, therefore, short cases of disease reduced to its most essential elementary symptoms, and divested of all merely sympathetic symptoms or after effects. 3rd.-Where he has split up larger groups, he has for the most part given us the key in the introductory remarks, or the same has been done by the thousand-fold repeated experience of Homoeopathic practitioners of the usus in morbis. It appears then that I propose in reality nothing new, but I merely attempt to follow Hahnemann in the principles that guided him in the construction of his early proving-schemas, and to render visible the natural barriers that separate a good from a bad schema; and also, by introducing the index as an aid to the memory, to render intelligible the much greater mass of materials we have now to work with. I may add that nothing has given me such an exalted view of the greatness of the talent and industry of Halmemann displayed in his Materia Medica, as the months I have spent in the endeavour to arrange one medicine in the manner in which he has done so many; and I cannot but feel that the voluminous groups I have found necessary to display the characteristics of the medicine, present a very unfavourable contrast to the terse and pregnant paragraphs in which Hahnemaln has given the same information. J. J. DRYSDALE, M.D. r i; 'I ---- VOCABULARY OF GERMAN MEDICAL EXPRESSIONS. (This is not intended to he a cornplete vocabulary of German medical words, but merely of some terms of frequent occurrence in hommeopatbic literature, of which it is desirable to secure a uniform translation.) Abgeschlageniheit-(mental) dejection, (corporeal) prostration Abmagerung-emaciation Absetzencl-intermittent Ader, giil1den e-hemorrhoids Aengstlichkeit }anxiety Angst Aergerlich-peevish Anwandlung-attack, fit *Aufgedunsen-swollen, puffed Aufseclrecken-starting Aufecliwulken- rising up (from the stomach into the mouth) Aufstossen-eruotation Auftreibung-inflation, distension Ausschlag- eruption, rash Auszebrung-emaciation Bangigkeit-apprehensiveness Bauch-abdomen, belly Beissend--smarting, biting Beklemmung - constriction, oppression Berserkerw-uth-furi&.is, rage (like that of the Berserkers) Besinnungeverlust-loss. of power of recollecting himself Betiiubung-stupefaction, confusion Beule-boil, fur'unculus Blijeschen-vesieles Blasen-blebs, blisters Blass-pale Blick-lookBlodigkeit-weakness -Blodsinn-weakness of mind, imbecility Bliltehen-small pustules Bliithen-pustules Blutsch-wir-boil Bohrend--boring Brausen-roaringy Brechwiirgen-retching Buokel-boll Diimisch-dull, confused (in head) ]Jehnend-stretching ]Jrbhnen-tingling Driicken-pressure Driickend-pressive Dumm-stupid. Dumpf-dull, Durchfall-dliarrhcea Diiselig-dizzy Thisterheit-dulness (of head) Binfressend-burrowing Bingenommenheit-confusion Eiter-(laudablc) pus Eiterbliithen-pustulesi Bitern-to suppurate Ekel-disgust Engbrustigkeit-tightness of the chest Erbrechen-vomit Erschi"'pfung-exhaustion Fippern-quivering Flechte-herpes Fleck-spot Fluttern-flutter Fressen-gnaw, corrode Funk-en-sparks Gkrhnen-yawning G~hren-fermentation Gaistrig-rancid Gluckern-gurgling Glucksen-gurgle, bubble Gram-grief, sadness Grausen-shudder Greifen-claw Grinunen-griping Gurren-rumbling Hacken-k-nock Hammern-hammer Hin und her schwanken-swaying to and fro, undulation Herb e-astrin gent Her zgrub e-scrobiculuis cordis HbIOcker-protuberance Hiiftgricht-sciatica Jammera-wailing, Ilamenting Jiaimmerlich-piteous Jauche-unhealthy pus, ichor Jiicken-itch Kaldtes Fieber-aguc Kitzcln-ticklc Klamm-cramp Kiemmen-squceze Klilgen-ring Klopfen-beat, throb Knacken, crack Knarren, creak Kneipen-piiuch Knickcern crpte Knistern rIitt Knirsehien-grnd (the teeth) Knb~tchcn-papukve Inoten-pimples Knurren- grunmble (applied to gas in the bowelsi) NilVOCAIIUI Krcbg& cwiircancrousulcer K rp ftch mrnr z headache Kropfwc-b f h'Jp-walun-cblliionof blood in the hexad Koitzen-hlacking-j Kotziusen-sorthacking tussiculation 1K rAchsen-croak Ixrallle-n-eiaw Kramp) f-spwsrn K ratzi n-scraping Wren i.it-sin all of lback, sacral region riceln-rcepngfurrnicatiori L,:imirni-paralytic Langrwicrigr-chronic, long-standing L.uziiren-lan-11citating Jiip i1i 4eh -qilly I~itclii-disgrccblyinsipid \llarleni- w iirnwer-ascarides MaUt t-we ak?%llleiis4eiienxilass,,-niisanthiropy IIV l-1ShCIU!nSChe1uL-RAnt Ijropophobia NI ckeul-inepecking NI idighukit-fatiguec, lassitude N.pierit-backin spris, pri,.stra tion (of hotly') ýARY OF GERMHANI MEDICAL EX-PRESSIONS. Pochend-throbbing Poltern-rumblinig, borborygmus Quetschung-contusion Raehsen-hawk Raffend -scraping Rau seb-intox ication. Rauschen-rushing, rustling Ri-iuspern-clear the thbroat, hawk Ileissen-tear flueke-jerks Sausen-roaring Schluehzen. Sebluebsen 5 sob, hiccough Schneidend-puttingy griping (in bowels) Schreckhaftigkieit-fearfulness Schwvachi-weak, imbecile Schrammen-scraping, scratching Sebrundend-sore Schwcre-weight, Schwielc-caliosity Schwindcl-vertigo, Sehwindcn-tetters Spannung-tension Stechend-shooting Stich-shoot,7 Stitch Stichiicht-prickiing Stiinen-grroan Stoss-blow Striemnen-stripes Stumnpf-obtuse Sumscn-buzzing Taubhecitsgcrfiihl-benurnbed feeling Taunnel - reeling (sometimes giddi - niess) Torkehi-staggering Tube nd-bangring Tripp e 1-blcnnorrhicea Verdr-ehen-distort Yerdriesslich-morose V'ereitern-suppurate away Verheben-strain Veijauchen-to waste by destructive ulceration \rerrenkungsschmerz -pain as of a dislocation \Terschleimt-covered with mucus Verseblimmer-n-aggravate "Wallung-ebullition \V~abblichkeit-squeamishness W~eichlicbkeit-sickishness, faint feeling, Sinking W-einerlichkeit-lacryrmose humour Wimmelend-crawling Wimmerend-whining 'Winden-twisting "Wrohliistig-voluptuous Wifihlen-digging Wund-raw X\Tundheitsschmerz-soreness Wiirgen -strangling efforts to eructate, retch-ing Wiidrmerbeseigren-flow of water into mouth lf\Tfste...muddled Zaghaft-timorous Ztihneklappern-c'hattering of teeth Ziihneknirschen-gr~inding of teeth Zanksucht-quarrelsomeness Zerhauen-knocked to pieces Zersehlagren-bruised, beaten Ziehend-drawing Zisehen-hiss Zittern-trenible Zornigr-irascible Zottig-villous, shaggy Zucken-twitchi Zukieben-adhere Zusamimendrii'ckend-COMpressive __ __I __ __ __ __ KALI BJCIIIBOMJCUM. ARRANGED BY JOHN J. DRYSDALE, M.D. CONTENTS. 1.-Chemical and Natural Historical. 11.-Literature and Sources of our Knowledge on the Subject. 111.-Pathologrical Anatomy. IV.-The Proving in numbered Paragraphs, with Index and Analysis, Remarks and Concordanec. V.-Suiumary of the Physiological Action. VI.-The Therapeutic Action, and Cases of Cure with it. VIL.-Dose, Preparation, Antidotes, Relation to other Medicines. VIII.-Appendix, containing additional Cases, and the Proving of the Oxide of Chiromiium. - ~I '-----I-'^-' '' KALI BICHROMICUM. UeCmical.-The salts of Chromic Acid are mostly of either a yellow or red colour, the latter tint predominating whenever the acid is in excess. The chromates of the fixed alkalies sustain a very high temperature without decomposition; but they are all decomposed without exception by the united agency of heat and combustible matter. The chromates are in general sufficiently distinguished by their colour. They may be known chemically by the following character: on boiling a chromate in hydrochloric acid mixed with alcohol, the chromic acid is at first set free, and is then decomposed, a green solution of the chloride of chromium being generated. Cilromates of Potassa.-The neutral chromate, from which all the compounds of chromium are directly or indirectly prepared, is made by heating to redness the native oxide of chromium and iron, commonly called chromate of iron, with nitrate of potassa, when chromic acid is generated and unites with the alkali of the nitre. It is deposited from its solution in small prismatic anhydrous crystals of a lemon-yellow colour, which belong to the right prismatic system. Chromate of potassa has a cool, bitter and disagreeable taste. It is soluble to a great extent in boiling water, and in twice its weight of that liquid at 60~. It is insoluble in alcohol. It hlas an alkaline reaction, but Thomson has proved that it is neutral in composition, consisting of 52 parts or 1 eq. of chromic acid and 47-15 parts or 1 eq. of potassa. The bichromate of potassa, which is made in large quantity for dyeing, is prepared by acidulating the neutral chromate with sulphuric, or still better with acetic acid, and allowing the solution to crystallize by spontaneous evaporation. It crystallizes in large foursided tables, the form of which is an oblique rhombic prism. They have an exceedingly rich red colour, are anhydrous, and consist of 1 eq. of potash and 2 eq. of chromic acid. They are soluble in about ten times their weight of water at 600, and the solution reddens litmus paper. This salt fuses under a red heat, and forms a crystalline mass on cooling, of which the crystals have the same form as those obtained from an aqueous solution; but this mass falls to powder as it cools, from the unequal contraction of the crystals in different dimensions. Sesquioxide of Cfiromium.-This is the common green oxide of chromium, and is composed of 2 eq. of chromium and 3 eq. of oxygen. As this may also be used in homaeopathic practice, I give a convenient mode of preparing it pure, recommended by Dr. Brett of Liverpool. The hydrated green oxide may be prepared by boiling a saturated solution of the bichromate with an equal quantity of alcohol (rectified spirits), and a sufficient quantity of pure hydrochloric acid to render the mixture distinctly acid, until the whole possesses a distinct emerald-green colour, then ammonia is to be added in slight excess. The precipitated oxide of chromium is to be well washed with boiling water, and dried at a temperature of 212~. C[kemical uses.-Jacobson found that the neutral salt was inflammable when mixed with carbonaceous and sulphureous substances, and therefore proposed to use it in the composition of moxas, and those in which it was used were found very powerful. The same observer also found that this salt possesses great antiseptic powers, and he has employed it with success as a liquor conservatrix for keeping anatomical preparations. The composition of this antiseptic preparation is one drachm of the neutral chromate of potash to 32 ounces of water. The use of both these salts as caustics and local applications will be alluded to under the head of therapeutics. I KURLI BICHRIRABICU"Al. 3 KALI BICHROMTCTJM. 0 Chemical antidotes.-In cases of poisoning with the bichromate, Dr. Ducatel first proposed a solution of carbonate of soda or potash. Buchner recommends a mixture of bicarbonate of soda and hydrated peroxide of iron. Berndt tried the carbonate of potash in five animals poisoned with chrome, and three died; but he does not think the two that recovered were saved by the antidotal power, as the poison was most likely all ejected by the vomiting, and besides as we know the neutral chromate is not much less poisonous than the bichromate. As the peroxide of iron gives an insoluble precipitate with the chrome salts it seemed a more likely antidote, but it was given to three rabbits without success: a scruple of the bichromate was given to each, and soon after an ounce of the oxide, yet they all died in from three to five hours, and in the stomach some of the chrome salt was still detected. The tincture of galls was also tried without success. The acetate of lime has also been proposed as a chemical antidote. Mr. Alfred Taylor recommends carbonate of magnesia, or lime, in linseed tea, and also suggests the trial of brown sugar dissolved in water at 102~, which reduces the chromic acid to the state of oxide of chrome. Chemical antidotes, however, can be of little avail unless administered within a few minutes after the poison is swallowed; and it may be added none of the above are of tried efficacy nor promise much success, so the chief reliance must be placed on removing the poison with the stomach-pump and by vomiting. Literature and sources of information.-The first notice of the action of this substance on the animal organism seems to be in the experiments of Gmelin of Tftbingen in 1824. Then Dr. Cumin of Glasgow in 1827 observed its poisonous effects on the workmnen engaged in its preparation, and also suggested its use and occasionally employed it as a caustic. In 1841 and 1842 it was used by Hauche and Jacobson in Germany as a caustic and external application in eruptions, &c. In 1844 the first homceopathic proving was published by me, with experiments on animals and observations on the workmen, in the British Journal of HIomoeopathy for that year. In 1845 the Austrian Proving Society undertook the additional proving of this drug, and the results of their labours are published in the Austrian Journal of Homceopathy for 1847, Vol. iii, p. 252, by Dr. Arneth, who has incorporated into this in the most up to that date. To save constant reference, I may say here that I have endeavoured to incorporate in the following pages all the information contained in Dr. Arneth's treatise, and have frequently also adopted the opinions and remarks of Dr. Arneth. The number of persons who have been the subjects of the following observations and experiments is very considerable, amounting to about 100. Of these, it is quite unnecessary to give the names and abbreviations of all the individuals, as in many cases little is known of the workmen except their names and the symptoms reported; it is sufficient to say, that the workpeople on whom observations were made were all males, and of ages varying from 16 to 70. Any observation as to the influence of temperament, &c., on the action of the drug among the workmen, must be taken on the authority of those who furnished the observations, as we have not the means of proving it numerically. The names and abbreviations of the voluntary experimenters here, and in Austria and America, are as follows -comprising 11 males and 5 females already named in the British Journal of Homneopathy in 1844, and 12 males and 2 females named in the Austrian Journal, 1847. A. B.-an unmarried female, aged 23, of sanguine lymphatic temperament. (A. B.) Dr. Arneth-aged 25, of choleric temperament and strong constituntion. (A.) Dr. Drysdale-aged 28, nervous sanguine temperament. (DIe.) Three provings. Dr. Dudgeon-aged 25, nervous sanguine temperament. (Dg,.) Dr. Hamilton-sanguine temperament. (1lii,) Joseph King-a young man of lymphatic temperament, with red hair. (Kg.) Mr. K.-aged 30, of nervous lymphatic temperament. (K.) K. K.-aged 30, a female, brunette and of choleric temperament. (K. K.) Kostler, a medical student. Lackner-aged 23, bilious nervous temperament. (Lk.) M. J.-aged 21. Dr. Marenzeller-aged 26, sanguine nervous temperament, lspare habit. (Mz.) Dr. Mayerhofer. (Mr.) Dr. Miiller-aged 37, tall and slender, bilious temperament, disposition to hiemorrhoids. (AL.) N.-an unmarried girl, aged 18, bilious temperament, black hair, soft disposition, of a chlorotic complexion, and irregular menstnratioi. Dr. Neidhard-dark hair, strong frame. Dr. Norton-aged 32, tall, thir haired, lymphatic temperament. (Na.) Dr. Reisinger-aged above 30, lymphatic temperament, string franmc. Dr. RussclIl-aged 28, fair hair, sanguine nervous temperamenit. (I/ii.) complete manner all that was known upon the subject - - --- 11 KALI BICHROMIICUM. 4 KALI BICHItOMICUM. I Dr.;-hlheinger-aged 30, sanguine temperament, disposed to coryza and ha-rnorrhrds., but of good health. S Dr. cihwarz-aged 30, sanguine temperament, somewhat stout, and of exrc-llent health. ( ch.).J. Taylor, aged 26, bilious sanguine temperament. (Tyr.) SHenry Turner-aged 31, sanguine lymphatic temperament, (17. T.) Dr. Walker-aged 29, bilious sanguine lymphatic temperament. X. Y.-an unmarried female, aged 30, sanguine lymphatic temperament. IProf. Zlatarovich-aged 38, of strong constitution, dark complexion, 4 sanguine nervous temperament. (ZL.) Two provings. In youth had intcrniittent fever, and when 29 had typhus-subject to haemorrhoids. The dose is generally noted accurately at the end of each group of symptoms, but sometimes it is less definitely indicated. Anything beyond the 2nd dilution being named infinitesimal dose (inf. d.), and the immediate fractions of a grain above 1'/th, or more than one grain, being called strong dose (s. d.). When dilution is mentioned the centesimal is always meant: the 1st and 2nd dilutions arc sometimes indefinitely indicated Zas low dilutions (1. d.). The form in which the medicine was taken by the voluntary provers was that of aqueous solution or of trituration with milk-sugar, in the proportion of 1 grain of the salt to 100 drops or grains of the water or sugar respectively. The workmen are exposed to its influence chiefly in the form of solution, of vapour arising from the solution, the dust of the salt, and of the chrome ore. I have placed most reliance on the cases of those employed in packing the perfect salt, as they are exposed to the influence of the salt in its purest form, viz., the dust of the crystals necessarily inhaled in the process. Neverthele.ss, doubtless many of the symptoms derived from th, worknen are to be ascribed to the chromic acid, the action of which however must be very similar to that of the bichromate of potash, as that is an acid salt.(1) (1) In selct ing the groups of symptoms which compose the following 'scl,-pia, I litvc subjected tihe narratives of the experimenters to what may anppar soimewhat rigid criticism a; nd in the fear of incorporating any niile:s or diibtltful Vlsymptoms may have left out ma'ny that really belng to tire dnrug, andl which may turn out to be valuable. But I hold that it is lbe'ttcr to r'.,ct many real symptoms than admit one false one, S as,i,, falso svmrpto tnids to vitiate the whole, by destroying our contile,' i, tihe rest. In most cases I have not admitted any marked S phonmorin on tlh evildence of one experimenter, but only adopted such syiiptint, - aree in sirval. I have also omitted the greater part iof th,,xp, rixwit, of snme provers, in consequence of the want of suftici,.t infonmatiorn as to the constitution or habits of the prover, or from Results of the experiments on the lower animals.Our knowledge of the morbid appearances produced by this substance, as far as can be ascertained from experiments on the lower animals, is tolerably complete, being derived from 39 experiments with the neutral salt and the bichromate on various animals, but chiefly dogs and rabbits. The first experiments made known were those of Gmelin (see Wibmer Arzneimittel und Gifte, Bd. iv, p. 313), next my own with the bichromate (published with plates in No. VI of the British Journal of Homceopathy), then those of Zlatarovich, Schlesinger and Norton (in the Austrian Journal), and lastly those by Berndt (Frank's Mlfagazin, vol. i, p. 34). As all these experiments are narrated or quoted in full in the Austrian proving so often referred to, it is unnecessary to give them literally here,-it will be sufficient to give a summary of the results. The experiments may be divided into three classes: 1st, those that proved fatal within less than ten or twelve hours; 2nd, those fatal between twelve hours and two or three weeks; and 3rd, those that lasted from one to two months. The first class furnishes few facts of practical interest. As regards the quantity: in different experiments, 3, 6, 12, 30 grains produced no further effect than their ejection by vomit direct evidence of their doubtful character. Thus a most formidable group of symptoms, including total blindness for a short time, is given by one experimenter; but as we have no information as to his constitution, and are told he had a headache before beginning to take the medicine, we cannot adopt his results till they are confirmed, as for all I know he may be subject to sick headaches, preceeded by loss of sight, as in this case. The proving of Dr. Wachtel I have also taken the liberty to omit entirely. This gentleman took one dose of the 12th dilution only. Sixteen days thereafter he had a tickling cough, and spat up during the day, on the whole, about half a pound of bright red blood: next day he discovered a small fissure in the posterior wall of the pharyax, from which the blood had exuded. Farther evidence is certainly required to establish any connection between these phenomena and the dose of K. bich. I have omitted also some of the symptoms of the excellent and indefatigable Professor Zlatarovich; as on comparing them, (especially those connected with hemmorrhoids, the flickering before the eye, and the hemicrania) with his own symptoms, while wiunder the influence of other and very dissimilar medicines, they were very much the same. It is certainly very much to be desired that each experimenter should hand in at the same time with his narrative a critical analysis of it, pointing out or expunging those symptoms which from knowledge of himself he considers may be doubtful. Till that is done we cannot attain to accuracy, for it is impossible for any one afterwards, at a distance of time and space, to subject the narrative to a sifting cross-examination, such as might be practicable on the spot: all that can be done is to omit in each what is not confirmed by the narrative of some other experimenters. II --- --------------- ALI BICHROMICUM. 5 ing; while in others, from 30 to 60 grains of the neutral, or 10 grains of the bichromate, were fatal in dogs and rabbits in from half an hour to three hours. A solution of 10 grains injected into the jugular vein of a dog produced instant death. The appearances found in these rapid poisonings were: the mucous membrane of the stomach was found violently inflamed in all its extent except the pyloric portion; or there were brown, or brownish-red, or even blackish spots in several places, and the membrane was partly destroyed. The ileum injected. Red spots in the coecum. Trachea vascular or bronchia and lungs full of blood, and in one, the lower lobes said to be inflamed. Heart containing dark coagulated blood. Brain and spinal marrow full of blood and soft. The second class furnishes the most important results. They are chiefly derived from the following experiments. (1) No. 13, Gmelin's case- 3 j of pulverized neutral chromate of potash was introduced into the cellular tissue of the back of the neck of a dog. Death on the 6th day. 15 (and three following), mine.-10 grains of the bichromate were inserted into the cellular tissue of the integuments of the abdomen behind the foreleg of a small dog. Death in 16 hours. 16.-Small and gradually increased doses were given by the mouth to a dog. At first half a grain dissolved in one ounce of water; this was gradually increased to 10 grains in the day, but as immediate vomiting was produced when the dose exceeded 2 or 3 grains, the quantity was diminished to that dose, and given twice a day till its death in 15 days. 17.-5 grains in an ounce of water once a day for 3 days, then twice a day. Death in 6 days. 18.-5 grains in 1 ounce of water daily, divided into 3 doses for 19 days. Then 5 grains were inserted into a wound as above, and the animal died next day. 22, 23 and 24, Norton's.-These were 3 dogs, all treated by strewing daily a quantity (undetermined) of the bichromate on a wound in the neck. Death took place in 6, 14 and 16 days. 29, Schlesinger's.-2 teaspoonfuls of 1st dilution daily to a rabbit. Death in 14 days. 33, Berndt's.-30 grains of bichromate inserted to neck of a dog. Death in 11 hours. With the exception of the ulcers in the primnl vie, the effects were the same whether the salt was given internally or inserted into a wound. In several cases poisoned in this last manner, Berndt analysed the ejected matters, and also the contents of the stomach and bowels, and also the urine, without finding any trace of clurome in them. In those poisoned by the internal exhibition it was readily detected. The symptoms usually manifested by the animals werevomiting, violent and often incessant, renewed after driinking, at first injecta then mucus frothy or bloody and then dry retching. Pains and tenderness in the belly. Frequent pinging of mucus and blood; quick pulse. At first great thirst, then the animals refused all food and drink. Frequent micturition. Nose stuffed. Flow of mucus from the mouth, cough and expectoration of thick ropy mucus. Eyes covered with a purulent secretion from the conjuntiva which dimmed the cornea; when washed off it was speedily renewed. Rapid emaciation. Great weakness, especially of hind legs, and finally loss of power of them. Death, at times with convulsions, but generally none. A dry exanthematous eruption on the back, with falling off of the hair in several spots. MORBID APPEARANCES. Mouth and (Esoplagus.-In cases 16, 18, and 29, all poisoned by internal exhibition of the salt, the mouth was in one (16) found studded with ulcerations, and there were small dry excavated ulcerations on the tongue. The msophagus in its upper two-thirds was externally of a dark red colour and thickened: in the corresponding internal portion the mucous membrane was entirely destroyed by ulceration, and could easily be scraped off with the handle of the scalpel: it had a greenish grey colour. The lower third was studded with small scattered oblong elevated ulcers. In No. 18 the cesophagus, internally near the pharynx, contained several irregular fleshylooking ulcerations. [See plate I, fig. 1.] In 29 the esophagus was intensely reddened towards the lower end. Stomack.-In almost all cases, however the substance was exhibited, this organ was specially acted on. There were red spots here and there, or (13) it was slightly inflamed, and had at the bottom several patches of blood extravasated between its coats with similar patches in the duodenum. In 15 the cardiac half was healthy, but the pyloric half dark violet red coloured, though at the pyloric orifice and for an inch before it there was no trace of inflammation. The cardiac orifice was, on the other hand, found several times partaking of the inflammation of the neighbouring parts to a great degree. In 16, at the cardiac orifice and central portion of the stomach were cx d1 (1) The plates referred to are in the Appendix to No. VI (2nd vol.) of the British Journal of Homxopathy. -- I t i - 6 KALI BICRROIMICMI.~ 6 KALI BIORROMICUM. tensive superficial ulcerations. Over the rest of the stomach were scattered deep irregular ulcers of a greenish colour, penetrating completely through the mucous membrane. The pyloric extremity was more healthy. The rugm were here and there of a bright red colour. In case 18 there was great constriction of the middle of the stomach, and the pyloric extremity was partly invaginated in the cardiac. The mucous membrane was very rugous and intensely injected. In the cardiac culde-sac were two violet-coloured elevated irregular patches, besides several abrasions or slight ulcerations, surrounded by highly inflamed mucous membrane. [See plate I, fig. 2.] In 29 the mucous membrane yellowish red and easily stripped off. Duodenum.-This portion of the intestinal tube was even more constantly acted on than the stomach. The injection began immediately beyond the pylorus, and varied from slight redness, or detached red spots and stripes, to intense inflammation and even ulceration. In case 15 the same deep injection began immediately after the pylorus, and extended along the whole duodenum in equal intensity: in the jejunum it became gradually lighter, and ceased about the beginning of the ileum: the rest of the intestinal tube was healthy, except the rectum, which was deeply injected. In 16 the duodenum presented numerous vascular streaks, and scattered over it through its whole extent numerous oval ulcers. In 18 the mucous membrane of the duodenum was highly injected, plum coloured and thickened, containing numerous very regular ulcers of an oval shape with sharply defined edges, the mucous membrane completely eaten out. The injection and ulcerations extended throughout the jejunum. The ulcers varied from a quarter of an inch to an inch in long diameter. [See plate I, fig. 3.] Ieum to Rectum.-Throughout the small intestines (case 16) were numerous injected patches. There was a recent intussusception of the ileum in 16 and 18. In 18, 23, and several others, the colour and injection gradually died away, and were entirely absent in the colon and rectum. In 23 and 24 the mucous membrane of the cmcal valve was reddened, and had blackish spots on it. In 22 the colon and rectum were deeply reddened; and in 16 there were longitudinal bright red patches in the rectum, apparently the result of inflammation, and several spots of extravasated blood. In case 22 the mesentery is reported to be injected. Contents-In general neither food nor facccs were found in the stomach and intestinal canal; but they were lined with a tough reddish mucus. Liver.-In 29 and 39 dark brown, very friable, and full of blood. In most, the gall bladder was full of bile. In 17 the surface presented the appearance of alternate very dark and pale patches. The section had a mottled appearance. [See plate II, fig. 6.] Scattered over both surfaces were numerous spots of a whitish yellow colour about the size of a pea, slightly depressed, and of a softer consistence than the surrounding structure. When cut into they were found to extend into the substance of the gland in a globular form. In 18 both surfaces of the liver were studded with yellowish spots of a spherical shape, the size of large peas, reaching from one quarter to half an inch into the substance of the gland. Where they touch the surface there is a slight depression or indentation showing a loss of substance. They are of a softer consistence than the surrounding parenchyma. [See plate II, fig. 5.] Kidneys.-In case 18 the tubuli were much injected, and the whole substance of these organs in a state of congestion. In Schindler's fatal case in the human subject, the kidneys were found enlarged, and when cut into, deep marbled red and filled with frothy blood. In case 33 the bladder and its immediate neighbourhood were reddened. Nose and Eyes.-In case 13 the nose was full of purulentlooking mucus, which, however, did not reach into the sinuses; the conjunctiva was inflamed and covered with the same purulent-looking mucus. Respiratory Organs.-In case 13 in the upper part of the larynx, between the ligaments of the glottis, were found bloodstained coagulated masses, which could be separated from the walls of the windpipe like a membrane. In the bronchi were also found similar polypus-looking masses of mucus tinged with blood, which could be traced like cords through all the branches of the air-tubes. These masses when put in water were softened, and coloured it red, at the same time being partly blanched, but did not swell up in vinegar or ammonia; they were, therefore, not fibrine, but mucus coloured with the red matter of the blood. In 16 the epiglottis and rima glottidis were congested and covered with thick ropy mucus. The internal surface of the larynx was highly injected and covered with muco-purulent matter. The trachea throughout its whole extent was very much injected, and lined with a dirty whitish coating like a false membrane, which could be easily detached with the back of the scalpel. This false membrane did not reach below the bifurcation, although the redness extended into the ramifications of the bronchia as far as they could be traced. The lungs were apparently healthy, except that the dependent portions were congested with blood: they floated with the heart, however, in water. In 17 the same thick purulent mucus lined the larynx and trachea; but there was no false membrane or injection. In 18 the larynx and trachea vascular, and in the trachea there were irregular longitudinal streaks and patches deeply injected [see plate I, fig. 4] covered with viscid mucus - -- KALI BICHROMICUAI. 7 KALT BICHROMTCUM. 7 similar to that reported to have been vomited. The injection continued to where the bronchia began to divide in the parenchyma; but the lungs themselves were not in the least injected: on the contrary, they were pale and bloodless. In 22 the larynx and trachea contained about a tablespoonful of healthy looking pus. There was pus also in the bronchial tubes. In 17 the lungs were mottled but quite crepitant: there was a yellowish spot of about an inch in length on the surface of the inferior lobe of one of the lungs. Heart.-The heart was generally distended with blood in both cavities. In 16 the pericardium was slightly injected, but there was no effusion. Brain and Spinal Marrow were generally normal; but in one or two experiments they are said to be more full of blood than usual, and of a softer consistence. General appearance.-Greatly emaciated. The irritability of the muscles, especially of the heart, diminished. Appearance of the wound.-The application of the salt to the raw surface always gave great pain; but in case No. 13, the wound was found pure and scarcely any pus secreted: in No. 15 the salt was entirely absorbed and the wound not inflamed: in Nos. 33 and 39 the wound was very painful to the touch, and secreted much lymph; yet it was after death quite dry and not reddened. Morbid appearances in experiments which lasted from 4 to 10 weeks. The five subjects of these experiments were all rabbits. Experiment 24.-A rabbit got 1 grain of 1st trituration of kali bichromicumn (1/iooth grain) for 22 days, then 2 grains of the same till its death in 6 days more. No. 25 received the salt in the same way, and died in 40 days. No. 26 was treated in the same manner, but as it was not much affected the quantity was gradually increased till on the 60th day 5 grains of the 1st trituration ('/soth grain) were given. On the 62nd the daily quantity was increased to 6 grains. On the 67th day 8 grains. On the 69th day 12 grains. On the 71st and 72nd days the medicament was omitted. On the 73rd and 74th again 12 grains. On the 78th day it died. No. 27 was treated in the same way with gradually increased doses, and it died on the 74th day. No. 28 also in the same way. For the last 6 days it received 20 grains of 1st trituration daily ('/3th grain of the pure salt). Under this treatment the animals exhibited the following symptoms. In about two weeks a thin watery discharge from the nose came on and gradually increased in quantity and consistency, till the nostrils were partially obstructed and the hair beside them matted together. Soon after the commencement of the discharge from the nose the fur of their coat began to stick out and lose its smoothness, then layers of white scales formed on the skin at different parts, and gradually spread over the whole surface; but were thicker at the neck, back and thighs. They lost flesh rapidly, even to emaciation, before the appetite and excretions were perceptibly affected. Then they got dull and weak, and trembled in moving about, refused food and drink, and finally died. Skin.-The coat was rough and staring, and the fur sticking up. It was everywhere covered with patches of scurfy whitish scales. Inside the parts of the skin corresponding to the scurfy patches were thickened, and the corium of cartilaginous consistence: when cut into were white and shining like fibrocartilage. In case 27 the skin internally seemed to the feel thickened, and interspersed with gritty particles between the lamellHe of the skin. The muscles of the body were thin and wasted, and the whole body emaciated to a remarkable degree, so that the vertebral spines stuck out conspicuously. Stomach.-The stomach was generally found full of the remains of food. The mucous membrane in No. 25, at the bottom and towards the pylorus, easily stripped off from the muscular coat, and easily rubbed to a pulp in the fingers. In No. 26 and 27, on the whole inner surface, especially at the cardiac orifice, it was thickened and raised in scales easily stripped off while the outer surface of the viscus was red. Small Intestines.-The ileum (24) in its inner surface was pretty strongly reddened, with great injection of the vessels, and the whole tract of the small intestines contained a viscid gelatinous mucus. In 26 and 27 the gut was outwardly reddened and injected, and the tissue easily torn; but internally no trace of inflammation, and the contents the same viscid mucus. Large Intestines.-At the point of junction with the small intestines (24) there was considerable vascular injection, and the coats of the gut had lost their transparency. In 26 the coats of the large intestine were easily torn. In 28 throughout the whole course of the colon, between the muscular and peritonaeal coat, there was an abundant collection of a briny, coagulated (sulzartig geronnenen) transparent, gelatinous mass. In 25 the rectum was constricted at three places, and distended with gas between these constricted places. The contents were pitchy, or green or clayey freces. M.esentery and Glands.-In 24 and 25 the vessels of the mesentery and meso-colon were filled with blood. In 26, 27, 8 KA-LI BICHROMICUM. 8 KALI BICHROMICUM. and 28, besides the injection of the mesenteric vessels, the glands of the mesentery were in some spots thickened, enlarged to the size of peas, and containing a bluish brown or brown friable substance. In the three last cases the diaphragm was reddened and traversed by enlarged vessels. Liver.-The liver was in every case enlarged, and in some even to twice its natural size; it was in all cases full of blood and friable, and easily rubbed to a pulp between the fingers. Its colour was dark reddish brown, or even blackish in Nos. 24 and 25. It was double its natural size, but the colour lighter than natural in No. 26. The gall bladder was full of bile in all cases. Ifcnes and Bladder.-In No. 24 the tubular substance was somewhat softer than natural, and reddened: the bladder was full of clear watery urine. In No. 25 the kidneys were dense and firm: the vertical and tubular parts not to be distinguished by their colour, which was in both dark brownishred: the bladder was quite filled with thickish yellow purulent looking urine; its coats soft but without any traces of inflammation. In No. 26 the kidneys were outwardly dark coloured, and inwardly shewed only slight traces of the tubular substance. In 27, when cut into, they showed a brownish red colour, so that no trace of the tubular substance was to be seen. No. 28 presented exactly the same appearances. In the three last cases the bladder was quite empty. Nasal Passages.-In No. 28 nasal passages were reddened. In 25 they contained a considerable quantity of cheesy white soft masses: the mucous membrane was softened and discoloured, showing several spots like small ulcers; but it could not be distinctly made out whether they were ulcers or softened spots. Lungs.-In Nos. 24, 25, and 27 the lungs were collapsed so much as in 24 only to fill the posterior cavity of the chest: their colour, both on the surface and in the parenchyma was deep pink or cinnabar colour; they were unaltered in tissue, crepitating and swimming in water. In No. 26 the front extremity (dependent part) of both lungs showed marks of inflammation, and sank somewhat under the surface in water. Heart.-In all cases the auricles and ventricles were filled with dark clotted blood. In 26 the heart was enlarged to nearly the size of a whole lung. In 27 the heart seemed larger than both lungs put together: the pericardium was reddened, and the coronary arteries full of blood. Brain and its Membranes.-In No. 27 the meningeal vessels and the sinuses were gorged with blood: the surface of the left hemisphere very vascular. In 26 the membranes were reddened, and posteriorly there was an extravasation of dark blood on the surface of the brain. In 25 the membranes somewhat reddened, and there was considerable vascular development in the ventricles: the brain was very soft. In 24 vascular development in the membranes, which were uniformly reddened: the vessels of the cerebellum and medulla obligata as if injected: the substance of the brain was very soft, and falling into pulp under the pressure of the finger. Ii _ __ SYMPTOMS OF KALI BICHROMICUM. -.-------- N.B.-The symptoms are given in groups in the natural order of their occurrence in each prover. These groups are numbered, and arranged in the same order as Hahnemann's provings. When the number of symptoms is not great in any section, so thant the ee can easily run over them all, no analysis is added; but only the index pointing out where symptoms referring to that section arc met with in other parts of the proving. In the concordance the correspondence only applies to the words over which the letter of reference is placed; but if the latter is placed at the end of a sentence or paragraph, it applies to the whole. A mark of interrogation implies that no medicine corresponding to the sympttom to which it refers could be found. Head and a Arg n. n ry. Ars. Mere. Nux. b Aur. Bry. Mere. Sars. c Aur. Led. Nitr. ac. Puls. Staph. Phos. d (?) e Bor. f Phos. ac. Rhus, Tarax. g Puls. h (?) i Am. m. Lye. Sars. Veratr. j Tongo. A Bry. Gins. Mang. Sep. Natr. ro. I Bov. m Cocc. (?) 1, Inclination to vomit for an hour, and in the eveninga frequent threatenings of giddiness. Next day, frequent sudden attacks of vertigo on standingb or walking, so violent that he staggered and thought he would have fallen. (Mfr., 3 provings, 1. d.) 2. Soon after the dose, nausea, giddiness, and drawing pains in the hands, feet and back. (IMr., 1 dose 1. d.) 3. Paroxysms of vertigo every 2 hours, lasting for 12 hours, succeeded by headache chiefly in the frontal protuberance, with extreme prostration of strength. (A female, aged 36, after 30 gtts. 1st. dil.) 4. Giddiness at 10 or 11 o'clock, A. M., increased on stooping.5 Stabbing pains in the left hypochondrium. (Ch. TW.) 5. Giddiness in the morning, relieved by tea.' Lightness across the forehead on stooping, chiefly in the morning." On stooping, frontal headache as after a debauch.' Musty taste in the morning. Bad appetite and foul tongue. Sour vomiting, excited by stooping or moving,s with pain at epigastrium. (Atgn. Ch. TV.) 6. Vertigo on rising from his seat: everything appeared turning round: accompanied by pain in epigastrium." Pain across the loins: he cannot straighten himself after stooping.' (Bru. Ch. W.) 7. On the 4th day a severe headache came on in the afternoon and increased gradually till dinner, after which (eaten with appetite) it was relieved, though not gone. Next morning it was gone, and he had a copious loose stool. (Dle., 2nd. dil. night and morning for 6 days.) 8. Violent shooting pains from the root of the nose along the left orbital archk to the external angle of the eye exactly, with dimness' of sight like a scale on the eye: begins in the morning and increases till noon, goes away towards the evening. Lasted 3 weeks. (Bws. 1st dil. bis die.) 9. Soon after rising in the morning a darting pain in a small spot over the left eye, spreading" over the forehead, but still remaining worst at the original spot; worse on motion. Sensoriun. After breakfast, aching pain beginning at the navel" and rising up the throat, lasting half-anhour. (A female, aged 14, 1st dil. bis die.) 10. Soon after dinner a dull heavy throbbing pain in the forehead, feeling as if it would burst,0 above the eyes extending into the head, with desire to lie down, and relieved by lying down or resting the head on anything, and by being in the open air; worse on stooping or moving about. 11. Dryness of the nose, with sensation of pressure at the root of the noseP as at the beginning of a stuffing cold in the head. The pressing pain spread to the temples and confused the whole head; later in the day very violent headache with weariness of the limbs. Vertigo, nausea and inclination to vomit, with retching up of sour watery5 fluid; shambling of the legs; he must sit down. Drawing pain in right hip stretching to the knee. Aching in the lowest ribs in the right side, lasting 2 days. (Reisinger, 1/. gr. I dose.) 12. On the 3rd day, both while sitting and walking about, he had distinct pain in the bone at the middle of the left tibia; it came suddenly, lasted for a few seconds, and then went off suddenly, and returned thus frequently: also for a few minutes a similar pain along the left orbital ridge of the frontal bone. Next morning, 10 A. M., this latter pain came again, and gradually increased and spread to the upper left maxilla," and was attended with flow of saliva;' then it went off imperceptibly. It returned for 3 subsequent days at the same hour. (Schlesinger, ~/o, to "/,o gr. 4 doses in 7 days.) 13, On the 2nd day lie had again the pain in the forehead for about 2 hours in the morning: next day 3 hours. It returned daily for 10 or 12 days in all; G or 7 days after the medicine was stopped. It became daily milder and of shorter duration, and came later in the day. For the last 5 or 6 days there came also a iparoxysm in the evening, which followed the same course. (Schl. /o gr., 3 doses in 5 days.) 13A. He was seized with violent pain in the left parietal region above and bcliind the temple in a spot the size of a crown-piece. n Lach (. o.\n.c. Gralpht.inc. p Asar. Coloc. lcll. 1.Ion.. Mercurial. Sep. Sl,. Mcz. r Si,. eIlrb. Sil. Thuja..a Evon. Krr. I,alh. I (I) It 11 l- --~-F-r_ __. _ 10 KALI BICHROMICUM. [SYMPTOMS 13 TO 2 Head and Sensorium. u Phos. Plat. Staph. v Anr. The pain was felt chiefly at night" and subsided during the day, and came on violent again at the same hour in the evening about sunset. A swelling' soon formed at the seat of the pain: it grew more in the night, and went down a little in the day: in a week it got to its height, and was then about the size of an egg. It was then quite hard and not sore tocthe touch. i The pain was confined to the lump, and was of a stabbing character, and as if the head were opening. It lasted in all about 2 months, and then the pains and swelling gradually went away without any suppuration or softening. (1 Ch. TV. aged 16.) [It was carefully ascertained that this lad never had syphilis nor mercury. See Appendix.] Vertigo, 84, 92, 94 (im. eff.), 99 (gastr.) 153, (cough), 163 (renal).,, etter in walking, 106 (gastr.), worse on stooping, 106 (gastr.), better in the open air, 109 (gastr.), on moving the head rapidly, 129 (gastr.), on sitting up in bed, 132 (abd.), aggravated on lying back, 132 (abd.), after coughing, 160 (cough4). Almost total insensibility, 96 (im. eff., poisonous ldose). Confusion, maziness, &c., 99 (gastr.),, in the morning, 107 (gastr.),, in the temples, 109. Head generally, aching, 45 (nose).,, heaviness and weight, 160 (cough, &c.),, humming in, 127 (abd.),, bursting pain, 136.,,,, most in the temples, 136 (abd.) INDEX. Head, pressive tearing pains (with lacrymation) 137. Pain the bones of the head, 204 (general pains). Creeping contraction on the scalp (with nausea) 111 (gastr.) Flushes up to the head, 86 (im. eff.) Flying pams in head, 135 (abd.) Forehead, pain, 89, 92 (im. eff.), 104 (gastr.), 129 (gastr.) 1.,, with cold sweat, 109.,, and colic, 120. S heaviness in, evening, 65., darting pain, 129.,, violent pressive, after dinner, 128. Forehead and occiput, darting pain in, 137. Vertex, pressive pain, 136, 163. Sspreading to the temple, 130. Sthrobbing, 120. Vertex, followed by paralytic drawing in righ shoulder, 204. Semi-lateral, 135, in a small spot, 112 (gastr.),, pulsative, 129, lancinating in paroxysms 204 (gen. pains). Temples, 102 (gastr.), shooting, 98, 94, 129, 135, 137 (gastr." 193 (gen. pains).,,, relieved by rest, 129. S throbbing, 123 (gastr.),, temporal muscle, 201, fascia, 204. Occiput, 104 (gastr.) S and forehead, pressing tearing in paroxysms, 201 (pains).,, from occiput to forehead, 53 (nose). Pain in right side of occiput and left fore arm 204 (gen. pains). Pain in right parietal bone, 202 (gen. pains). REMARKS.-The affections of the head and sensorium appear to present themselves seldom as independent symptoms, or as the chief affection in the groups where they occur; but are generally met with in conjunction with symptoms belonging to the digestive organs. There is generally a dull confusion, described as " maziness," " swimming," &c. worse in the morning, and accompaniec with heaviness in the eyes and nausea. The actual vertigo is generally worse on motion and relieved by rest. The headache is mostly in the temples and forehead, and of a shooting or pressing character, or in a small spot. The chief local pains seem to have their seat in the exterior tissues of the head, especially over the left orbit; see Nos. 8, 12, 13, 13A, 202, 204. Eyes. a Asar. Bell. CaTe. Mere. Nitr. n ac. rhoo. ac. Stan. 8ulph. Zinc. "6 Aur. Bell. Clem. K. hyd. Nitr. ac. Nux, ihus, Ysulph. Zinc. c IawT. Stan. Itan. b. d Euphras. e Arn. Iell. Croc. Clem. Dig. Mere. I'hos.Sabad. Sulph. Iec. f Try. Nx, PIuls. Zinc. Staph. a Colch. Mang. Nux. A rClm. Ich. Laur. Plia. Siyph. i A\rt.. t l. ach. M cre. lrht. pigcl. i j Ars.Croton,Rbus r. I k Alum.Cin. Euphor. SPuis. Veratr. 14. Burning of the eyelids.' 15. Smarting and biting of the eye.b 10, On awaking on the second day, burning in the inner canthus, which extended over the whole lower lid:0 aggravated by writing. (Lack., 1st trit. daily for 9 days.) 17, Smarting in the eyes, worse in the open air,d on the 1st; on the 2nd and 5th pressive pain in the ball and burning; on the 4th soreness in the right caruncula.' (Dgn., 1. d.) 18. Burning in the eyelids, increasing in intensity daily, and on the 6th they were glued "up on waking. (Zl., 1st trit. daily 1. d.) 10. On the 5th day smarting of the external canthus:* on the 11th redness of the conjunctiva, with heat and an uneasy sensation as if when opened under water. (Dle., 1st dil. 14 days.) 20. On the 2nd day, watering, itching and burning of the eyes, especially the upper eyelids." The con. oculi is reddened and traversed by large red' vessels, and he had the sensation of something fallen into the left eye. (iMz., 1/, gr. 1 dose.) 21. After burning in the eyes frequently, on the 19th day there was some cedematousJ swelling of both eyelids, which lasted till night. (Lack., Ist trit. 1 dose daily.) 22. On the 1st day, itching of the canthi,k drynessk of the eyelids, slight redness of the conjunctiva, and troubled vision. Next day itching and watering of the eyes: the albuginea is dirty yellow and appears puffy,1 with yellowish-brown" points the size of pinheads: heat in the eyes and desire to rub them. On the 3rd day troubled vision: this was worse on the 4th day, and on looking at an object the eyes burn and the sight goes away, the objects appearing without distinct outline. These symptoms went off gradually in 3 days more. (Mr., 1. d. 1 dose.) 23. After smarting, itching and watering frequently during the day, and morning agglutination during the previous days. On the 7th the eyes..were glued in the morning; the itching and watering continued all day. In the afternoon the photophobia increased to such a degree that he could not open the eyes or bear the light of day without constant quivering and twitching of the eyelids, and great watering of the eyes and burning of the lids. Towards evening the photophobia went quite off:" the tarsi were much reddened, and the conj. palpebrarum injected and red. The eye symptoms went off gradually in the next 2 or 3 days. (1z1., 9 grs. 1st trit. daily for 10 days.) 24. After frequent burning in the eyes, es k Alum.Cin. Euphor Puls. Veratr. I Bry. Bell. Sulph. mn() n Graph. ft r SYM~PTOMS 25 To 41.] KCALI BICHROMrICU]NI. 11 Eyes. o Are.BcU. Bry.Calc. Euphorb. Ign. lod. Merc.Natr.m.Nitr. ac. Puls. Spig. p Cic. Dig. Graph. Phos. Sil. Staph. Sul. Ver. q Camph. r Bel. Nux, Sars. s Sel. Staph. t (?) pecially in the outer canthus, during the previous days, on the 21st day at noon, in the house, he had pressure and burning in the eyes, and feeling as if sharp sand " in them. In the albuginea of the right eye, not far from the cornea on the outer side, he saw a brown spot of the size of a pin's-head. Towards evening again, great burning and the feeling of increased heat in the right eye, and also at times in the skinP round it. For the next few days the eyes were agglutinated, and sensitive to touch and motion, and heavy. (Zlat., 2nd trit. 1 dose daily for 27 days.) 25. On the 8th day several bright red" spots and streaks' appeared on the white of the eye; in progress of time they changed their place, and in 13 days disappeared. (Zth., 1. d. 1 dose daily for 4 days.) 26. After burning of the eyes and agglutination of the lids, and accumulation of yellow matter at the angles repeatedly on the previous days, on the 11th and again on the 30th days the tarsi were reddened and itch," and burn, and seem rough,t causing the sensation of frictiont on the eyeball on moving the lids. The burning and slight eye symptoms continued to return for about 4 weeks after the last dose. (ZI., 2 provings, 2nd trit. 1 d. daily for 23 days, and '/, ggr. every 4 days for 8 weeks.) Among the Workmen. 27. Redness of conjunctiva with lacrymation. 28. Heaviness and soreness of the eyes. 29. Pains in the eyes for the first fortnight. (Mc G.) 30. Eyes inflamed, and adherence of the lids in the morning, and yellow discharge. (IIwe.) 31. Eyelids inflamed and much swollen, and eruption" broke out on them and adjacent parts of the face, lasting 2 days. (1 Ch. W. the day after exposure to the vapour of chrome liquor.) 32. Eyelids inflamed and much swollen. (Ghm.) 33. Eyes tender, conj. oculi injected, eyelids slightly granular." (Plt.) 31. Pustule x on the left cornea, with surrounding indolent inflammation, attended with pricking pain: leucoma on left cornea. (Leg.) 35. When any of the solution accidentally gets into the eyes it produces violent inflammation and loss of vision. 36. Heat in the eyes: lacrymation in the morning at home: appearance of small white pustules in the conjunctiva of left eye towards the inner canthus. These "pustules" are small white granulary elevations surrounded with a good deal of redness. (A young man 9 days at the works.) 37. In the second week of exposure he had itching and pain in the eyes like sand in them, worse in the evening and night: the conjunctiva both of the bulb and lids injected. (1 Ch. Wi.) 38. Redness and swelling of the upper eyelids, and next day pustules appear upon the hands. (These are experienced by an individual very sensitive to the action of chrome if he merely passes through the works during the boiling.) 39. Ophthalmia: it commenced with itching for several days, followed by pain and heat in the eyes and agglutination of the lids: the conjunctiva was red. (1 Ch. W.) u Crot.(?) Mere. Sep. Iep. r Acon. Bell. Bar. Bry.. Con.Graph. He'p. Mere. Rhus, Sars. Sen. Sep. Sul. Puls. Thtya. ft (?) x Sul.(?) y (?) z Cupr. Lach. Puls. INDEX and ANALYSIS [Local Symptoms 14 to 39]. OB.ECTIVE SYMPTOMS. Conjunctiva, yellow colour of, 22, 171 (fatal sup- Smarting, in the open air, 17. Agglutination in the morning, 18, 23, 26, 39. pression of urine).,, in ext. canthus, 19.,, and yellow matter,,, pustule on, 36. Soreness, 28. * 29. Cornea, pustule on, 34.,, right cunmcula, 17. Eyelids swelled and inflamed, 31, 32, 38. Lachrymation, 20, 22, 23, 27, 36. Tender to touch, eyelids, 24., and granular, 33.,, of right eye (nose) 51. Itching, 20, 22, 23, 37, 39.,, cdematous, 21., with headache, 137. Heat, 19, 24, 36.,, swelled up and heavy, 123 (gastr.) Pupils dilated and fixed, 96 (im. eff., poisonous Dryness, 22., fleeting stiches in, 137 (gastr.) dose). Roughness of tarsi, feeling of, 26. Tarsi red, 23, 26. SUnrECTIVE SMProTMS. Pressive pain in ball, 17, 24, 31. Conjunctiva, red, 19, 20, 22, 23, 27, 29, 33, 36, Burning, 14, 17, 18, 20, 21, 24, 45 (nose), 92 Something in the eye, 20, 24, 37. 37, 39. (i. eff.) Photophobia, afternoon, 23, 57 (nose)., large vessels, 20.,, inner canthus and lower lid, 16. Dimness of sight, 22, 8 (headache), 65 (gastr.),,, brown spots on, 22, 24.,, ext. canthus, 24. 102, 123 (gastr.), 168 (renal).,, red spots and streaks, 24. Smarting, 15, 19, 23. Objects seem yellow, 92 (vonsiting). REIARxs.-The idiopathic action on the eyes is plainly shewn in the foregoing, and its character well expressed. The anatomical nature of the changes seems to be inflammat~ n of the conjunctiva oculi and palpebrarum, also of the caruncula lacrymalis, and probably also of the conjunctiva of the cornea accompanied with a blennorrhagic process. The tarsal edges of the lids are implicated, and probably the meibomian follicles. The inflammation most closely resembles that of the catarrho-strumous character, as indicated by the phlyctenule towards the inner canthus, the photophobia ameliorated towards evening, and the lacrymation. The inflammation tends to assume a subacute or chronic character, and commencing symptoms of granular conjunctiva and thickening of the lids are present. The deeper tissues are also not unaffected. The brown spots on the conjunctiva are peculiar. Nose. S40. In the morning sneezing ten times in 41. At noon tickling and itching of the nose, succession. First day. (ZI., 2nd trit. 8 days.) and feeling of coldness" in drawing air through a Mercurials. 0,1 12 KALI BICHROMICUM. [SYMrTOMS 42 TO 5 Nose. 6 Calc. Con. Lye. Staph. sil. c Am. Aur. Carb. v. Ran. b. Teucr. d Asa. Calc. Cyc. Magn.w. 5fz. buL Tab. e Aniar. Ilep. K.hyd. Mani. Pib. Pbcl. Sang. Sul. f Are. Aur. Bell. Calc. Con. Nitr.ac. Pul,. Sang. Sul. g Calc.Cocc.Magn.m. Zinc. A Aur. Bar. e. Graph. Ma.gn. m. Petrol. Phos. Thuja. i Mosch. j Mcrcurials,. k Ant. Bor. Colch. Ferr. Gmph. Leech. Phos. Sep. Sulph. 1 (0) rn Am. nry. Carb.v. ('or. Graph. K. chl. Magn. s. Natr. m. Rhils, Vcratr. n Ver. io? j,?) q Air. Dell. ral,. C('r. li-n. Kali r. Mere. I'retr. Pho. Sep. $l. it; dull sorenessb in the septum, smarting when touched; flow of watery fluid from both nostrils; troublesome quivering and creeping, as of ants, beginning at the right sidee of nose and spreading up to the eyelids, causing jerking of them: sneezing. These symptoms came back daily for 2 or 3 days. (Mz., 15 yr. 1st trit.) 42. The smell even of strong scents bluntedd on the 3rd day, to the surprise of others, succeeded by frequent sneezing and incipient coryza. Obstruction of left nostril, with discharge of thick yellow mucus on the 4th day. Losse of smell; and bad' smell before nose, preceeded by stuffing and increased secretion. (3 male provers, low dil. I dose daily.) 43. On the 9th day soreness and swelling of the right" ala nasi. (Low dil. 1 dose daily.) 44. In half an hour, sneezing with pressing sensation at the upper part of the larynx, which extended through the choanm to the nose. It changes into a tickling in the larynx, and spreads through the mouth and ears; forcible sneezing; aching in the root of the nose (cribriform plate) with heat to the touch of the nose at that spot, and pulsation. The nose swells, and is red and stuffed, and she speaks through it, and feels as if there was a thick" substance in it, making her blow it often, but nothing comes out-it is dry. The same continued next day, and on the 3rd day she had constant attacks of convulsive sneezing with heaviness in the head, and in the afternoon burning in the right nostril, and flow of bright red blood' in drops. On the 4th day the same bleeding after dinner. (N., 3rd dil.) 45. On the 1st day, in the evening he had some pressive headache with burning in the eyes, and afterwards sensation as if the nose were stopped, with great heat1 of the expired air from the nostril. In two hours epistaxis came on. The epistaxis reappeared on the eveningk of the 6th day, and after dinner on the 7th, preceeded' by burning of the eyes. (Lack. 1st trit. 5 days, daily.) 46. After several days of no symptoms he awoke in the nightm with bleeding of the right" nostril, which stopped with difficulty. (Schl., 1st dil. I dose daily.) 47, On the 2nd day, bleeding of the nose, and in the evening quite suddenly coryza, chiefly in the right nostril. Next day it was worse, and much fluid was secreted by the right nostril, and a spot in the right lachrymal bone0 is swelled and throbbing. On the fifth day, the right side of the nose was painful, and in blowing the nose he feels as if two loose 1 bones rubbed against each other. This continued till the 8th, and there were greyish masses blown out, and slight ulcerated spots formed at the entrance of the nostrils, and healed up in the next two or three days. (Arn., '/a grain 1 dose.) 48, On the 1st day a considerable mass of tough concocted mucus hawkedr up. After dinner several times he had a short dry cough. On the 4th day he awoke' with considerable dryness of the nose; this symptom reappeared on the next day for a short time, accompanied with soreness; and again on several days towards the latter end of the proving accompanied with soreness and burning, and with intervening days of more or less mucous discharge; on one occasion a pain spread to the ear. On the twelfth day in the evening (without smoking) there was a tickling like a hair' moving in the top of the left nostril, lasting for a quarter of an hour, and forcing him to bore his finger into it, although the nostril was empty and quite dry. (ZI., 2nd trit. 27 days, 1 dose daily.) 49. At the commencement of the proving there was a considerable flow of water from the nose, subsequently becoming acrid," burning the upper lip and excoriating" the nostril. On the 10th and 20th days, dull aching at the rootY of the nose. On the 13th, the nose became dry and continued sometimes dry and sometimes watery until the end of the proving. The nose often being dry in the morning and watery towards evening. On the 10th day, after exercise, he had bleeding from the nose (quite unusual). On the 25th day he had a sensation as if he drew in sulphurettedw hydrogen with each breath. On the 29th day he had dryness, with a sensation as if the mucous membrane was swollen. On the 40th day, the nose being dry and smarting, and on the 41st, he had a peculiar sensation, as if the nostrils were of parchment,x and rigid. Towards the end of the proving the nose became very sore; and on the 55th day there was dryness, and the passages seemed as if widened, with easy passage of air. (ZI., 'Ao gr. every 4th day, for 8 weeks.) r Magn. m. Dule. a Magn. c. Amm mnac. t Spigel. uu Am.c. Ars. Am. K. hyd. Nitr. a Sulph. Mez. Mer Squill. v Aeon. Cann. He. Hyose. Ruta, Se w Be.(?) Calc. Nux, (2) Trif.(i z (?) y Croton. Arn.Bary Bovist. Natr. m. z Calc. Lye. Magr m. Nitr. ae. Sep. a Am. Cale. Cant Rhus, Magn. em Mere. Phel. Suipt b (?) Individual Cases among the Workmen. (Except the first, they had been several weeks, or months, or years at the works.) 50. Soreness at the nose, at the lower (outer) surface of the septum' there is a yellow scab, which is increasing. It is chiefly at the junction of the septum with the upper lip. Fluent coryza, especially when at the chrome house and in the open air, going off when at home. In the morning' on waking, obstruction of the nose, and bleeding of it after getting up, when washing himself. (A man aged 25, 9 days in the works.) 51. Swelling of both alna of the nose. Sneezing, with lachrymation of the right eye. 52. Watery discharge, with redness of the nose, and a fetid smell from it. (IRyn.) 53. Great discharge of thick clear mucus from the nose; when this stops,b he has head-!? I -- SYM~PTOMS 54 To 64.] BCLIIICHRO-MICUAT.~I~ 13 Nose, Am. c. Man. m. Nitr. ac. Staph. ache, pain from the occiput to the forehead. (Brrt.) 54. Discharge, with swelling, and pains of nose and sneezing. (l7kw.) 55. Watery discharge from the nose, with soreness, much sneezing, snufflinge in speaking. (Mid.) 56. Nose painful and dry, except in the morning, when a watery discharge took place. (Nyn.) 57. Clinkers form in the course of a few days, and can then be easily detached; but if pulled away too soon, it causes soreness at root of nose, and intolerance of light. (Hdn.) 58. Almost immediately on commencing, coryza and epistaxis, which continue. (12 months. Hrl.) 59. The first week at the works he had frequent bleeding of the nose, which returned at intervals for a year, and since then (19 years) has been destitute of smell. (Dlln.) SuU-MnARY. 60. For the first days there is discharge of clear water from the nose with sneezing, chiefly in going into the open air; then soreness and redness of the nose, with sensation of a foetid smell. Then they have great pain and tenderness, most at the junction of the cartilage, and the septum ulcerates quite through, while the nose becomes obstructed by the repeated formation of hard elastic plugs (called by the workmen clinkers). Finally the membrane loses its sensibility and remains dry, and with the septum gone, and frequently loss of smell for years. In about two-thirds of the workmen the septum was found to be gone, in many cases without their being aware of it. The above process runs its course and the septum is destroyed within a few weeks, or is spread over many months. Sneezing, 40, 41, 42, 44, 51, 54, 55, 157, 151 (chest). Tickling and itching, 41, 48. Formication, 41. Heat, 44. Hot feeling of expired air, 45. Cold do. do. 41. Sense of smell diminished or lost, 42, 59, 128., fetid smell, 49, 52, 129, 135 (abd.) Stuffed feeling, 45. Dryness, 48, 49. 56. DJEX and ANALYSIS [Local Symptoms from 40 to 60]. Pulsation, 44. Sw Pressure and pain at the root, 11 (head), 44, 49, 57. Di Soreness of the nose, 47, 48, 49, 50, 54, 55. S of septum, 36. S of ala, 43. S of lachrymal bone, 47. Ulceration at nostrils, 47, 50, 157 (chest)., of septum, 60. Redness, 52. Elf elling, 44. S ala, 43, 51. scharge, watery, 41, 47, 49, 52, 54, 55. in open air, 50, 151. in the morning, 56. thick yellow mucus, 42, 53. blood, 4-1, 45, 47, 49, 50, 58. at night, 46. in bright drops, 44. astic plugs, clinkers, 57, 60. REMAs.ts.-The specific action on the nose is among the most decided of the effects of this substance, as it is observed in almost all persons exposed to its influence, equally in the provers and in the workmen, and also in the animals. It is to be observed that the watery coryza came on in some provers in warm clear weather, and without any probable extraneous exciting cause. a Phos. Phos. ac. Trif. Ears. 61. Singing in the ears, which continued for three days incessantly." (Zoth., 2 provings, 1st cl trit.for 3 and 5 days.) w p 62, A swelling" of slightly inflammatory b Natr.m.Sep. Merc. haracter in the external meatus of the left ear, hich disappeared in four days, without much ain. (Zth., 2nd trit. several days.) Singing in the ears, 168 (renal). INDEX I Stitches in the ears, 193 (general pains). Face. a Aur. Colch. Coloc. Natr. m. Phos. Zinc. 63. On 2nd and 10th days, slight indistinct painful feeling on one side of the face (one time right and the other left), especially in the malar bone" and towards the ear. 5th day, slight drawing pain of short duration here and there on the throat, at first in front between the lower jaw and the hyoid bone, then at the cribriform plate, reaching to behind the ears. (Zl., 1st trit. low dil. daily, for 10 days.) Stitches in the left sub-maxillary" bones towards the ear. (Neidhard.) 64. On 1st day, a digging pain in the rami of the lower jaw, and next day a swelling' on lower ramus-an elastic circumscribed elevation under the periosteum, the size of a nutit began to diminish on the 4th day. (N., a female, 3rd dil.) b Mere. Clem. Agar. Sil}g. Kal. hyd. c sil. (1) Staph. (I) Pino^.fO Anxious countenance, 96 (gastro-enteritis). Paleness, 93 (imm. effects). INDEX. Very pale and cadaverous, 96 (im. eff.),, and eyes sunk, 96 (dysentery). I Sallow complexion, 100, 119, 130, 137 (gastric and abd.) I- - I 14 KALI BICHROMICUTM. [SYMPTOMS 65 to 76 14 KALI[ BIORROMICUM. [SYMPTOMS 65 to 76 Aged look, 160 (cough, &a.) Heat of the face, 92 (im. eff.), 97 (gastr.) Flashed face, 96 (gastro enteritis).,, in the afternoon, 120 (gastr.),, and head, 127 (abd.) Rash on the face, 92 (im. eff.) Sweating of the upper lip, 109 (with pain in stomach). Face. Cold sweat on face, 96 (im. eff.) Pains in the face, left side, 204 (genl. pains).,, in infra-orbital ridge, 204.,, behind the ear and in the lower jaw, with tension of the muscles of the neck. 204.,, gnawing in the malar bone and the extremities, 200, 204. Pains, bruise pain in the bones of the face, 20(,,,,,, with sensitive. ness, 204. S t, 2 in upper maxilla, below th orbits, 204. Expansive pressure in the Zygoma, 202 (gen pains). Houth. a Ara. Nux, sil. Lycop. (?) b Mere. Lach. 65, Heaviness across forehead, and in the evening dimness of vision in walking. Ulcerations, with indurated edges, and smarting" pain on the mucous surface of both lips. Great thirst; bad appetite. Coppery taste. Disposition to constipation, and then symptoms aggravated. (Hwe. Ch. WV.) 6O. After four doses of one grain, on four successive days, he had a partial eruptive swellingb of the tongue, which after two days became depressed, and out of its hollow blood oozed for three days. No pain; but his speech was obstructed.b 67. Painfulc ulcer on the tongue, lasting for weeks. (CA. W.) 68. Excavated cicatrix on roof of the mouth, from which a slough separated seven months ago;. no pain until separation of slough; sore took six months to heal. The velum presentSd a rough papular elevated appearance. (Bryn. C 7. w.) bbMere. Lach. c Cie. d Mez. Flow of water in the mouth, (im. off.) 80, 82, 91, 93, 94 l "a;;".i. 1,,, wtu pam in stomach, 117 (gastr.),, ~ in the evening, 135 (gastr.). Dryness of the mouth, 88 (im. off.), 168 (gastric and renal). a,, and lips, 136 (abdominal). Itching vesicles on the lips, 136 (abd.) INDEX. Tension in the Masseters, 117 (after cramp in stomach). Toothache, with salivation, 114 (gastr.),, general pains, 193. Tongue coated, yellow, 103, 130 (gastr.), 158 (cough).,, yellowish white, 119, 137 (gastr.), 159 (cough). 1 white, with taste and appetite good, 127 (abd.),, brown fur, 78, 144 (catarrh). Tongue dry and dark brown, furred, 96 (gastrc enteritis)., dry and thickly coated, 123 (gastr. anc abd.) ) smooth, red and cracked, 125 (dysen tery). 1) pricking, stinging pains in, 135 (abd.' 69 (throat)., salivation, salt-tasted, 70. Gaping, 79 (im. eff.) Throat. a Acon. Nitr. ac. Alum. x Natr.m.811. b Bell. Canth. Chin. Cinn. Colch. Con. Lath. Merc. c Am.e. Mere. Natr. c. Sal. Tax. d Bell. Graph. iirn. Lach. Mere. Natr. r,. 69, Stinging' pains in the tongue 1st day, and on the 4th, sensation of a hairy at the back of the tongue and velum, lasting a considerable time, and not relieved by eating and drinking: felt for some days, and ending in sore throat in the morning, which went off in the course of the day. (Nn. /,o gr. 6 days, several times a day.) 70. At first no symptom. Then about the 10th day the salivation,b which had existed slight before, became a notable symptom. On the tenth day, three hours after %/1o gr. of the salt, he had slight difficulty of swallowing. The salivation was troublesome, and caused frequent hawking and spitting; worse after smoking. Next day dryness of the throat, with a little pain in empty swallowing. This dryness soon gave place to the usual mucous secretion, and the saliva tasted salt.c On examination the soft parts of fauces seemed slightly reddened, and the uvula elongated; and he had the sensationd of a plug in the throat, which would not go away on swallowing. The same continued for three days. The salivation continued for ten days longer. (Schwarz. 1st dil.for 10 days, daily.) 71. On the 4th day, pain in the throat on waking; sore on swallowing or speaking, con siderably increased by motiona of lower jaw, extending to the ears; the fore part of the palate slightly red. Next day, at noon, sore throat worse. In the fore part of the palate are single circumscribed spots of the size of a barley corn, coloured red, as if little ulcers were about to form. Next day, sore throat lessened, and the following day gone. (Ms., 2nd trit. 1 dose daily for 5 days.) 72. On the 5th 6th and 7th, he had sore throat, as if of a broad' prickly body. (A., inf. dose, 1 daily, for 12 days.) 73. Sharp shooting pains in the left tonsil towardst the ear; relieved5 by swallowing. (Dle., 1st week, 1st dil.) 74, Relaxed uvula1 and injected fauces, without uneasy feelings. (Several CA. TV.) 75. Long continued erythematous blush of the fauces and soft palate, varying in hue from a darkk to a bright red; occasionally of a coppery colour. (In many, CA. W.) 76. On the root of the uvula, on the right side, an excavated' sore, half the size of a split pea, with a reddish areola, and containing a yellow tenacious matter; fauces and palate presenting an erythematous blush. (Che., Ch. W.) e Alum. Bell. f Aeon. g Mere. A Ipee. Iod. Nux. i Cale. Croc. Iod Lye. Natr. m. Sil. k Aeon. Arg. nit. Al, Amm. caus. I Dros. (7) Cale. (7 Mere. (?) Nitr. ac. (7) [1 - - - - -- - - - - - -- - - - SYnPTOms 77 TO 88.] KALI BICHROM ICUM. Ib Throat. 77. The uvula and tonsils became red and swelled and painful, and finally ulcerated, and were suspected by a surgeon to be syphilitic. (Hry., Ch. W., 3 days after exposure to the solution.) 78. Awoke with sore throat, pain being at the palate; cough with dense transparent small lumpy sputa, easily expectorated; tongue covered with a thick loose fur; the papille very long on the dorsum, with a brown coloured patch; sore throat went away in an hour; the cough continued occasionally during the day. (Nn., 20 to 60 gtts. 1st dil. several times a day, 1Oth day.) Dryness, 144 (catarrh), 168 (renal) 96. S and heat with thirst, 96 (im. eff.) Hawking of mucus, 48 (nose), 105 (after meals), 111, 127 (gastr.) S tough white sputa, 106 (gastr.) Tickling and pressing from throat to choanae, 44 (nose). Scratching and scraping in the throat, 88 (im. eff.), 111, 127 (gastr.), 171 (fatal). INDEX. Sensation of something sticking in the throat, 116 (flatulence)., food in the gullet, 135 (gastr.) Burning in the gullet, 79, 96 (im. eff.), 109 (with headache). Cool feeling in the fauces, 81 (im. eff.), 97. Swallowing, difficult, 81 (im. eff.),, painful, 144 (coryza).,, with a stitch in right lung, 152. Tension of the muscles of the neck, 204. Fauces reddened, 106 (gastr.), 144 (catarrh), 158. Tonsils,, 158. Uvula relaxed, 106. Painless undulating sensation from the epigastriun up the chest, 97. Shooting from left hypochondrium up to the neck, 110. REP.ARs.-The idiopathic action on the throat is well marked. The inflammatory process seems of a chronic indolent character, tending to ulceration, with little swelling or pain. Nausea, Vomiting and immediate effects. [As this medicine is of an acrid and chemically irritant nature, and also a powerful and certain emetic, the immediate effects on the taste, mouth, throat and stomach, are little characteristic of the peculiar dynamic and specific character of the action of the substance, if the dose is comparatively great. These effects are, therefore, arranged together, and a sufficient number of examples given to show distinctly their nature; but to save useless repetition they are often omitted. It is to be understood, that when the 'dose amounted to from 1/. to 1 grain, vomiting was generally produced, and often prevented the development of any further symptoms; or if not, some of the symptoms in this division preceded those described in other places. However, some of the groups which are necessarily arranged here, from the magnitude of the dose, contain very valuable and characteristic symptoms which succeeded the vomiting or the shock to the system caused by the poisonous dose, so they must not be overlooked as homceopathic indications.] 79, Immediately, sourish salt taste in the 85. Soon after, while walking in the open air, mouth; disgust for food; nausea; slight burn- he had nausea, even to faintness, and desire to ing in gullet; constant gaping; in half an hour vomit, but could not; and after some hours, strong pressive pain in stomach, with great sour eructations and griping in the bowels. nausea and inclination to vomit, which was The sour eructation returned twice the day with difficulty repressed. (R., 20 gr. 1st trit.) after the dose was taken. (Schl. '/o gr.) 80. Scarcely had he taken the drug than he 86. Immediately, disagreeable metallic taste had strong nausea and metallic taste, continued and uneasy sensation in the stomach. Nausea eructation without vomiting, and great flow of like sea-sickness, an indescribable sensation of water in the mouth. (EKstler, 1/oth gr.) gentle tearing and constriction in the stomach, 81. Two or three minutes after taking the with slight rushese of blood to the head at in- J Itropiha. ver. t) a Carb. v. Kal. chl. dose, he had a cool" feeling on the hinder wall tervals-accompanied by great weariness and Veratr. of the pharynx. This increased to a dry scratch- exhaustion-so that after trying a couple of ing, which caused repeated painful cough for a few minutes. This was felt every time he took it; and also on the 3rd slight difficulty of swallowing spittle. Then he had a few empty eructations, and in about a quarter of an hour some slight griping. After the above, in five minutes, on 4th day, he had a slight dull uneasiness in stomach, empty eructations and rumbling in the bowels. (Schl., 1. d., 1 dose daily, 4 days.) 8., Nausea, heaving at the stomach and shuddering, with flow of water in the mouth, sensation of coldnessb in the stomach, and want of appetite. (3j, 1st dil. Die.) 83. Half an hour after taking 15 gtts. 1st dil., sickness and great inclination to vomit, and slight chilliness.0 (M. J.) 84. Eructations, nausea, giddiness and feeling of heat all over the body.d (A3z., 10 grs. 2nd trit.) hours to overcome it, and the bad taste and uneasiness in stomach (increased by walking) he was obliged to lie down and slept two hours. In the rest of the day he still had the sweetish metallic taste, and water tasted bad, but food right. (A., 15 gtts. 1st dil.) 87. The nausea was compared by many others to sea-sickness, and was excited or aggravated by movingr about. 88. He woke in about two hours with great uneasiness in stomach, and soreness and tenderness in the region of the same, particularly in a small spoth towards tie left of xyphoid cartilage. The pains continued for sonime time, with dryness of the mouth, nausea, restlessness and wakefulness, heat' of the hands and feet; then perspiration of the hands, feet and legs, followed by subsidence of the symptoms for about two hours, when they occurred again as before. (Dle., after j, 1st dil. taken at lbedime.) f Coir. Lyc. Mere. tr.m. Nitr nc. g Ars. Tabac, h, Phos. b Magn. Tabac. e Dulc.Crotal.Kreos. Pule. d (?): lod. fec. Stann. -- - - -- I I I 16 KALI BICHROMICUtM. [SYMPTOMS 89 TO 96 Nausea, Vomiting and immediate effects. ji Ant. cr. Calc. ph. Camph. IIyosc. I'hos. kk Ignatia, Nux. 1 (1) ax Mere. Sulph. n Bor. ac. Natr. m. Si Nitr.. Sp u P.1 lapli. Tart.eraTr. o Mrrrur. Sulph. 89, He awoke at 2 Ax.. with violent sickness, but unable to vomit, and headache, chiefly in the forehead, preventing sleep for about an hour, then it subsided, and he had restless sleep. ( Wyt., after /2 gr. at bedtime.) 90. Nausea and violent shooting pains in the stomach, then vomiting of the drug. (Xy., 25 guts. 1st dil.) 91. Soon after taking it, excessive nausea and inclination to vomit, and flow of saliva, aggravated by motion and sight of food; in two hours, while walking in the open air, deadly sickness, with vomiting of light yellow insipid fluid. (Dgn., 1%/ gr.) 92, Immediately after taking it, while he sat writing, he was seized with giddiness, so that the pen trembled in his hand. -He rushed to the window for fresh air, but in a moment he had the most violent vomiting of a white, mucous, sourish fluid; accompanied with frightful nausea and pressive and burning pains in the stomach. Then the symptoms remitted for a little while; but five minutes had scarcely passed when the giddinessJ and nauseaj increased to the greatest height again, and the painful vomiting was repeated as before, though less in quantity. At the same time, pain in forehead, burning in eyes, and glowing heatk of face and upper part of the body, while he had an inwardk cold shivering which continued for three hours. There was a portion of bright red blood, the size of a hazel nut in the vomited mucus. The body was now covered with anxious sweat, and the burning headache and giddiness increased, and with it he saw objects' as through a yellow veil. He took some warm soup, and sat down to finish the letter, when he was immediately seized with vomiting as before, in successive throes, which followed on each other so rapidly that he could scarcely get breath: the matter vomited was yellow, bitter and bilious. For the rest of the day he had headache, and the face broke out in a rash with the straining. Taste bitter," and salt;" great thirst. The external flushes of heat and inward coldm continued; pain in the breast in deep inspiration; epigastrium sensitive to touch, and the least" pressure brings on the inclination to vomit. No appetite. After a short sleep the nausea was gone, but he still felt weary, and heat of the hands and face, while the arms were cold to the touch, and he had inward" shivering. He had distension of the abdomen and gurgling in it, as if a fluid stool was going to come; discharge of foetid flatus. Next few days the fulness in abdomen after eating was the only symptom left. (R1., % gr. 1 dlose.) 93. In half an hour smart salivation; salt and bitter saliva. In the epigastrium he had a sensation of over-loaded p stomach, though he had eaten breakfast with relish. This uneasy sensation increasedq to a violent pressure, then nausea, eructation with a rancidr taste; inclination to vomit, and slight griping in upper belly. This was followed by flushes of heat alternating with shuddering; and slight sweating on the back and inside of the thighs. As the nausea increased he became irritable, had paleness of the face, and finally vomiting, with relief of the symptoms. (Sch., 2/, gr. 1 dose taken after breakfast.) 94. Soon after 40 gtts. 1st dil., nausea' and inclination to vomit without being able, with mouth full of water as before sea-sickness; accompanied with vertigo," as if she would feel relieved in lying down; but the nausea continued, and she vomited clear watery fluid. The vomiting was attended with cold perspirationt on the hands, and coldness of the body. Then heat over the body with feeling of cold; heaviness in head and transient shooting pains in the temple, worse on lying down. This lasted some hours. (A. B.) 95. A workman, aged 35, got by chance some of the solution of the bichromate of potash into his mouth: he spit it all out, as he conceived, but scarcely had a few minutes elapsed when he felt great heat in the throat and stomach, and he was seized with violent vomiting of blood and mucus, which continued till within a few moments of his death, five hours after the commencement of the symptoms. On dissection, the mucous membrane of the stomach, duodenum, and a fifth of the jejunum, were found destroyed in patches, and the remaining parts could be easily removed with the handle of the scalpel. The lower part of the intestinal canal was healthy. (Baer's case.) 96. A young man swallowed about 2 oz. of the salt dissolved in warm water shortly after breakfast. In five minutes, vomiting, first of the food, then of a thin glairy fluid of a pinkish hue. In half an hour, face exceedingly pale, cadaverous, and covered with cold perspiration; the pupils dilated and fixed; pulse exceedingly feeble; cramps in the calves" of the legs, and almost total insensibility: occasional vomiting, attended with violent epigastric pain. [The stomach pump, &c. were used till the washings of the stomach became colourless.] The patient now complained of a burning pain at the pit of the stomach, an'd of a sense of dryness and heat in the throat, accompanied with excessive thirst. Vomiting and straining still occurred at intervals. In about two hours and a half the vomiting had subsided, and he began to assume his natural look. The temperature of the skin rose; and with the exception of slight epigas p Am. c. Chin. Bar q Agar. Bell. Bor Chain. Chin. Lye Mere. Nuxv. Phos Sep. Sulp. Thu' r Asa. Mere. BaT sc. Bar. Calc. N vom. Thuj. Va s Ant.cr. Cale. PI Camph. Hyose Phos. t Camph. u Ars. Cal.c.c.ampl Cann. Colocyr Con. Cupr. Grapl IHep. Hyos. Lact Lye. Magn. Magr m. Mere. Natr. Nitr.. a. Nux Sepia. Sil. Sulpl See. --------- -- ~ I - SYMPTOMS 96, 97.] KALI BICHROMICUtM. 17 Nausea, Vomiting and immediate effects. u Ars.Calc.c Camph. Cann. Colocyn. Con. Cupr. Graph. Hep. Hyos. Lach. Lye. Magn. Magn. m. Mere. Natr. c. Nitr. ac. Nux v. Sepia. Sil. Sulph. Sec. v Magm. Plat. Sep. wAcon. Ars. Bell. Canth. lod. Merc. c. Coloc. Lach. Tart. tric pain and dryness in the fauces, he seemed comparatively comfortable. The pulse was 100, and rather full; the pupils responded to light. Mind calm and intelligence undisturbed. Twelve hours after taking the poison, very severe gastro-intestinal inflammation had set in, accompanied with severe cramp in various parts of the body, particularly" the calves of the legs and inner' parts of the thighs. The skin was hot and dry; cheeks flushed; countenance anxious; pain in the head; pulse 120, hard and full; respiration rapid; epigastrium and abdomen very painful, not bearing the slightest pressure; constant straining and retching. The blood drawn was cupped and buffed. In ten hours the vomiting and cramps had ceased, and the other symptoms less intense, though still persisting; the tongue was also dry and covered with a dark brown fur; pulse 100, hard and jerking; the bowels had not acted; great complaint of the taste of the chromate in the fauces. In the evening the symptoms were all subsiding, and the bowels had acted once. In the night, sixty-six hours after taking the poison, he was seized with violent purging, which continued almost incessantly; the bowels were evacuated as he lay in bed; the evacuations consisted of mucus and blood; x when this had lasted two hours he was reported to be "dying," and was found with the skin cold and clammy, face pale, eyes sunk, feet and hands cold; pulse scarcely perceptible; abdomen swollen and tender. Reaction set in in about two hours, and the symptoms gradually subsided towards evening of that day. During the day were observed: excessive thirst; pulse 120; abdomen tender and swollen; frequent twitches" in the calves of the legs; straining and purging. Next day the purging returned, but not so violent as before, and the stools contained feculent matter; tenesmus not severe; abdomen very tender in the region of the sigmoid flexure; distension slight; thirst and fever abated. Next day, symptoms subsiding, and bowels acted only once, and stool natural. (After efects lasting 4 months.) The convalescence was exceedingly slow, ulceration of the bowels having set in, and with difficulty been subdued. There was considerable emaciation with urgent dyspepsia; bowels habitually costive. Ar,\. Alo. Canth. Caps. Colcb. Mere. Merc. ec. p. Teart. Verat. Sal. ar. in, Cupr. Arg. nit. a Ars.Calc.e Campli. Cann.Colovi. Con. Cupr. Gripli. JIep. ]lyo. Lac. Lach. Lye. M1n. M nITa. i. Mre. Natr. c. Nitr. a. Nux v. S~.pia. Sil. Sulph. sre. INDEX and ANALYSIS [Local Symptoms, 79 to 96]. Nausea, 2, 79, 80, 84, 88, 90, 92, 93, 96, 97, (gastr.), 99, 101, 114, 137.,, to faintness, 85.,,, in the open air, 85, 91. like sea-sickness, 86.,, worse on motion, 87, 91, 100., better in the open air, 109. in the morning (with maziness), 107. at the sight of food, 91. during meals, 111. after meals, 130, 137. after breakfast (with pain in the shoulders) 136. S excited by drinking, 118.,,, smoking, 130. after stool, 127. relieved by eating, 135., accompanied by vertigo, 94, 92, 84, 98. t Nausea, accompanied by pains in both hypochondria, 128. 101. shivers, 93., feet. 88., pain in hypogastinum, alternate heats and Vomiting, undigested food, 100 (gastr.),, easy of food, 111 (gastr.),, clear watery fluid, 94., brownish yellow, 98.,, pinkish glairv fluid, 96.,, yellow and bitter, 98., preceeded by vertigo, 92., followed by nausea, 100. accompanied by coldness, then heat all over, 94. I,,, cold sweat on hands, 94.,, 1~ 11 chilliness, 82, 83. heat all over, 84. heat of hands and,,,, weariness, 86. S., irritability, 93.,,, followed by coldness all over, 101. Inclination to vomit, 79, 82, 83, 89, 91, 93, 94, 111 (gastr.) i, on pressing the epigastrium, 92. I, with diarrhoea, 137. Vomiting, 90, 91, 94, 99, 137, 171., in successive throes, 92.,, great straining, 98. 99, 96., sour. 5 (vertigo), 10, 92, 108., of blood, 97., some bright blood, 92., bitter, 92, 99, 118 (gastr.) head,,, headache, 92, 89. S rushes of blood to the ples, 94. stomach, 92, 96. 99. inward chill, 92.,,,p if to,, all over, 99. shooting in the teinheadache, 92. pressive pains in tih burning do., 92, 95, heat of the faco, 92. heat of the body with ldrowiness, 98. hitter taste, 98. vertigo, 99. 86. 9,,, 79, 86, 88, 90,/99.,$ i, objects seem yellow,92. pains in the stomach, coldness in do., 82. REARKs.-The nausea and vomiting are constant symptoms whenever the dose is moderately great; so that this medicine is a powerful and certain emetic. They are also frequently symptomatic of other gastric effects of the drug. The nausea is generally preceded or accompanied by vertigo, and is worse on motion; it was compared to sea-sickness by several. The vomiting is generally accompanied, and often followed by excessive nausea; also by chilliness and heat and many other symptoms. Stomach and After Meals. 97. On the 4th, in the afternoon, he felt a [This was to him quite a new sensation, its seat very strong but quite painless undulating con- seemed to be in the stomach and (esophagus.] traction in the pit of the stomach, which spread On the 5th, in the morning, before taking from thence into the cavity of the chest and any of the drug, he had a cool, sour taste at the there ceased;a within about five minutes this root of the tonguet and fauces, and nausea for b lii. irl. was repeated several times and then disappeared. about ten minutes. cI a Asa. (1) Con. (1) - II~-------~ ii II ii 18 KALI BICHROMICU1M. [SYMPTOMS 98 TO 10O Stomach and After Meals. c Carb. anj. PY. ac. d Ar. A.Ar.Dig.Crot. Icx. crat. JLob. i'hoa. Tart. r hel:l. Ipec. Tart. f PuL.. gy Ant. cr. Cale. ph. Caat-ph. IIyoac. Phoa. Ith Bry. Grat. Ipec. ll,). ac. ii Am.c. Crotonr,Mere. lita. Sul. Tri. Fluor. j Are. Asar. Dig.Crot. 1I-. Grat. Lob. th(. Tart. k BIll. Oran. Ilyose. lach. I Aeon. Bell. Camph. Oran. Sail. Tat)b. n Digit. Graph.Tart. vNcr. i Arg. n. Cilc. lPhos. alL c. t Tart. q Ar" Thre. C, Naer. n.. N',it l'... SaTt. On the 6th, in the afternoon,c without any cause, sensation of glowing heat of the face for half an hour, but it did not look red. Same evening, itching on the glans and at the rectum. (Schl., 6/to to 8/ioIts 4 times in 7 days.) 98, After '/ o gr. he had nausea and diminished appetite; after breakfast vomiting with much straining,d injection of the eyelids and drowsiness.: After the lapse of half an hour, again vomiting of brownish yellow pappy matter. In three hours the vomiting returned with violent retching and very bitter' taste in the mouth. Nauseag lasted the whole day, and occasional griping in the bowels and sudden attacks of vertigo.; 3rd day, transient smart shooting pains in the right temple, lasting 2 or 3 minutes and returning at intervals of 10 minutes for several days. Loss of appetite, languor and disinclination to exertion, with nausea and offensive taste and watering of the mouth. Sickness in the morning and yellow" bitter' vomiting. (Rll., 1st dil. several times a day for a week.) ".99, In about an hour, violent pressure at stomach and nausea and inclination to vomit, and actual vomiting of the ingesta half an hour after, with great straining. The prcssive' pain and the nausea' continued the whole day, so that he could scarcely eat anything, and in the evening, after a cup of coffee, he vomited again with great strainingj and accompanied by vertigo,k violent burning pain in the stomach, anxious sweat' on the whole surface of the body, and chilliness amounting to shivering.m The ejected fluid in the evening was bilious. There remained exhaustion and irritation, which hindered sleep. In the same day he had confusion of the head, especially over the eyes. (R., 15 gr. 1 trit. 1 dose.) W 100. After breakfast squeamishness, and in half an hour vomiting of the food, quite undigested and not the least acid; followed" by nausea on moving about, for several hours. (X. Y., 5th day, '/ gr.) 101. Directly after taking it, and for at least an hour after, and even after breakfast, he had to contend with nausea. During this there arose heaviness and tightness in the hypogastrium,o towards the symphisis pubis, and a general feeling of malaise and disordered centesthesis; a very repulsive taste in the mouth; the nausea lessens after a while, and, instead,P there arises an unpleasant coolness ' over the whole body. About midday, while smoking, frequent spitting and slight return of nausea. On the 3rd day, very umpleasant taste in the mouth while smoking. (Zl., %^, one dose daily for 2 days.) 102. For several days, sour taste in the mouth the whole day, but the taste of food not affected.2 Hiccup, loss of appetite and no thirst; headache, chiefly in the temples, with uneasiness in stomach and dimness of sight. (A. B., /, to 2/, gr. several times a day for 4 days.) 103. Stomach disordered, with heat of the whole body at night; yellow-coated tongue; gnawing at epigastrium. Transient darting pain in the mamma (female). (X. Y., 12th day, 10 to 60 gtt. 1 dil.) 104. For the 4 last days, frontal and occipital headache; transient pains in the right mamma (male) and left elbow; stitches in right hypochondrium. On 7th day, acid risings and burning in stomach, several times a day. In the afternoon, salt taste in the mouth.r Transient acute pain in left scapula. (Nn., 1st trit. 3 times a day for 7 days.) 105. Generally after dinner nausea, eructations, distension, flow of saliva and expectoration of mucus from the throat; all subsiding towards evening, but succeeded on the 8th by extreme weakness of the hands, so that he had to lay down the newspaper. (Lackner, 1st trit. 1 yr. daily for 9 days.) 106. On rising in the morning, heaviness and giddiness, increased on stooping,t relieved by walking about. Relaxed uvula and fauces injected without any uneasy feelings. Distension of stomach, sour eructation, flatulence. Disposition to constipation, and when that exists the general symptoms are aggravated. Urine red, with pain across the back. Oppression at the pit of the stomach, with smarting, burning pain, followed by expectoration of tough light-coloured sputa. Complexion pale and yellowish. Feverishness in the first part of the night. (Wfd. CA. W.) 107. Occasionally dyspeptic attacks, loss of appetite, food lies like a load, with low spirits and much flatulence, and maziness in the head in the morning, and nausea, with sometimes vomiting of clear fluid. (Br. CA. TV.) 108. Habitual attacks of sour vomiting, excited by stooping or moving,j with pain at epigastrium. (Ch. W.) 109. On the 1st day, immediately after the usual sourish-salt taste, he had pressive pain in stomach, which hourly increased to a sharp pain. He had for about 3 hours the feeling as if he had received a severe blow " on the stomach, accompanied with slight nausea and inclination to vomit. In spite of these feelings he sat down to dinner with tolerable appetite, but little thirst, which is unusual for him. He did not relish the wine and water, which tasted bitter.1 After dinner all the symptoms better. r Bar. c. s (1) t Aeon. Am. c. Br Staph. Zinc. u Calc. Croc. lo Lye. Natr. m. Sil. v (7) w Euphorb. Dulc. x Coff. Puts. Sil. ~_ 1 SYMrPTOMS 110 TO 116.) B-AI;I BICH~RO--,\ICUA~l 19 Stomach and After Meals. y Chin. Hep. Ign. Cale. Nux. z Lye. Rhus, Toucr. a Dig. Magn. c. Sab. b Coloo. cc Ars. Alum. Arg. Col.Hell.lod.Hyos. Mer. c. Natr. c Nux. d (?) e Bar. c.'Bism. Cocc. f (7) g Bor. Carb. v. Chin. Colch. Perr. ac. Graph. K. carb. Lye. Nux. h 01. an. Tart. i at. Lob. Mez.Nux. Sec. Tab. Z. ox. On the 2nd, anxiety at epigastrium; the nausea relieved by warm soup; the stomachache continued throughout the day, so that he could not bear tight clothes. He feels sick and giddy in the room; better in open air. Next day, towards evening, the aching in stomach increased, with a feeling of anxiety in epigastrium and sweating on upper lip. The pain in stomach is confined to a spot' the size of a thimble, about a hand breadth above the navel. The 4th day, the stomach pain and thirst for soura things were the only symptoms. Pain in forehead and cold sweat, 3rd day. Confusion of head in rightb temple, with pressure at root of the nose, 1st day. Eructation of pure flatus; stool hard and knotty; abdomen, for 2 days (3rd and 4th), distended0 and sensitive.0 (R., 20 grs. twice in 4 days.) 110. 1st day, empty eructations and no other symptom. Next day, soon after breakfast, she had intense shooting in the left hypochondrium, which spread up the chest to the clavicle and side of the neck, unaffected by respiration, but increased by stooping." It lasted an hour. Next day (3rd) the same pain came again and lasted most of the day, at intervals. Next day it was gone. (N., young female, 1st trit. 1 dose daily for 2 days.) 111. The very disagreeable sweetish metallic taste, particularly at the roote of the tongue and palate, was felt always immediately after taking the drug; it also returned frequently during the following days, hours after the drug had been taken, particularly after smoking a cigar and after breakfast. It was felt some days before taking anything in the morning. On the 4th day, in the forenoon, slight attacks of burning pressive pain in stomach, and again an hour after dinner. It returned on the 7th, 9th and 10th, as heartburn after dinner and in the evening. On the 7th, he took breakfast without appetite. At 10 A. M., nausea' and creeping contraction of the scalp of the forehead and top of head. 8th, no relish for breakfast, and duringe it nausea, which continued with watering of the mouth, and vomiting could with difficulty be kept down. Soon after breakfast the sweetish metallic taste came back, with continued nausea and disgust. In the forenoon, while dressing, the inclination to vomit came suddenly h with such violence that he could not overcome it, but he threw up the whole contents of the stomach in a stream, before he could get to any proper place. This vomiting was without' effort and left no bad taste, and soon after he felt so well that he could give his lecture. 8th, roughness in throat, in the morning, and hawking of thick phlegm. 8th, in the evening, he was overpowered with sleepiness, and fell asleep on the sofa. On the 5th and 6th he had 2 semi-fluid stools, and on the 8th, hard knotty stool. The abdomen was distended, with grumbling and griping for the 3 or 4 last days. (Zl., 1 dose 1st trit. daily for 10 days.) 112. For 6 days he took gr.:1, 2 or 3 times a day. Uneasiness at the stomach on the 1st day; next day nausea. On the 4th he awoke with severe pain in the stomach, which lasted three quarters of an hour; the uneasiness at the stomach lasted all day, and was situated about the great curvature of the stomach, about 3 inches below the ensiform cartilage: the sensation resembling most the feeling of an overloadedJ stomach. On the 6th, again the pain at great curvature of stomach, with a sense of weight. Headache at sundry times, generally on one side and at a point that may be covered with the finger. (Nn.) 113. Dull, cold, heavy pain at cardiac region, with tightness in chest and dyspnaea. Griping in the lower belly, as if something was piercing the bowels, worse on deep inspiration, better on pressure. This lasted for 2 days. (Nt., 45 gtts. 1 dil.) 114. After the local effects, on the 1st day, he had in half an hour, sour eructations and nausea for 2 hours. At midnight k of the same day [he had eaten fruit ice] he was wakened up with a cramp in the stomach, which kept him awake 2 hours, and was alternated with similar pinching pains at the navel. During the fore and afternoon, next day, he had similar spasmodic pains in the bowels, which gradually became weaker and did not disturb the appetite or stool. 4th day, toothache, with salivation for an hour and a half. (Schl., '/. gr. 1 dose.) 115. On the 3rd day, in the evening, he had sweetish astringent taste, and aching in the stomach, which goes away after smoking but comes back soon, so that he had to go to bed with it and passed a quiet night. Next morning the aching in stomach continued in a less degree, though the appetite was not disturbed by it, but even increased.' (R., 1st trit. 1 doser daily for 5 days.) 11(i. Soon after the dose, pressive pain in stomach, with continual eructation of pure flatulence. At times the feeling thereby as if something remained sticking in the throat on the passage of the flatulence."' The pain in stomach was rather sharp and lasted 3 hours. For the next 2 days there remained a soreness at epigastrium, rendering it tender to pressure. (R., 1 dose of 1st Itit.) 117. Before dinner, suddenly a violcnt painl j Am.,. ( bi. Baryt. k \rg. n. Color. Curb. Natr. n. Sul. I ( I.,n tiaiI vri w,. '~-----~--~-*- I--I II 20 KALI BICHROMICUM. [SYMPTOMS 118 TO 120. 11 Stomach and After Heals, it Sin anterior surface of the stomach, boring and n Bar. Cac.. Cann. contractive, with nausea and flow of water in uilph. saad.P'how the mouth, increased by external pressure.0 In i, (!) 10 minutes it subsided, and in its place came a tension and drawing in the muscles of mastication and more flow of water in the mouth. 1st day. (ZI., gr. 1/Ao every 4 days for 8 weeks.) TAnTE. Ital in the morning, 5 (vertigo), 101, 123. Co ppery, 65 (mouti). Salt, 70 (salivation), 92 (im. off.),, in the afternoon, 104. Sour, 07, 102. Cool, sour, 97. Hour-salt, 79, (ir. cff.) 109. Metallic, 80, 86 (im. eff.), 135 (abd.),, and sweet, 111, 127 (abdL),, in the evening, 114. Bloxly, 129 (abd.) Offensive, 98. Bitter, 92 (in). eff.), 98 (gastr.),, after meals, 130, 136 (alxl.) in the morning, 167, (pain in the back.) Water tastes bld, 86, (im. eff.) 109. Bad taste on smoking, 101.,,,, after meals, 111. Ar''PETITE AND TnmrST. Bad appetite, 5 (vertigo), 65 (mouth), 98. 82 (im. cf.), 102, 111, 130, 137 (abd.),, for breakfast, 127, 136. Capricious, 153 (cough, &c.) Enictations, 70, 81, 83, (imra. off.) 105, 109, 110, 116.,, food, 129 (abd.) sour, 85 (im. off.), 104, 106, 159 (cough.) )EX and ANALYSIS [Local Symptoms, from 97 to Eructations, rancid, 93 (im. eff), 129 (abd.) Disgust for food, 79 (im. eff.) Dislike to water, 118.,, meat, 160 (cough, &c.) Appetite increased, 115, 121, 135. Hiccup, 102, 135. Heartburn at night, 129 (abd.),, in the evening, 168 (back.) Thirst, 92, (im. effi) 118, 121, 137.,, great, 65 (mouth), 96 (gastro-enteritis.),, for-acids, 109. No thirst, 102, 109. STOiMACH. Pain at epigastrium, 5, 6, (with vomiting and vertigo) 79, 81, 82, (im. eff.) 99,106,112, 114, 136, 110.,, like a blow, 109.,, relieved by smoking, 115., after meals, 137., at night, 129. Soreness, 88 (im. eff.),, to touch, 92, 115, 117. Shooting pains, 96, (gastro-enteritis.) Anxiety, 109. Uneasiness, 86, 93, (im. eff.) 112. Gnawing, 103, 153.,, with emptiness, 153. Feeling of sinking, 129. i,,, in the morning, 153, 129. Oppression, followed by expectoration, 106. Inability to bear tight clothes, 109, 129. Food a load, 93, 107, 159 (cough, &c.) Coldness, 82 (im. eff.) Burning, 106, 111, 129, 96.. and cramp, going afterwards to the jaws, 117. Digestion easily disordered, 159, 160. Meat disagrees, 160. Painless undulation from epigastrium up to the chest, 97. AFTER MEALS. [Not the direct effect of a dose taken shortly before.] External stitches and pains in the chest, 135, 128. Hawking of mucus, 105. Gastric symptoms relieved, 109, 135. Pain in stomach, 137. Drowsiness, 129. Headache, frontal, 128. Weakness of the hands, 105. Bitter taste, 130, 136. Nausea, 105, 101. Vomiting undigested food, 100. food, 99. Distension of abdomen, 127. Rumbling in,, 127. Hard stool, 127. REMNARKs.-The primary action seems to depress the digestive powers, as the secretion of gastric juice and the process of digestion seem interrupted and the digestion slow, with uneasiness and other more active symptoms. The appetite after a time seems not affected or even increased, and many of the pains and disorders connected with the stomach and intestinal canal seem relieved for the time by eating. The pains in the stomach are generally worse on moving about. Thirst does not seem generally present in the non-febrile gastric derangements. Taste is frequently perverted, and there is a sour, salt or bitter taste in the mouth, and water tastes bitter and there is no relish for tobacco; the food tastes natural. The tongue is generally thickly coated yellow. External pains in the chest after meals are observed. The symptoms of disorder of the stomach seem to be generally worse on moving about and in the morning. Abdomen. 118, An hour after the dose he vomited 6 times, and at the last with much bruised pain 1 nor. nry. Cc.. at upper belly, ejected a dark-brown excesc.nSt.nt.rr Nitr. sively bitterO matter; followed by thirst, but SNaitr.,n. Nix.uti,. drinking" the least excited the nausea again, S chin. wn1. 'Tab. solid food did not; dislike to water~ for several days. On the 2nd and 3rd he had often a contractive pain in abdomen, and on the 2nd pappy d ArT.. x. stools followed by sensation as if littled was passed. Next 2 days stool scanty and hard. (A '/y gr. I dose, the last of his series.) For many weeks after the proving, even in the finest weather, he had a sensitiveness of Al, the abdomen to the least cold" air, and on exposure to the slightest draught he felt the tearf Am. Ml--rhr M. ing and constrictive feel in the abdomen.' The stools were hard. 119. Much flatus for the first 3 days, no stool on the 4th, and a hard difficult and scanty stool on the 5th. Tongue yellowish-white; complexion sallow and sickly; general feeling of discomfort and irritability. Sleepiness early in the evening. (Mz., 2nd trit., 1 dose daily for 5 days.) [A similar group of symptoms was common to several provers.] 120. After breakfast 1st day, was seized with violent pinching pains in the upper and middle of abdomen, with anxietyg and sweat of the g Spig. Sul. ac. forehead. They gradually diminished and went off in 21 hours. Next day some rumbling and uneasiness at the navel, and no more colic. Only on the 5th, towards evening, a copious pappy stool, otherwise the stool was normal. On 1st, in the afternoon,h a sudden flush of Sulb. an. rlb. ac. I 1 I SYMPTOMS 121 TO 129.] KALI BICHROMICUM. 21 Abdomen. i Bry. (?) Sulph. (7) jArs. Gamb. Caps. kk Ars. Cham. Spig. Sul. Veratr. m Caps. n Bar. c. Bism. Euphorb. Kreos. Mang. Cocc. Rhod. o Sul. heat on the face; again on 2nd and 4th, and 7th and 8th. On the 2nd he was disproportionately depressed, and grieved with a small vexation. (Schl., 1/2 gr. before breakfast, daily for 5 days.) 121. A slight oppressive pain at navel, and in a few hours'soreness at right hypochondriac region, coming and going off at intervals during the day. 2nd day. On the 3rd day (evening), fulness and heaviness of whole head, particularly the vertex, and general throbbing in it on bending forwards, and increase of appetite and thirst. (lM. J., 1st dil. for 3 days.) 122. Urine red. Periodic constipation occurring every 3 months. (Gall. C7M. TV.) 123. Frequent throbbing headache at the angles of the forehead, in a small spot, accompanied with dimness of sight. Tongue dry and thickly coated in the morning, with nauseous taste in the mouth. Eyes swelled up and heavy in the morning. Shortness of breath, as if something were tied round the upper belly, so that he cannot take a deep breath:I equal in all positions and circumstances, without cough or pain in the chest. Generally costive. (Slt., a workman aged 36.) [The above symptoms had lasted for months.] 124. Habitual constipation in common among the chrome workmen. 125. In the beginning of summer, for several successive years since employed at the works, has had dysenteric attacks lasting about 3 weeks; frequent bloody motions with gnawing pain at the navel,J followed by ineffectual straining; tongue smooth, red,k and cracked.k (Sit., a workman aged 35.) 126. Dysenteric attacks, with pain at the navel" and bloody evacuations. (Sm. Ch. WY.) 127. 5th.-Hawking of mucus and roughness in throat in the morning. 7th.-Has a peculiar feel in the whole body, as of an acrid humour or diathesis, or the psora had been stirred up in him and caused all the symptoms. On the 21st, hard stool; and on the 22nd, hard scanty stool. On the 23rd, nausea, want of appetite for breakfast, and after it rumbling in belly and distension of abdomen; slight pressive pain at region of heart;, distension after meals; tongue white, thick coated, but good appetite and taste for food; humming" in the head. 24th, two rather hard stools. 25th, in the morning, slight griping in the bowels, followed by a semifluid stool with much rumbling. Breakfast with little appetite, and after it constant rumbling'and searching and slight griping, then a second quite fluid stool, followed by retraction of the anus and slight nausea. Disagreeable astringent taste at the rootP of the tongue. A third stool very scanty and fluid, but with relief to the uneasiness in abdomen. Later in the forenoon, burning in the whole skin of head and face without redness;q then again desire to stool but only flatus passed: during the effort suddenly sweat burst out all over but especially on the face,' soon went off, and he ate dinner with good appetite. (Zl., Vio gr. every 4 days for 8 weeks.) 128. On the 2nd day, soon after taking the medicine, he had eructations and great nausea, which lasted for a short time; the nausea came on again the 4th and 9th day, lasting for a short time, and on the 10th and 11th day towards noon, as also on the evening of the 11th day, with inclination to vomit, which lasted an hour and a half; at the same time a dull pressive" pain appeared in the region of the three last true ribs of both sides, aggravated by deep breathing. On the 12th day (without medicine) the same pain appeared, together with the nausea, which disappeared gradually towards noon, but reappeared the next day in a much less degree. After dinner he had a violent pressive headache, especially in the forehead,t also a drawing tensive dull pain" in the region of the nipple of the right side, aggravated by deep breathing and going up stairs, continuing till night. On the 12th day he had a tearing pain in the right shoulder, and later in the day in the left elbow and forearm, which soon passed away. (Lack., 2 grs. 1st. trit. one dose daily for 10 days.) 129. Eructations on the 1st of food, 2nd and 3rd like rancid' bacon. Slight circumscribed pain in left hypochondrium on 1st, boring w ditto on 3rd, and also dull pain in hepatic region, increased on full inspiration,- and cough; the latter again next day. On the 2nd, darting pain in precordium. On the 5th, shooting in the livery and dull aching in it posteriorly. Transitory darting pain in the forehead, and after a fresh dose obtuse heavy pain above the eyes and occasionally in the temple, aggravated by the open air, with the nausea and burning at the pharynx on 1st day; and 2nd and 4th days pressive darting pains in both temples: vertigo on moving the head rapidly, lasting hours. 3rd day, slight shooting in forehead, and pulsative pain in parietal bone. 5th, shooting across forehead and temples while walking, relieved by rest. Heartburn' and slight transitory pain in the middle of the lung woke' him in the night. A fixed burning pain in middle of sternum; dull circumscribed pain in right chest, aggravated by inspiration; on the 2nd day and 4th, constant pain in chest under left axilla. On rising in the morning, 2nd day, taste of blood b in the mouth, and again in the evening, and again on 7th. Imaginary putrid smells on the 2nd. r Trif. * (7) t Am. c. Cale. Natr. m. u Natr. c. (1) Phos. Trif. o Asa. Aim. Bar. Grat. Puls. Ran. Thuja. w Natr. m. x Arn. Cocc. Merc. y Am. Carb. v. Chin. Con. Kal. c. Kal. IlL. Mtagn. m. Nitr. m. Nux. Sulpih. SIIcpar. a Ar.. Colch. Cnnthi. Mez. Latur. Slur. ac. Phil. Phts. Puls. Sep. Bill. Zinc. b Aim. Am. c. hr.rb. tism. Cantli. Ip'c. Kal. c. Natr. c. nb. il. Zuinc. q () - ------ ---- --- --- iL1--~---------~ll~-- - 22 KALI BICHROMICUM. [SrYPTOMS 130 TO 13S Abdomen. d Cale. lHep. Ign. Nux. Chin. r Thuja. / Am. Chin. Colch. Mere. Sabad. Stan. 17 Argent. (?) h An,. Ar.. Chin. lod. Kal. Ltur. Nitr. a-,. P'ho. Sul. Disinclination for exertion on 2nd; drowsiness and yawning after dinner on 4th. Frequent startings, tossing about the arms, incoherent talking, and finally snoring, on 2nd. Copious dark-coloured evacuation with tenesmus, on the 5th. Swelling of stomach in the evening, with fulness and pain on pressure: cannot bear tight clothes," on the 6th. Next day feeling of sinking in stomach before breakfast. (Dyn., 14 to 24 grs. daily for 2 days.) 130, Nauseous and a resinouse bitter taste after breakfast and dinner, and after smoking; tongue yellow' coated; little appetite; sallow complexion. On the 2nd, towards noon, a sudden spasmodic contractions of the intestines with nausea, which lasted about a quarter of an hour, and was then followeds by a pappy stool with burning in the anus and straining: after this all the symptoms disappeared, but returned at 4 and 10, lasting for a short time, but without the stool. Violent pressing headache on the top of the head, spreading to the sides of the head and temples, in the afternoon." On the 3rd, oppression and a stitch in the lower part of the chest on deep inspiration. On the 4th, in the evening, a stitch for a short time in the region of the heart. Irritability and querulous disposition. On the 4th, urine muddy and with copious sediment in the morning. (Three male provers, 1 dose of 1st trit. once dailyfor 6 to 8 days.) 131. On the 28th day, pressing pain in a small spot' in the bowels to the right of the navel. Normal stool. Pressure in a small spot in the upper lobe of right lung, which changed into a drawing pain in the whole length of the right lung, and went off after sitting half an hour; thereupon he had a strong pressure at the anus) This gave place to pressure in stomach and upper belly) He feels altogether very ill without being able to ascribe it to any distinct symptoms. (ZI., '/ogr. every 4 days for 8 weeks.) 132. Soon after the usual eructation, nausea, confusion in head, and flow of saliva. 1st day, in the afternoon, violent stitches in the left' hypochondrium, spreading to the loins, worse on motion and pressure, with some inclination to cough, and thick white expectoration. Towards evening, a stool, at the first consistent and then diarrhceal,' and an hour after violent shooting in the region of the liver, increased by slight pressure; quarter of an hour afterwards, cutting and griping in abdomen, as if diarrhea were coming on," and soreness of the whole belly to rough touching." This whole attack went off in about 10 minutes, and left the abdomen painless to strong pressure. There remained ill-humour and indescribable discomfort. Next day, a solid stool, followed in an hour by a fluid one; headache; frequent short attacks of nausea and colic, soon going off. 3rd day, repeated troublesome colicky attacks. On the mornings of the 2nd and 3rd, giddiness on sitting up in bed, as if everything turned round; on suddenly lying back again it was increased and nausea came on: it lasted a quarter of an hour. (Mz., gr. /,', one dose.) 133, No symptoms 1st day. Next morning0 she wakened at 6 A.M. with hurried desire to stool, and the watery contents gushed out; after it, violent colicky straining, so that she could not get up; after this, burning in the whole belly,P and great nausea and retching. Felt weak and ill the whole day after. (K. K., a female, one dose 1st trit.) 134. Pale slate-coloured stools.q (K., "/,o gtts. 1st dil. daily for 10 days.) 135. Frequently, on different days, short stinging and pricking pains in the tongue.' Shooting pains generally in one temple. Pains darting or aching in one side of the head. Flying pains about the head. Sensation of a foetid smell. On the 3rd and 7th, tearing shooting pains in the right hypochondrium, of short duration." 5th.-Sensation as if the food remained in the aesophagus. Scanty urine with white film and whitish deposit. 6th, in the evening, weariness, distension of the abdomen, hiccup and waterbrash; and at night,' deep seated dull shooting pains under the scapulae; vivid dreams, and he awoke early, and then fell into a confused heavy half sleep; in the morning unrefreshed and weary. On the 7th, transient heavy pains in the right temple immediately after eating; frequently recurring in the afternoon, accompanied by an uneasy craving sensation in the stomach. 8th.-After dinner, external stitches in the epigastrium and breast" into the nipple (male), and in the right hypochondrium:' dull pressive pain in the right side of the spine about the 9th dorsal vertebra, with uneasiness in the stomach. From the 10th day till some days after leaving off the proving, he had aching at the right hypochondrium; scanty, pale, claycoloured x stools, sometimes twice a day; metallicy taste, foetid breath, and confusion in the head. In the 2nd week, nausea, relieved by eating. Frequent fine' irregular stitches in the integuments of the chest, unconnected with respiration or palpitation. Sharp irritative fixed pain in the region of apex of heart, unaffected by respiration or position. In the 2nd week the appetite was increased, being better than at the beginning of the proving, and the gastric symptoms were relieved after eating in general, while the rheumatic o Chin, s. Cop. Nit Nux, Phos. Rhoc Sul. Crot. Mere. P (V) q Asar. Mere. Pho. Hep.Ign.Chin. Ioc Nitr.ac. Nux, Pul Sep. r Berb. Chin. Dro Ign. Led. Ph Sabad. Spig. Spon Trif. Mercurialis. a Am. Baryt. Nu: Phos. Sil. Sulph. t Natr.c.Puls.Ang. i Grat. Natr. c. ( Phos. (?) Trif. (1 v Cauth. (1) Grat. fo Cocc. Chin. Iod. Ii carb.Magn.c. Nat m. Nux, Nitr. ac Sep. Sul. Tarax. x Mere. Phos. Het Ign.Chin.Iod.Nit ac. Nux, Puls. Sec y Aur. m. Cale. Cocu Hep. Merc. Natr.e Coloc. Nux,Thuj: z Canth. Chel. Coec GratNitr. Mur. ac Sabad. Trif. i Kal. e. Lye. Pib, RlhuiTcecr. Zinc i (I) k Arm. Chin. lRan. Notrc. nlo.. Msgn. mn. rib. ae. Sart. I Aim. Cale. Colch, Ign. K. hyd. 'Marn. t. Pho.lliheum,Scp. sul. aR. ma ar. Chin. Orat. Krrv, led. Natrts. Nur, Rat. Sab. Sqiti. Zinc. Rn Ara. Alm. An,. Ci. 11011. i114. it,4-0. MNer. Natr.S. Nux. ~~~ -~-- - -~---~~~-~- -~-- [L SYMPTOMS 136, 137.] KALI BICHROMICUeM. 23 Abdomen. a Puls. Carbo veg. China, Lycop. b Ang. Ars. Berb. Bry. Lvcop. Nitr. ae. Puls. Ran. cc Cyc. Lach. Meph. d Ars. Bry. Canth. Caps. Carbo v. e Lach. Natr. m. Cale. c. f China. g Kali c. h Cann. Chin. Aur. Con. Cyc. Rhus, Lach. Mere. i Ars. Aur. Berb. Mere. Natr. c. j Ars.Bell.Berb.Bry. Carb..Cha.Chas.Chin. Euphorb. Hyos. Laur. Lye. Phos. Phos. ac. Verat. k Bell. Lye. Phos. I Bell. Chin. symptoms (distant pains, &c.) reappeared. (Dle., from 5 to 60 gits. 1st dil. several times a day for 14 days.) 136. For the first 2 or 3 days no stool or scanty and hard stools. For the first 10 days or fortnight much distension" of the abdomen and rumbling of pent up flatus. Appetite bad, and resinous bitter taste b after meals. In the 3rd and 4th weeks, frequently two semifluid stools, not copious, one often on rising in the morning. Throughout, appetite bad for breakfaste and often nausea during or after it, and bade taste. On the 3rd the nausea after breakfast was accompanied by a paralytic tearing pain in the shoulder. Throughout, every day or two an aching or burningd pressive pain in the stomach at various times, and in the first week several times towards evening a pressinge pain at the heart, with a peculiar uneasy sensation. In the 1st week, several days an uncomfortable feeling of pressure in the back between' the scapulak, recurring several times in the day. In the 2nd week, several times a dull5 stitch in the right side at the edge of the thorax in the region of the liver, not affected by motion or deep inspiration. In the 8th and 11th, turbid" urine in the afternoon and depositing a thick mucous' sediment. In the 4th week, for several days dryness of the mouthj and lips, and after breakfast on the 26th some itching and burning' vesicles break out on the margin of the lips: better next day. At different times pressure on the top of the head, and on the 22nd he had on waking pretty severe headache, especially at the top, disappeared on rising but left languor behind: it returned in the afternoon. In the evening the feeling as if all the bones of the head would fly asunder, by the pressure of the too large brain; this feeling cannot exactly be called pain, but is very oppressive, and is felt most on the temples towards the ears and on the parietal bone.' (3 male provers, 2nd trit. one dose daily, 20 to 27 days.) 137. For the first 2 days he had nausea and emptiness,m little appetite and confined bowels. On the 3rd complete loss of appetite," constant thirst and yellow-coated tongue, and no stool. Very severe headache, sometimes in the morning about 3 or 4 hours after the dose; sometimes in the evening pressing tearing pain through the whole head, especially severe in the forehead and occiput, with stitches constantly recurring in the same spot in the temples. The headache unusually severe on the 3rd evening, as if a knife P were cutting through the head, with quickened pulse. After going to bed he had palpitation, with dull burdensome pain in region of heart. Sleep good. On the 1st, along with the headache, copious flowa of tears from both eyes, with fleeting stitches in the eyelids, the conjunctiva of the eyelids more reddened than usual, in conjunctiva of eyeball several red injected vessels. 4th day a hard stool in the evening. 5th, half an hour after a moderate dinner, sudden nausea, uncomfortable feelings of pressure in stomach, stabbing pinching pain in region of liver, forcible call to vomit, rumbling in the belly, passage of foetid' flatus, violent griping in the whole abdomen, cutting as by a knife" in the belly: after a stool of usual consistence and colour, a dysenteric diarrhoea of brown frothy water, with violent painful pressure, kneading, and tenesmus in the anus.' After seven or eight similar loose stools, accompanied by constant pain in the belly, nausea and inclination to vomit, complete quiet suddenly followed, and except a bitter pappy taste and whitish-yellow coated tongue no symptoms remained: the universal disturbance in the belly, which had lasted scarce an hour, was appeased. 7th.-General emaciation is apparent, yellow complexion, no stool. Irritability and indisposition to mental effort. (Jz., 8 grs. 1st trit. one dose daily, 11 days.) en Ign. K. hvd. Senn. Sep. Tart. n Am. c. Bell. Cale. Bry. Chin. Chi. sulph. Merc.Nux v. Pib. Sul. o Ant, Calc. Chin. p Ign. Bell. Baryt. c. Lach. q Eugen.Puls.Stram. r Chin.o.Lob. Natr.,. Nice. Plb.?SarS. Sil. Staph. Coloc. s Con. Sabad. t Cointlh. Mnii, c. Sabad. Arg. nit. l|fc. Mere. Sul. Nux. I 11 RIGHT IIYPOCIIONDnRIUM Aching, 11 (head), 121, 135, 137. Stitches, 104, 129, 132, 135, 136. Pain worse on respiration and cough, 129. Dull pain in both hypochondria with nausea, 128. LEFT HYPOCnoNDRIUM. Shooting, 4 (vertigo).,, up to the chest, clavicle and neck, 110. Dull pain, 129. Shooting to loins, 132. ABDOMEN. Pains at the navel, 120, 121, 125, 126, 131.,, from navel to throat, 9 (headache, &c.).,, as if to diarrhoea, 132.,, in a small spot above navel, 109. VD-EX and ANAL7YSI8 [Local Symptoms 118 to 13 Pinching in the upper belly, 120.,, alternately with cramp at the stomach, 114. Burning in the belly with nausea, 133. Griping, 81, 85 (hn. eff.), 93, 111, 113, 114 (gastr.), with diarrhoea, 137. Piercing, 113. A transient stitch through abdomen backwards, 204. Contractive pain, 118, 130. Short colicky, with nausea, 132. Swollen and tender, 96 (dysentery). Abdomen sensitive, 109, 132.,,, to the least pressure, 96 (gastro-enteritis). Rumbling, 81, 92 (im. fef.), 111, 120, 127, 136, 137. Distension, 92 (im. ciT.), 106, 109, 136, 111., in the evening, 129, 135. Flatulence, 106, 107. Tenderness at signmid Ilexure, 96 (dysMutery). STOOL. Periodic consti ption, 122. Constipation, tlisposition to, 65, 106, 123, 12 1, 159, 160, 168 (pain in back). No stool for two dvays or more, 119, 130, 137. Iard or knotty stool, 109, 111, 118, 119, 127, 136, 137. Semilluid stools, b ll, 118, 120, 127, 130, 135.,,, ttwo dLtily, 135, 136. Dark-colourud stouol, 12). First consistent, then loose, 132. air, 118. to the least draught of cold - -- - --- I I _ _ _ _ 24 KALI BICHROMICUM. [SYMPTOMS 138 TO 147 Abdomen. Slate-coloured stools, 134, 135. Bloody motions, 125, 126. Incessant purging of mucus and blood passed in bed, 96 (dysentery). Diarrhcea early in the morning, 133, 136. Diarrhoea, 137. AxUs. Itching at rectum, 97. Straining, 125 (dysentery), 129, 96 (dysentery). Retraction of anus after stool, 127. Pressure at anus followed by pain at stomach 131. After stool, colic and straining, 133, 137. REuMAxKs.-The signs of action on the liver are frequent and different pains are experienced in it by many provers. The secretion of bile seems at first diminished. The pale stools in No. 134 occurred as the only noticeable symptom in the prover who was a healthy young man. Colic and flatulent symptoms were very frequent. The direct action on the stool seems to be tc render them hard and scanty. Violent dysentery (see 96) is also in the primary action. As the indirect action we often see one o more fluid stools daily. Bladder and Urine. a An. Aur. Cinn. Mez. Mere. Phos. Stann. sul. Thuja. b Teanr. 138. On the 2nd and 8th slight pricking pain in glans penis," and occasional smarting during micturition, lasting two days. Next day high coloured urine and heat in passing it. (Dgn. s, d.) 139. On waking in the morning a constrictive pain at the rootb of the penis. 7th day.-While urinating, and long after, a burning pain was felt in the glandular portion of the urethra. (Lacl., 1st dil. 14 days.) 140. Painful drawing from the perinceum into the urethra." (Zl., 1st trit. 3 days.) 141. On the 14th day, in the afternoon, he had several times shooting pains in the prostate,d extremely severe, and preventing his walking. (Lach., 14 d. 1st dil.) " 142. Irritation at the orifice of the meatus urinarius (male). (N-n.) 143. Several others had slight pricking or burning in urethra during or after micturition. c Mez. d Thuja. (1) Urine high coloured, 164, 165. Sred, 106 (gastr.), 122, 166, 168 (back), 170. Smuddy, with copious sediment, 130.,, scanty, 135. INDEX. Urine with white film and deposit, 135, 164, 165, 166, 170., turbid, with mucous sediment, 136. b, brownish, 159 (cough and cachexia).,, pearly white deposit, 164 (ronal). Frequent desire to pass it, 166 (renal pains). Total suppression of mine, 171. Itching on glans, 97. Pain from glans into urethra, 200 (genera pains). Cough and Chest. a Sep. Lye. Krcos. Lach. b Phos. sfl. c Carb.v. Dros, Ferr. ac. LactL.. Lyc. Aep. Aeon. d Mangac. e.K. carb. a lod. (?) / Teucr. 144. In the course of the 10th day took in all 4 drams of the solution, equal to 2 grs., and on the 11th awoke with all the feelings of having caught a severe cold, the nose full and loaded, as if going to discharge abundantly, the throat dry, with pain in swallowing; tongue thickly furred, and of a light brown colour on the dorsum; soreness in the larynx; pain in the sides and nape of the neck, and left shoulder; the throat looks red and inflamed around the tonsils. The cough began on awaking; the sputa free and thick, transparent, of a slatya colour. Cough with dense transparentb sputa in small lumps easily detached. Slight dyspncea, as if the mucous membrane of the bronchi was thickened, on rising in the morning. Sensation of dryness' in the bronchi on awaking in the morning. 145. 9th.-In the morning frequent short, broken cough, till a few lumpsd of tough mucus were detached, and there remained some soreness' at the larynx. (Zl., 2nd trit. 23 days.) 146. Sneezing in the morning and evening. On the 1st day tickling in the larynx, causing clearing of the throat, and at night tickling at the top of the larynx, causing considerable coughing on first lying' down. Dull circumscribed pain in right side of chest, aggravated by inspiration. On the 2nd day, feeling of irritation in the larynx in themorning, causing to hawk up mucus. SInsupportable tickling of larynx, causing cough at almost every inspiration;g not much mucus ejected. On the 3rd day the same in the morning; and later in the day cough causing pain in the middle of the sternum,h painful to pressure, darting to between the shoulders,' and also cough with expectoration of thick yellow mucus, with traces of blood. Next day soreness as if ulceration of the larynx; at dinner great tickling in larynx after the first few mouthfuls, going after eating more.k (Dgn., s. d. 5 days.) 147. On the 1st day towards noon, occasional tickling in the larynx, and constant hoarseness of voice, which reappeared with increased intensity on the succeeding days, lasting till evening, when it was generally the worst.' The tickling in the larynx was generally present, with hawking or coughing up of thick phlegm, gradually subsiding. On the 6th night he suffered from much tightness of the chest, especially at the bifurcation of the trachea, obliging him to breathe deeply.1(Lach., 1st trit. 1 dose dailyfor 2 days.) g Bell. Puls. Brom h Chin. Gin. Sep Staph. Sul. Am. c Ars. Bry. i (?) j lod. Brom. Chin Argent. k Carb. an. (1) I Carb. an. m Bry. Ign. Lact.v Lob. Stann. -- - I SYMPTUNIS 148 TO 160.] KALI BICHXIOO`N\ICC"UNl. 25~ Cough and Chest. n Chain. K. broin. Nus, Sep. Stann. Puis. o Caps. Am. m. Buphoib. taur. Sang. Sil. Aeon. p Bell.Rhme. q Am. c. Ara. Bry. Chin. Cmn. Sep. Sul. Staph. r Aeon. Ambr. Puns. 14&. On the 7th day, collection of mucus in the lary-nx, obligring him to hawk it up; towards noon dry ticklingr cougrh caine on, with shootings in the chest. On the 10Oth day there was frequent hawking up of thick tougrh yellowish whitish mucus, contained in great quantitics in the trachea, succeeded by increased hoarseness. (Lack., 2 provings, 2 grs. 2nd trit.for 9 dlays and 8 days.) 149. On the 1st day, along with the sy'mptoms of coryza, &c., described at No. 44, she had a pressive aching at the upper part of the larynx, increased after speaking, and the voice fails in speaking." This aching changed to a tickling which extended to the throat and ears, and at night amounted to burning and scrapingc in the throat and upper part of the larynx to the hyoid bone. Next dlay the dryness in the throat causes frequent swallowing, which is attended with tearing. On the 3rd day, in the night, the burning in the throat ceased and she began to cough. On the 6th day the cough continued, as frequent short count in the morning, and during the whole day much tickling in the larynx, exciting short dry cough.' In the night a nauseous sweet taste, as if blood, began to rise up from the chest into the mouth. The dry ticlding cough continued day and night in frequent p-aroxysms, and was accom-- panied by aching in the middle of the stru and in the larynx up to the hyoid bone. W1,heni she coughs stronger it bringrs on the bloody taste in the mouth. The symptoms subsided in five or six days, and the cough ended then with expectoration of sweetish yellow sputa tasting like pus. (N., 1st dii. 1 yr.) 150. On the 2nd day he had a pressing squeezing sensation in the upper part of the right lung,' which on exertion increased to a shooting pain and lasted the -whole day. Next day the shooting increased, so that in walking he had to bend towards the right side, and draw very short breaths. It gradually diminished and went off in three days. Along with it there was frequent sneezing, which caused a violent stitch in the sore part of the right lung.' Also in swaldlowingt a morsel at dinner he felt the same pain. (Hliz.) Among the Workmen. 151. There was the usual soreness of nose, D~yspncea with much cough and expectoration of blacksY tougrh mucus, difficult to detach. y P s Capricious appetite. In the morning gcnawing pain at the epigastrium, with sensation of emaptiness and faint- rCr~.In ai ness. (Cit. I.) mr Cartec. Nig.Ma. 153. Dyspnma, especially in the morning, N itr. ac. P eos. 1Pih. with cough and expectoration of white mucus "CCas tough as pitch," and which could be drawn out into strings.4 (CGall., ('i. JF) a Aeaf. Q 15.Coughl with expectoration of yellowish green tough matter. (Sink., Oh. W., after 2 years.) 115 5. "Stuffing " cough with pain at the chest, and expectoration of yellowish heavy tough matter. (' liwe., ('is. I) 156. Hard cough, with wveight and soreness in the chest, and copious expectoration. Drspncea and slight pains in the che-st. (Thin. Cll. UK)ý 157'. Pain, stuffing and ulceration of nostrils bAa.MI hm and sneezing; then cough in fits,2' lastingr for ~Aa.le.Can 0 Cupr. Ilep. Khe 0. ten minutes, from tickling C at the bifurcation ~nux v. Ptos. of the bronchi, with expectoration of reddish c JAm n Del.tann,. mucus. (Sm., Ch. TUK) 158. Continued to -work until five weeks agro, when he had to leave, and for four weekis suffered from the following symptoms. Pain in the back extending from lumbar re- dAg.MezCast. gion to the nape of the neck, striking through'd d JtW.'N.Cue to the sternum, with oppression at the chest. -en.Zinc. Dyspnea. and cough, at first dry, but speedily followed by expectoration of dark coloured verye fhs tough mucus.0" ihe The cough and expectoration still continue. 1-is general appearance is anemic. The tongue is covered at the roots with a, thick coatingr of yellowish. fur. The tonsils and fauces generally bave an erythemnatous injected appearance. (Ig.,Cmonths, C'i. WE) 1159. His health before working here was always good, but in a fortnight he was seized with tightness across the chest, oppression and dyspunca, attended with a hard dr~y cough which lasted six weekis, when expectoration of dark grey' mucus of the con'sistence Of I fPi~e white of egg camne on. Soreness of the chest exists at present, and he still feels much oppressed on making any exertion. Has febrile paroxysins night and morning. The tongue at the root thickly coated with a yellowish white fur, and lie comlplains of inidigestion. Load at the stomach; er'uctationis of flatus and acid mnatter. TJhe bowels are jH t Bor. Mere. IJ a (?) it Tod]. Teuci. "V err P rhuja. ýnq w Ars. [Suit. Chin. s. IodL. Ipec. Thee. Puls. Sen. Sul. X Step. from. Nitr. KNux. 3, -CI _ __I fl I I, 26 KALI BICHROMICTJM. [SYMPTOMS 161 TO 166 Cough and Chest. h Aur. In. Pho.ac. Sep. Sil. Rhua. i Ar. Hyos..Nice. Pho'. I Anne. Chin. Ferr. Nux, Arg. nit. Staph. Sil. Tart. k Amhr. Pula. Bquil. Verat. time, with retching and expectoration of tough mucus, so viscid that it can be drawn in strings down to the feet. Immediately on wakingb violent wheezing and panting; then violent cough, causing him to sit' up and bend forwards. On lying down at night, and in sleep, the cough is absent; but he has then wheezing and rattling in the chest, heard at a distance. After meals swelling and heaving of the stomach, and the coughJ comes on. The cough is accompanied by pains in the loins and sides,k causing him to hold them. After the cough he has pain and swimming' in the forehead, almost causing him to fall. Besides the cough, he has weight in the head; weakness of digestion, so that the stomach is disordered by any but the mildest food. Dislike to meatm and disordered digestion from it; habitual constipation. Emaciated, and looks aged, and great weakness, so that he was obliged to give up work. (fEmm. Ch. W. came on soon after he came to the works and continued for months. Got quite well in 3 or 4 weeks under Homwopathic treatment, chiefly Nux and Phos.) I Calc. m Bell. Carb. Igr Lye. Magn, s. s. Nitr ac. Puls. Mur.ac Sulph. Sep. COUGH AND EXPECTORATION. Short dry, after dinner, 48 (nose). S 81 (im. eff.) Short, till lumps are expectorated, 145. Cough from the open air, 151., on awaking, 144, 153, 160. Wheezing cough, 160. At first dry, then with expectoration, 158. Hard and dry, 159. Cough in fits, 157, 160, 149.,, with soreness at sternum, 146, 149.,, darting to between shoulders, 146. S, shootings in chest, 150. S, vertigo, 152, 160., dyHpncea, 153, 154, 156, 158, 159., pain in chest, 155, 156. rettching, 160., taste of blood, 149.,, pains in loins and sides, 160. S,, Pain in larynx, 149. Sputa, copious, 156.,transparent, 144., slaty, 144, 159., thick yellow, 146., traces of blood, 146. thick, 147, 153, 155., tough, 106, 152, 153, 154, 155, 158, 159, 160. 9)EX AND ANALYSIS [Local Symptoms 144 to: Sputa stringy, 153.,blackish, 152, 158.,yellowish green, 154.,reddish mucus, 157.,sweetish, and yellow, 149. Cough from oppression at epigastrium, 153.,,,, a sore spot, 160.,, tickling at bifurcation of bronchi, 157.,, after meals, 160. LARYNX. Soreness, 144, 145, 146, 147. Tickling, 146, 149, 147.,, at dinner, 146. Accumulation of mucus in larynx, 150. Hoarseness, 147, 149, 150.,, worse in evening, 147. Dyspnoaa, as from something tied round belly 123 (gastr.) Oppression, with pain to back, 158. Pam in lung, migrating to anus, 131. Tightness at bifurcation of bronchia, 147. Tickling at do., 157. Pain in upper part of right lung, 152. Wheezing and panting, then cough, 160.,, in sleep, 160. Pains in mamma and nipple (male) 181, (leg 104 (gastr.), 135, 128 (abd.) Transient pains in mamma (female) 103. Pains under axilla, 129 (abd.) Pain in chest, between scapulas, and in the extremities, 204. Transient external stitches, 135. Pain from back to sternum, 158.,, in sides to back, 196., pectoral muscles, 198, 201 (and intercostal' and wrists).,, of pressure, and shooting in a small spo the size of half-a-crown, sore to touch, 204.,, superficial in whole left side of breast or waking, 204. Pain in ribs, preceded by pain in thumb ani arm, 204. Dull circumscribed pain in right side, aggravatec by inspiration, 146. CHEST. Pain at night, 129 (abd.),, on deep inspiration, 92 (im. eff.),, atcardiac region, 113 (gastr.), 127,130, 136 (palpitation), 137.,, burmng in sternum, 129 (abd.) Stitches in nner surface of the sternum, (pains). Tightness, 113 (gastr.), 130. Dyspnoea, 113, on exertion, 158. 135, 200 Back, Kidneys, &c. a Plat. Rhus. SAUTr. r Bcrb. Cyc. Iye. d Ammoniac. Led. f nrb. / Tax. Dne. 161. Dull pressive pains in different parts of the back, going off in the evening. Deep-seated aching at upper angle a of left scapula. (Dle., 7th day, 1st dil.) 162. Rheumatic pains between 7th and 8th ribs at their angles on the right side, increased on raising or twisting the body to the left.b Transient stitch at the inferior angle of left scapula, then a similar pain in the toe. (TWkr., '/ o to I/ gr. daily for 10 days.) 163. On 2nd, darting pains in renal region c and severe stitch in lumbar region, aggravated by inspiration,d and cough. 3rd day, transient dull pain under right scapula; sharp shooting pains first in left then in right renal region, extending down" the thigh, aggravated by inspiration and coughing, on 4th. The lumbar pain felt next day also. On the 8th, cutting pain on left side of sacral' bone shooting up and down. (Dyn., 1. d.) 164, Vertigo and heavy pain in the vertex subsiding in 6 or 8 hours, then severe pain in the lumbar region, extending into the sacrum and down the thigh, at first aching then increasing to a numb sensation so severe that he could scarcely rise from the chair. It continued 3 days and gradually decreased in severity. The urine was scanty, high coloured, and deposited a pearly white sediment; no irritation in passing it. (Hin., 90 gtts. s1t dil. in 3 doses, 1 day.) 165. At times, for about a week or a fortnight, he has pains across the loins and scanty high coloured urine. (B. F., Ch. W.) 166. Was seized with pain like a knife through the loins, suddenly, so that he could scarcely walk in the afternoon. He was with difficulty helped home, and had great pain all night, and could not sleep all night more than an hour for the pain that continued even when g Bell. Berb. ~~~~~ --~~~-- - ---~~- ~- -~~~~-~ I SYMPTOMS 167 TO 176.] IKALI BICHROATICMT 1.~l 27 SYMPTOMS 167 TO 176.] KALT BTCHROMTCTJM. 27 Back, Kidneys, &c. h Dig. Hell. Lach. Led. Trif. Nitr. ac. i Nat. m. j Lach. k Ang, v. (7) I Sarsa. Canth. still, but greatly worse on moving or turning; he had frequent desire to pass urine, with scanty reddish urine." He [got some nitre and] was somewhat relieved, so that he could go back to work next day, but remained with pain in back and scanty urine for a fortnight. (Ch. TW. aged 19.) 167. Bitter taste in the morning;' aching at the inferior angle of right scapula. (Fan. Ch. W.) 168. Aching pain in the back, running down on the left side into the hip.) Urine red. Dryness in mouth and throat. Sight confused and dim; singing in the ears. (Hem. Ch. W.) 169. Stabbing pain from the 3rd cervical to the 5th dorsal vertebra, striking forward through the chest to the sternum,k increased on motion, with inability to straighten the spine after stooping. It prevented him from working for 6 weeks. Constipation with pain across the loins. Heartburn only in the evening after tea. (Swy. UC. W.) 170,. Occasional attacks, lasting about a week, of aching pain in the region of the kidneys, extending' to the groins, worse after rest, with scanty reddish urine, nausea and impaired appetite. (1 Ch. TV.) 171. A dyer, in a fit of rage, took a piece of bichromate of potash, dissolved it in water, and swallowed the solution. Nausea immediately came on, and, after copious draughts of milk, soap-water, and oil, violent vomiting was produced. After the stomach was completely evacuated, the patient felt well and free from pain, and walked about, and in the evening ate his supper with appetite and refused to have medical advice. The night was passed quietly. Next morning after getting up he felt such weakness, that he was obliged to lie down again; the belly was neither swelled nor painful; the pulse quiet, but small. The patient felt only some shooting pains in the back, and in the region of the kidneys, and a feeling of scraping in the throat; he was able to eat, and he drank large quantities of pure water and demulcent drinks; he had several stools of natural colour and consistence, but did not pass a drop of urine. The 2nd night was somewhat restless, and next morning the patient was very much weaker; he had scarcely power to rise, and trembled greatly on making the attempt, but without, however, feeling any increase of pain. At a later period he could scarcely raise himself up, and he sank back on making the attempt, but his spirits remained good, and he felt sure he would soon be well. The debility increased and the patient died, sleeping calmly, in fifty-four hours after taking the poison, as if from pure exhaustion, without any disturbance of the mental faculties. Some hours before death, the white of the eye became coloured yellow, and shortly before death, spasmodic contraction of the hands was observed. On dissection, the stomach was found unchanged, the duodenum slightly reddened, the liver coloured yellow, the spleen gorged with blood; the kidneys were large, and when cut open, deeply marbled red, filled with frothy blood; bladder empty. The fluid in the stomach still shewed the presence of Chrome to chemical tests. J NArpe, pain in, 203.,, stiffness, 193, 197, 203 (gen. pains). Scapute, pain in left scapula, 104 (gastr.),, dull shooting under left scapula, in the evening, 135 (abd.) Between scapulas, pain pressive, 136 (abd.) Pain between scapula, in the front of the chest and in the extremities on waldng, 204. INDEX. Back, pains in, 106 (gastr.), pains hindering straightening, 6 (vertigo)., pain in the middle on the right, 135 (abd.) Peculiar undulating contraction of the muscles of the right side of the back, 204 (gen. pains). Loins, achine in, 159 (cough and dyspepsia).,, pain from the loins to theo nape, and through to the sternum, 158 (cough, &c.) Coccyx, pains in, in the morning, 200 (gen. painR.),,, during coition, 200.,, in walking and in the act of sitting down, 200.,, relieved after stool, 200. Upper Extremities. 172. Violent tearing aching pain in the left shoulder. (Die., 1st dil. and Tye. C. W.) Rheumatic pains in both shoulders, worse at night. (Tye. Ch. TV.) 173. At night, soon after lying down, tearing pains in the shoulder and upper arm, on the side not" lain upon; on turning, the pain went to the other arm. (Die.) 174. On the 1st day, he had now and then, quite suddenly, a violent crampyb pain in the middle of the outer surface of the right upper arm, leaving the spot tender to touch. (Arn., 1. d. 2 doses daily for 5 days.) 175. Darting in the elbow on 2nd, 5th and 7th, and dartings in right wrist 2nd and 8th, also severe throbbing. Darting in left wrist, near pisiform bone," for nearly an hour, and slight aching in 2nd joint of fingers. (Dyn., s. d. 5 days.) 176. 4th day, afternoon, a sharp wrenchingd pain on the radial side of the left hand, that made him groan aloud. On 8th, in the afternoon, a few transient a Ign. 6 Cia. Arg. Petrol. c Ar nr,t. (7) Stalui. () d lisp. I'us. (?) - - -- It ---- -- 28 KALI BICHROMICUM. [SYMPTOMS 177 TO 19~ C Cale, Clem. Hyp. lmd. Gu;aj. Led. Rhod. Spig. Staph. Sul. f Phos. Upper Extr wrenches and stitches in the right axilla and hinder surface of left thigh; also frequent single jerking wrenching pain from right shoulder to elbow. (Zl., 1st dil. 10 days.) 177. Tearing pain in the shin bone and in the joints of the fingers of both hands, but especially so violent in the right thumb e that he could not write for the space of an hour. Next day the pain in the thumb returned at short intervals till the evening, and it and the other pains gradually became less frequent and severe in the next 2 or 3 days. (Mr., 15 grs. 1st trit.) 178, On the 6th, painful tension f at the extensor side of right thumb lasted the whole day, and is tender to pressure at the articulation of metacarpal bone of thumb with wrist. Next morningg he awoke with such a violent pain in the thumb that he could hardly hold the pen, increased by every movement of the hand or arm, no swelling or redness visible. The pains continued the whole forenoon, and were often so violent that he could not take his handkerchief out of his pocket; they reached up to the elbow; nothing to be seen; better in the evening, and next morning gone. (Zi., 1/lo gr. every 4 days for 8 weeks.) 179. On the 10th day he had a sudden tearing and convulsive movement in the right deltoid muscle. (Lack., 2 trit. 17 days.) g Magnet. Sloulder, stiff, 194.,, paralytic tearing pain, 136 (with nausea).,, after pain on vertex, 204.,, joint, as if loose, 194.,,, pains in, and left breast, on raising the arm, 204.,,, right shoulder, then in left elbow, 128 Pain and numbness in shoulder and elbow, 204. Pains in scapula, whole arm, hand and thumb, disappearing on motion, 203 (genl. pains). INDEX. Pain and jerking in upper arm and thigh, 183. Pain in the left forearm and right side of occiut, 204. 1ndds, Pains in hands, feet and back, 2 (vertigo).,,,, and chest, 197 (genl. pains).,,,,, and forearm, 204. Pains in wrists and pectoral and intercostal muscles, 201. 1,, ] and external malleolus, 202. Pain in hands, as if bruised, 193. Weakness of the hands, 105 (gastr.) Spasmodic contraction of the hands, 171 (fata suppression of urine). Pustuies on hands, 38 (eyes). Thumb, pains in, 193, 203, 204. Pain in right thumb, then left upper arm, thei left ribs, 204. Bones, pains in, of hand, 195.,,, ulna, 204.,,,, forearm, 195, Lower Extremities. a Cham.Colch. Lach. Nice. Ferr. b K. hyd. e Assa. Mng. fMur. ac. Phos. Rc. P1i). ac. Sep. Sil. Squll. Val. d Kal. c, Krcog. Nftr. in. Nux, PhoFe. Sulph. SArA. Kal. c, / nRh-u () Zinc. (!) SBIll. Bry. Mcn. Phren. Mcrcurialis. 180. Rheumatic pains in the hip, coming on at night.0 (Tyn. Ch. W.) 181. 2nd, the whole right leg was painful, especially on the hip, that he could not lie b on the right side that night. In the evening next day, after a walk, tensive, troublesome drawing pains in the whole right leg. (Zi., /1,, gr. every 4 days for 8 weeks.) 182. Rheumatic pains in the right thigh. (C'he. Ch. W.) 18-3. On the 2nd day, in the evening, he had a drawing and jerking in single muscles of the thigh and upper arm.' On the 6th day, also in the evening,d he had sudden tearing pain in the left knee, very painful, and preventing every movement of the joint. This pain lasted about a minute and reappeared again in about half an hour. (Lack., 2nd trit. 17 days.) 184. On rising from his seat, a violent pain, as if dislocated in the knee,o of short duration, repeatedly. Once a similar pain, but slighter, in the ankle joint. (Lack., 2 provings, 1st trit. 9 and 13 days.) 185. Acute rheumatic pains and stiffness in the knees without swelling, felt only in walking and not at night. (Brrt. Ch. WU.) 180. On the 4th day, external burning and smarting sensation over the right trochanter major.' 9th and 11th days, tearing pain from left ham 1 down the leg. (Die.) 187. Pain in the course of the left sciatic nerve, extending from behind the great trochanter to the calf of the leg. (Dyn.,.Nn.) 188. Darting pain down the outside ' of the left thigh. (Dgn.) 189. On the 9th day, in the afternoon, a pain came on in the tendons of the muscles of the calf, as if stretched, much felt in walking, and causing lameness. It extends up to the ham and down to the tendo achillis.1 It continued 2 days. (Dle., 3rd dil. twice a day for 10 days.) 190. Soreness in the heelsj in walking, continued for some days after the proving. Painful shooting in the 2nd joint of the great toe, at night in bed.k (Wkr.,from '/, to '/, gr. about 10 days.) 191. Pains, heat and throbbing1 in the toes. (Die.) h Mang. Mur. ac. Rhod. Staph. i Bar. c. Graph. Teucr. Itan. Sep. Zinc. I Bor. Nux, Phos.ac Sep. k Led. Nitr.ac. Puls I Phos. ac. I 192. Seven hours after the 4th dose he was attacked by violent enduring tearing pains in the bones: they were concentrated in both little toes of the lower extremities, and accompanied by very troublesome creeping pains; they reached such a grade of intensity, that he feared both toes would tear themselves away; these pains lessened indeed in a few hours, but still continued during the night and next forenoon; then there arose slight pains in the thigh and small of back, which went off in a few hours. (Zoth., 1st trit. 4 days.) _ __ ___ ___ _ __ __ __.. KALI BICHROMICUM. '2 SYMPTOMS 193 TO 198.] - --- --- -- Pain in hip to knee, 11, (head) 197, 199.,, from back, 168. S and left breast and shoulder, 198. Pain in thigh, from loins, 162, 163. S and axilla, 176. S after pain in sacrum, 200. Pain in tibia, 12 (head). Sshin-bone and finger joints, 177, 193 (general)., shin-bone, 193. Lower Extremities. IN1DEX. Pain in tibia and ulna, followed by burning on surface of thigh, 204., knee, 198. Tendo achillis, pain, 193. Toe, 193, (general) 203.,, and scapula, 161.,, first in one then in the other, 198. Heaviness of legs, 195 (pains). Tearing in lower limbs, hands and nape, 203. Pain in leg, after pain in sacrum, 200., in sartorius muscle, 201 (scalp). S legs and feet, forearms and hands, on waking, 284. Cramps in the calves and inner part of the thighs, 96 (gastro-enteritis). Formication in metatarsus, 195. Malleolus, hard lump, painless, 194.,, pain in ext. m. and wrist, 202. REMARKS.-Pains are often mentioned in the hips and knees, chiefly felt in the day time and on movement. Swelling has not been observed. Some symptoms, apparently of the sciatic nerve, are to be noted. The action on the toes is also marked, and the pains often fly quickly from one leg to the other and to other parts of the body. General Pains and Sensations with no fixed Seat. a Ar. Puls. Mez. b Ang. Graph. Mez. Mang. Pls. c Puls. d Croc. e Berb. Zinc. f Aur. Sab. g MIerc. (?) 193. 2nd.-At noon, drawing tearing pain in several parts of the upper and lower extremities, in the right ankle joint and shinbone, also in the right big toe and right thumb, of particular violence; transitory stiffness of neck; toothache with stitches in the left ear and temple. On the 3rd, single fleeting but violent stitches in the left ear, fleeting drawing and tearing in the left molars, and also in various joints of the limbs, vague, and quickly changing place. Violent pain in the bone of the leg towards the ankle, as if the feet were broken or bruised;b intolerably increased on bending the anlde upwards,0 impeding locomotion, coming on about three hours after the medicine; and on the following day, at the same time, arms and hands as if bruised and lame; the thumbs of both hands especially painful; stiffness of neck. (Mfz., 2 provings, /1,/ gr. daily, 7 and 11 days.) 194. Pain in the right shoulder joint on motion, and feeling of looseness d of the joint3rd day. For the next two days it continued much the same; and on the 6th it increased to stiffness of the joint, and painfulness on being raised high. 11th and 12th again worse; went off on 14th. On the 4th he had swellingo and pain in left tendo Achillis, which on the 6th was diminished by walking; but came after sitting.' It continued till the 9th, and on that day the right became also affected in the same way and hindered walking. 11th.-Pain went from left tendo Achillis and staid in right. On the 12th, he observed a small hard swelling,9 painful on firm pressure, on right inner malleolus. On the 14th the swelling at the inner malleolus increased; it is very hard, and has a rhomboid shape, not moveable on pressure, painful only to strong pressure, and seems to be seated on the bone: it went off in three or four days. (Amrn., 18 days, 10th, 7th and 3rd dils. each for some days, 2 doses daily.) 195. On the I st, heaviness of the legs while sitting. On the 3rd, pain in a fixed spot of the outside of the upper part of the forearm, chiefly in the muscles, and partly in the periosteum;- A Mez. ihod. the spot is sore on motion. On the 4th, slight drawing in the bones of the right hand; heaviness of right leg. On the 6th, a fleeting but piercing pain in the bone of the first phalanx of the right middle finger; in sitting sudden numbness and creeping in the right metatarsus.' (Zlat., 1st trit. i Graph. (1) 1 dose daily, 6 days.) 196. A dull heavy pain in right side of chest through to the back,j continuing and passing off j Kreos. ( Ag. (1) at intervals of twenty minutes; and in the Ind. middle of the day a sharp shooting in left side of chest: all went off in the evening, 2nd day. Next morning the same pain, but less violent. On the 3rd day, aching at right hip joint; a sensation of stiffness in the back of the neck when bending down the head. Rheumatic pain in shoulder and elbow joint on motion, with numbness from shoulder to elbow.k (L.f J., 10 gtts. 1st dil.) k Puls. 197. On waking, and also after rising, single short twitches in the extremities, chiefly in front towards the hands and feet, which soon passed off, and were followed by a pressing pain in the pectoral muscles under both axille, which also lasted but a short time. (Zlat., Ist trit. 3 days.) 198. Sharp pain in the right knee and hip joints, and left breast and shoulder 1st day. Next day sharp pain in knee. 3rd day.Rheumatic pains in knees and chest. 5th.-In knee and hip joint. On the 6th, in the evening an acute twinging pain in the ball' of left great toe, lasting n rb. nry. K.carb. four minutes; pricking and stinging pails in l' '. l ". different parts of the body; acute gouty pain zine. in ball of right great toe, precisely like that in left foot, and succeeding the other after an interval of four or five minutes." (N--n., '/, yr. tv in. several times a day for 6 days.) ----- r I ii -- -------- ---- 30 KALI BICHROMICUM. [SYMPTOMS 199 To 204 General Pains and Sensations with no fixed Seat. n Colch. o Cape. Aur. sBrta IIep. Sulph. Stap. lihrd. p IeU. Carb.an. Ign. K. hyd. PetroL Phos. Sil. Graph. q iUl. Phos. r Carb. an. Petrol. a Ign. / Graph. u K.hyd.Ruta,Cocc. More. r Zie. r \eon. rGran. rib. ac. $iil. r Aeon. Brr. Cabc. Proi. Mur.,r. ltaph 199. Aching and jerking pains in the hip, felt only in the day. In the morning, shooting and pricking pains in all the limbs;" he is stiff all over and can hardly move." (Hwe., C%. WI.) 200. On the 13th, in the morning on awaking, and after rising he felt a pain in the coccyxP (steissbein), deep as if in the bone, worse from walkingq and touch. This continued in all, more or less daily, for about four weeks, generally felt only in the morning," but at times lasting the whole day, or coming back in the afternoon and evening. 33rd.-The pain in coccyx came on again about noon, and was very severe when he got up to pass urine;t it reached then to the urethra, and forced him to bend the belly forwards; it went off in half an hour. On the 37th it was felt during coition. 44th.-At noon, while sitting, again that peculiar pain in the sacrum (kreutzbein), as if he had got a smart blow" on it. It went off in half an hour, and then he had tearing and drawing pains in the muscles of the front of right thigh. 45th.-Again the pains in sacrum coming on in paroxysms in walking, so violent that walking was hindered for a few moments at a time, going off next moment, though felt in the act of sitting down. In the afternoon they went off quite, and instead he had drawing pains in the right leg till evening. 46th.-On awaking, pretty severe pains in sacrum, which returned again later. He then had a pretty copious stool, after which the pains went quite off, but came back again after dinner slightly, and returned again for several days, but not so severe again. Besides these, he had pains, chiefly after the 3rd week, in the bones at various times; gnawing pains in the malar bone, and in the bones of the extremities; pain like a bruise in the bones of the face,' especially on the facial surface of the upper maxillary bones. On the 39th day, he had stitches in the inner surface of the sternum. He felt occasional returns of these pains till nearly a month after the last dose. (Zlat., '/o yr. every 4 days, for 8 weeks.) 201. On the 9th and 1 Oth days he had pressing pain, especially in the occiput and forehead, which caused the sleep to be restless; also tearing and drawing pain in the right temporal muscle, which continued till the 11th day. These symptoms came on in paroxysms, and for the most part were more severe before noon than in the evening. For some days before, he had pains in the wrists, and violent flying stitches in the large pectoral muscles" and in the intercostals.3 Also a tensive pain in the sartorius muscle, which came on suddenly and hindered walking. (Lach., 1st trit. 14 days.) 202, 2nd day.-Expansiver pressure at zygomatic process of left temporal bone; in the afternoon. On the 3rd, tearing and squeezing over the external' malleolus of left foot, as if in the tibia, (?) along with squeezing tearing above theleft wrist. On the 4th day, (no medicine for 2 days) severe cutting pain along the right parietal bone.a (Muller, 1st trit. 1 dose daily, for 2 days.) 203. Three hours after taking the medicine there occurred regularly everyb day, drawing pains, on the first day, in the left shoulder blade, in the left upper and forearm, hand, and especially the thumb, which quite disappeared on moving the arm, and occupied more the bones than the joints; pressing pain in the whole right side of the head, especially, and most violent, in the occipital part of this side, accompanied by fleeting, but violent stitchesd therein. On the 2nd, drawing tearing pain in the lower limbs, especially in the right big toe; jerking in the little finger of left hand; tearing pain on the slightest movement of nape of neck; stiffness of the same. 204. On the 5th, slight tearing0 pain in left side of face, and at times (10th) in the bones of the head. 6th.-External drawing pain in the left temple,' as if in the fascial covering of the muscle. 7th.-In the evening, lancinatingg pains on the right side of the head, in distinct paroxysms lasting only a short time. 10th.-About noon, constricting pain in the top of the head, and later paralytich drawing in the right shoulder. 13th.-In waking slight drawing pain behind the left ear, and left lower1 jaw. The movement of the head is not quite free; the muscles of the neck on the left side appear to be stretched. After breakfast feeling of pressure in the bones of the upper jaw, immediately below the orbits. The same in the afternoon of the 21st. 18th.-Several times in the day a sharp pain in the infraorbital edges of both ialar bones, and sensitiveness of the bones of the face. 15th.-The whole evening a pain composed of pressure and shooting on a spot the size of half-a-crown, in the region of the seventh rib of the left side, like a pain in the costal pleura. Next morning on waking, the same pain, and the spot was sore to touch: in the forenoon, the shooting in it came frequently. Next day quite gone. 19th.-On waking, painful cutting and tearing in whole left side of the breast, seemingly superficial. 6th.-A transient stitch through the abdomen backwards towards the spinal column; in the evening in walking, tensive pain in the left breast, more externally. 22nd.-In the evening on sitting down, after y Colch. a Ign. Mez. a Sars. Kal. hyd Thuja. Mang. b Chinin. c Dros. Stront. d Magnet, e Coloc. Graph. Magn c. f Asar. Calc. g (1) Lacl h (1) i Rhus, Silic. ~-II - lj= SYMPTOMS 204 TO 210.] KALI BICHROMICUM. 31 -- General Pains and Sensations with no fixed seat. j Mere. Rhus, k Rhus, Sil. 1 Chin. Lye. m Lycop. Sil. strong exercise, he felt a peculiar undulating contraction of the muscles of the back on the right side, lasting quarter of an hour. Though he slept well he had the feeling of insufficient sleep on getting up. lst.-On waking, drawing pains in various parts of the body; but everyvhere near the bone, and as if the periosteum and the tendinous expansion lying next it were affected. On rising very troublesome, drawingk and pressing pains in various parts of the body, especially in the bones of the face; but also in the long bones of the extremities. 12th.-In waking, tearing drawing pains here and there in the body, mostly in the extremities, yet also on the front of the chest and between the shoulders. 14th and 16th.-Tearings in hands and feet and forearms. 15th.-On awaking, tearing pain in the right tibia and ulna, afterwards burning on the outer surface of the left thigh. 18th.-On waking from good sleep, very sharp tearing pains" in the legs and feet, and forearms and hands. These pains were peculiar, they came in jerks, and were not extended, but it was always as if a single fibre or twig of nerve was suddenly pulled." They disappeared in an hour. 13th.-On waking, slight pains in the fascia, now here, now there, in the neck, back and extremities. 7th.-Slight prcssive pain in the left shoulder, which extended to the left breast; increased by moving the arm, particularly by raising it. Tearing pain in the right thumb, then in left upper arm, and then at the arch of the ribs on the left side. 8th.-Tearing in the left forearm, and on the right side of the back of the head. Towards evening repeated stitches in the metacarpal joint of middle finger of right hand.o Besides these, on other days various less distinctly marked pains in the extremities, transient, and affecting different members simultaneously, or in quick succession.P (Zl., 2 provinys, 2nd trit. 1 dose daily, 23 and 27 days.) n Paus. o Am.n. m. los. a. p Asar. Short twitches, 197. Stinging pains, 198. Pains, wide spread, regularly every day, 203., in short jerks, as if a nerve suddenly pulled, 204. Aching and stiffness all over in the morning, 199, 204, 196. Pains crosswise. right mamma and left elbow, 104. left forearm and right side of occiput, 204.,, right knee and hip, and left breast and shoulder, 198., right axilla and left thigh, 176. right big toe and left little finger, 203. Periodic pains, 13, 13A, 203. Slifting pains, 193. INDEX and ANALYSIS. SAlfting pains from sacrum to right thigh, 200. o, ne arm to the other, 173. right thumb to left arm, and then left ribs, 204.,, left to right great toe, 198.,, left scapula to the toe, 162. vertex to loins, 164., right shoulder to left elbow, 128.,, twitching pains in hands and feet; then aching in the pectoral muscles, 197. Cramps in various parts of the body, 96 (gastroenteritis). Pains in the joints, 193. BONES. A hard swelling on the bone. A hard swelling on the lower jaw, 64.,,, tibia, 194. P,,, parietal bone, 13A. Pains in the bones, periosteuu and fascia, all over, 204. Pains in tibia, 193.,, ann and fingers, 195. face and extremities, 200., sternum, 200. coccyx and sacrum, 103, 200. zygoina.and parietal, 202. upper extrenmties, &c., 203. head, 201. face, 204, 200. malar bone, 200. a Ant. Aur. Berb. Cann. Crotal. Hyos. Natr. m. Plb. Sep. Tax. Thuja. b Sepia. c Ar. Baryt. Calc. Lyc. Mur. ac. SOeand. d (?) e Aim. Arg. Ars. Berb. Caps. Clem. Graph. Kal.c.Puls. Sep. Stann. Viol. tr. Skin and 205. Brown a spots on the throat,b like freckles, on the 7th and 17th. On the 18th, itching and burning of the scalp, with eruption of small pimples here and there.e 23rd, in the forenoon, while in the open air,d severe burning in the face,e below the eyes and on both sides of the nose, as if he was going to have erysipelas. In the evening, burning of the same and forehead and right thigh. 30th, burning of forehead. 32nd, burning in skin of outside of the leg, in the evening. (2 provers, Zl. and Lackner, 8 weeks and 2 weeks.) 206. On the 10th day, soon after awaking, he had severe itching in the skin of the neck. After a little time this disappeared; yet soon reappeared, first on the left shoulder, later on the left upper arm, and on the left side of the chest, and finally on the back. This continued Ulcers. from 6 to 10 o'clock, and after midday the same itching appeared on the skin of the loins and quickly disappeared. (Lack., 2nd trit. 11 days.) 207. 16th day, two vesicles on the under' lip. On the succeeding days, on different parts of the face and body, burning and itching," and burning and itching in the eyes. (Zl., 1st trit. 23 days.) 208. 9th, a blister 1 full of serum in sole of right foot from walking, which never happened before. 9th and 17th, a few inflamed pimples on the back. (R.) 209. On the right side of the back,' near the last rib, a boil formed, painful on the least motion, and lasted 5 days. (R., 1st trit. gr. 15.) 210. On the night of the 2nd, he had considerable itching of the hairy parts of the genitals; it increased to inflammation of the skin and formation of about 20 pustules the size of SMagni. c. Sarc. Si.p. Staplh. Sulphb. y Am. mn. Bry. CI,. ('anti. Carb. i,~rli, Mna li. c. Mr I, Nattr. Nitrac.l'lio, ^*|i..Spolg. S,,iplih h Ar". Sulli. i Lach. Met. j Ant,. 'art. -1 --- - 32 KALI BICHROMICUM. [SYMPTOMS 211 TO 23f Skin and Ulcers. k Sil. Sul. ac. Tarax. Zinc. I Agar. Ars. Aur, Con. Cop. Graph. lod. Kul c. Kal. chl. Kal. hyd. Led. Mere. Natr. Rims, Stram. Tercb. Zinc. luglans. Aeon. m Bell. Cop. Guaj. Mere. n Ka). chl. o (?) P (1) q Tart. Cocce. Cop. Anac. Bor. Thuja. r Tart. Ilyosc. 8il. Veratrine. Tliuja, Kreos. Petrol. Ant. cr. a Ant. 1ov. Crot. Dulc. Mere. Tart. I SAw. 8il, Tart. a (1) r An Ant. Carb. "an. 3,Pv. ilywot. ic. pin heads, which were clustered together in the space of a square inch. Next (3rd) day it continued all day very troublesome, causing him to scratch constantly. 4th and 5th, the pustules form little ulcers and run together into one, which discharges matter, and severe shootings in it, waking him at night. Healed up in 5 or 6 days. (R., 2nd trit. one dose daily for 5 days.) 211. On the 6th day, a red pimple appeared on the back of the hand.k (Dyn., s. d. 5 days.) Among the Workmen. 212. Papular eruptions on fore-arms, lasting a few days, recurring frequently. (Swny.) 213. Three months after exposure, papular1 rash lasting 3 months. (Hrl.) 214. After 9 days exposure to the dust of the K. bich., he had an itching papular eruption on the fore-arm and legs, which lasted a fortnight, disappearing after he gave up the occupation. (CI. WV.) 215. Solid eruption, like measles,m over the body. (M. Ch. TV.) 216. Eruption generally comes on in the first 14 days. 217. Rash commencing in hot weather. 218. Rash lasted only 3 days. (Hgn.) 219. In 7 days vesicular eruption on a red" and elevated base (itching and burning much, especially when exposed to steam) in a few days becoming pustular, and in some presenting a dark point in the centre-invading hands, arms, face, back and belly. On the belly, near the umbilicus, some spots evidently of abraded vesicles, presenting a deep hollowed appearance, which remains after they are healed. (M1cl.) 220. Pustules on the arm, the size of a split pea, with a hair in the centre.0 (L. C. W.) 221. Eruption over the whole body of pustules the size of peas, with a small black slough' in the centre on an inflamed q base. (Hwe. Ch. T7.) 222. Small pustules all over the body, like the small-pox,' which disappear without bursting. (.A. Ch. TV) 223. In a few days an eruption of red round spots broke out on the back, arms and belly: the spots then formed pustules the size of a pea, covered with a scab" which came off in a few days and left a small dry ulcer,' which mostly healed up in about a fortnight leaving a colourless depressed cicatrix." After 3 months there still remained an irregular ulcer, twice the size of a bean, with a scab, on the left scapula, quite out of the reach of contact of the solution. It is dry and superficial. (CA. WV.) 224. Eruption on the face like small-pox,' for some weeks on first entering the works. (Brrt. Ch. IV.) 225. The face is covered with a profuse eruption like acne. (1 Ch. W., aged 35.) [Other parts equally exposed are not so affected]. 226. During the 1st week a profuse yellow scabby eruption formed over the upper lip. (1 Ch. W.) 227. Small yellow pustules on the calf of the leg, about the size of a split pea, not unlike small-pox ' pustules. (1 Ch. W.) 22S. Small pustules made their appearance at the roots of the nails on both hands, extended over the back of the hand to the wrist, and also, but slightly, on the palm; the arm became red, inflamed, and very painful, as far as the shoulder, the glands of the axilla suppurated, but did not break. The pustule on the hand was small and round, and secreted a limpid, watery matter, when the head of it was broken.off; but if left alone, the secretion consolidated into a yellow, viscid mass. (Hvy., after 3 days exposure to the solution.) Painful ulcer under the thumb nail. (McG. C7i. Sol.) 229. Violent itching of the skin all over the body; then eruption of small pustules forming scabs,s most on the arms and legs; the scabs are then painful, smarting and burning. (2 Ch. T.) 230. Itching in the legs, followed next day by breaking out of a red eruption, which run together and formed scabs, discharging thin matter with aching smarting pains. It has lasted above a year, and is in large pustules on the front of the leg; better in cold weather. (1 Ch. W.) 231. Heat and itching of the skin at night in the warmth of the bed,Y followed by eruption on the thighs and legs of reddish hard knots,' from the size of a pin's head to that of a split pea, with a depressed dark scurf11 in the centre, surrounded with an inflamed base; declining in 2 or 3 days. Similar attacks recurred frequently. (Cpr. Ch. W.) 232. After a week's exposure to the chrome solution (without any abrasion) there appears a small red elevation with a dark centre and elevated circumference,b itching and slightly painful. (Crn.) 233. Inflammation of the feet, and in 24 hours breaking out of numerous ulcers (14 in one foot, and 19 on the other) of the characteristic form: they healed in a fortnight. (IIoln., after standing for half an hour in a weak solution of the K. bich. with shoes not water-tight.) 234. Without his being aware of any scratch, the arm swelled as high as the axilla, then a boil like elevation formed, which turned into a large ulcer with dark centre and over-hanginge edges. (Mty.) 235. Redness, swelling, and itching in a spot on the wrist, then great pain: after some time, matter formed and broke the skin, and continued to ooze out for 2 or 3 months, then w Tart. Hyosc. Si: Veratrine, Tbuj Kreos. Ant. c Petrol. z Ant. Bov. Crotoc Dule. Mere. Tart. y Cocc. lual Lye Nux. LaCh. Sar Sil. Sulph. Zinc. x Bar. m. Carb. Lcc Bov. Graph. a (?) b Nitr. ac. c Ars. Mere. PhoE ac. SY-,IPTO-.IS 236 TO 2"49.] TLAZI BICHiRn-MICUM.I 33 Skin and Ulcers, healed, leaving a cicatrix depressed, as if scooped out. (lcM., exposed to ch. sol. after some months.) 236. Itchiness of the fore-arms and hands, then intolerable pain and formation of numerous ulcers, from which above a dozen nearly solid masses of matter fell on striking the arm firmly. The ulcers were left clean dry cavities, which gradually filled up and healed in about a month, leaving a white cicatrix. (Ghm., 4 days after exposure to ch. sol.) 237. In the seat of a scratch, exposed to ch. sol. swelling and irregular ulcer, covered with a scab, painful on pressure, dry: this continued for months, and a hard knot moveable is felt under the skin, with an ulcerated spot like a corn. This gradually hardens, and is covered with a white skin, and remains so for months. (Brd. Ins.) 23S. After swelling and redness of the finger With severe throbbing pain, an ulcer formed over the joint of the fore-finger with white overhanging edges, and dark gangrenous central point; the skin and cellular tissue moveable as if separated from their attachments. (Crn.) 239. The ulcers are always formed where any abrasion exists in parts exposed to the chromic solution, and frequently without any perceptible abrasion. 240. The ulcers vary in size, from that of a pea to that of half-a-crown; they are generally dry, of an oval form, with overhanging edges, inflamed bright red areola,d hardened base moveable on the subjacent tissues, with a blackish spot in the centre. 241. Sores in the parts exposed to the solution, which gradually pierced deeper and deeper, without extending laterally, till they sometimes made their way through the hand or arm altogether. (Cm.) 212. In some persons, though exposed to the dust, abrasions did not lead to the formation of sores. 243. The ulcers were painful in cold weather. (IM'G. An. Nvn.) 244. Ulcer painful on touch. (Crn.) 245. Ulceration of fore-finger to such an extent, that the two last phalanges had to be cut off. (Brn.) 246. Elevated painless induration, where an ulcer was 4 months before. (Mife.) 247. Hands completely covered with depressed cicatrices, which look as if they bad been punched out with a wadding cutter. (Mlm.) 218. Sloughs on the fingers and glans penis, from exposure to solution. (Cumin.) (r Ant. Cocc. Bell. Kreos. Lach. Nitr. ac. Nux, Phos. Staph. lhus. Il OBJECTIVE. Papule, 212, 113, 214, 215, 231. Papulas changing to pustules, 223. Pimples, 205, 208, 211. Vesicles, 207, 136. Pustules, 209, 210, 222, 224, 227, 228, 229., like acne, 225.,, with a black spot in centre, 221. with a hair in centre, 220. Brown spots, 205. INDEX and ANALYSIS. Yellow, scabby eruption, 226. Vesicular, then pustular, 219. Scabs, 223, 228, 230. SUBJECTIVE. Itching without eruption, 206, 207.. before and with ditto, 205, 210, 214, 219, 229, 230, 231. Burning without eruption, 205, 127. Burning and smarting with ditto, 229, 230, 136. PARTS AFFECTED. Whole body, 213, 215, 221, 222, 223, 229. Head, face, or neck, 127, 205, 207, 2241, 226' 225, 136. Trunk, 206, 207, 209, 219, 223.,, genitals, 210. Extremities, upper, 212, 214, 219, 220, 228.,, lower, 205, 214, 227, 230, 231. REMARKS.-The idiopathic and peculiar action on the skin is well marked. On the provers we have as many indications of it as usually appear in such experiments. In the workmen it appears fully developed, probably from the different channels through which it is introduced into the system, and thus penetrates it more completely; but certainly not from mere local irritation, because, as many of the cases well show, there was a simultaneous eruption all over the body, or in parts that were not touched by the salt. The forms of eruption are sufficiently well shewn in the above cases. The large ulcers were only formed under the influence of direct contact of the salt, but their fundamental character appears in some of the eruptions above alluded to as appearing on untouched parts. The local action of the salt in producing ulceration, may be described as follows: if there is any abrasion on the skin of Ilhe hands when exposed to the chrome solution, a swelling appears, like a knot, and on this forms an irregular ulcer covered with a dry scab and painful to touch. This continues for months, and under the skin is felt a hard moveable knot, like a corn, with a small ulcerated spot at the middle, where it touches the cuticle. It gradually heals and becomes covered with a white skin, but the hard knotty feel remains for some time longer. But if the solution is stronger and the cuticle more tender, so that it is penetrated even without any previous abrasion, then ulcers form from the size of a pea to a crown, and often penetrate deep. They are generally oval or round in shape, and are dry; they have overhanging edges, a bright red inflamed environ; hard base, moveable on the subjacent tissues, and have a dark spot in the centre; they heal, leaving a depressed cicatrix. General Debility and Weariness, &c. 249. After the usual local symptoms in the in spirits, and unfit for work; he feels exmouth, he had in half an hour, while walking hausted with heat, as if after great muscular in the open air, unusual weariness, heaviness of efforts; he is tired with walking a short way the limbs, exhaustion, indifferent and depressed and is obliged to sit down, and he cannot well E1 - - 34 KALI BICHROMICUM. [SYMPTOMS 250, 25 34 KALI BTCHROMICUM. [SYMPTOMS 250, 25 General Debility and Weariness, &c. collect his thoughts; he wishes to be alone and the extremities, alternating with flushes of heat in the open air. Nevertheless in going his and general sweat; nausea, eructations, flow round of visits on the sight of food he is seized of water and inclination to vomit. These subwith craving appetite [unusual at that hour], sided in an hour or two. (Schwartz, gr. '1/rd, and on eating he feels better, but in half an 1 dose.) hour has cold and horripilation, especially on INDEX. Weariness and exhaustion, 83, (im. off.) weak- Weakness and prostration, 3 (vertigo), 10 (head- General uneasiness, 95 (gastr.), 113, 121, 12 ness so that he trembled, ache), 152 (cough, &c.) (abd.) Disinclination for exertion, 122 (abd.), on at- Tottering gait, 10 (headache). tempting to risec, 162 (fatal). REMARKS.-General debility, weariness and weakness of the limbs are a prominent accompaniment of many symptoms, ar often seem out of proportion to the primary symptoms. Sleep, &c. 250. On the 21st day he had a quite peculiar unpleasant feeling at 4 o'clock in the morning, which might be best described as a nightmare. He dreamed that somebody had laid himself across his breast and belly, which so hampered his breathing that he thought he would choke, called out aloud, and on waking was covered with sweat, and with his blood in great commotion. After rising felt rather fatigued. (Zlat., gr. '/oth every 4 days for 8 weeks.) 251. On the 1st, at midnight, awoke with an oppression on the chest, hitherto never experienced, which took away his breath and was very highly oppressive (like what he had imagined the nightmare to be). 2nd day, sleepiness towards evening; at midnight was again awakened by a violent oppression on the chest, as if a hundred weight lay on it, and could not fall asleep again till dawn. (Mz., gr. '/,oth daily for 6 days.) Sleepiness, 83 (imra. eff.), 105 (gastr.),, and yawning, 122 (abd.),, early in the o evening, 113. INDEX. Restless sleep, 85, 86 (im. eff.), 122, 128 Unrefreshed feel after good sleep, 193 (generE (abd.) pains).,, starting, tossing and talking, 122. REMARKs.-There seems to be no idiopathic action on sleep, and even the sympathetic action is rare and not great; it i often remarked that the sleep was good, even when symptoms of considerable intensity were present during the day. Febrile paroxysm night and morning, 159. Feoverishness in the first part of the night, 106. Shuddering and chilliness, 82, 83, 99, 101. "1 inward, 92. Heat all over, 84 (im. off.),, at night, 103 (gastr.) Fever. Heat all over, with inward cold, 90, 94.; Heat of hands and feet, 88.,, face and upper part of the body, 92. Skin hot and dry, 96 (gastro-enteritis). Flushes alternately with shuddering, 93. Sweating, 92, 99. Sweating on the back, 93.,, during effort at stool, 127. Pulse small, 171. Pulse at first feeble, then hard and full, 12( Then 100 and jerking, 96 (gastro-ent.) Blood buffed and cupped, 96. REMxARKS.-Idiopathic continued fever does not lie within the sphere of the action of this substance; but as periodicity i observed, it is possible some of the above symptoms may indicate the elements of intermittent fever. Mental Symptoms. Anxiety and depression of spirits, 107, 114 (colic Indifference and depression of spirits, 249 (geand gastr.) neral languor). Anxiety, 109 (gastr.) Ill-humour, 132 (abd.) General Nutrition. Irritability, 129, 119, 137, 93. Much disturbed by a slight vexation, 120. Emaciation, 137, 160 (cough, &c.), 96. Dyspepsia, 96 (gastro-enteritis). SCachexia, 158 (cough, &c.) I Feeling of an acrid humour or psorie diathesi 127 (abd.) II SY',NIPTO'.Nl 252.] ICALI BICHRO-MICU-Al. 35 SYMPTOM 252.] KALT BICHROMICUM. 35 25- Etioogica 'onditions. Several of the workmen stated that the cough ioo and expectoration were worse after the use of The rheumatic pains are aggravated, and the coffee, and they gave it up for tea. gastric relieved after eating. (109, 135.) Fat and light-haired persons seem more In general where the gastric symptoms are easily affected by this drug. very prominent the rheumatic symptoms do not. The open air, when moderately cold, affects appear. him painfully. (Zl.) appear. Some of the symptoms in the workmen are Many pains are worst in the morning on increased in warm weather [possibly only from awaking. (197, 204.) the greater escape of chromic acid]. The pains all over seem worst in the morn- Some symptoms are periodic, returning at ing on awaking. the same hour daily, or at longer intervals. CONCLUDING REMARxs.-I may conclude by noting a few general remarks that were made by the provers or on the workmen. The after effects of the proving experienced by Arn. are given at No. 118. Those of Zlat. are given in a note in the following words:" The Bichromas Kali displayed itself to me as a medicine that expresses its action more in the vegetative than the sensitive sphere; and which more especially attacks the bones and their immediate coverings, as well as the mucous membrane and the fibrous tissues. It shewed a quite peculiar operation on the nose, both on the schneiderian membrane and the bones of the nose; then on the long bones of the extremities, on the sacrum and coccyx; in a slighter degree also on the sternum. The bones of the organ of hearing were also not quite unaffected. "I would have no hesitation in counting it among the antipsoric medicines, and ascribing to it a long duration of action. I can assert that even a month after the last dose I took, the action of the medicine was not finished. It seems in many respects to be analogous to Arsenic, and may, in all probability be administered in diseases with advantage in very high potencies." Mz. adds the following " concluding remarks:" " I was compelled to give up my experiments on account of the greatly deteriorated state of general health brought on by them. Yet for three weeks after I continued far from well. During that time I had frequent returns of the eructations, nausea, inclination to vomit, want of appetite, and troublesome griping in the abdomen. And I was troubled daily, and almost constantly, with dull aching and cracking in different joints; smarting and watering in the eyes; tickling and burning in the nose; pressive aching in the head and cardia. As regards the bowels, I had, with few exceptions, daily two motions; the first regular and consistent, and soon after it a loose one. I did not regain my former good health till the fourth week after these experiments." The writer also was powerfully effected by the drug, and the general health considerably deteriorated for a time; so that some time after the actual distinct symptoms of the drug had subsided, he had a return of a species of severe nervous or bilious headache, which he had had before, but not within two years. The general impression from an examination of men engaged in the manufacture of Bichromate of Potash, on whom it has produced its peculiar effects, is, that they suffer from dyspepsia; and though the appetite is generally good, yet many become anemic, the skin acquiring a yellowish hue, which affects even the conjunctiva. In at least two-thirds of them the septum narium was perforated more or less, a phenomenon which would seem to take place in a very few weeks after commencing to work: but the exact timthe when this happened could not be ascertained, as many of them were not aware of the existence of this state of disease until pointed out to them by the person making the examination. In three-fourths of them the fauces and soft palate were red and injected although without pain or soreness. In two cases deep ulcers on the palate, but without pain. That the pain mostly complained of was across the loins; that catarrh (chronic) existed in about 25 per cent. of the cases, attended with an expectoration of tough viscid tenacious mucus generally white, but sometimes dark grey, approaching to black. _~ _~___ I SUMMARY OF THE PHYSIOLOGICAL ACTION. GENERAL ACTION. This substance may be classed as a pure irritant to the organic tissues. It does not appear to act directly on any of the functions of animal or organic life-except perhaps to a certain extent on those of the stomach -but only indirectly through its action on the tissues that compose the organs. Its action is of a profound and intense character, producing inflammation which goes on to the formation of morbid products even in parts on which it acts only by sympathy. The specific tendency of its action to certain organs and tissues is well marked, and much more circumscribed than that of Arsenic or Mercury. Its influence is confined ahnost wholly to the tissues of organic or vegetative life, and is most marked on the mucous membranes of the stomach and bowels, and of the air passages and nose: next the eyes; then it effects, with about equal intensity, the skin, the liver, and the kidneys, and lastly the fibrous and muscular tissues and the periosteum, and probably the hones. It seems to have little or no specific relation to the serous membranes, to the genital organs of either sex, to the cerebro-spinal nervous system (except neuralgic affection of certain individual nerves), or to the mind. Its action is rapid, and also long continued-evcn after the moderate doses of the provers its action could 1be traced beyond four weeks after the last dose was taken.,Whenl swallowed in dangerous doses, the effects have been known to last in a serious form for four imonths. STOXICA ALACTION. In the hulman subject it has produced death in two Sill'stnc( on record. In one, a few minutes after it was s.wallowdl gricat heat was filt in the throat and stomach, ( and then violent vomiting of blood and mucus came on, S and continnued till death, which took place in five hours. The mucous membrane of the stomach, duodenum and part of the jejunum was destroyed in patches. In the other case narrated in full at No. 171, death was produced by the remote action of the drug, and the stomach was unchanged, though after death traces of chrome were still detected in the stomach. Death seemed to have been produced by congestion of the kidneys, and the only symptoms were suppression of urine, stitches in the back, and extreme debility. In another case of poisoning, which however did not prove fatal, (see Appendix, Bishop's case,) the individual was attacked with vomiting immediately, and ejected most of the poison, but nevertheless in half-anhour was found in a state of extreme collapse, with pale face, very feeble pulse, cramp in the calves of the legs, and almost total insensibility. Twelve hours afterwards severe gastro-intestinal inflammation came on, attended with severe cramps in the limbs and inflammatory fever. When this subsided he was seized 66 hours after the poison was swallowed with a severe attack of dysentery. The effects of these were not wholly removed till after the expiration of four months. In the lower animals, when given in doses of 10 grains to dogs and rabbits, it proved fatal in from halfan-hour to three hours, by the shock to the system and destruction of the irritability of the heart and the irritation of the stomach. When given in smaller doses, either by the mouth or inserted into a wound, it produced death by exciting violent inflanmmation of the stomach and duodenum, and in a less degree the rectum: or by exciting inflanmmation with exudation of a substance like a false membrane in the trachea and bronchia: while at the same time there is general wasting, eruption on the skin, and excessive muscular debility. In other cases where given in very small doses to rabbits, and death protracted beyond seven or eight weeks, there was found degeneration of the kid ~~::. - - --~-~~--- -- ~----e PHYSIOLOGICAL SUMMARY. 37 neys and of the coats of the large intestines; affection of the mesenteric glands; enlargement of the heart; and disease of the skin; attended with emaciation and scurfy eruption and roughness of the coat of the animal. Although such a powerful poison, it does not exercise such an unhealthy influence on the workmen employed in its manufacture by any means as Arsenic or Mercury: most probably on account of its not being volatile like those metals, and thus it is comparatively easy to escape its influence by ordinary precautions. Summary in Anatomical Order. GASTRO-INTESTINAL MUCOUS MEMBRANE AND APPENDAGES. Mouth and (Esophagus.-In the animals in which the salt was exhibited internally, ulcerations were found in the mouth, and the resophagus thickened, and reddened and ulcerated. In the workmen ulcerations were observed in the tongue and palate, and throat and lips. Among the provers signs of idiopathic action were not wanting; among them may be noted the pricking pain in the tongue, and a swelling in it described at No. 66. There seemed to be little action on the teeth and gums, though in soime cases salivation appears. In the aesophagus was remarked a peculiar spasmodic feeling, described at No. 97. Stomach and small Intestines.-In the stomach and duodenum we remark constantly signs of violent inflammation, whether the salt was introduced into the system by the stomach or by any other channel, and when none of it could be detected in the prima via? by chemical tests. The action seems to be most marked at the cardiac portion, and the pylorus seems not affected, while the intense action begins again in the duodenum and gradually diminishes in the small intestine, and reappears in the colon and rectum. In the provers we have numerous symptoms corresponding to these organic affections, and also others showing functional derangement of the stomach. In particular nausea and vomiting are constant symptoms, also want of appetite, yellow tongue, pains in the stomach-both of a spasmodic and inflammatory character, sympathetic headaches, and a variety of symptoms described at length in the previous pages. In the large intestine we have also among the provers the marks of idiopathic action in constipation and colics, and also in severe dysentery, as described at Nos. 96, 125, 126. In this respect the Kali bichromicum seems to resemble most closely the corrosive sublimate. On the Liver we have signs of organic changes seldom met with in the pathological anatomy of the effects of poisons. As that organ is so intimately connected with the venous circulation, we very often find reports of congestion and variations in the size and fulness of blood in it, yet these changes have little or no practical bearing. It is otherwise in this case, for we find marked morbid appearances of a distinct and peculiar character, described at p. 5, and indicating most probably circumscribed inflammation and incipient suppuration. In the provers we have also strong evidence of the action on the liver from the frequency of pains in that region, and the symptoms of the digestive system and the appearance of the stools, which indicate irregularity in the secretion of bile. Of its action on the mesentery and mesenteric glands we have likewise evidence in the pathological anatomy at pp. 5 and 7, and along with that, chronic disease of the coats of the large intestine. As symptoms of this we may probably consider the excessive emaciation of the animals disproportioned to the consumption of food, and among the provers and workmen the anemic and cachectic appearance of some. We have no evidence of any action on the peritonmumn. In three of the experiments (p. 7) the diaphragm was found acted on. URINARY AND GENITAL ORGANS. In a considerable proportion of cases the kidneys were acted on in a marked manner. The nature of the action seemed to be inflammation of the whole tissue of these organs. In some cases, as in the fatal case in the human subject, No. 171, the congestion was of an active nature, and produced total suppression of urine and death in two days. In the experiments of Zlatarovich, which lasted from a month to ten weeks, the kidneys were in every case affected, and in general in a state of degeneration, with the tubular portion softened and reddened, and undistinguishable from the rest. The urine was also apparently suppressed or altered, for the bladder was either empty as in most cases or full of pus. Connected with these changes we may also note the state of the brain and membranes, which were found injected, and in one case there was extravasation of blood. It is most likely these appearances were dcpcn ji II 38 -KA--L-I BICHROMICUAL 38 KALI BICHROMJCTh1IL dent on the state of the kidney, as in other experiments the medicine did not display any idiopathic action on that organ. It must be observed however also that in these cases there was great enlargement of the heart. The symptoms in the provers do not shew any primary functional disturbance of the urinary secretion, and that seems only modified in cases such as those of the workmen who are affected with signs of inflammatory irritation of the kidneys. I regret that I have not had the opportunity of examining chemically or microscopically the urine in such cases, as it would be interesting to know how far the degeneration of the kidney in question resembles that of Bright's disease. The action on the rest of the urinary organs seems to be only slight, as we have only a few indications referable to the urethra. We have no evidence of its possessing any action on the genital functions or organs of either sex. RESPIRATORY ORGANS. These are undoubtedly, more especially in the mucous membrane, one of the chief spheres of action of this substance. The action is of a distinctly inflammatory character, and even morbid products are fully formed. The action seems confined to the bronchial membrane; and in some of the experiments we find it remarked that the lungs were quite pale in cases in which the bronchia were highly inflamed. The symptoms in the living subjects fully bear out the experiments on animals, and are so fully set forth in the foregoing pages that it is needless to recapitulate. In the symptoms we have also various signs of action on the integuments and even the bones of the chest. In the Heart the appearances are somewhat contra dictory. In the animals we find it often affected, several times with very considerable enlargement in the chronic poisoning, and once with some marks of inflammation of the pericardium; while in the provers we find very few symptoms referring to that organ. Whether it produces a slow alteration in the nutrition of the muscular tissue of it, remains yet to be shown. THE FIBROUS, MUSCULAR, AND OSSEOUS TISSUES AND THE JOINTS. On these it evidently acts to a certain extent, producing the numerous and frequently sharp pains. On the joints, especially of the knee and hip, it produces considerable influence, but swelling has not been observed. The action on the perioste-un and bones is well marked. On the Nervous System we have few signs of its influence. The brain in the provers does not seem in any way idiopathically affected, nor is the mind. In some of the experiments, particularly those of Zlatarovich, the membranes were reddened and the substance softened; but I think we may with justice refer these signs to the state of the kidneys and the heart which was also observed in these cases. Whether, like Arsenic, it acts on the spinal marrow, is not quite obvious. In some of the animals paralytic weakness was observed before death, and in the human experimenters great weakness was observed at times, but still the signs of its influence are not very strong. The action on some individual nervous trunks is, however, distinct, more particularly the neuralgic affection of the supraorbital and sciatic nerves. Finally, the influence of this medicine on the nose, the eyes and the skin, are so plainly set forth, that it is needless to do more than notice it here. Jl I! ii THERAPEUTIC USE. In giving the following cases it is not meant to put them forward as therapeutic indications, for these must always be found in the pure symptoms, but merely to show more plainly the classes of disease in which it is useful. Many of the cases correspond well in the minute symptoms with those of the proving; but in others the description is too meagre to enable us to see a complete correspondence. This mainly arises from the circumstance, that in dispensary cases, of which there are a great number, we are prevented, as every one is aware, by numerous and unavoidable causes, from obtaining any minute histories of the progress of the cases. I he exact time occupied by the cure is also difficult to ascertain correctly, owing to the irregularity of attendance of many such patients. Besides the cases here given this medicine has been used with good effect in a great many other cases. In fact it is used almost daily by myself and my colleagues in Liverpool, both in dispensary and private practice; but in complicated cases of derangement of the digestive organs in which it is often serviceable, it is seldom that one medicine suffices for the cure, and the exact share of each in bringing about that result is not possible to determine. This medicine being a pure irritant and acting on a somewhat circumscribed series of tissues and organs, is well adapted for homceopathic use, as the indications are not obscured in the way that occurs with the narcotics: we are likewise not embarrassed by the difficulty of distinguishing primary and secondary symptoms which meets us in the study of those medicines which act directly in producing functional derangements, such as the evacuants, &c. As general characteristics of its action, we should expect to find it useful both in acute and chronic diseases: in inflammations of an intense character, principally seated in the mucous membranes, and tending to the formation of pseudo-membranous and other morbid products and to ulcerations. The pains are sharp and fly rapidly from one place to another, are generally worse towards morning, and unaccompanied with swelling. It acts most powerfully in fat, fair-haired persons, and many symptoms are aggravated in hot weather. We should not expect to find it useful in merely functional disorders, except, perhaps, in some of those of the stomach. In going through the cases in which it is indicated, we may follow the usual Hahnemannic order. HEAD. Although headache is a very common symptom of the medicine, yet it is generally merely concomitant of other disturbances, and it will be found ih cases in other parts. The chief pains are in the temples and over one eye, and are of a neuralgic or dyspeptic or rheumatic character. The following three cases may be noted: CAsE lst.-Pain in the temples. R. D., aged 24. A month ago (27th Feb.) he was suddenly seized with violent pain in both temples, which has continued since; it is a shooting outwards, in the temples and over the eyes, continuing day and night, but less severe during the night; it is worse on stooping, which also brings on vertigo; no coryza: otherwise healthy. A powder of K. bich. 6 was given, to be dissolved as usual, and a spoonful taken three times a day. Three weeks after he came to report that he had got well while taking the medicine, and had had no return of the pain. CASE 2nd.-E. M., a woman, aged 46, had had for a month a violent pain in left side of the head, at the zygomatic process; worse when tying on it; shooting inwards and towards the throat; the throat was a little reddened but not swelled; she had also some gastric symptoms. K. bich. 3 ter. die relieved it in a few days after Mere. and Ars. had failed. CASE 3rd.-A woman, aged 38, had complained for six months of pain in the left side of the head and over the left eye; worse at night; she had also pain in right side of the chest, from the scapula round to the anterior part; also gnawing at epigastrium after meals; catamenia scanty and some leucorrhwea. K. bich. 6, bis die, then the 3rd and 12th dil. alternately every 6 hours removed the symptoms in about 3 weeks. In the face, ears and teeth we have few indications of action, and we have only to report cases of supraorbital neuralgia, in which it seems quite specific in many varieties. Besides the two cases here given, I have had several other cases in which it was remarkably successful. In case No. 4 it will be observed the pain came almost at the same hour as in the pathogenetic group No. 13. CASE 4th.-Sulra-orbital Neuralgia.-M. M., a female, aged 44, had suffered for a fortnight on the 4th Dec., from pain in the forehead; it begins at 9 o'clock, a. m., in the left temple, and stretches across the forehead to the right temple, and round the eye and the malar bone of the right side; attended with complete loss of sight in the right eye during the pain, and puffy swelling on the minar bone; the paroxysm goes off in the afternoon; she was otherwise well. K. bich. 12, bis die. Next day the pain began later but was more violent, and the attacks gradually declined, though irregularly, till, on the 10th, she had no pain; on the 12th she had another attack on the opposite side of the face, which lasted twelve hours, and after that she ad no return of it at all. CASE 5th.-H. F., a man, aged 32, had been for some time affected with neuralgia. The pain begins at the right supra-orbital ridgo and spreads over one side of the head; it comes on early in the day and lasts ten hours, leaving soreness of the scalp; lie is otherwise healthy. K. bich 12 ter. die. In a week he came to say that hl began to improve immediately, and there remained none of the violent pains, but still a slight pain of the same character. K. b. 6 bis die. In another week he was quite well. EYES. From the symptoms we naturally expect much in cases of inflammatory affections of several of the tissues of the eyes and its consequences; and we may also expect to effect cures of some morbid changes of structure and new growths. The diseases in which it is applicable are catarrhal and catarrhostrumous ophthalmia, blennorrhmea, and even perhaps, Egyptian ophthalmia, in which it might also be used locally; also rheumatic inflammation and inflammation of the eyelids. Altera -I 1ý1_ 40 -K-ALI ]BICHROMICUM.. 40 KALI BJCHROMTCUM. ~ ~ tions of vision as concomitant of these changes, may also yield, but as yet we have no reason to hope for any influence in amaurotic cases. WX-e have found it serviceable in a number of cases of catarrhal ophthalmia, among these we may notice that of CASE fOth.-1I. (., a boy, aged 6, who had been two days affected with inflammation of the ev ees; the conjunctiva was reddened and injected and chemnoseud; much flow of tears; eyelids reddened and ag flutinated with thick matter at the edges. K. bich. 3 ter. die. In Otffree cdays all. rubexics gone, and 'no symptoms remaining except slight morning agglutination, which was also removed by the same treatment in a fe w days. We have also seen very good results from its use in ophthairnia tarsi. In these cases we ]have sometimes with good effect, conjoined the external with the internal use of the remedy: using as a collyrium once or twice a day a lotion composed of 4 grain of the pure salt to the oz. of water. I would suggest that the neutral chromate might be used with advantage, as being, less liable to decomposition, in the form of anointment. I have not yet tried it. CAsBE h-coflu Opidtholnia and Ulceration of the Corea.M. Gi., a girl, agred 13, ha-,d been for a month affected with inflammation of the eyes, which was little improved under several medicines. On the 28th April there was much injection of the conjunctiva, both of the bull) and the eyelids of both, eyes; very red at the edges of the cornea, and a numnber (of philyetcnulin on the edge; several (Jeep ulcers on the corne-a; great photophoc-bia and flow of tears; no pain. K. bich. 3 ter. die, and K. bich. lotion of 4 g-rain to the oz. of water, to be used twice a day. On the 1s8t of May thiere was improvement, but still the above syniptoins, and thec intolerance of light and flow of tears were very trouti )esome. K. blob, tnit. 1,iin water-a spoonful twice a day; lotion as before. On the 5th thecre was much greater improvement, and the, svmp~toms were not troublesome. The medicine was then continued tili the 19th, when. there were no inflammatory symptoms remaining, and only a slight spzwk, for which Euphrasia was given. CASE. 8th.-The case of M. M. was of a similar nature, but this patient, a girl of 7 years of age, had been affected more than half her Ife with ophithalmia scrofulosa, and attended eye dispensaries continually. There were large, ulcers on the cornea, and constantly recurring aggravation of inflammation on the slightest exposure. She was treated successfuilly with K. bich. internally and externally, in the 6th and 3rd dilution, with an interposition once of E uphi-asia, and once of Natrum Inur., and the remaining speck was treated with Cannabis. In another case of eatarrbo-strnmous ophithalmia it was remarkably successful; the eorniea was affected with a large opaque spot, to which large. red vessels ran from the injected conjunctiva across the clear Margin, and there was also a zone of fine injection of the bulb round the cornea; the usual subjective symptomns were also present. Oiie grain of the I st trit. was given1, dissolved in 14 spoonfuls of water, and one taken every 4 hours, and the solution of 41 grain to 1 oz. used externially twice a dany. Under this it was very much improved in a couple of Janys, and in a week all traces of inflammation were gone, and only a Speck remained. (tsz 9th.-Illieuratic Inflanimation,-A. gentleman, aged about 40, had been in bad health for two yearts, since an attack of rheumatic gont, brought on by cold and wet; h lie shabad several attacks of rhieunuatic. initis within the la~st six or eight mnonthos, and has been treated with C'alomel and Ilyoscyarnus. Thle last attack hind come on at fortnight before I saw huin; lie improved undler Sulphur, Pulsatilla and Belladonna, when, after imprudent exposure, the inflamnmation came hack a,; had as beore; Suilphur again did good in the course of five dayqs to) a certain extent, buit there still remained most of the symptomns; gr. j. of the I st centesimal ti-it. of IK. bich., to dissolve in the same way, and take a spoonful night and morning. I saw him agnin in a little more than a fortnight, and the eye was then in every respect the same as the other. NOSE. We may expect to find this one of our best remedies in -various affections of the nose, and some of a formidable character. Inflammation and ulceration of the membranmes, and even of the bones and cartilages of a scrofulous or syphilitic character, may in some cases find a remedy: also ozena and perversion of the sense of smell: also epistaxis from congestion of the mucous membrane not depending on general hwemorrhagie diathesis. The following are a few cases ia which it was used beneficially, and besides these I have seen a good many more, more or less completely successful. CA~sE lOth.-Muco pa-let disclwn-ge.-A girl, aged 15, had for a year a copious muco-purulent discharge from the nose: the discharge is worse at night. The nose is swelled and the septum painful to the touch; nose constantly stuffed. K. b. 6 bis die cured the case in about a fortnight. CASE llth.-Aft'ection of the nose and throat after syphcilis.-J. C., a woman, aged 33, had the venereal disease severalycears ago, and since then had laboured under the following~: sore.throat; short cough, with hoarseness and difficulty of speaking; copious yellow discharge from the nose. On the 31st January She got K. bich. 3, 6, 12, 30, of each a powder to be dissolved in fourteen spoonfuls of water, and one taken twice a day. On the 9th March she came back and reported herself much better: the cough and sore throat gone and thle voice clear, but still the running from the nose and pain in the head. She had other gastric symptoms, for which Nun 3 bis die was now gven. This gave relief, an she only came back at long intervals and got an occasional dose of Nux without any fresh report of her symptoms being taken till the 15th August, when the gastric symptoms were gone, but she still had the copious yellow discharge from the nose and a dull, heavy, constant pain in the forehead. K. bich. was repeated as before, and in two months she was well. CASE 13th.-Dr. Russell writes-", In some cases of stuffing of the nostrils, especially the upper part, with a difficulty of detaching the thick mucus which more readily passes by the posterior nares, and is found very troublesome to the patient, although the complaint is trifiig,Ihave seen undoubted benefit from K. bich."1 Dr. Watake, of Vienna, reports his experience of it in three cases of polypus of the nose. CASnB 14th.-One case was that of a man, aged 50, who had been operated on three times in the course of twenty-three years. On its fourth growth it was treated with K. b. in the 2nd decimal dilution (1st centesimial), internally and externally, with the effect of removing it in eight days. Dr. NV. has since lost sight of the patient, so he does not know whether the disease returned. CASE lflth.-The second was that of a young girl. The polyps had only begun to form a few months. before. An operation had bPeen attempted but only partially succeeded, and the chief part of the growth and symptoms were still present. It was qulte cured within a short time by the same dilution inwardly and outwardly as above. After the lapse of a year and a half there ~had been no return of, the disease. The third case was not complete as the patient lived far away, and reported improvement only when Dr. W. last heard from him. _ _ I1 THEERAPEUTIC USE. 41 THERAPEUTIC USE. 41 The following case was communicated by Mr. Moore, of Liverpool. It seems to have been one of those cases of chronic affection both of the fauces and larynx. CASE 16th.-The patient was an unmarried lady, aged 30, who had been affected more or less for twelve years with the following symptoms: "Oppression of the chest; without cough, expectoration of blood mixed with phlegm, brought on by any exertion, or by reading or talking loud or laughing; this is always worse in the morning. Cannot bear the clothes tight over the chest or throat, otherwise a sensation of faintness comes on. In the left side of the throat she has a sore, smarting feeling, somewhat relieved by swallowing; and the feeling of the throat as if it were lined with wash-leather. These symptoms are relieved by dry warm air, but aggravated by damp weather, whether hot or cold. Examination of the chest gives no morbid symptoms. Bowels and catamenia regular. She had some other nervous and flatulent symptoms which were relieved by China, Lachesis and Sepia, but the above in the throat remained unchanged: lagnes mur., Ac. nitri. and Hepar, which were afterwards given, had no better result. IL bich. was then given for six or eight weeks in the 12th and 6th dilutions with complete success, and the above symptoms were quite removed, and though she has subsequently caught a common cold there has been no return of them." CAsE 17th.-Syphilitic sore throat.-M. B., aged 30, had syphilis eleven years ago, and was treated with mercurial pills. After that she had one still-born child, and since then three healthy children, and continued in good health till her present illness, which began six months ago. She has now ulceration of the fauces to a great extent, with much redness of the tissue surrounding the ulcerated parts. At one part the ulcer has perforated the velum palati, forming a clean oval hole. There is much pain excited by swallowing. Cough and thick, blackish mucus in the morning. Frequent tickling cough. Swelling and feeling of fulness in the nose and sensation of a fetid smell. She is pregnant two months. K. bich. 3 bis die. In a week there:was considerable improvement in the throat, and the smell in the nose gone. The medicine was continued at intervals for a month longer in the same dose, and she was then quite well and no remains of the disease except the hole in the velum, which remained permanent. Dr. Watzke of Vienna reports in the Austrian Journal that he has used this remedy in several cases of sore throat in patients who had had chancre shortly before. CASEs No. 18.-There was swelling of the amygdalis with dirty redness, violent pain on swallowing; no trace of exudation of the surface; no suppuration; accompanied by very little fever. They disappeared in a ew days under the use of K. bich. 1st dil. three or four times a day. STOMACH AND HYPOCHONDRIA. To enumerate the affections of the stomach and liver in which our remedy is likely to be useful, would be simply to recapitulate a large part of the proving, therefore it may be sufficient summarily to notice that it is curative in a variety of cases of dyspepsia, spasms in the stomach, chronic inflammation of the stomach and duodenum, and many affections of these parts accompanied with nausea and vomiting. It may likewise be useful in sea-sickness, in flatulent and bilious colics of various descriptions; also it may probably be a capital remedy in acute suppurative inflammation of the liver, as well as in various chronic diseases of that organ. CASE 19th.-Gastric derangement-A fair haired young man had suffered on the 29th August for a week with the following symptoms, which came on with vertigo and pain right hypochondnum; he has now pain in the right hypochondriac region, towards the epigastrium, aggravated by touch and by walking; vomiting of greenish watery mucus in the morning; tongue very thick yellow furred; no appetite; no thirst; taste natural; bowels open. K. bich. 6 ter. die. On the 1st September no more vomiting; pain nearly gone; tolerable appetite; tongue better. The medicine was continued and he was well before it was finished. CABE 20th.-A young lady, aged 14, not yet menstruated, had had for a considerable time the following symptoms: nausea on moving about or taking a short walk; frequently a sensation of nausea rising from the stomach to the pit of the throat; with paleness of the face; flow of water in the mouth, and coppery taste; with faintness and general coldness, and desire to lie down; she has frequent pain at cpigastrium, pricking through to the back, for about half an hour at a time; thirst; brown tongue in the morning; bowels very costive, seldom moved without injections or pills; abdomen distended; constant hunger and craving; milk disagrees; almost daily headache, shooting from back to front; pains in both hypochondria on walking; excessive languor and indisposition to bodily and mental exertion; sleep unrcfreshing. She got 6 powders of K. bich. hi different dilutions, from the 18th to the 3rd, and was told to take one every second night. After the 2nd powder (6) the nausea was gone, and gradually all the other symptoms subdued, and she could eat milk, and the bowels acted. STO3MACH. CASE 21st.-Dyspepsia.-W. W., aged 39, had been for eighteen months affected with the following symptoms: he has vomiting of the food, sour, with nausea, coming on an hour after eating; also pain at the pit of the stomach, like a stone; the tongue is white and dabby; the bowels costive; he cannot eat meat, or tea or coffee, as he vomnts them immediately. K. bich. 6 bis die. In a week he was improved, and in three weeks under K bich. alone, in the 18th, 6th, and 3rd dilutions, quite cured. CASE 22nd.-Vomiting.-E. D., a girl, aged 11, had been ill for two months with the following symptoms: almost immediately after eating she vomits nearly all her food, sour; she has tolerable appetite; the tongue is red in the middle; bitter taste; bowels rather confined. She had received Ipec., Cham., Ars., and Bry., with partial and only temporary relief. K. bich. 6 bis die. The vomiting ceased after the first day of the medicine, and she was quite well within the week. CASE 23rd.- Vomiting of Preqnancy.-I administered this remedy in a case of severe and long continued vomiting with very good results speedily. The patient was quite unable to retain any food on the stomach, and was in consequence emaciated and debilitated to a dangerous degree; after she was better it turned out she was pregnant, though that was not known at the time, as she was otherwise in bad health, and had been married several years without any children. CASE 24th.-Nausea and Gastric Disorder.-P. P., aged 37, had had for seven weeks the following: constant nausea and at times vomiting; she has a choking feeling, like a hair in the back of the throat, that comes suddenly and causes sickness; constant pain tearing at epigastrium; and smarting between the scapulte; bad taste; tongue white; bowels open; vertigo on rising. Ant. cr. 3 bis die for 3 days made no change; then K. bich. 6 bis die removed the feeling of a hair soon, and all the symptoms in about a fortnight. CASE 25th.-Gastro-intestinal irritation--A fair haired girl, aged 6, had scarcely recovered from the hooping-cough when, after cold and changeable weather, she was seized with the following symptoms, which have now lasted a week, on the 5th April: almost immediately after eating she complains of coldness and nausea, and looks pale, and has pain n the abdomen; then she vomits the food unchanged, some1 times sour or tinged with bile; the vomiting gives relief; during ttho rest of the day she is languid, drowsy and complains of cold, though the body is hot; frequent colicky pains in the abdomen; tongue white, furred; thirst; bowels moved several times a-day; stools pale and liquid. K. bich. 3 bis die. On 10th April she had had no retuni of vomiting or nausea and was altogether botter, and got quite well in a day or two more. Dr. Russell writes: " In some cases of stomach complaint where there is pain in the region of the liver and a sodden looking tongue, without much acidity or other symptoms, except general discomfort and sometimes white stools; in more than one such case I have seen unequivocal benefit from Kal. bich." HYPOCHONDRIA. CASE 26th.-Pain in rigid hypochondrium,-Mrs. S., aged 35, fairhaired and stout. For about ten days she has suffered almost daily with attacks of pain as follows: in the evening she is seized witlll a violent aching continued pain, drawing her downwards, in the right hypochondrium, stretching from the epigastrium round to the shoulder; she has to undress immediately, though not perceptibly swelled, and F il 13 I 42 KALI BICHROMI b~CUINI. 42 KALI BICHROMICUM. has great oppression of the breathing; the pain lasts several hours and subsides gradually, without any evacuation or passing of wind; at times it is accompanied with nausea and some little vomiting; the tongue is flat and furred; the bowels are regular; the complexion not yellow, and she is otherwise healthy. Gall-stones were suspected, but none have been detected. She got Hepar and then Colocynth, but in a fortnight was no better, and had similar attacks every second evening; she added to the above description that she first feels as if the bowels would be moved, but they are not, and the pain comes on. Next day (hours after the attack has ceased) they are copiously relieved. K. bich. 6 bis die. After taking this for a day or two the pains went off, and had not returned six weeks afterwards, and she had been in all respects well. I have seen other cases where similar spasmodic attacks resembling those accompanying gall-stones were treated with success with K. bich. as the principal remedy, though others were also given. I have not seen it given in any case where the presence of gall-stones was positively ascertained. CASE 27th.-A man, aged 32, who had suffered for three years from pain in the right side, came to the dispensary. The pain was in a small spot in the right hypochondrium; pretty constant, but aggravated to a sharp stitch on sudden motion after sitting; his appetite was good and his health not much affected, but the pain was so severe and troublesome that lie had been to various medical men seeking relief in vain. Bry., Nux, and other medicines were given without result. K. bich. 6 was then given with speedy relief, and effected a permanent cure in a few weeks. CASE 28th.-In a case of pain in the left hypochondrium, under the ribs, unaffected by eating or pressure, or respiration, but increased by a chill, or great bodily exertion, K. bich. 6 and 3 effected a cure after Am. and Bry. had failed. The patient was a blacksmith and accustomed to striking and lifting heavy weights; he was otherwise in good health and therefore the pain was probably muscular. CASE 29th.-Dr. Rocho writes: "I was consulted by a young lady, aged 17, who had just returned from India, suffering from a constant dull aching in the right hypochondriac region; in other respects she felt well. I gave her K. bich. 3 ter. die, which removed the pain in a few days, without any return." CASE 30th.-Dr. R. found the same remedy equally successful in removing the pain in the same place in a lady, aged 22, who had also catamonial derangement. ABDOMEN. In the bowels we may expect to find it useful in chronic ulceration of the mucous membrane or of the glands, and in distension and flatulent colics; also in disease of the mesenteric glands and of the coats of the large intestines; probably in chronic colitis with constipation or diarrhoea. In general, as to the state of bowels, it may suit a constipated state, but there are also forms of diarrhoea, especially pale and foetid, connected with some of the above morbid states, that we shall find it useful. We may also expect to find it one of the chief remedies in dysentery: in fact it will probably be found equal to Mere. corr. in that disease. Chronic ulceration of the intestinal mucous membrane.The two following interesting cases have been furnished by Dr. Hilbers. CAE 31 st.-"An unmarried lady, aged about 35, consulted me first in (Xctolber, 1850. She informed me that she had suffered for many years from delicate health, and that she had always been more or less subject to diarrhlca. About twelve months previous to her consulting me she was attacked with most violent diarrhoea, accompanied by great weakness of digestion, so that even the slightest irregularity of diet caused extreme suffering, and greatly increased the diarrhoea. lHer medical attendant prescribed for her Laudanum in large doses, which so.mewhat checked the diarrhoea, but the slightest evil influence brought ibck all the symptoms as bad as ever. The usual allopathic remedies were tried with the same results. She then was given a course of Calomel, and afterwards the Muriated tincture of Iron. Under this treatment she improved somewhat as regarded the diarrhoea; the motions became less frequent and she gained some strength. In June she discontinued the Iron and the diarrhoea almost immediately returned, and has continued ever since. She is now exceedingly emaciated, and complains of much weakness. Her digestive powers are much impaired, and her diet is obliged to be of the simplest description, otherwise it causes her extreme suffering. The bowels are moved from three to twenty times in the day; the motions are sometimes accompanied by violent, sharp, griping pains, at other times they pass off unnoticed-this is especially the case in the night, and causes extreme distress; sometimes they are in large quantities and with much tenesmus; their colour is pale, yellowish, watery, sometimes flocculent with streaks of blood; the tongue was much coated. On examining the abdomen there was much tenderness on pressure over the whole course of the colon, which seemed to increase towards the right iliac fossa, where even slight pressure could hardly be borne. There was also much irritation of the spinal nerves. She was occasionally attacked with violent spasms in the stomach. I determined in this case fairly to try the Bichromate of Potash, and therefore prescribed it for a month m the 3rd, 6th and 12th dilutions. At the end of this time all her symptoms were greatly better. The motions were not nearly so frequent, not more than two or three times a day, and were of a much more solid character. The involuntary or rather unnoticed evacuations at night had entirely ceased, and she expressed herself as feeling generally stronger and better. The medicine was therefore continued, and with slight variations, produced by some error in diet or by taking too long walks, the improvement continued also until at the end of aboutten weeks, the evacuations had nearly attained a healthy state. The general health also being greatly improved. In the middle of January she was suddenly seized with haemoptysis, which returned on several successive weeks in small quantities. Examination of the chest showed a tendency to tuberculous development in one lung. For this she has continued under treatment since, and is now almost entirely restored to health. During the whole of this latter period, with one or two unimportant exceptions, the bowels have remained in a healthy state." CASE 32nd.-" A lady had long laboured from haemorrhage from the bowels. Her strength was much impaired; her lips were completely blanched; she had palpitation on the slightest exertion; she had no symptoms of piles; she had much tenderness over the coecum; her stools were sometimes natural, sometimes mucus streaked with blood, sometimes almost pure blood; there was somewhat distended abdomen; the stools never caused pain when they were solid, but when there was mucus or blood there was some tenesmus. She got the Bichromate. The bleeding speedily ceased, and on its return on one or two subsequent occasions in a very mitigated degree it ceased almost immediately after she took the Bichromate. It was administered first in low dilutions (3) and afterwards in higher, from the 12th to 30th. The tenderness over the coecum subsided, and her health was restored." CAsEs No. 33.-In two eases of chronic ulceration of the mucous membrane attended with vomiting of all ingesta, and hectic and emaciation, I obtained temporary beneficial results of a striking nature in relieving the vomiting, pain and diarrhoea, and the patients were enabled to eat but, alternately sunk. In several cases of chronic whitish diarrhoea and hepatic derangement of children, I have obtained very satisfactory results with this medicine as the basis of the treatment. CASE 34th.-A boy, aged 4, of sanguine temperament, had for some time been subject to a chronic diarrhea, for which a variety of homceopathic medicines were tried with partial or temporary benefit. His appetite and general health appear pretty good, but the bowels are disordered-several thin motions daily, clayey and offensive. Before stool he looks pale and shivering, and during it has uneasiness and paleness. Frequent thirst. It bich. 6 and 3, a dose every alternate night removed the disease in a fortnight CASE 35th.-This medicine I found also useful in a chronic case of dull colicky pain round the navel, coming on after any exposure to cold wind. CASE 36th.-Dysentery after a large burn.-A boy of stout make and large head, about 8 years old, accidentally set fire to his clothes, whereby he sustained a severe burn, causing an extensive slough of __ _ L 1 THERAPEUTIC UTJSE. 43 THERAPEUTIC USE. 43 the skin all over one hip and thigh and down the leg. From the time of receiving the injury he had frequently complained of pains in the abdomen of a more or less transitory character; but four weeks after, he had diarrhoea and febrile irritation, and frequent pains in the bowels; in three or four days more the evacuations became bloody and very frequent, and the pains incessant. This state had lasted three days under allopathic treatment (Opiates, &c., and latterly Acetate of Lead and Opium had been ordered) in the hands of two eminent and skilful practitioners, who pronounced the case to be one of ulceration of the bowels, and had given a very bad prognosis when the parents requested me to prescribe. They were quite in despair, and naturally in great distress, for it was their only child. On the 24th October in the evening I found him suffering from constant pain in the abdomen, so that his mother has to be rubbing it gently without ceasing; he is fretful; much emaciated; intolerant of light; pulse 120. He has very frequent evacuations of mucus and blood, preceded by violent pain in the abdomen, but not followed by much tenesmus. The tongue is pointed and red like a piece of raw beef; there is little thirst and no appetite. He has scarcely any sleep for the pain, which causes him to awake screaming after a very short sleep. Ars. 6 every four hours. In thirty-six hours he was considerably improved, and there had been some feculent appearance in some of the motions, but still the main symptoms continued and the pain was very severe. He had also feverish paroxysms towards evening; slight nausea; some watery eructations; sudden starts and screams on waking. I now gave K. bich. 4, every six hours. On the 28th he was very much improved, in fact convalescing very rapidly. He had slept three hours at a time; had had no stool for twelve hours; but still the last evacuation contained mucus and bright red blood, though the one before was feculent. He had a great appetite and scarcely any pain in abdomen. Cont. med. 1st Nov.-By the 29th the motions had become quite free from blood and natural in appearance, and were since costive. The dysentery was now quite well, and he got Nux and afterwards Puls. for some other symptoms of little moment, and finally made a good recovery. In this case the action of the K. bich. was much more marked and beneficial than that of the Ars., and if it had been given sooner would, I doubt not, have effected the cure alone. Whether this was a case of ordinary dysentery, or ought to be looked on as colitis or entero-colitis, and how far it may be connected with the lesion of the mucous membrane, which most frequently accompanies large burns, it is difficult to say, but it suggests the reflection that our remedy is likely to be indicated in those secondary effects of burns. On this subject Mr. Long, of Liverpool, has published (in the London Mled. Gazette, Feb. 7, 1840) some interesting cases, and among them two in which death was caused by a perforating ulcer of the duodenum. Mr. T. B. Curling has re-published these, with some additional cases and some interesting remarks in the twenty-fifth vol. of the MIedico Clir-urgical Transactions. From these it appears that after burns, by far the most frequent secondary lesion, is inflammation of the duodenum, more especially of Brunner's glands, sometimes followed by perforating ulcer, which is the common cause of the sudden death at times observed in cases of severe burns which appear otherwise to be doing well. From the specific effect of the K. bich. on the intestinal mucous membrane, and especially the duodenum, when introduced even through a wound, we may expect to find it a useful remedy in the secondary effects of burns on the intestinal tube. CASE 37th.-We have also among the dispensary records a case of painful dry piles, protruding after stool, cured by KIC, bich. alone in various dilutions, from 12 to 3. KIDNEYS. The action on the urinary organs, all except the kidneys themselves, appears to be very slight. From the action on the kidney already described we should expect to find it useful in congestion of those organs, and accordingly I have tried it in the suppression of urine of cholera, with the result described at p. 119 and 161 of vol. viii of the British Journal of Homewopatlty. Although Arsenic also produces suppression of urine, and doubtless this is one reason more for the great utility of that medicine in the Asiatic cholera, still we found in some cases the suppression continue after the use of Arsenic, and therefore we used this medicine in twelve cases in the 2nd trituration. Of these the urine returned in eleven, but the number of cases is still too small to form a positive opinion on its utility. In incipient cases of Bright's diseases it may be tried, I think with good hopes of success, though I have not yet had any opportunity of putting it to the test. CAsE 38th.-B. D., aged 50, had for three weeks a constant acliing in the region of the kidneys, worse in the right side, where the pain was frequently shooting through to the bowels. There was also soreness at the stomach and acidity. The urine was high coloured and scanty. K. bich. 3 ter. die. In ten days the urinary symptom and pain were gone, but the bowels were costive: Nux removed this. CAsE 39th.-Mr. M., a gentleman aged about 30, after being exposed to cold some months before, had pains in the loins, &c., which were attributed to the kidneys, and he was cupped, &c., but lie still complained on the 23rd Oct. of a dull, constant pain and feeling of pressure m the loins, worse early in the morning, when it wakes him, and lie tosses about to find rest: the places are tender to pressure. Urine red, but not scanty; no difficulty in passing it; white tongue. Kal. bich. 3 ter. die. In a few days the pain was gone, and ho awoke free from uneasiness, and the urine was clear. In the progress of the caso other symptoms shewed themselves, and other medicine had to be given, so that it was not a cure by this medicine. RxsPIIrn TOxY ORGANS. From its marked action on these organs we should expect them to hold an important place in its therapeutic action. And experience has tended to confirm that expectation hitherto. The affections in which it has been found useful are the varieties of acute and chronic inflammation of the trachea and larger bronchial tubes, and along with these we may also include the catarrhal affections of the nasal mucous membrane. CASE 40th. Case of iay fever, communicated by Dr. Black.--" A lady aged 25, of strumnous constitution, has suffered for many years from hay fever, commencing in the early sumnimer months and lasting till the end of autumn. On 1st May, 18,18, she was seized with sneezing, redness of the sclneidcrian membrane and alt of the nose, suffused eyes, lachrymation, rawness of the throat, and great general languor, &c. She was treated with Mercurius, Arsenic, and then K. bicli. at different times throughout the summer, and got through it with less of the complaint than usual. The K. bich. was continued at intervals for a month. Next year, though the weather had been warm, the hay fever did not appear till the 8th June, and she had sneezing, &c. On the 9th Mere. was given, and then in in a week Arsenic, but both without any benefit: K. bich. was then given with immediato amid permanent relief. She took a few doses of K. bich., and remnained well throughout the summer, even though exposed to rain and dust." Two cases of catarrh, communicated iby Dr. HUlbcrn. CASE 41st.-I. "A very delicate lady, subject to violent attacks of catarrh, applied for advice. She informed mno that the attacks always assumed a similar character to her present symptoms, iand that she continued confined to the house lby them fior many dlays; that they made her extremely ill, and that frequently shel did not regain her strength for mnnyfweeks. She was suflbring, wlen I saw lher, fronl severe cough, causing soreness all down time throat andl clhest, withl much tenacious expectoration: constnnt rnlning fontm the eyaes anil nose, severe pain in tlhe frontal sinuses, some fuver andl great weakness. The preceding night the cough had almost entirely prevcntd her sleeping. The cough was always worse at nIighlt. I ordered tit: Bichromate, and in two days, to her great surprise, she was quite well." _ ____ __ j 44 KALI BICHROMICUM. CAsE 42nd.-II. "A gentleman applied to me for advice with a somewhat similar attack. He had constant cough, which kept him awake the whole of the preceding night, and occasioned much distress from the pain in the chest, which he described as tearing and burning. Constant running from the nose, and pain in the frontal sinuses. General feeling of lassitude and languor. I ordered the bichbromate, and next day he was greatly better, and on the following day well. These are two cases out of many similar ones that might be mentioned." From the very marked action of this medicine on the mucous membrane of the nose and trachea, we should expect it to occupy an important place-second probably only to Arsenic-in the treatment of some forms of epidemic catarrh and influenza. CAsE 43rd. Case of hoarseness, &by A. Jf., in ile Austrian Journal of Jirwsoxpathy, vol. iv, p. 634. " My little boy, aged 2j, has been troubled almost constantly for the last nine months with hoarseness and want of clearness of the voice, for which several medical friends recommended a variety of medicines which I had already administered without benefit. The child was also inclined to constipation. I gave a globule half the size of a pinhead of the first (decimal?) trituration of IC bich. Thereupon le had diarrhoea which lasted above two weeks, and wa-s then treated with China: but since the time he took the K. bich. the voice is clearer than is often agreeable, and his health is excellent." CAsK 44th.-M. D., a girl aged 12, came to our dispensary on the 5th March, 1849. She had had croup six years before, and since that time had been subject to frequent attacks of hoarseness, cough and difficulty of swallowing. She complained that for three weeks she had sore throat, and tie sensation of a lump, partially relieved by swallowing down: there is also hoarseness and loss of voice; cough with blackish sputa, most in the morning, accompanied with pain at the sternum, "like pins and needles." K. bich. 6, night and morning, removed all symptoms in about ten days. CAsE 45th.-F. M., aged 5, a healthy girl, with fair hair and florid complexion, had been affected for a fortnight on the 5th March, 1850, with a loud harsh cough, in single coughs, at different times for an hour or two, and then not for some hours-most in the morning on waking; the voice was not hoarse; there was no pain; and the health otherwise undisturbed. K. bich. 6 night and morning. The cough was soon much improved and subsided im about a week or ten days. Croup.-Dr. W. E. Payne, of Bath in America, has published in the Homceopathic Examiner for March 1846, a paper distinguished by sound reflective and observational powers. After noticing that the homceopathic materia medica by no means possesses as yet the true homoeopathic specific remedies for all forms of croup in Aeon., Spong., and Hepar, however admirable these medicines are in cases to which they are suitable, yet, he remarks, we are not to rush to the opposite extreme, as some are inclined to do, and maintain the extravagant opinion that the hommeopathic principle is not applicable to true membranous croup at all, whenever we meet an epidemic that bids defiance to the above standard remedies; but we must study diligently the yet untried medicines. Some such epidemic secmns to have been prevalent at Bath and the adjoining towns in that year, and bade defiance to all medical treatment, both allopathic and homceopatbic, and whole families of children were swept off by it. I extract our author's three cases, with his remarks, verbatim, as the comparison of the cases serves to throw light on the differential diagnosis of the various forms of croup to which our different remedies are applicable. It is much to be desired that homoeopathic writers would publish cases in a similar manner, viz., unsuccessful along with successful cases, and endeavour to discriminate between the various forms of the same disease. CASE. 46th.-I., Iey of two years; had enjoyed good health up to the time of this attack. A slight difficulty of breathing, when the mouth was closed, owing to one nostril being obstructed with a plug of mucus, was observable. Pulse irregular and intermittent. There was a slight elevation of the temperature of the skin. Otherwise the child appeared well; he was lively and playful. This state continued for three or four days without any perceptible change, except the appearance of a few small sores below the nostrils, which were somewhat moist. On the evening of the third or fourth day there was, evidently, a change or increase of the disease. The respiration, though not hard, could be heard distinctly in any part of the room when the child made a deep inspiration. This did not seem to proceed, as before, from the obstructed nostril, though this remained the same, but from some difficulty about the larynx. The child would frequently canrry his hand to his throat and put his fingers into his mouth. On the following day the difficulty of breathing had evidently increased. On applying the ear to the neck a whistling sound was apparent, like that which may be produced by the passage of air through a metallic tube. Voice hoarse. Cough not frequent, but hoarse, dry and barking or crowing. The child was restless, sleepless, and refused to drink, apparently because deglutition was painful. The tonsils and upper part of the larynx were red and swollen, and about the fauces was a small quantity of tenacious mucus. After the first day of invasion' the child could swallow his drinks without difficulty, and was thirsty. As the disease progressed the difficulty of breathing gradually increased, causing a strong action of the abdominal muscles, the muscles of the neck and shoulder-blades. The head was inclined backwards. The shrill whistling respiratory sound increased, together with a tearing sound like that produced by a saw running through a dry board. The cough was mostly dry, but occasionally sounded loose and rattling. It however grew less and less distinct, until towards the close of the disease it amounted to little more than a grunt. The child would be carried to and fro continually-not one moment would he allow his parents to sit with him. The breath became very offensive, and this offensiveness increased to an intolerable degree as the disease advanced. The plug of mucus remained in the nostril, but the herpetic sores gradually dried away. The temperature of the skin was rather below than above the natural standard During the last day or two of the disease the child was inclined to stupor. Though these symptoms gradually increased, yet there were occasional remissions:-the breathing became less difficult, and the whole general appearance of the child was much better; but this apparent giving way of the disease lasted only for a short time. The breathing could be heard often in the street. In my search for remedies in this case, I could find none that appeared to me to be homoeopathic. Neither Aeon., Spong., lod., Phos. or Bell. seemed to cover the case. But I knew of no remedies that presented a fairer prospect of success, so I began the treatment with Aeon., hoping to gain some power over the local inflammation. But I could perceive no effect. Aeon. was followed by Spong., but still no effect. Then Aeon. and Spong. in alternation. Then Hep., and afterwards Hep. and Spong. alternately, but I could perceive no more effect than if these medicines had remained in my ease. I then gave lod., according to the method of Dr. Koch. Still the disease went on without interruption. Phos. was equally inefficient. The disease terminated fatally, but I have to remark, with much less suffering than the little brother endured who was treated with emetics, cathartics, warm baths, and blisters. This was the first case that I had ever lost by croup, and I felt that I had to grapple with a disease for which I had no homceopathic remedy; and I heartily desired that I might never meet with another case until the odds were less fearful, for I looked upon it, that in this case I had no power whatever. But two or three days had elapsed, however, when I was called in the night to see another case. I went with a heavy heart, expecting to find a case oxactly similar to the above, for as yet all had presented a similar aspect, and all terminated fatally. I had, however, fixed upon Bichromate of Potash as a remedy more likely to meet such cases than any other of which I had any knowledcre; but I did not know that it had ever been used, therefore I could not lean upon it with that confidence which is inspired by actual experience. This case, however, proved to be.different in its character, as may be seen from the following symptoms:" CASE 47th.-II. " Boy four years old, very fleshy, and subject to croup attacks, was seized on the night of January 27 with fever: skin hot and dry; pulse frequent and full; face flushed, dark and swollen; eves suffused; loud and hard breathing; cough hoarse, rough and barking. Coming on in paroxysms, thus-a loud hooping and sawing inspiration, followed by a violent expulsion of air, which produced this hoarse, barking somund. The clhild slept for a few moments at a time between the paroxysms of cough, but sleep not quiet-the breathing was very laborious-the child constantly started and moaned. Tongue coated. Acon. 6, in a tumbler one-third filled with rain water; dose, a teaspoonful every two hours. Jan. 28, 10 o'clock A.M.-Report of i '----- ______________* ---- ________________________-~----- -- - -. ~------ --- -- ----- THERAPEUTIC USE. 45 mother: child passed a restless night - breathing very hard, and cough frequent; but appeared somewhat relieved early in the morning. Child now sleeps; hard sawing respiration much increased. Great action of abdominal muscles-muscles of neck and shoulder blades. Sudden starts. Sweat about the head and neck. Fever in no degree abated. The child was soon roused by cough, which appeared the same as last night. Thirsty, but swallows with difficulty. omplains of pain in larynx, and frequently grasps the throat with the hand. Cries, and writhes about. Does not want to be looked at, and asks to be carried about. Will get out of bed. Tonsils are red, there is mucus about the fauces, and from the mouth is drivelling saliva. Sneezing and fluent coryza. Spong. 6, every two hours. Half-past 1 o'clock, r.M.-Remission of all symptoms except fever, Cough hoarse, but not so frequent. Spong. 6, to be repeated if symptoms increase. 8 o'clock, P.M.-Fever abated; sawing respiration less. Cough less frequent and loose. Perspired all P.. The child has seemed bright and playful. Bowels opened. Spong. to be given if symptoms increased during night. January 29, 9 o'clock A.M.--Boy seems bright-sits up and wants food. Cough loose, but less hoarse. Hep. 16, given once. 2 o'clock, P.M.-Child continues better; has taken food. Bowels opened three times. Hep. 16, to be repeated at 9 o'clock. January 30.-Cough hoarse and frequent during the night, but now less so. The child appears active-has good appetite, and wants to play about on the floor: this is forbidden. Hep. 16 at halfpast 9 o'clock A.M., and at 9 P.M. January 31st. Cough hoarse and frequent during the night, as on the previous night, but less so this morning. Spong. 6, given. This removed the cough entirely, and the patient was discharged. By a comparison of this case with the preceding, a manifest difference is observable in many respects. It is very evident that in this case Spongia was the remedy. Though Aeon. was apparently indicated in the outset, it did not seem to produce good results. Neither did Hep. do well after Spong. The characteristic differences between these two cases were very apparent, first in the period of accession. In case No. 1 the approach of the disease was very slow and gradual; while in No. 2 it was sudden. In the one case the nostril was plugged with elastic mucus; while in the other fluent CORYZA was present. In the one case the cough was not frequent nor violent; while in the other it was very frequent and paroxysmal. In the one case the temperature of the skin was not greatly increased, and fell as the disease advanced; while in the other it amounted to a burning heat. In the one case the pulse was irregular and not full; while in the other it was regular, full and bounding. In some points, however, there was a great similarity. The sound of the cough-the respiratory sound-remission of the symptoms-the sore throat, and, at first, the difficulty of swallowing, and afterwards a subsidence of this latter symptom, were very similar in both cases." CAsE 48th.-III. " in which I used Bichromate of Potash, occurred in a few days after case II. The symptoms in this case were precisely like those in case I, with this difference only, the difficulty of breathing increased rather more rapidly, and the cough rather more frequent. The character of the cough and respiration was alike in both cases. The gradual approach and increase of disease were similar; the temperature of the skin and frequency of pulse were alike; in both cases the nostril of the left side contained a plug of elastic mucus, and the general appearance of the children was in every way similar. In this case I used Kal. bich. 6, one drop in a tumbler half filled with rain water; and a teaspoonful of this was given every five hours. A small patch of linen was wet with cold water and laid upon the throat. The difficulty of breathing was much increased during the first eight hours of the treatment, but after this period it became less and less difficult, until it assumed almost its natural character. The hoarseness, however, remained, together with the barking cough, after Kali bich. had effected all that it appeared capable of doing. These latter symptoms were removed in three or four days by Hep. sulph., repeated morning and evening. I am aware that the use of the wet linen to the neck may possibly render the effects of Kali bich. somewhat doubtful, though I do not attribute the good effect to the linen that might have been fairly attributable if its application had been carried to the extent that a hydropathist would have required. And what would render the good effects of the wet linen still more doubtful in my estimation, is the fact that, since treating the above case, I have treated my own child for a similar attack, with Kali bich. without the use of the wet linen. But K. bich. was given to my own child earlier in the course of the disease than it was given in case No. 3, for in this case I was not called until about eighteen hours after the period of accession. Though we cannot certainly predict what the result would have been in either of these cases if LK bich. had not been used, yet the inference is fair that case 3 would have terminated fatally, as all other similar cases had before." I extract two cases from the same Journal, November, 1846, treated by Dr. Kitchen, of Philadelphia. CASE 49th.-I. "Alberson, aged 6 years, a thin, unhealthy boy from his birth, of poor parents, was taken with fever and dry hoarse cough three days before I saw him, which was on Oct. 11. He had all tIhe symptoms of Angina Membranacca, for which I gave Spong. and Aeon. in alternation, at short intervals. Next day e was no better, and the parents wishing to give him an emetic, I consented, believing that no treatment could be of any avail. This proving abortive, vo1iting the child but imperfectly, I then administered the Bi-Chlirom. Potass. 6 in water, a teaspoonful every hour. This evidently had a better effect than any of the other remedies; the cough was slightly loosened, and he occasionally, with great agony, expectorated shreds of yellow mucus tinged with blood, and a bloody speck here and there. Owing to the ignorance and dissatisfaction of thie parents, this remedy was only tried about twelve hours, when a resort was had again to emetics, and the child died the third day after my first visit." CAsE 50th.-II. " Boggs, slightly made but healthy female, light complexion, 18 months old, had had a dry cough thrco or four days, having suffered under the whooping cough previously. Oct. 31, was called to see her at 9 A. M., but owing to business did not get to the house till noon. The father told me that the attack commenced the previous evening at 9 o'clock, and that she was croupy all night. I considered her in a very dangerous condition, and told tlihe parents of my fears as to the result. As they were intelligent, and put every confidence in me and in homceopathy, I commenced the treatment, I confess, with a great degree of mistrust as to the means. I gave Spong. and Aeon. 3, in alternation, every 4 hour. At 6 P. M. there was less fever, but the intense drawing-in of the breath, shrill cough, &c., were the same. I now gave Tart. Antim., which I have frequently found to promote the secretion of bronchial and trachcal mucus in these cases, and produce relief-the dose was a teaspoonful of a saturated solution inhalf a tumbler of water, of which a teaspoonful was to be given according to circumstances. Sometimes it vomits, but not always. Nov. 1, at 3 o'clock, A. M., I was called up with the disagreeable intelligence that the child was dying, and that the parents wished me to come around. I complied, of course. My own opinion, on looking at the patient, coincided with that of the by-standers. Nevertheless, I dissolved some Bi-Chrom. Potass. 6 in half a tumbler of water, and put a teaspoonful into the mouth of the child; with agony it was swallowed. I remained till 4 o'clock, and then went home, never more expecting to see that child a breathing one. To my surprise, however, on driving to the house at 9 o'clock, I found her alive, but on examination, still in a very bad condition. One symptom was favourable; some yellow sputa had been ejected by coughing, which she endeavoured to restrain as much as possible; here was something to lay hold of; possibly only a straw; still it was encouraging to go on; the other symptoms were the same. At noon all again was obscured; the child appeared worse; the breathing intense; ale nasi flapping; white circle around the mouth; eyes sunk; disposition to sleep. I got off with as good a grace as possible, with no view of returning, as I had no hopes left, and it is not a pleasant thing to be among mourners. As I was sitting in my office at 6 P. M., the father entered, as I supposed to demand a certificate, but what was my surprise, when he told me that his daughter was much relieved, and had eaten a piece of bread, the first morsel of food for three days. At 9 I called to see her; all the symptoms had wonderfully abated, and she had had some trifling ex pectoration and several passages. Nov. 2.-She is improving, and a distinct flapping, on inspiration and expiration, can be heard in the windpipe, no doubt the anginous membrane in a loosened state; this disappeared in the course of twenty-four hours, and free expectoration took place, no doubt softenin and carrying off this membranaceons exsndation in the larynx and trachea. This was certainly a wonderful escape, and as it was made under the use of the Bi-Chromnate, tlie question is, whether it was attributable to that, or whether it was by the solo efforts of the system. A solitary case proves nothing. 1 put not confidence in solitary cases. I want evidence of iany, very miany. With such feelings, I call upon the profession to try thi remedy, and let us know the result. It is important that it should be tried, as we have no reliable remedy in this disease. Nearly every ease proves fatal. We hope, then, we shall have it tried, faithfully tried, and the results published." CAse 51st, by Dr. Black.-" A little girl of delicate constitution, was seized in the night with violent croup. Aconite and Spongia were given, and then HIcpar, but with little relief; learning next forenoon i I 46 KALI BICHROMICUM. that the nurse, owing to the difficulty of swallowing, had given the medicine very irregularly, and had suspended it for three hours, I continued with the -lepar, but by the evening, the symptoms increasing and the child in most imminent danger, I gave K. bich. 6, about twenty globules in a wineglass of water-a teaspoonful to be given every fifteen minutes for an hour, and then from every hour to four hours, according to the relief. In three hours there was gradual relief, and the little patient was well and able to run about in about a week." The following Case has been published by Dr. Bayard, of New York, in the American Journal of Homeopathy, 6th February, 1847:CAsK 52nd.--" On Tuesday the 1st Dec., the patient a girl of 13, was suffering from catarrh, with severe pain in her head and back; Nux was administered at night, a few pellets of the 4th or 5th dilution. On Wednesday morning she coughed frequently, and complained of great soreness of the throat, difficulty of swallowing, &c. Belladonna was given, and as there was little or no melioration of the symptoms, in the evening it was followed by Mere. viv. The weather was now severely cold, and from reckless exposure of herself during rain on Thursday, her sufferings seemed much increased. In the afternoon of that day her face became flushed; her skin dry and hot; and the difficulty of swallowing so great that she refused to eat or drink. About 7 p. m. she retired to bed, and remained quiet, and as it was supposed, asleep, for some time; but between 9 and 10 p. m. one of the family passing her door was startled by hearing a rough, hoarse, barking cough, which seemed to come with every inhalation of the breath. There was something indescribably alarming in its sound, which told the most inexperienced that there was not a moment to be lost in administering the appropriate remedies. Accordingly Aconite-about a dozen pellets of the 4th or 5th dilution dissolved in three-fourths of a tumbler of water-was given two or three times, at intervals of fifteen or twenty minutes; then Spongia of the same dilution, prepared in the same way, was alternated with the Aconite. No change occurred in the symptoms except what scomed a rapid progression of the disease, the cough becoming more deep and hoarse, the flush of the face deepening first into crimson and then into purple, and the contortions of the whole form showing the agony with which every breath was won. Such was the condition of the patient at midnight, when Dr. Bayard arrived, too late, it was feared, to be of service. ' She will die before morning,' had been the conviction of every one who heard that cough, and when, in less than half an hour after Dr. Bayard's arrival, its deep, rough sound became in some degree changed, and its violence lessened, every heart sank under the sad impression that the powers of life were failing, and the stillness which soon succeeded that change was fearful to those who stood not beside her, for it seemed to them as the stillness of death. In little more than an hour after first seeing her, Dr. Bayard was able to leave her without apprehension. The medicine, of which a single dose had produced such wonderful results, was left for her with directions that it should not be repeated unless there should be a decided revival of the symptoms that had first demanded it. The patient slept with little interruption for several hours, and it was not till nearly 6 A. M., that the cough returned with any persistence. The medicine was repeated-half a spoonful of the water in which it had been dissolved being given-it gave immediate and enduring relief. The patient had no return of cough or hoarseness. The above statement was drawn up at my request, by the accomplished author of ' Two Lives,' &c., who was an eye witness to the mufferings of the child. I found the patient under a harsh dry cough, the respiration stridulous, the expression of the countenance anxious, the checks puffed and livid, pulse frequent and small, extremities cold; great restlessness and jactitation. On looking into the throat, I found the fauces highly inflamed and swollen. I dissolved six pellets of the Kali bichro., of the 6th dilution, in a tumbler half full of water, and under these circumstances I administered a dessert spoonful of the solution. In ten minutes thereafter, there were pauses in the before incessant cough; in thirty minutes the child had sunk into a quiet sleep, and the difficult respiration subsided." From all these cases it is sufficiently evident that clinical experience has already confirmed our expectations of the utility of this medicine in membranous croup, derived from its physiological action. We can scarcely determine the exact variety in which it is to be preferred to our other approved remedies; -as yet that can only be discovered by clinical experience of the character of the epidemic on the first cases that occur in each locality. Case 53rd.-Laryngitis.-Dr. Russell has communicated the following case. " The patient was a gentleman, aged 45; he had been taken ill the day before I saw him, and had been hot and restless the whole night. I found the pulse 110 in the minute, and the face flushed; he had very frequent cough, hard and barking, attended with a little tenacious mucus and pain at the larynx and top of the trachea, increased by pressure; no pain nor any abnormal sound on percussion and auscultation in any part of the chest. I began with Aconite for the first six hours, a dose every hour, and then gave Aeon. in alternation with Kali bichr. 3. The general symptoms were better next morning, but there was still much hard cough and pain on pressure, and slight fever; I continued the Kali bichrom. the whole of that day and found the symptoms gradually ameliorating, and in the course of the third day the tough expectoration had given place to an easier kind, the pain was gone, and the patient was in every respect in a state of convalescence. I should be inclined to place LK. bich. very high among the list of medicines for laryngitis of adults." The following case occurred in my own practice: CASE 54th.-The patient was a delicate woman, about 50, who had suffered for several years from severe catarrh in the trachea, with loss of voice, especially in winter, so that she could scarcely go out for several weeks at a time. On the 6th of November, 1850, she was attacked with acute catarrhal inflammation of the windpipe, and great aggravation of her former symptoms, and pulse 90. In the course of the next two days the symptoms were relieved under the use of Belladonna, Cinnabar and Hepar. On the 9th the weather had become close and damp, and I was sent for in the morning in great haste, as the patient had been much worse in the night; she had frequent paroxysms of very harsh cough, with such feeling of suffocation that she gasps and tosses about for breath; respiration loud, wheezing and hissing; the larynx is painful to touch, and there is swelling at one side of the throat, outwardly; swallowing is excessively difficult, and the attempt brings on pain and tearing, and constriction of the throat and shooting up to the ears; pulse 120; the patient cannot lie down at all; internally there is no visible swelling in the fauces. I considered the patient in great danger. Spongia 2 was ordered every half hour, and two doses of Mangan. acet. to be interposed in the middle of the day. In the evening there was some mitigation of the violence of the symptoms; the pulse was 120, full and hard. Continue the Spongia and interpose two doses of Aconite. 10th.-The night was rather better and the pulse slower, and the swallowing easier. Interpose Lachesis 6 and then cont. Spongia. 11th.-Pulse 90 and swallowing easier, but no further change in the laryngeal symptoms; the cough still hard and in paroxysms and very deep, as if from the bottom of the chest; she is quite unable to lie down, and the inspiration is loud and hissing; the sputa are tough and difficult to detach. K. bich. 2, every two hours. 12th Nov.-She is much better and can lie down, and has had some hours of sleep; the cough and wheezing is better, and there is no pain in swallowing. Cont. K. bich. 2 every three hours. 13th. Nov.-Still further improvement, and she has had a better night than for some weeks before the acute attack; has been able to sleep several hours at a time, and had only one or two paroxysms of cough in the night; the pain in the larynx is quite gone, and also the swelling at the side of it; there is little or no wheezing; still a little pain after the fits of cough; the expectoration is in roundish greyish masses, and is ejected with tolerable ease and relief; has some appetite. Cont. K. bich. 2, 4 tis. horis. 19th.-She was better altogether than for months before, and complained only of some huskiness of voice and loose cough, for which Phellandrium was now given. CASE 55th. Chronic inflammation of larynx and tracwea, communicated by Dr. Black.-" Major H., aged 55; has for three winters been subject to chronic inflammation of the fauces, extending to the larynx, resembling much the disease described by Dr. Green, of New York. For this he has had his throat frequently touched with the Nitr. Argent, both solid and in solution; in summer the symptoms are much easier. Nov. 27th, 1848. He has had frequent teasing cough coming on every five minutes, and worse after meals and at mnight, excited by tickling in the trachea, which is tender to the touch; the expectoratibn is scanty and very difficult. Has for six weeks tried the ordinary medicine, and is oblged to take a sedative draught every night, in order to allay the cough and procure sleep. Prescrip. K. bich. 3, gr. ij, in iij, of water, and 5 es to be taken every 2 to 4 hours, according to the relief. Nov. 28th.-After two doses of the K. bich. the cough abated, and he slept well; to-day, no wheezing, and the cough is much easier. Cont The next day there was no further amendment, and Lach. was given, followed up by other medicines. I11 I I THERAPEUTIC USE. 47 THERAPEUTIC USE. 47 CAsE 56th, by Dr. Roche, of Liverpool.-" I was requested to visit Mrs. H., aged 45, of nervous temperament. I found her suffering from chronic inflammation of the larynx and trachea, for which she had been treated by an allopathic surgeon for several months. The chief remedy employed by him was blistering, often repeated; this was followed by temporary relief only. She was occasionally seized with dyspncea, and had more or less difficulty in taking an inspiration at all times; the expectoration was tough and offensive, and she was always hoarse; appetite bad; and emaciation going on. I gave her KaL bich. 3, ter. die. In about a week she wag able to report some improvement; the attacks of dyspncea were much slighter; the expectoration less in quantity and not so offensive; appetite increasing. At the end of three weeks she was decidedly stronger, the dyspncea entirely removed, little hoarseness and distress on inspiring. In a week more she was quite well." CASE 57th-A woman, aged 36. She had suffered for about two months from the following symptoms: Pains in the throat, and pain and feeling of swelling in the larynx; a hoarse and husky voice; "cough with sputa difficult to detach; cough and dyspncea in the morning. Pain across the epigastrium and abdomen, and bowels costive. Otherwise well Ka bich. 6 was given three times a day for a fortnight, within which time she was quite well CASE 58th.-Syphilitic affection of t7he larnx.-E. M., a fair haired, unhealthy child of 2 years of age, was brought to me on the 30th May, 189. She had been syphilitic from birth, and had been treated allopathically for long, and had had much mercury, and the parents despaired of its recovery. The child had an unhealthy complexion and anxious look, and the breathing was difficult and loud, with wheezing as if from obstruction in the windpipe, audible at some distance; there was complete loss of voice, even in crying; a faint, husky cough. At night there was much dyspnoca and rattling in the throat during sleep, and she is often awoke by it. There is ulcertionat the angles of the mouth and soreness round it. Eruption round the anus. I gave K. bich. 6, every six hours. On the 5th June she was altogether somewhat improved, and the breathing better; but the eruption and soreness at the angles of the mouth was not better, and was very troublesome. Arsenic 6, and then Ars. 3, were given night and morning, each for a week. On June 18th she was still farther improved, and the mouth much better, and also the breathing better. Cont. Ars. 3 bis die. On the 28th June the mouth showed only one slight crack. The eruption at the anus and the laryngeal symptoms were much the same. I. bich. 3 bis die. 13th July, there is more voice, and she is altogether improved; the cough is observed chiefly when she drinks; mouth is quite healed. 25th July, the voice is now quite good, and there is scarcely any cough; the appetite is good and the child gets stronger and thrives. Cont. K. bich. 4th August, the child is quite well, except the eruption at the anus, which comes and goes-at times scarcely visible, at others elevated and raw. It was finally removed under Sulphur in different dilutions. CAsE 59th.--Acute Bronchial Catarrh.-A lady, aged 44, of stout frame and florid countenance, subject to chronic coughs, was attacked with febrile symptoms and acute bronchial catarrh on the 25th May, 1850. She was treated with Aconite and Mere. corr. for three days, during which the general febrile symptoms got somewhat better, but the chest symptoms on the 28th were: last night she did not sleep the whole night on account of violent ringing cough and difficult, yellowish-white expectoration, with burning, raw pain down the throat and along the breast-bone; dyspncea and wheezing so that she must sit partially up in bed; pulse quick and rather small. I gave K. bich 3, every two hours. The symptomssubsided gradually and steadily, and on the second night she slept the whole night without cough, except the habitual cough she has long had towards morning. I have used this medicine in a number of cases of acute bronchitis, especially of children, but it has seldom been the only medicine, and I have not sufficiently accurate notes of them to relate any complete case. But as far as my experience goes, I think it is a remedy to be given with confidence in cases of acute bronchitis, especially the exudative, both idiopathic and of measles, where the pathogenetic symptoms correspond. Dr. Black also writes me-" I have found K. b., in the 3rd dilution, useful in several cases of acute bronchitis in the early stage with a dry sonorous rMe and scanty expectoration, preceded or alternated with Aconite. In this stage of bronchitis it promises to rank with Bryonia and Spongia." After the experience of last winter Dr. B. subsequently writes that he has found it so useful in acute bronchial affections that it is one of the medicines he now carries in his pocket-case, and which he uses very frequently. CAsE 60th.-Brondiial Catarrh witlt loud w7ieezing.-E. M., aged 3, a child of good constitution, was brouglht to our dispensary on the 22nd May, and was reported to have suffered from the following symptoms for two months, during wnich time lie had had allopathic treatment without relief. He had frequent severe paroxysms of cough, which had a loose and wheezing sound, but no sputa were got up. These fits of cough were accompanied by perspiration, and were worst at night; besides there was a constant loud wheezing and rattling, audible at a considerable distance. There was also much dyspnmea on lying down, and he has frequently to be raised up in his sleep; bowels rather costive and little appetite. In other respects the child does not look very ill, and it has not much fever and will not remain in bed. K. bich. 3 was given every four hours. On the 26th there was an improvement. The fits of cough were not so frequent, though still present, and there was still auditle wheezing and rattling. K. bich 2, every four hours. On the 7th of June the child was brought again, looking quite well, and no wheezing to be heard. The mother reported that in about a week after last visit the cough was gone, and lie could lie down well, and even in sleep no wheezing was to be heard, and he was in all other respects well. It is in chronic bronchitis as we might expect from the physiological action of the drug, and from the frequency of the disease in this climate, that we must look for the most frequent use of this remedy; and accordingly it has become one of the stock medicines of the Homceopathic Dispensary at Liverpool, and there is not a day in which it is not frequently prescribed by all the physicians in such cases, and striking, curative results are very often obtained. The cases of cure by it alone, or as a chief remedy, are so numerous, even in cases of long standing in which the consequences of chronic bronchitis are far advanced, that it would occupy too much space to give more than the heads of a few cases illustrating some of the symptoms which indicate the choice of this remedy. CASE 61st.-G. M., a man, aged 67, long subject to winter coughs; and the present attack had lasted for months. Besides the other usual symptoms the cough and dyspncea were worst early in the morning, and the sputa excessively touh. K. bich. 3 effected a complete curo. CASE 62nd.-Aun B., aged 65. The usual symptoms, and the cough was attended with stitches in the sides, and the sputa very tough tnd difficult to detach. K. bich. 6 ter.die. Cured in a fortnight. CASE 63rd.-A. P., aged 26. Had chronic bronchitis for many months; the cough was not great, but there was much very viscid expectoration, in grey lumps; slight sore throat; pain at the epigastrium; and flatulence. Cured in about two months with different dilutions of K. bich. alone. CASE 64th.-Mary D., aged 17. Caught cold a year ago, and has since (8th May) suffered from cough, with great oppression,,f tli:e chest and swelling of the veins of tih neck; tho snta Care in tough blackish lumps; the cough is most after eating or dnnking; dyspncea on exertion. K. bich. 6 and 3, bis die, removed all synmptums by the 12th June. CASE S6th.--W. W., a man, aged 55, had been treated with much benefit for chronic bronchitis with Arsenic andl Gralphits, from the 16th Nov. to the llth Dec., at which date all thle symptolmM weore relieved except rattling in le c/icul and dyspncca on lying diwn. ThusC were removed in two weeks by K. bich. 6 bis die. CASE 66th.-IT. R., aged 48, lhad for a long timn chronic bronchitis, the chief character of which was a violent, tighlt dry couglh, wursu in tihe day, and always excited by any c.pooura to smoke. Il!'iczr,,t at night mn bed. Petroleum 3 was first given without any ueffcct; (hen K. biclhi. 6 and 3 effectced a cure. _ _ _~_ ~ ~__~ ~_~_~_ 48 KEALI B ICHROMI M:CUM. 48 KJJIBJCHOMTTJM CASE 67th.-A man, aged 45. The characteristic of the cough was, that it was accompanied by inward soreness in the chest, especially in one point, as if there was an ulcer there. K. bich. cured him. CASE 68th.-A case of chronic bronchitis was cured by K. bich., in which the cause of the disease was attributed to the inhalation of the vapour of Arsenic, to which the patient was exposed. CASE 69th.-E. S., a woman, aged 30, complained since her confinement three months before, of cough, accompanied with pain at the sternum; worse in the morning; dyspncea, &c. The symptoms were removed in about a fortnight by K. ich. 6 bis die. We have found it very useful in the course of many cases which also required other medicines, in some stages of the case when the expectoration was excessively tough and stringy. The cases of this are so numerous that it is needless to occupy more space in dwelling on the subject further. CASE 70th.-Of a child, aged 1l, which had hooping cough six months before and the cough still continued, loose and rattling and tickling in fits at night, and wheezing in the day without cough; occasional pititous vomiting in the day, K. bich. 3 bis die effected a cure in about a fortnight. We have also other cases where it was successful in removing the vomiting (after meals and at night), and other gastric symptoms, and the cough remaining after whooping cough had been treated with other medicines. CAE 71st.-I may noto also a case (a child, aged 4) where the whooping cough was treated with the usual homceopathic remedies, and there remained only the single symptom of wheezing at night; this was removed by K. b. 6. The following case of recurring bronchial attacks may perhaps also be traced to the whooping cough: CASE 72nd.-M. W. a girl, aged 8, had whooping cough about 4 years before, and since then was delicate and subject to cough. For some considerable time her illness had assumed the following shape: every two or three weeks after any slight exposure, she is seized with chilliness and languor, with flushed ace and headache and hot hands for half a day; then heat of the whole body; thirst; disturbed sleep and screaming at night, followed by paroxysms of coughing, with vomiting (as she says) of tough mucus like white of egg and yellow acid fluid; then for several days she has cough; want of appetite; foul tongue; and costive bowels, which gradually all go off. There are no worms. She got K. in the 30, 6, 18, 3, 12, 6th dilutions, a dose every third day, and these attacks were removed in about four or six weeks. In fact she had no attack after taking the medicine. Dr. Walker of Manchester, informs me that he has used this remedy with very good effect in chronic bronchitis and catarrhs. CAxs 73rd. Dr. Black writes:-" In a case of chronic bronchitis attendant on a scirrhous degeneration of both lungs, when the expectoration was very clear and so viscid that it could be drawn a yard from the mouth, and whore the cough was very violent, preventing sleep and rest, the K. bichrom. 3rd dil. gave very marked relief; mitigating the cough and changing the character of the expectoration, which became more of a clear frothy mucus. This relief continued for eight or ten days, and the symptom never returned to the same extent, though the patient ultimately died." CASE 74th. Dr. Black also notices the case of-" A lady, aged 65, who had acute bronchitis, complicated with pleuritic effusion on one Fside, and slight pneumonia of one lobe of the lung. Aeon., Ars., JKali bichrom., Sencga, Phos., and then Sulphur were the remedies. Squills was of no use. The case was very severe, and had a distinct intermission every second night; she was delirious for three days." CAr. 75th. Dr. Roche of Liverpool, wtrrites:-" I was consulted by a gentleman, aged 69, suffering from chronic bronchitis, and who had taken Sulphur and Arsenicum without benefit. There was constant wheezing with oppression of the chest, chiefly at night, with stringy expectoration. K. bich. 3 entirely relieved him in three weeks." Dr. Russell writes:-" In several cases of bronchial catarrh, especially of old persons, I have seen the most decided improvement follow the administration of this medicine, and that in those obstinate cases which had resisted Tart. ant., Arsen., and all the other ordinary remedies, and threatened to be very serious to the patients." CABE 76th.--" In one case where it was of marked use there were violent paroxysms of cough, with little expectoration, and that of stringy mucus, leaving the patient excessively exhausted, and sometimes attended with dry retching. The patient was an old lady who had been long subject to such attacks, which generally occur early in winter, and she expressed herself as greatly pleased with the Kal. bich. She is a person of much intelligence, and has been under my care for many years, so that she has had a trial of various homoeopathic medicines in her former illnesses." We have no reason to expect any good from this remedy in the ordinary forms of pneumonia; but it is otherwise in the pneumonia notha, or catarrhal pneumonia, which is the extension of catarrhal and frequently plastic inflammation of the bronchiae into the smaller bronchial tubes, finally implicating the parenchyma of the lungs. This insidious form of pulmonary inflammation is liable to occur in some epidemics of catarrh and influenza; and in searching for the appropriate remedy, I think K. bich. should be kept in view. Pains in the chest and trunk.-In several cases we found pains in these parts apparently situated in the muscles or fibrous tissue, either alone or connected with cough, or dyspeptic symptoms, removed by this remedy. HEART. Although enlargement of the heart even to a remarkable extent is shewn in the experiments on animals, yet there are extremely few symptoms in the schema that relate to that organ. It is difficult to say whether this arises from a different action of the substance on men and on the lower animals, or whether its action is of that slow character on the nutrition of the muscular tissue of the organ that would not give rise to any perceptible symptoms within the limits of an ordinary proving. If the latter should be the case, it may be found useful when given for a sufficient length of time in passive dilatation. BACK. CASE 77th. Lumbago.-A man aged about 47, of lymphatic temperament On the 27th December 1848 he complained that for some days previously he had felt slight rheumatic pains in the back, and yesterday while stooping he felt as if something cracked across the sacrum, and he had to catch hold of something, and could not move for some minutes from the violence of the pain. It continued during the night, and to-day he cannot stoop or move for pain, which remains constant even while at rest, but greatly aggravated on the least movement of the trunk or the legs. There is no fever or other symptoms. K. bich. 3, 6tis horis. 29th.-Since yesterday morning he has steadily improved, and he can walk about, though stiffly and with dull pain across the hips and sacrum on lifting the feet; nearly free from pain when at rest The medicine was continued, and in a couple of days more all symptoms were gone. W. G., aged 34, had had a rheumatic attack thirteen months before, which had lasted seven months. When seen on August 2 he had suffered for three weeks from the following symptoms: pain from the back of the head to between the scapulae, so that he is quite stiff, and cannot turn; the pain also extends from the scapula down to the elbows, so that he cannot raise his arms to his head, and the shoulder joints crack on movement. He is worse when lying down, and especially in the morning. The tongue is broad and flabby, and white; the urine scanty and difficult; bowels open; appetite good; sleep hindered by the pain. K. bich. 6, every six hours. On the 5th he was worse, and Bryon. 2, ter. die, was given by another of the physicians. I L "'- I~ THERAPEUTIC USE. 49 On the 7th somewhat better, but the symptom's were exactly the same. K. bich. 3, ter. die. On tbe 14tbh le was very much better. On the 19th no symptoms remained but some stiffness of the nape and between the shoulders, for which Mez. 3 was given with complete success. CASE 79tb.-A man aged. 24 had been under treatinent for four or five months at our dispensary for a variety of gastric and rheumatic symptoms, which had gradually improved under various medicines, and the chief symptom left was a violent pain in the hack which had lasted since the 1st of May, in spite of Bryonia and Nux in different dilutions. On the 5th of June a more minute examination gave the following symptoms. A violent aching pain '1like a gathering"1 in a small sp~ot in the sacrum: it is a steady throbbing pain, and is most felt at night, when it is so violent that it wakens him in a short time, and hinders sleep the rest of the night. It is better hin the day, when he is up and walking about, but he is unable to lift anything for the pain which strikes in at the sacnnm. on his making the attempt. K.bich. 3, ter. die. 19th June.-He came to report that soon after beginning the medicine the pain began to diminish, and in three days could scarcely be felt, and since then it has gradually quite gone. LOWER EXTREMITIES. CASE 8Oth.-Sciatica.-A gentleman of tall.and spare frame, who had suffered about eight years before from sciatica in a severe form, lasting several years, applied to me in February 1350 with the following symptoms, which he said were exactly the same as he felt at the commencement of his former attack-, and he dreaded a return of his former tedious disease. He had had for a week severe pains in the hip and down the outside of the thigh. The pains were worse in the afternoon and evening, and better in bed; worse on any chang n the weather. In other respects the health was good. I-I got Nux for a week., and improved somewhat, but the pains were as bad as ever on the next chiange of weather, and exactly of the same character. He now got K. bich. 6, twice a day, and nil symptoms completely and permanently disappeared, and he had remained free from them last Marc (1351), when I saw him agrain. CASE Slst.-G. H., aged 62, bad been ill for years with chronic rheumatism. Came to the dispensary in the latter part of March, and the disease seemed then to be concentrated in the tibioa, knees and thighs. He complained of violent pains in the shin-bones and burning, extending up the legs, and he had aching and shooting in the front of the thighs and knees, worse at night, without swelling. A variety of medicines were givedi without effect, till Kal. hyd., gr. j, ter. dlie, was given on 21st June. This was continued till the 5th July, when the pain in the shins was entirely gone, but the pain in the thighs and kaces remained unchanged. K. bich. 8, ter. die, was now given with speedy benefit, and continued for some weeks, when he reported himself quite well. CASE 82nd. Acute attack cof pain in the tibia, communicated by Dr. Blackz.-" Mrs. D., aged 32, of phthisical h abit and lymphatic temperameat, was convalescent from a mild attack of gastric er, when she had complained on the 4th August 1850, for four days, of tenderness of the middle third of the left tibia, which gradually increased fill on this day neither the foot nor leg could be moved. There was great tenderiiess and slight swelling, but no redness. The pain is described as boring, as if in the bone, and constant, with frequent paroxysms of acute pain extending up the anterior part of the thigh and down to the instep; increased by heat. K. hick. 3, glob. ij in water, a spoonful every hour to four hours, fill relief is obtained. On the 5th the tenderness was much better; there were no paroxysmns of pain, and she was able to move the foot; she experienced relief after every dlose; the first four or five doses were always followed by a burning feel over both limbs, ' as if the medicine was In eighlt days the sore was ne.arly- healed, hut still hte had the shootingr painis up to the kiiee, which hie could not, straighteni. The niedicine was continued at intervalsz, with steady amendment, for four or five weeks, when he reported Ihimself well. CASE 34 th.- Gene-ral Peiias.-J. H., a. manl of 50, had suiffered from rheamnatisni, chiefly coni~ned to the hip, for two years, and had had miuch allopatliic tre~atment withocut henefit duriiig that time. WN7hen lie camie to our dispensary the pain was excessively violent in the hip on motio.n; at times it is one hip and nt others the other that is affected. Uider the action of Colocynth:3 and.30 alternated ev.ery- six hoturs the coxalgria was entirely removed in ahoit three Nveeks, *and on the 28thl October he complained of no pain iii the hip, but painis flying about to different parts of the hod)-; a few hours iii the shouitlders, then in the hack, then in the knees, then in the ankle awl big toe; lie is hetter when warm in hed.lie had already re-ceived Palsatilla 3 his die for -a week without benefit. K. bich. 30 his dlie removed all sympltonis within a fortnight. This case corresponds remnarkably wvith the characteristic pains produced by our remedy.T CASE 85-th.-Geaerai C'ackeximn-Our remnedy effected g~reat amendmeat though not complebte cure in the case of aý man, aged 44, wvlo had been for years ill. He had jaundiced, puffy countenance., ivith 'pale lips; toii go broad, cracked and flabby'; had taste iii the maiming; hIls gUums bleed, at nighit, and be finds clotted hlood iii his mouth in the morniing; constant thirst; appetite at times cra.-ving, at othier-s no-ne, with a faint nausea; after meals load at the stomach and dull pain, and nausea and empty retching; bowels rather loose w~ith yelloiwish and slim)y motions. lie has a large, flabby ulcer on the leg, and the skin of the whole leg is thickened,~ard and pasty. Under K. hich. 3, 2 and 6, for several weeks, he iniproved very much; and the howvels aiid gums and digrestive org-ans and general appeara.,ncethee.-nme much better, and the leg grew softer. Hc wa,-s inot, however, care of the ulcer, nor do I think. such a ease could be cured without the coniforts of an hospital. CASE 36tb1.-P11stela-r ETh-aptoions.-A boy, aged 14, of lymphatic, ner'vous temperament, with fair hair and light eyes, had been affected with an iintpeviginious eruptioni on the fiace. Thle pustules form frequently, discharge a watery pus~ andi leave a. browvnishi sc-ab, and are acc~ompanied with mucli itching. K. bich. 4 bis (lie. In a fortnight almost well. Coat. K. bich. 4 his die. Quite well in another wveek. CASE 87thi.-G. H., a boy, agred 7, of pale complexion and lymphiatic, sanguine temperament, bad for many weeks an eruption whiich hcgnn~i on the ear and spread over half the head. It presented, wheni first seen, the appearance of greenish censts, with oozing of whitish, thick matter fromi beneath them. It w~as removed under the action of K. hick. alone in 6th, 3rd and 2nd dilutions within six weeks. CASE, 88th.-A youing man, aged 28, had had for a fortnight anl eruption of pustules on the cheecks, forehead and chin, becomning covered 'with a brownish scab, without oozing (of matter; itching aifter washing. Two powders were given, one of thec 6th amid the othier the 3rd dil. of K. bicli., to be taken in succession, each in fourteen doses, one night and mormiing. The eruption was entirely removed bef'ore the niedicine was finished. CASE 8S9thi.-R. B., a grirl, aged 6, hind for so~nihemiegth. of time an eruption of pustules oii the scalp) and the liamuols, whlich had untproved very much under Sa15lplhur given for a fortnight. Then ianl eruption covered with dlark, thiick yellow crusts brokeouott round the lips. K. bichi. 3 ter. die removed that and till the remiaininig symptomls hi a foi-tnight. --I I J j f I 50 KALI BICHROMICUM. was cured by the 6th, 3rd and 1st dil. It consisted of thick brown scabs, under which yellow matter was formed, and was attended with much itching; it was situated on the face, extending from the root of the nose to the cheek and upper lip. CASP. 93rd.-I have used it in a case of zona as the sole remedy, and the case did very well, but as the disease often runs a short course with or without treatment no deduction can be drawn from a single case. CASE. 94th.-It was also successful in the 2nd trituration in removing an eruption of painful small boils on the back of the head, of a man aged 40. The disetse had lasted three months. CAsE 95th.-Pecodiar Pustular Eruption.--A man, aged 46, had had for seven years an eruption all over the body of the following description: First a small lump comes on in the skin, then it inflames and gets red; then discharges a bloody fluid, and leaves a small, depressed, ulcerative surface with an inflamed base, which heals and breaks out again. Wherever the discharge touches it causes a fresh spot. It itches violently at night. General health good. K. b. 3, 12, 2, 6, of each a powder to be dissolved, and taken for a week. In a month lhe reported he had more discharge and more spots, but somewhat different in character. Re peat. In a month again, there was less itching and fewer spots, and they are not persistent, but come and go, and the discharge no longer causes fresh pustules. He now got the 1st trit. his die for a fortnight, and was then still further improved. The same was repeated, and when finished lie gave up his paper and reported himself well. He was seen again ten weeks after and was then still free from any return. We did not ascertain whether he had had syphilis. CARE 96th.-Porrigo.-A boy, aged 2, had for four months an eruption of small yellow round pustules, with a rather depressed seab, running together and oozing yellow matter; he had also scrofulous ophthalmia, with a pustule on the cornea and photophobia. The head and eyes were quite cured in two months with K. bich. 3 and 6 ter. die with the interposition of Belladonna, 6 ter. die, for several days every now and then. A remaining moist eruption of the cars was removed by Hepar. Dr. Wright of Birkenhead, has communicated the following case:CASF 96A.-" M. 1B., aged 5 months, strumous constitution; has been ailing three months and treated allopathically without benefit. Oct. 19th, 1850.-Circumscribed patches of eruption, varying in size from sixpence to half-a-crown, covering nearly the entire scalp, commencing at the supra-orbital regions; the eruption consists of a number of minute vesicles closely crowded together, and filled with a transparent viscid fluid, which burst and form thick, laminated crusts, of a dirty grey colour; no inflammation or swelling of the skin in the intervals between the patches of eruption; much itching; eyelids agglutinated together, and discharge from the inner canthus a quantity of purulent matter; patches of eruption on the face, and thick crusts around the nostrils; the external cars much swollen, red and glazed, and behind the ears excoriated with profuse discharge of serous fluid; patches of eruption about an inch and a half in length, deeply fissured, between the folds of the integuments of the neck, with sero-purtulent discharge; child very fretful, and rests badly; sucks with difiiculty from stuffing of the nostrils; emaciation; bowels relaxed; stools green and slimy. Tie 2nd dilution of K. bich. was given, a dose night and morning, and at the satnme time the lotion of 1 gr. of the salt to 4 oz. of water, was used. Under this treatment it steadily improved ad a was ell in four weeks." CAsK 97th.-Papmlar Eirption.-Mrs. K., aged about 30, had for some time been delicate and subject to perspirations, when three months ago a spot formed on the calf of the leg, and spread gradually all over her. it is now 5th Nov. 18.50, on the trunk, and thigh, and hack, and, in fact, all over her except the face. It consists of large papular elevations, red and irregular, like measles but more raised, with intcnte and excessive itching, especially at night, so that for om nighlts shOe hIas had to walk about the room most of the night it is a burning itching-like a fire, as she says. She has also general debility; for son weeks a gnawing and pain at epigastrium, and a sensation of internal itching there, Which is relieved by taking food; bIowcls optn: urine hot and high coloured, and at times scanty; catamenia regular. K bich. 1st trit gr. ij in fourteen tablespoonfuls of water-one night and morning. [She had been five weeks under allopathic treatment, and had taken mercurial pills to a considerable extent without benefit.] In a week she was improved, and the itching less and the spots paler, and some desquamation had set in from the patches. The medicine was continued in the 1st and at times the 3rd dilution, and all the symptoms gradually declined till towards the end of December, when she was quite well CASE 98th.-Dr. Dudgeon uas communicated the following case.S. A., aged 18 months, was brought to the West London Dispensary in 1849, for a curious skin affection. The whole of the lower part of the body, from a little below the navel in front and from the top of the nates behind, down the thighs and legs, was covered with a smooth, shining, elevated, bright red eruption, so as to give those parts of her the appearance of a boiled lobster-shell. This affection had been coming on gradually for some months, and under the use of all manner of antipsorics and all the ordinary homoeopathic remedies for skin affections, it had rather increased than otherwise. The child's health was not disturbed. After some months of fruitless treatment, Kali bich. 6 was prescribed in globules and in less than a month the whole of the rash had disappeared, leaving only a brownish tinge of the skin, which also gradually went off. The disease communicated to the skin an appearance of thickening and induration, but the rash did not seem to be attended by much irritation or heat. This child was brought to the Hahnemann Hospital about eighteen months after the above-mentioned skin disease was removed as above detailed, with that curious disease molluscum contagiosum, which is gradually going off under the use principally of Silicea and Lycopodium. The mode in which this latter disease is removed is worth noticing. The individual tubercles, or tumours, which vary in size from a large pin's head to a pea, inflame, suppurate, and drop off as a scab, leaving bluish-red cicatrices, which gradually die away. CASE 99th.--Eczema.-A girl, aged 10, had been ill five or six weeks, and had been treated allopathically the greater part of that time. There was an eruption covering both ears entirely, and a considerable portion of the surrounding skin. It was hot and itching, and had a constant oozing watery discharge. The general health was good. K. bich. 3 bis die, and the lotion of K. b. (4 gr. to oz). In a week there was great improvement. The medicine was repeated at intervals, not regular after the first three weeks, as she was so much better. It was not finally removed for two months, without any other medicine. CASE 100th.-In a case of herpes exedens (lupus) of the face, this medicine was given uninterruptedly (i. e. without other medicines), at intervals, in different dilutions (from 3 to 30) for nine months, and the disease was apparently arrested, but we cannot conclude anything positive from one such observation. ULCEss. We have used this medicine to a great extent in the Liverpool Homaeopathic Dispensary, and on the whole obtained as much success as can be hoped for from any single remedy, and cured some cases as extensive as we could suppose the cure attainable, without the comforts of hospital accommodation, which is indispensable, as is well known, in many cases of ulcer of the lower extremities. We have used it at the same time externally in a considerable number of cases, but not by any means in all. When used externally it must be much diluted, as even the strength of the 1st dilution gives rise to violent pain, as was also found by Dr. Watzke of Vienna. We have gradually diminished the strength of the common lotion used at the dispensary, and the strength now recommended is 4 grain of the pure salt to the oz. of water; this is about half the strength of the 3rd decimal dilution. It would be tedious to narrate any considerable number of cases. We may shortly notice, that it seemed most useful in those cases where there was much pain and irritation, and several small ulcers broke out simultaneously, or in quick succession; though it was also useful in many large ulcers when there was inflammation about them. Among the cases we may shortly notice one of: CASE 101st-A man of 60 years of age, who had hurt his leg in a fall sixteen years before; since that time he had been subject to _I I _ _ ~_I_ THERAPEUTIC USE. 51 THERAPEUTIC USE. 51 frequent ulcers in the leg; it breaks out in small, irregular, deep ulcers, surrounded with thickened, red cellular tissue. The pain is violent and twitching; worse at night in bed, and often obliges him to get up and apply cold wet rags; he has some varicose veins; general health good. K. bich. 6 bis die, and lotion. The pain was relieved after the first application of the wash, and the whole symptoms were removed in a fortnight. CASE 102nd.-In another case of a female, a large ulcer with a slough in the centre and hard shining knobby environs, was treated with K. b. 6 bis die, and yeast poultices. When much better and half filled up, the lotion was given, but having been of too great strength and kept too long to the sound skin by mistake, brought out its characteristic pustular rash, ending in painful superficial ulcerations, while the original ulcer was nearly healed. Simple ointment was used, and Sulphur, followed by Arsenicum internally, removed all the symptoms. CASE 103rd.-A woman, aged 28, had had a similar ulceration some years before which had lasted a year. On the 16th May she had complained for five weeks of a violent burning heat round the ankle and heel, deep seated, and hindering sleep; there are three small, irregular, shallow ulcers; costive bowels; fluttering at the heart; otherwise well. K. bich. 12, bis die, relieved her much in ten days, but while taking it the burning began to come back again; K. bich. 6 bis die was then given, and also the lotion, and in a fortnight more she was cured. [This case apparently shews that the higher dilution had exhausted its power, and the disease was again making head till checked by the lower potency.] CASE 104th.-A woman, aged 39, of bad general health and feeble frame, had for ten months a large ulcer on the leg, much inflamed and painful; under Arsenic 3, and then Sulphur 3, the health iunproved, and also for a time the ulcer, and then the latter became stationary, or even worse. K. bich. 6 ter. die, and the lotion were then given, and it speedily improved, and in about a month was quite cicatrized, but a small inflamed ulcerated spot had formed in the skin at the side of the old ulcer; there were some catarrhal and gastric symptoms, for which Pulsatilla was given for a fortnight; then the little ulcer remaining the same, K. bich. 6 bis die was again given with the effect of removing it quite. CASE 105th. Ulcer after syphilis.-A young man, aged 22, had had syphilis two years before, and tor a year on the 25th March had suffered from a number of small irregular ulcers on one leg, which leave a depressed cicatrix on healing. K. bich. 3 bis die. On the 4th April he was much better. The same medicine was continued and in a fortnight he was quite well, and had remained so at the end of May when last seen. Among the diseases of the general system we may mention Rheumatism.-Of its utility in this, various examples will be found under the individual organs: it seems more suitable to the chronic form, unaccompanied with much swelling. Whether it may be useful in rheumatic fever is doubtful, except as an intercurrent medicine, for idiopathic fever seems not to lie within its sphere of action. In Gout we should expect it to prove a useful remedy: we have the extremely acute pain in the small joints, and also the rapidly flying of the pains from one limb to another, and also a variety of the disordered conditions of the digestive organs which accompany that disease. Experience has to a certain extent confirmed this hope, and I have used it with good effect after other homceopathic remedies in several cases of gout, and also in the interval to ward off the disposition to the disease; -in one well marked case of a gentleman who has been a martyr to the disease for many years, and in whom the attacks were become more frequent and severe: since coming under treatment he has suffered much fewer attacks, and those milder and shorter. I attribute a great part of this improvement to several courses of K. bich. in different dilutions, given at the end of each attack, which had been, it is true, treated with homceopathic remedies. I would recommend the trial of it in this manner. Perhaps as a preventive the oxyde of Chromium would be more suitable, given in trituration every two or three days for several weeks, and then omitted for a time. Fever.-Idiopathic fever seems not to be within the range of the action of the medicine as far as the provings go; though sympathetic inflammatory fever of great intensity accompanied some of the local diseased states. Nevertheless, we know how difficult it is to obtain in the provings a complete case of intermittent fever, and it is quite possible that among the symptoms given may be included some of the elementary symptoms of intermittent fever, as the analogy of the general action of the medicine with Arsenic, and some intermittence among the symptoms, would lead us to suppose. Clinical observation must decide that point. Syphilis.-The resemblance in many respects between the action of this medicine and that of the syphilitic virus, and also its analogy to Mercury, would lead us to hope that we may find in it another remedy for that disease. Though we would not place any weight on such a merely superficial resemblance, yet we cannot refrain from noticing the likeness that the chrome ulcer when healed presents to the indurated chancre. A more correct way of judging of the resemblance is in the further development of the constitutional symptoms. We have in this remedy the rash on the skin; then the sore throat, which has been mistaken for syphilitic; then the periosteal pains; then the rheumatism; and lastly, the diseases of the skin, chiefly of the pustular character, which have the hard dark scab, and leave the depressed cicatrix. These circumstances lead us to hope for much success in secondary syphilitic and mercurio-syphilitic diseases, and the cases above narrated tend to confirm this expectation. Whether it will be useful in primary syphilis I am not able to say. It seems pretty well established among homceopathic practitioners now, that the lower dilutions are most suitable in syphilitic cases, and many of our body hardly dilute Kali hydriod. at all. If therefore the Chrome should prove a useful medicine in these cases, probably the neutral Chromate may be best, as acting less powerfully on the stomach: though this preparation has not been specially proved, yet it may be recommended on the same principle that we adopt several different preparations of Mercury ex usu in morbis, in different varieties of syphilitic cases. Dr. Russell writes, " I have seen unequivocal benefit derived from it in cases of secondary syphilis where the symptoms were mild and the disease affected the throat chiefly, without going the length of extensive ulceration. I should place it next to Nitric acid in this affection." General cach/exia.-Though we have no evidence of the primary action of this medicine in causing a disordered condition of the blood, yet we may expect to find it useful where such a condition has ensued in consequence of long-standing disease of the liver and other important organs of the ldigestive system. Dropsy.-We have likewise no evidence of any prinmary tendency of this medicine to produce the dropsical state, yet from its action on the kidneys we may expect it to prove a help in the early stage of some renal diseases whichl when further advanced produce consecutive dropsy. Nervous system.-Except in neuralgia of some individual branches of the nerves, we do not expect much utility of this medicine in disease of the cerebro-spinal system, nor in mental disorders. In Delirium /remens however, from its anllogy to Tartar emetic, and from its probable primary depressing influence on the ganglionic nerves, it may perhaps prove a II i 52 KALI B3ICHROMIC M1.T~I: 52 KALI BICHROMICUM. useful auxiliary in many of the gastric complications of that disease. Allopathic wue.-The following is the sum of what has been collected by Arneth and myself on this head. Dr. Cumin, of Glasgow, writes (in the Ed. Aed. and Surg. Journ., Oct. 1827, p. 295), " I began to prescribe a saturated solution of the Bichromate as an application to tubercular elevations, excrescences and warts. In these cases the new growth has sometimes been removed by absorption without any slough, but where a slough has formed it has always served to hasten the cure, and in no instance have I observed it to be followed by a deep or unmanageable ulceration. In a case of warts more extensive and formidable than any I had before met with or seen delineated, which I treated last winter, the Bichromate in solution was the only remedy which acted effectually, without causing such intolerable pain as to preclude the continuance of its application. According to Hauche (Riecce. N. Arzneimittel., ~ 427, quoted by Arneth) this medicine is useful in removing syphilitic excrescences without ulceration or the formation of an eschar. It is said also to have hastened the cicatrization of ulcers, and to have been useful in scrofulous sores and cancer of the uterus. Jacobson reports good effects from the use of the neutral Chromate in old and callous ulcers, in herpes and tinea, and in eone inflammations and ophthalmias. Also maculse are removed by it. He holds the neutral salt to be a far more certain medicine than the acid salt. In ulcers he uses a solution of one drachm of the neutral chromate in 10 oz. of water, with which he pencils over the ulcer or the herpes every second or third day. On the ulcer, after a few applications, there shews itself a slight soft crust, after which good granulations make their appearance. A herpes disappears, according to him, without any marked symptoms, or there appears a slight scaly efflorescence, after which the herpes disappears. Jacobson also reports that he has found it useful as a corrosive in fungosities, excrescences and nmvi, in herpetic eruptions, impure and callous ulcers, and as a discutient in zona and pustulous ophthalmias. He wishes it should be tried in ophthalmia neonatorum and 0. Egyptica. As regards the internal exhibition of it, he would often prefer it to Tartar emetic as an emetic in doses of 2 to 4 grains, because it does not act so powerfully on the intestinal canal. He recommends it also to be used as a nauseant and alterative, as the constitution can bear the use of it for several weeks in the dose of a quarter to a half-grain four times a day. He concludes with the remark, " It might be administered in diseases in which Antimony, Zinc, Bismuth, Copper, &c., are used, and therefore may be tried in croup, as well as in cholera." (Gerson's and Julius's Magazine, xxv, quoted by Arneth.) Use as a caustic.-Dr. H. Madden has used the Bichromate as a caustic in ulceration of the neck of the uterus. He painted the ulcer with a saturated solution, but he does not think it was very useful. Perhaps on further trial it may be found more suitable for some forms of disease than others, and other modes of applying it may be invented. Preparation and dose.-As this salt acts upon alcohol, the dilutions below the 2nd centesimal must be prepared with distilled water or in trituration with milk sugar. The third dilution and all above may be prepared with the ordinary rectified spirits. For external use a lotion may be prepared in the proportion of 1 gr. of the pure salt to 4 oz. of water. It may also be used as an ointment in the 1st or 2nd trituration. For the sake of uniformity I have hitherto used only the bichromate externally as well as internally, but it is possible the neutral chromate may be found more convenient and of sufficiently similar action. In the foregoing cases it will be seen that it has been used in various dilutions, from the 1st to the 30th. Analogous Medicines.-The chief medicines whose general action is similar to that of the bichromate are: Arsenic, Mercurius corrosivus, Tartar emetic, Pulsatilla, and Aurum. Antidotes.-There is no antidote to the general action of this substance known. Nux and Phosphorus proved curative in the dyspeptic and bronchial symptoms narrated at No. 160. The best antidotes for individual symptoms are doubtless indicated by the concordance. APPENDIX. In addition to the cases contained in Dr. Arneth's treatise, I have incrpor ated in the foregoing proving the information obtained personally in visiting the chrome works of Manchester again last year, and also that kindly communicated by Dr. Walker of Manchester, and Dr. Beilby, of Glasgow. At Mr. Dentith's works in Manchester we were again received with great courtesy, and every facility afforded of making observations. But in another manufactory in Manchester we were completely baffled in our attempts to obtain information, apparently from sonme mistaken notion as to our object in making the enquiries. Among the cases we saw were many confirmatory of the general remarks formerly made, and which it was unnecessary to notice in detail. The additional examples we selected were almost all from nwn exposed to the dust of the pure salt. The most of these require no remark leyond what is contained in the proving, but one is particularly interesting, viz., the subject of the symptoms described at I31. This was W. C., a fair haired slender youth, then under 17 years of age. He was exposed to the dust in packing the salt. In conscr nirnce of some doubt as to whether he had had syphilis or mercury, I did not include his case in the proving till the sheets were passing through the press, when I received from Dr. Walker the results of enquiries carefillv instituted by him. It appears the infection was considered to be venereal by the surgeon who first saw him, and who only prescribed once for him, and he then went to the Infirmary, where it was called and treated as rheumatic, and no mercury was given as far as can now be ascertained; at any rate there was no quantity given sufficient to affect the gums. Dr. Walker is quite satisfied that the evidence he obtained is sufficient for the conclusion that neither syphilis nor mercury had any part in the case, and I have therefore admitted it, and it forms a most interesting case, as there are few medicinal substances in which the pathogenetic phenomena of that nature are so distinct. Dr. Walker has also mentioned a few details of the case of a well known modeller in wax in Manchester. The wax is coloured with various metallic poisons, among which chromate of lead is supposed to be in considerable proportion. Among other symptoms the patient has had for a long time an obstinate ulceration of the throat, which was observed by Dr. Walker to be invariably aggravated in a distressing manner if K. bich. was given medicinally, before the true nature of the ailment was suspected. From Glasgow Dr. Beilby has kindly reported seven cases seen by him at Mr. White's works. Among them he narrates the case of a gentleman who was at one time manager of the works at St. Rollox. At that time he had painful swelling of the glands under the armpit, and severe ulcers in the hands; inflammation and abscess of the ~ THERAPEUTIC USE. 53 _ _ __ uvula; and sickness and general malaise. Now when he occasionally visits the works he cannot pass through them during the boiling operations without suffering from the vapour, which causes inflammation of the upper eyelids and pustules on the hands. The workmen, says Dr. Beilby, on the whole suffer comparatively little after having been some time at the works, partly because they lose the susceptibility to some of the effects, and partly because they are more careful. Mr. White has remarked that now the men are much more careful than formerly. I have also remarked that the men seemed much more cereful than at my first visit to the Manchester works, and I could meet with fewer striking cases. I may here quote in full that interesting case of poisoning which forms paragraph 96. Extract from Mr. Alfred S. Taylor's Cases and Observations in Medical Jurisprudence, Guy's Hospital Reports. Vol. vii, part 1, page 214. " Case of poisoning by the Bichromate of Potash-recovery after four montlis.-Instances of poisoning by the Bichromate of potash are so unusual, that the details of any well observed case must be always acceptable to toxicologists. The following occurred in the practice of Mr. E. Bishop, of Kirkstall. On Monday, the llth October, 1847, Mr. Bishop was hastily summoned, about 8 o'clock in the morning, to attend the son of C. B., a dyer, who was said to have swallowed poison with the intention of destroying life. Half an hour after the youth had taken the poison he was found labouring under the following symptoms: face exceedingly pale, cadaverous, and covered with cold perspiration; the pupils dilated and fixed; pulse exceedingly feeble; cramp in the calves of the legs; and almost total insensibility; occasional vomiting, attended with violent epigastric pain. Mr. Bishop was informed by the young man's father as to the character of the poison, and he found that vomiting had taken place very soon after the substance had been swallowed; the vomited matter at first consisting of the morning's meal (which had been taken recently) mixed with the poison, but afterwards nothing came up but thin glairy fluid, of a pinkish colour. Half a drachm of Sulphate of zinc was immediately administered with some warm milk which was at hand. This was speedily ejected, tinged of a pinkish hue and having a very sour smell. Olive oil and white of eggs were given with copious draughts of warm water. All the ejected matters were coloured, even after the administration of the magnesia, hence the stomach-pump was used until the washings of the stomach became colourless. The patient now complained of a burning pain at the pit of the stomach, and of a sense of heat and dryness in the throat, accompanied with excessive thirst; vomiting and straining still occurred at intervals; he was allowed occasional draughts of milk and water; in about two hours and a half the vomiting had subsided, and he began to assume his natural look; the temperature of the skin rose; and with the exception of slight epigastric pain and dryness in the fauces he seemed comparatively comfortable; the pulse was 100, and rather full; the pupils responded to light. The patient was calm and can give a minute account of the occurrences of the morning. 8 o'clock, r. m., twelve hours after the poison had been swallowed; very severe gastro-intestinal inflammation has set in, accompanied with severe cramp in various parts of the body, particularly the calves of the legs and inner parts of the thighs; the skin was hot and dry; cheeks flushed; countenance indicative of anxiety; there was pain in the head; pulse 120, hard and full; respiration rapid; epigastrium and abdomen very painful, not bearing the slightest pressure; there was constant straining and retching; he was bled; and calomel and opium with other remedies were administered. October 12th, 6 o'clock, A. M.-Blood buffed and cupped; vomiting had ceased; the countenance was not so anxious; the pain had abated; the skin was dry and hot; tongue dry and covered with a dark brown fur; pulse 100, full and jerking; the pain was still very much increased on pressure, over the whole abdomen; patient complained bitterly of the taste of 'the chromate in the fauces;' the respiration was calm; the bowels had not acted; the cramp had subsided. Leeches were applied to the abdomen. 12 o'clock.Symptoms subsiding. 8 o'clock, r. M.-the patient was still going on favourably; the bowels had acted once. On the 14th at 4 o'clock, A. M., Mr. Bishop was sent for to see the patient, who was reported "dying;" he found him exceedingly ill. The skin was cold and clammy; face pale; eyes sunk; feet and hands cold; pulse scarcely perceptible; abdomen swollen and tender. About two hours previously violent purging had conummenced, and had been almost incessant; the bowels were evacuated as lie lay in bed-the evacuation consisted of mucus and blood. Ordered bottles filled with hot water to be applied to the feet, hands and thighs, and gave hot brandy and water; in two hours time the pulse rose and the bowels were quieter. A starch enema with Tincture of Opium was administered. 12 o'clock.-Enema retained two hours; brought away a little feculent matter, tinged with blood; pulse 120; great thirst; face not so pale as in the morning; abdomen tender and swollen; frequent twitches in the muscles of the calves of the legs. An opiate suppository was introduced within the anus, and hot bran poultices were applied to the abdomen. 8 o'clock.-The straining and purging have nearly ceased; the skin was hot; pulse 100 and firmer; thirst excessive; abdomen not so large but painful on pressure. 15th.-Purging had again returned, but not so violent as before; stools contained feculent matter; tenesmus not severe; skin cool; thirst abated; abdomen very tender in the region of the sigmoid flexure; distension slight. 16th.-The symptoms were subsiding; the pain was relieved; the bowels had acted once and the evacuation was natural. Dec. 14th.Convalescence had been exceedingly slow; ulceration of the bowels having set in, and with difficulty been subdued by means of Nitrate of silver and Opium, and successive blisters on the abdomen. There was considerable emaciation with urgent dyspepsia. February 14th, 1848. -Had no pain in the epigastrium; appetite and digestion good; bowels habitually costive. To have change of air and regular exercise." Remarks by Mr. Bishop.-" The cases of poisoning by this substance, which is now commonly used in the arts, are rare; no antidote is pointed out in toxicological works. But the first object is evidently to get rid of the poison; second, to decompose what cannot be thus got rid of. The first object is to be effected by emetics and the stomachpump: I should be inclined to rely most on the latter. The second, perhaps, will be best effected by the alkaline earths, although I should rather suspect the activity of chromate of lime. As near as I can ascertain this young man swallowed two ounces of the salt; he took as much as a handful out of the tub, and dissolved it in warm water; and so intent was he on destroying life, that, while dissolving it, he chewed several small crystals. Vomiting occurred in about five minutes after he swallowed the solution. From the violence of the symptoms it seems probable that a far less quantity than what was swallowed would destroy life, but it must be borne in mind that breakfast had just been taken-a large mess of pottage, with which the poison had become mixed and afterwards expelled. Had so large a quantity come in contact with the walls of an empty stomach, 1 think there can be little doubt that death would have ensued speedily from the shock to the nervous system before there could have been time for inflammatory symptoms to have come on." Bemarks by Mr. Taylor.-t" I shall only add to these remarks that in my opinion the patient owed his recovery to the very active and judicious treatment pursued by Mr. Bishop. It will be observed that the case was under treatment from October 11th to February 14tha period of four months. In the latter stage the urgent symptoms were undoubtedly due to the local action of the poison on the mucous membrane of the stomach and bowels. In the only two cases of poisoning with the Bichromate of Potash with which I have yet met, one proved fatal in twelve hours and the other in five hours. In the first there had been neither vomiting nor diarrhea; and in the second, vomiting only. The vomited matters, as in Mr. Bishop's case, consisted of mucus mixed with blood. The case hero reported, and which is now for the first time published, is, I believe, the only instance of the chronic effects produced by this poison hitherto recorded. It clearly proves that, as in poisoning by the strong mineral acids, a practitioner may have formidable after-effects to encounter-honce he should be guarded in his prognosis. With respect to the treatment of the acute stage of poisoning, the removal of the salt from the alimentary canal by emetics or the free use of the stomach-pump is the principal object. A mixture of ('arbonate of Magnesia or of Lime in linseed tea might be exhibited with benefit. Brown sugar dissolved in water at 102~ tends to decompose the chromic acid, and to reduce it to the less irritating state of Oxide of Chromium. Chemical antidotes can, however, be of little avail unless administered within a few minutes after the poison has been Sswallowed." HT 534 On the 24th of Nov of the 1st decimal trituri On the 25th.-Dull I the evening. 26th.-In the morni elbows. 27th.-After breakfa the posterior nares, chi forenoon dull confusion in the skin in various pa 28th.-For several d the legs, especially abo, pressure. Transitory p ness and uneasiness in tl 29th.-Bad taste in t ing pains about the anus and irritation of the skin evening. 30th.-In the morni the apex of the heart, inclination to vomit in of water in the mouth Unusual hunger in the r Dec. 1st.-Metallic t ing in the tongue. I especially the inner cai back of the left side of in the front, with a feeli the lung could not exj feet, toes and various itching in the toes like 2nd.-Vivid dreams. shifting to various parts the inferior angles of t hypochondrium, at the e of the bladder; pain di symptoms seem to be g( Frequent passing o. aching and shooting pail the rectum, and diffict Pains in the knee. 31 left scapula, in the mo A sort of sudden jerk o 4th.-In the night a the chest below the axil motion or respiration, g( Pains in the knee. Ite the feet, at the root ol tround. 5-th.-In the evening:i fine-drawing nervous KALI BICH ROMICUM. PROVING OF THE OXIDE OF CHROMIUM, BY DR. DRYSDALE. ember (1842) began to take one grain chest to the shoulder and neck; on lying on the heart, a sort ation ('/,,th gr.) three times a day. of clucking painful sensation on deep inspiration. In the evepain at inner angle of left scapula, in ning violent disagreeable pain like flatulence came on in the right side from lumbar region round to the ccecum, brought ng, transitory undefined pains in the on by any movement of the trunk or by deep inspiration-not felt in setting or lying still..st and dinner a fetid, musty smell in 6th.-This morning in bed the same pain (in loins, and right iefly perceived in expiration. In the side) still felt very troublesome-rather better on getting up. in the head. In the evening pricking 7th.-Still the pain in the loin; it seems to arise in a spot irts; smarting in the eyelids, which is tender to pressure, about an inch to the right of the ays a dull, bruised, fatigued feeling in middle lumber spine. Rheumatic pains about the right shoulder ve the knees, with some pain on firm and various parts of the back. The flatulence and rumbling ains in various parts. Feeling of dry- in the abdomen have continued troublesome for several days; he right eye and right nostril. and also almost daily pricking in the tongue at various times. he morning. Fulness and slight shoot- 7th. -Superficial burning pains about the middle dorsal s in the morning and forenoon. Itching spines; sudden jerking pains in the left ear; cold feeling in a i round the eyes and cheekbones in the small spot in the meatus of the left ear. In bed a severe quivering boring deep-seated pain in the inner side of the ng he had a dream, with pain under thighs, chiefly the left. and awoke with that pain. Sudden 8th.-The pain in the loins continues. Occasionally indisthe morning while dressing, with flow tinct pains like a strain about the feet and ankles. Shooting i and dull pressure in the stomach, drawing pains about the balls of the feet. Shooting pains in middle of the day. the left temple. 9th.-Still the lumbar pain, most felt in the aste in the mouth before dinner. Prick- morning in bed. Itching in the palm of the right hand in the tching and smarting round the eyes, morning. Pricking in the tongue. Several sharp cutting pains nthi. Deep seated pain again in the across the left eyeball at night in bed; smarting and heavithe chest and the corresponding place ness in the eyelids in the evening. 10th.-The lumbar pain ng on deep inspiration as if the root of gone. The same symptoms in the tongue and eyes continue. pand and was painful. Itching in the 12th.-Yesterday morning and this morning heavy muscular parts, in the evening. Burning and pains in the neck and shoulders, and various parts of the chillblains (to which he is not subject). trunk; soon went off and only slightly felt in the back during He awoke early with pains suddenly the day. 13th. - Drawing pains in the left scapula occaof the trunk; dull pain at one time at sionally throughout the day, but most in the morning. Sharp he scapulae, then pressive in the right drawing pains in the bones and ligaments of the right foot. dge of the false ribs, then in the region 14th.-The dose was now changed to one grain of the first all pressive over the right eye. The centesimal trituration (1/10oth), four times a day. In the morenerally most in the morning. ning uneasiness, stiffness and dull pain in the muscles. Chiefly f flatus for several days. Frequent in the shoulder blades and back of the neck, also between ns at the epigastrium. Fulness about shoulders and in the hips. Coming occasionally during the ilt evacuation of a soft scanty stool. day till the evening. 15th.-Cutting pain across the left rd December.-The same pain about eyeball, with flow of tears in the morning in bed. Pricking )rning; pinching pain in epigastrium. itching in various parts. 16th.-Pains in the left scapula. f both eyeballs for a second. Quivering of the lower lip. After tea a sudden and pressing severe boring pain in the left side of desire to stool, with scanty, thin, lumpy evacuation. 17th.la, about the 4th rib, not increased by The fixed pressive pain at apex of the heart as before. Flatuoing off on turning to the right side. lence. Itching in the arm-pits at night. Frequent dull hing and drawing pains in the balls of deep-seated pains in the hands and fingers. Pains in the f the toes, painful on treading on the back as before. Finished the proving. For some days the pains in the back continued, and then in bed, pain in the region of the heart, gradually all symptoms disappeared. pain, at times reaching tlu-ougli the __ __ _____ ACONITUM NAPELLUS.* ARRANGED BY R. E. DUDGEON, M.D. SYNONYMS.-Aconitum ceruleum, Tora, Tura, Thora, Taura (Dodoncus, Stirp. Hist. Pempt. iii, lib. iv, c. 12, p. 438, Antwerp 1583). Superbia (Gesner, Hist. Animal. de Lupo). Lupi radix, Luparia (Baubinus, Hist. Plant.) In English: Wolf's bane, Monk's hood, Helmet flower. In French: Napel, Aconit, Tueloup, Cappe or * The derivation of the word Aconitum or Cdcovrov is involved in some idegree of uncertainty. According to Theophrastus, Nicandcr, and some others, it is derived from 'AKc6vac, a place near Heraclea, where Hercules descended to the infernal regions, and where the plant abounded, produced, as Ovid says, by the foam scattered about by the dog Cerberus when brought up on earth. "Acone, portus est Bithyniae, qui pro ventu malorum graminum, usque adeo celebris est, ut noxiam herbam aconita illine nominemus."-lsidorus, Origin. lib. xvii, cap. 9. Others derive it from d&bvqt a stone, or properly a whet stone, either because the plant affects stony localities, " Quae quia nascunter dura vivacia caute Agrestes aconita vocant."-Ovid's Metamorp7h. or because it was found chiefly beside that kind of stone used for sharpening tools. It is also said to be derived from & privitive and Komvi dust, likewise in allusion to its growing amongst rocks where there is but little soil. And M.M. Decandolle and Encontre in their Memoire cur V'Aconit des Anciens, supposing it to be derived from these words, think that it may be in allusion to its rapid and sure mode of killing, as a victor in the Olympic games was said to gain an easy victory and to shew his power when he conquered his adversary without covering himself with dust. ".. Cui spes Cui sit conditio dulcis sine ulvere palma." Hor. lib. i, ep. 1. Many poisonous plants were confounded by the ancient writers under the common name of aconitum; and by some writers the plant under consideration was evidently not understood by that name. Thus Virgil alluding to Italy says: " At rabids tigres absunt et sasva leonum Semina, nee miseros fallunt aconita legentes." The name napellus is derived from napuw a turnip, its root having some resemblance to a small turnip. Capuce de moine, Char de Venus. In Italian: Napello. In German: Sturmhut, Eisenhut, Sonnenhut, Mlbnchskappe, blaue Wolfswurzel. In Flemish: Wolfwortele, Motrinex-cappen. In Swedish: Stormhatt. It belongs to the natural order of Ranunculacee, Juss.; to the Polyandria polygynia of Linnreus's classification. It is supposed by Burgius that the experiments of Stdrk which Hahnemann has incorporated in his schema were made with the Acon. cammarum, as that is the most frequent in the neighbourhood of Vienna, but Endlicher contends they were made with the Acon. napellus. There does not however seem to be much if any difference between the medicinal properties of the two species. This plant is occasionally met with wild in some parts of England, but its chief localities are the mountainous districts of Switzerland, the Tyrol, Bavaria, and Sweden. The parts used in Homoeopathy are the flowers, leaves, and roots, and the best time for collecting the fresh plant, from which the tincture should be prepared, is in the flowering time in July and August. A beautiful figure of the flowering stem and leaves will be found in Dr. Hamilton's Flora Homceopathica. The following arrangement of the symptoms of Aconite includes those detailed by Hahnemann in the 1st Vol. of the Pure Materia Medica, those given in the 1st Vol. of the Austrian Journal, and some from other sources as indicated below. Hahnemann having given no particulars as to the characters of the individuals who proved the drug under his superintendence, I have not of course been able to rearrange the symptoms that rest on his authority in their natural order, so have arranged them just as they occur in his - - ~II -- 2 ACONITUM NAPELLUS. 2 ACONITUM NAPELLUS. schema. As however many of the symptoms recorded in Hahnemann's schema are taken from other sources, I have consulted these, and in many cases have been enabled from them to give a valuable morbid picture of the effects of the drug. With respect to the observations of other persons, in those cases where any thing like a well defined morbid state was produced, I have recorded the proving entire, only condensing it as much as possible; where, however, the symptoms seemed to offer no obvious connexion with one another, I have distributed them among the different sections of the schema. The Pathological Anatomy will be found in foot notes beneath the various organs to which it refers. The Concordance has no pretensions to being perfect, as I have only given a concordance where the symptoms were not common to very many drugs. Where a mark of interrogation occurs, that implies that I was unable to find amongst the symptoms of other medicines any precisely corresponding to the symptom to which it refers. The following is a brief account of the sources whence the symptoms recorded in the following schema have been derived, and an explanation of the signs after each symptom. Ahr.-Ahner, one of those who originally proved the drug under lHahnemann's superintendance. As with the rest of the provers whose labours are recorded in the Materia Medica Pura, we have no information as to the quantity of the drug swallowed,.the preparation or strength in which it was used, or the temperament and constitution of the prover. If we may judge from his symptoms he did not take the medicine in large doses. Ar.- Dr. F. H. Arneth, aged 25 years, of choleric temperament and robust constitution. Health generally good. He experimented with pretty large doses, 10, 15, 25, 30 and 40 drops at a time, as also with the medicine in the 2nd and Ist dilutions. His experiments are recorded in the (Eatcrrcichische Zeitschrift fir.Hombopathie, voL i, pt. ii, p. 27. A. J.-These letters indicate such symptoms as were observed by the generality of the members of the Vienna Proving Society, recorded in the (Lt. Zoit.ch. f. HRom., vol. i, pt. iL Bcon.-The case of a man who had eaten by mistake, instead of celery, a considerable quantity of monkshood, recorded by Mr. Vincent It acon in the Plilosophical Transactions, vol. xxxviii, p. 287. 1733-4. The symptoms are well detailed and exhibit a very violent action of the prison, very little interfered with by the remedies given. The patient recovered. The symptoms are incorporated in Hahnemann's schema. Jd.-The symptoms with this signature arc recorded by Dr. Baldriani, of BrKesil, in the Mcemoriale della medicina contcmporanea1 vol. iv, p. 209. 18i10. They were observed in 12 patients for whom cochlearea had been prescrilbed for some chronic affection of the skin, in place of which the freshly expressed juice of aconite was by mistake administered in doses of 3 oz. Three of the patients died 2 or 3 hours after swallowing the medicine; the others recovered under the use of emetics and powerful stimulants. Baldriani's paper is copied into the (Est. Zeitsch. 1. c., p. 115. Bm.-Dr. J. K. B]hm, aged 40, of choleric temperament; delicate, small, pale and thin, liable to mucous defluxions of all kinds, of extremely moderate habits, never seriously ill, but suffering from violent colics on committing any dietetic error; had been affected some years previously with htemoptysis, and still occasionally observed traces of blood in his sputa after any violent exertion. He took from 4 to 20 drops of the tincture in his experiments, but did not push the medicine to any great extent. Dv.-The ease of a man who by mistake swallowed about 40 grammes (32 scruples) of tincture of aconite. Although vomiting was excited shortly afterwards, yet the symptoms were those of violent poisoning, and lasted with more or less intensity for upwards of 4 days. The history of this interesting case is very fully detailed by Dr. F. Devay, in the Gazette Med. de Paris of the 5th January, 1844, p. 12. It is also to be found in the (Et. Zeitsch. fiir Hoom. 1. c., p. 123. Fg.-An.Enquiry into the Physiological and Medicinal Properties of the Aconitum napellus. By A. Fleming, M.D. London, 1845. The symptoms recorded in this work can scarcely be termed pure, but we give them as they corroborate the experiments of other observers. Gg.-Symptoms observed by Dr. J. E. Greding on patients to whom he had given aconite for the cure of other affections. The cases are given in detail by C. W. Greding, in his Vermischte Med. &hriften, p. 90-113. Greiz, 1790. They are incorporated in Hahnemann's R. A. M. L., and copied into the Essay on Aconite in the Austrian Journal, 1. e., p. 145. Hahnemann has admitted symptoms from no less than 7 cases treated by Greding, but on carefully examining these we find that only in one case can the symptoms be fairly referred to the medicine administered. The case was that of a woman, aged 35, deaf, fat and robust, who had not menstruated for a long time; from her childhood affected with indurated cervical glands, which from their size impeded respiration and deglutition; she took for 7 days, three times daily, 10 grains of a preparation of aconite made thus: the fresh juice of aconite inspissated over a slow fire, and 8 grains of this rubbed up with an ounce of sugar. Gl.-Dr. Henry Gerstel, 38 years old, of phlegmatic-sanguine temperament and robust make, never seriously ill since his 6th year when he had hooping-cough, yet subject to derangements of the digestive organs, cramps in the stomach and diarrhoea after a chill in the feet, also to slight rheumatic affections, palpitation, and moderate flow of blood from hmmorrhoids about once in 4 or 8 weeks; and in addition to these, for several years to a kind of paralytic feeling of the whole of the right side of the body. His experiments commenced with six drops of the tincture, which he gradually increased to 20, 40 and 50 drops p. dosi.-EEst. Zeitsch. 1. c., p. 34. Glw.-The wife of the foregoing, 30 years old, of nervous constitution and sanguine temperament; always healthy, except a periodical prosopalgia from which she had suffered occasionally during several years. She was suckling an infant nine months old at the period of her first experiment. She first took 3 drops of the tincture for two successive days. Her second experiment was with 20 drops of the tincture which she took at once, and which was immediately followed by the cutaneous eruption which will be found recorded in the schema. -tEst. Zeitsdl. 1. c., p. 40. ACONITUM NAPELLUS. 3 _ H.-The symptoms in Hahnemann's 1eine Arziwimetellehre undistinguished by any signature are here indicated by this letter. We have no information respecting the dose administered, and only occasionally the time that elapsed between the ingestion of the drug and the development of the symptoms is indicated. It is evident that the symptoms were observed in several different subjects, of both sexes, but we have no means of knowing who or what the persons were. h.-The symptoms observed by Fredk. Hahnemann, son of the above, they are very few in number and very unimportant. (R. A. M. L. vol. i.) v. H.-Symptoms observed on himself by Van Helmont, on taking a portion of the root of aconite into his mouth without however swallowing it. (Van Helmont, Demens idea, 12, Hahnemann's iR A. M. L. vol. i, also (Est. Zeitsch. 1. c., p. 19.) lbg.-The symptoms of Hornburg, one of Hahnemann's provers. They shew no very marked action of the drug. (R. A. M. L. vol. i.) BkI.-Dr. Carl Hencke, of Riga, has recorded in the Archiv.f. Honm. Heilk. vol. xx, pt. i, p. 181, four interesting observations with aconite on himself and others. We have distinguished the different provers by the letters a, b, c, d.-a. Dr. Hencke, of middle height, rather choleric temperament, healthy, unmarried, lives simply and temperately, rarely drinks beer or wine, but smokes and drinks tea at night. He took for five successive days 4, 8, 16, 24 and 30 drops of the tineture.-b. A youth, 19 years old, of spare habit, phthisical constitution and sanguine temperament, of regular, simple but sedentary modes of life, had two years previously suffered from pulmonary catarrh, during which he spat blood; at the time of the experiment he felt in perfect health. He took for four successive mornings 4, 8, 10 and 12 drops of the tincture. It will be observed the drug acted so powerfully on him as to occasion considerable hasmoptysis.-c. A healthy peasant girl of ruddy complexion, robust make, 22 years old, accustomed to simple and active habits of life, catamenia regular, took for five successive days 5, 10, 20, 30 and 40 drops of the tincture. The phenomena exhibited were those of an inflammatory cardiac affection.-d. An unmarried man, of choleric temperament, in good health and actively employed. The first time he took 8 drops of a preparation formed from 2 drops of the tincture mixed with 40 drops of water. The second time he took of a similar preparation, in one day, first 8 drops, then 5 drops, and again 20 drops. Another time he took, 3 times in one day, 8 drops of a preparation formed from 5 drops of the tincture with 30 drops of spirit. As might be expected no great results were obtained from such cautious experiments. M.-Dr. Karl Masehauer, 28 years of age, of scrofulous constitution, delicate make, phlegmatic temperament. He first took for two successive mornings 5 drops of the tincture, then for three successive mornings 10 drops, and then for two successive mornings 15 drops. Again 15 drops after one day's interval. Then after two day's interval 20 drops twice in succession. He then waited two days and took night and morning 10 drops. The next two days 20 drops, and the next day night and morning 15 drops. In another experiment he began with 40 drops, the next two days 50 drops each day. After one day's interval, 60 drops two successive days. He again paused one day and then took twice within the hour 40 drops, and the following day 80 drops in two doses. The symptoms developed in Dr. Maschaucr were in proportion to the large quantity of medicine swallowed.--Est. Zeitsch. 1. c., p. 41. Me.-Dr. Male, of Birmingham, aged 65, who had for two months suffered from pains in the back and loins, took tincture of aconite for four days, beginning with 5 drop doses either twice or three times a day and increasing the dose to 6, 8 and 10 drops. This proved fatal to him, and he died on the seventh day with all the symptoms of poisoning by aconite.-v. Brit, and For. IMcd. Reciac, vol. xx, p. 469. Jlli.-Two robbers who had been condemned to death, were poisoned by aconite in order to test the efficacy of antidotes. One (whose symptoms are indicated by 1) got first a drachm of the root of aconite, and 1j hours afterwards a drachm of the stem, leaves, flowers and seeds. The antidote proved of no avail, and death speedily ensued. The efficacy of the bezoar stone as an antidote was tested in the other, to whom a drachm of aconite was given. The bczoar was given an hour afterwards. After the lapse of 7 hours, during which many and violent symptoms of poisoning were evinced, he completely recovered. Halnemann has incorporated these two cases in his Materia Mcdica. They are detailed by Matthiolus in Comment, in lib. iv, Dioscoril. cap. 73, p. 761, copied into (Est. Zeilsch. L c., p. 104. Mor.-The symptoms of two men who had by mistake partaken of aconite instead of salad. One, in whom vomiting took place early, recovered rapidly; the other died in a comatose state. The histories of the cases are given by a non-medical person, and contain little of importance. Hahnemann, who has incorporated them in his schema, has passed over the most important, the comatose symptoms, and introduced one, ý 503 (R. A. M. L.), which does not exist in the original. The cases are detailed by Moraeus in the Konyl, Sensk. wcit. acad. Handlingar, 1739, p. 41; and also in the (Est. Zeitsch. 1. c., p. 109. N.-A medical student, aged 23, of sanguine temperament and slight make, who had during the past year suffered from palpitation, in which acon. 3 had been of service; since then he has enjoyed good health. In the course of 60 days he took, with very few intermissions, 2386 drops of the tincture, in doses of from 15 to 120 drops at a time. Well marked rheumatic and cardiac symptoms were developed in this individual. (Est. Zeitsch, 1. c., p. 45. Ot.-A most interesting case of poisoning, sccmudum artem, related by Dr. Otto in his Reiscn, Hamburg, 1825, pt. i, p. 377. The patient, a woman 27 years old, of bilious and robust constitution, who had hitherto always enjoyed good health, was admitted into the hospital on account of suspected venereal disease, supposed to have been caught from a child she was suckling. Her appearance was healthy, her appetite good, all her functions and her pulse natural, only her nipples wero slightly excoriated. The child had some ulcerations on its back. Tho treatment was: low diet, 2 drachms of aconito made into 12 pills with the powder of the plant. This dose was repeated the following day. The 3rd day she got 3 drachms of the extract; the 4th, half-an-ounce; the 7th day, a whole ounce; the same quantity on the 8th day; on the 9th day again, half-an-ounce. It was then thought prudent to stop tlhe aconite. On the 10th day a pound of blood was drawn. On the 1 Itlh day another venesection, 6 grains of tartar emetic by the mouth and '10 grains of the same substance in 2 clysters, followed by another venesection of a pound of blood, Human nature, of course, could stand no more, and death stepped in to terminate the treatment on the 12th day. There is not the slightest evidence to shew tlat there was the slightest syphilitic taint about this healthy young nurse, thcrefore we do not hesitate to admit this as a pure case of poisoning. '1Thi extract of aconite must, however, have been very bad, as a quarter of tihe quantity administered would, had it been good, have suflleed to dispHatht half-a-dozen men. The symptoms chielly developed were jaundlic and apoplexy. This case is also detailed in the (Est. Z it/ch. I. c., p. 111. Per.-Three cases of poisoning by aconite, recorded by l'creira in his Elements of Majlcrna Mutlta, vol. ii, p. 130J. They occurred in a gintlcinan, aged 57, his wife, of the samnii age, and a child, age:d 5. T'hi, Ii __ _1~1__1_~____1___ I i - i 4 ACONITUM NAPELLU S. all had partaken of the root of aconite, supposing it to be horse-radish. The man had eat the most, the child but little. The former died a few hours after partaking of the aconite, the other two recovered. Nopost rmodrtern examination was made. Pl..-Five persons poisoned with aconite, of whom three died (Pallas Dissert. inaug. de Aconito) in the course of 3 hours. The post mortem examination is given, and will be found in its proper place in the schema. Pa.-A person suffering from rheumatism, for which he had been getting extract of aconite for some time with benefit, when on obtaining a fresh supply of the extract, the same dose which he had previously taken with impunity proved fatal in 4 hours. The case is recorded and th,- autopsy detailed in the Gazette des Hopitaux, 26 March, 1839, by Dr. Perrin; also in the (Est. Zeibtch. 1. c., p. 122. P:a.-A case recorded by Dr. Percyra, of Bordeaux, in the same works as the last. It was that of a man 45 years old, affected with acute rheumatism. He had been treated with benefit, with from 2 to 5 grains of the old extract night and morning, when, on taking 5 grains of the new extract, symptoms of poisoning took place which continued all day, but on the following morning heo was quite well and had no more traces of the rheumatic affection. Rd.-Claudius Richard poisoned a condemned criminal with aconite, in order to test the efficacy of the IBezoar caprarum indicarum as an antidote. lie got a drachm of aconite and thereafter 5 grains of the counter-poison. After 8 hours the patient had completely recovered. As we cannot admit the bezoar to have had much influence on the course of the poisoning, we may consider this as a pure development of the action of aconite. The case is recorded in Schenk's observations, lib. vii, obs. 136, p. 876, and the symptoms are given in Halmemann's materia medica. Rei.-In a work entitled Dissertatio medica de Aconito wnpello, August, 1764, by S. A. Reinhold, the author details the general action of aconite as lie had observed it. riq.-lDr. Edward Reisinger, 30 years old, robust, sanguine temperament, in the enjoyment of uninterrupted health. His experiments lasted for about 3 months, during which time lie took almost constantly doses of the tincture, varying from 5 to 200 drops at a time. The symptoms developed were proportionally severe. They are given in the mEst. Z/tsch. 1. c., p. 50. 1Rkt.-The symptoms of Dr. Riickert, recorded in Hahnemann's mat. med. Their number is not great, but they are sufficiently characteristic. /i/.-Dr. Joseph Rothansl took for 9 days, every morning, some of the tincture; lie began with 6 drops and increased the dose every morning by 1 drop. The medicine continued to produce symptoms in him a fortnight after discontinuing it.-(Est. Zcitsch. 1. c., p. 56. JRr.-Symptomns observed after the introduction of the juice of acmoite into a wound, whereby, besides some general symptoms, the whole arm was affected with inflanmmation and suppuration, and the man only recovered after the lapse of a fortnight; by Roedder, in l/t, r/~ Jnrisprud. ricd. 1730. Vol. vi, obs. 24, p. 724. Hahnemann has adpted somo of the symptoms, and the case is detailed in the (Est. Z,;.. I. e., p. 111.,SL,--I)r. Schnellcr proved on himself the extract of aconite: he Ibrun with t /2 a grain, increased it by 1/2 a grain every day until he can, to r', grains, then hie t,<dk 201/2 grains, and lastly 261/2 grains; altg.lter 1l.-s g rnins. Hlis proving is recorded in the Zeitschrft d. 4.~.-lI. '.,tr:t in lien, 2nd year, vol. Li, p. 408. 1846; and in hr.;.,ir. ', I hii. vol. vi, p. 271. Sn.-A case of poisoning recorded by H. C. Sherwin. A servant girl had swallowed a mouthful of a tincture of aconite, made with a pound of the root of aconite to a gallon of alcohoL The symptoms that occurred were extremely severe, and the patient was in great danger of her life. The effects were felt for 5 or 6 days.-Lancet, vol. ii, 1836-7, p. 13. sSp.-At Suippes, a lively girl, of 21 months of age, eat a few leaves and 2 or 3 flowers of aconite: she was speedily seized with violent symptoms of poisoning, and, notwithstanding the exhibition of an emetic, died convulsed within 3 hours.--Journal de Ciimie med. Fevr. 1840, p. 94; also tEst. Zeitsch. 1. c., 115. St.-The symptoms of aconite observed by Drs. Stapf and Gross on themselves and others, recorded in the Archiv f. Homr. Heilk., vol. iv, pt. i, p. 160, and incorporated by Hahnemann in his mat. med. The authors furnish us with no particulars regarding the individuals or the dose of the medicine. Stoe.-Stirk made two experiments on himself with aconite: the first with a portion of the powder of the stalk and leaves, which caused only some sensations in his mouth and tongue. He then rubbed up 2 grains of the extract in 2 drachms of sugar, and took one day 6, the next 8, the 3rd, 10 grains of this without result. On taking the following day 20 grains it produced nothing but perspiration, which recurred whenever he again took the medicine. He also records the effects of aconite on some patients whom he treated with it, and Hahnemann has adopted several symptoms from these records, some of which we have found it necessary to expunge. Stirk's observations are contained in: Libellus de Stramonio, Hyoscyamo, Aconito, &c., Vindob, 1662, p. 69. Sw.-Dr. Frederick Schwarz, 29 years old, of sanguine temperament, short and stout, with unimpaired health, commenced his experiments with 3 drops of the tincture, and gradually increased the dose until he took 400 drops at once. The symptoms developed in him were of considerable severity.- st. Zeitsch. 1. c., p. 60. Sz.-Dr. John Sterz, 27 years old, florid, sanguine temperament, thin, in excellent health. He made four experiments with aconite: the first he commenced with 3 drops, increasing gradually to 20 drops. The second with 10 drops, increasing to 20. The third with 40 drops. increasing to 80. The fourth he made with the 1st and 2nd dilutions, The last did not exhibit anything peculiar, so as to require particular notice.-Eist. Zeitsch. 1. c., p. 64. TW.-Wahle, in Hahnemann's Mat Med., no particulars are given. Wk.-Dr. Weinke induced a girl, aged 18, of choleric temperament and robust constitution, to prove aconite. She first took a quantity of the 1st dilution, (marked /1 in schema), and then 10, 20 and 30 drops of the tincture, the effects of which lasted a week.-Est. Zeitsch. 1. c., p. 84. WTF.-Dr. Cajetan Wachtel, 30 years old, of choleric melancholic temperament, robust make, in the enjoyment of excellent health; began his experiments by smelling the tincture for 5 or 6 minutes. He then took for two successive days 8 and 12 drops respectively of the tincture, the effects of which were felt for 10 days. He next took 20 drops, and repeated the dose in 3 days, the effects of which lasted 8 or 9 days with considerable intensity. After this he took for two days 30 and 40 drops, and 3 days subsequently 50 drops, the effects of which were by no means so lasting as those of the former doses.-G(Est. Zeitsch. 1. c., p. 69. ITm.-Dr. Francis Wurmb, 36 years old, of sanguine temperament and athletic make, in excellent health, made two experiments: one with the tincture, of which he took for a considerable time from 5 to 100 drops night and morning, without great results; the other with ii ( 1 9 ____. ACONITUM NAPELLUS.US 5 ACONITTh NAPELLUS. 5 the 3rd dilution, of which he swallowed 100 drops morning and evening for six days, with very little effect.-CEst. Zeitech. L c., p. 88. Wo.-W. Woolley, in the Lancet, 1838-9, vol. i, p. 905, relates the case of a little boy, aged 13 months, who had taken some of the root of aconite and suffered from its effects. The child ultimately recovered. Wst.-Dr. Wiirstl, aged 39, of sanguine temperament, formerly subject to articular rheumatism and diarrhoea on the slightest chill, which however all disappeared after he had proved colocynth. He took on different occasions from 6 to 50 drops of the tincture, and exhibited some very peculiar and characteristic symptoms.-Est. Zeitech. L e., p. 86. Wz.-Dr. P. A. Watzke, aged 40, of sanguine choleric temperament and robust health, made four experiments with the tincture in doses of from 1 to 100 drops daily. Another trial he made with the 12th and 8th decimal dilutions, the latter alone produced any result. We have indicated those symptoms produced by the diluted medicine--Mst. Zeitsch. 1. c., p. 74. Z.-Professor Joseph Zlatarovich, 37 years old, robust, stout, dark complexion, of sanguine choleric temperament; in his youth affected with intermittent, when 29 had an attack of typhus, from which he was 5 years recovering. Is still subject to lymphatic and varicose swellings of the right leg. He took from 10 to 200 drops of the tincture daily for many days; in 68 days he had taken about 5000 drops, and managed to produce symptoms of proportionate severity. He likewise proved the 2nd centesimal dilution, for which he shewed great susceptibility.--Est Zeitsch 1. c., p. 91. Some other signs occur in the following schema which require explanation, thus: " aft. 3 d." means that the symptom in question occurred 3 days after leaving off the medicine; " aft. 6 h." that the symptoms occurred 6 hours after taking the dose; " aft. 3-6 d." that it occurred during the period comprised between the 3rd and 6th day after leaving off the medicine; " aft. 2, 24 7." that it was observed the 2nd and also the 24th hour after the dose. /, /2,/6, indicate the dilution which was employed when the symptom was developed. T. means that the tincture was used when the symptom was noted. I. _- ___ __-- - - I - -~~ SYMPTOMS OF ACONITUM NAPELLUS. Moral Symptoms. ai Bl.Grat. Natr-m. laht. Tab. b Air. Carb-a. Caus. Chin. Croc. Ign. Magnet-n. Natr. Nitr-ac. Sep. Zinc. c Nux-v. d Nux-v. E Autr. Bar-a. & c. Con. Crotal. Natr. Sep. Stan. f noll. Cann. Cupr. 1lyos. Stram. g 'ham. Nux - v. Sahin. A Anr.Camph. Kal-c. I',uI.Sep.Sulph-ar. Viol-t. i f'~. 1. Exalted spirits. (Schn.) 2. Gaiety with inclination to sing and dance (aft. J h. St.) 3. More gay and excited than usual (the Ist h. HI.) 4. Variable humour, at one time gay, at another cast down.1 (W1l. Z.) 5. Moroseness, as if she had no life in her (aft. 2 h. St.) 6. Moroseness, disinclination for everything, depression even whilst walking. (BHbg.) 7. Melancholy humour. (TVz.) 8, Anxiety and peevishness with fine dartings in the side of the chest, then palpitation, then headache. (I.) 9, Inconsolable anxiety and piteous howling, with complaints and reproaches about trifles" (aft. 5 h. II.) 10, Dolorous anxious complaints, with pusillanimous fears, despair, loud wailing and weeping, and bitter reproaches.d (1H.) 11, Solicitude, sadness. (i.) 12. Disinclination for conversation. (Z.) 13. Anthropophobia (aft. 3 h. H.) (WTV.) 14. Misanthropy. (II.) 15. Desire to be alone. (Z.) 16. He takes every joke in bad part (aft. 3 h. HI.) 17. Vexation about trifles. (JWV. Z.) 18, Easily vexed (aft. I h. H.) 19. Quarrelsomeness (aft. 6 h. Hi.) 20. Quarrelsomeness, with constantly varying silly delirium, he chatters childish nonsense, and is extravagantly gay.' (H.) 21. Irascibility. (H.) 22. Staid, resolute, but not lively humour (secondary and curative action. Aft. 8 h. H.) 23. Obstinacy. (H.) 24. Extreme fearfulness (aft. I h. IH.) 25, Apprehension. ( W1.) 26. Fear of approaching death (aft. 2-12 h. I.) (Fg.) 27. Dread of some accident happening. (H.) 2S, Fear of falling (H.) 29. The slightest noise is unbearable (aft. Sh. 11.) 30. Music is unbearable, it goes through every limb, and makes her quite sads (after 24 h. IH.) PATHOLOGICA.L ANATOMY. The features after death bear the traces of fright. (Pn.) 31, Everything is done hurriedly,h he runs about the house.' (v. H.) 32, Excessively disagreeable restlessness, without having occasion to hurry he is in the greatest haste," every obstacle that delays his rapid pace is excessively annoying to him, he knocks against some people who do not get out of his way fast enough, and runs in breathless haste up the steps. This hurried disposition lasted 2 hours, and was succeeded by an inclination to breathe deeply, as if he should give to the blood an impulse through the lungs. (Z. 7.) 33, He cannot remain long at one occupation.k (Schn.) 34. He raves, though awake, jumps out of bed, and imagines he is driving sheep (aft. 4h. I.) 35. After chewing a portion of the root, copious flow of saliva, the head seemed to be bound round by a band;' then having to do some domestic affairs, he hurried precipitately and ran about through the house." Then it appeared to him that he could not think, understand, or know anything in his head as usually, but that all these symptoms of the mind took place in the precordial region and about the mouth of the stomach; after 2 hours he was twice attacked with vertigo, and the ordinary thinking power returned. (v. H.) 30, Lucid vision. (H.)*37. Lively memory. (f.) 38. Lively imagination. (H.) 39. Great activity of mind. (Z.) 40. He sits buried in thought. (H.) 41. Rapid change of thought, great exertion is required to fix the train of thought." (Z.) 42. Unsteadiness of ideas; on attempting to think of one thing, another forces it out of the mind, and this is supplanted by another, and so on, until he becomes quite confused. (St.) 43. Distraction of the attention whilst reading or writing, owing to frequent cessation of the thoughts. (Rkt.) j (7) k Asaf.Bis.Ign.Lach. Natr. Stan. Ver. I Aeth. Ant-t. Bry. Carb-v. Coce. lod. Magn-s. Merc. Nitr- ac. Olean. Pctr. Pimp. Plat. Puls. Sars. Spigel. Stan. m lod. o (?) n Anac. Phos. Val. I * He said: " My beloved one must have just sung the difficult passage, which I now sang." It was ascertained that his betrothed, who was 50 miles distant and dangerously ill, had that day been present at a concert, and had sung remarkably well, only 5 hours previously, the piece from Beethoven, Ah perfido, which he had sung. He was peculiarly susceptible to Mesmerism. ----~-- ~ --- - ACONITrM NAPELLtoS. [SYMPTOMS 44 TO 76. Moral Symptoms. 44. Distraction. (Schn.) 45. Prepossession of the mind, the thoughts he has already conceived and half written down he is unable to register completely, without an effort to recal them (aft. 3 d. W.) 46. Want of memory, what has just been done appears like a dream, which can scarcely be called to remembrance. (St.) 47. Weakness of memory (aft. 5-9 h. It.) 48. Loss of memory for dates.0 (i.) o Fluor-ac. Lach. 49. Diminution of the intellectual powers (Sw. W.) 50. Indisposition to exert body or mind. (Fg.) ixalted spirits, 1-3, 20, 748. Jariable humour, 4. ndifference, 780. doroseness, 5, 475, 753. )epressed spirits, 6, 7, 11, 457, 746, 750, 753. t) from music, 30. Inxiety, 8, 10, 466,475, 478, 479, 480, 481,490, 491, 643, 645, 663, 674, 679, 778. &nxiety with pain in chest, 8. S with complaints, 9, 10. with reproaches, 9, 10. )espair, 10,128, 614, 746. 3olicitude, 11. )islike to talk, 12. aaziness, 340, 674. inthropophobia, 13..rLisanthropy, 14. INDEX TO MORAL SYMPTOMS. Love of solitude, 15, 475. Impatience, 678. Bad humour, 16-21, 456, 457, 466, 656, 753, 780. Bad humour, with delirium, 20. Resolution, 22. Obstinacy, 23, 751. Fear, 24, 475, 480, 663. Sof death, 26, 128, 614, 638, 663, 675. Sof an accident, 27. Sof falling, 28. Feeling as if a misfortune were about to happen, 479. Intolerance of noise, 29. is music, 30. HurryT, 31, 32, 35. Hurry in talking, 678. Restlessness, 32, 33, 478, 479, 663, 678, 679, 764. Delirium, 34, 35, 128, 130, 679. Lucid vision, 36. Increased mental powers, 37-41. Inability to fix the thoughts, 42-44-, 479, 674. Want of memory, 46, 47. Sfor dates, 48. Weakness of mental powers, 45, 49, 50. The mental operations appear to go on in the stomach, 35. As if madness would ensue, 99, 100. Disinclination for mental labour, 475, 480. Lethargy, 671. Loss of consciousness, 500, 678. Insensibility, 692. REMAmrs.-The moral symptoms are partly indicative of the febrile state of the system induced by this medicine, and partly )f direct action on the brain, from simple irritation to congestion and inflammation. Head. Lach-v. Am-c. Bry. K-bich. Staph. Zinc. SRhus-t. Hep. Spigel. 51, Vertigo; sense of swaying hither and thither in the brain. (H.) 52. Vertigo whilst stooping.q (Wz.) 53. Vertigo with staggering, chiefly towards the right side,r on stooping (aft. 36 h. St.) 54. Vertigo whilst standing. (Fg.) 55. Vertigo almost preventing her getting into bed, whereupon all goes round (aft. 37 h. St.) 56. Vertigo with commencing staggering, it seems to him as if he could not stand on his feet. (WT.) 57. Attacks of vertigo, with confusion in the head, in the forenoon, daily for 16 days after leaving off the medicine. (W. St.) 58. Vertigo and dizziness. (St.) 59. Vertigo and stupefaction on entering a warm room, as if intoxicated. (Z.) 60. Vertigo and headache, not affected by violent motion (aft. I h. H.) 61. Vertigo and headache in the forehead and occiput, both worst on bending forwards (aft. 10 m. H.) 62. Vertigo, much increased by shaking the head,' whereby complete blackness comes before the eyes. (St.) 63. Giddy heaviness of the head, principally in the forehead, on stooping, with nausea and feeling of sinking in the pit of the stomach (aft. 2 h. St.) 64. Whirling in the head, so that she dare not move it, with a sensation as if the eyes would close. (St.) 65. As if intoxicated, all goes round, staggering as if about to fiall, with nausea,t worst on rising from the sitting posture, less whilst walking, not at all whilst sitting (aft. - h. St.) 66. Easy stupefaction from tobacco smoke. 67. Confusion in the head, with pressure in the temples, as if after intoxication. (H-.) 68. Confusion and muddled feeling in the head, early in the morning after waldking. (A. J.) 69. Confusion with heaviness and fulness of the head, aggravated by motion. (A. J.) 70. Confusion of the head with pressure in the forehead, in the evening. (A. J.) 71. Sensation of fulness and heaviness in the forehead, as if there lay there a weight pressing outwards, and as if everything would come out at the forehead" (aft. I h. St.) 72. Sensation of fulness in the head. (A. J.) 73. Muddled sensation in the head. (N.) 74. Muddled and empty sensation in the head, in the morning, as if after intoxication. (Rkt.) 75. Heat in the head. (A. J.) 76. Heat in the whole head, followed by soreness of the whole head, particularly of the forehead, lasting all the evening (aft. 11 h. St.) t Mere. u 10., Magn-. Meny. _ ___ SYMLPTO31S 77 TO 1271 ] ACONITMI~c NA-PELLUS.$ Head. v Carb-v. Coce. l)p. K-bich. Krc. Lach. Lact-v. Lye. Magnet. Mang. Mur-ac. N itr - ac. Phos. Phoa - ac. Pals. Rhus - t. Stan. Staph. Zinc. cr Spigel. w Magn-m. M ur-ac. Sil. z Chain. Cocc. Magnet-n. Nux-v. Sep. bil. yAlum. Aur. Bov. Camph. Chin.Cupr. Euphr.Graph.I Iell. Ign. Ipcc. Magnet. Mere. Natr. Nic. Nux-v. Phos. Ver. z Bov. Caus. Kal-c. Stron. z Alum. Coloc. Ind. M1 ur-ac. Nltr,.Phow. a Bcll.Magn-s.M3ny. h \Anlr. ~ vw.h. 77. Humming in the head.' (N.) 78. Sensation of crepitation (such as is produced by bending gold tinsel backwards and forwards) in the temples, nose and forehead." (H1.) 79. Numbed feeling in the head, as if there were a board before the forehead' (aft.. h. (St.) 80. Headache increased by speaking. (H.) 81, Headache as if the eyes would fall out of the head x (aft. A h. IH.) 82. Headache as if the brain were pressing outwards (aft. I h. II.) 83. Headache as if a part of the brain were raised up here and there, increased by slight motion, drinking and speaking (aft. h. HI.) 84. Headache of a dull character, as if bruised,' with bruised feeling in all the limbs (aft. 14 h. H.) 85. Shooting, pulsating headache, as if from an internal ulcer,' sometimes preventing speaking. (.L) 86, Dragging all over the head, especially in the temporal muscles. (Z.) 87. Sensation as if some one drew him up by the hair." (St.) 88. Sensation as if something were drawn out of the head, causing the upper eyelids to be drawn upwards (aft. I h. St.) 89. Contractive pain in the forehead. (Ahr.) 900 Tension all over the forehead. (Hbg.) 91, Fulness and heavy feeling in the forehead, as if an outpressing weight lay there, and as if everything would come out at the forehead (aft. - h. St.) 92, Fulness in the forehead on stooping, as if everything would fall out (aft. 25 h. St.) 93, Frontal headache, sometimes shooting, sometimes pulsating, sometimes pressive, whilst walking, relieved by sitting. (II.) 94, Very acute pressive pain over the forehead. (7I.) 95, Outpressing pain in the forehead. (W.) 96. Jerking, shooting in the head, especially in the forehead. (St.) 97. Feeling of contraction of the brain under the forehead (aft. 20 h. St.) 98 Squeezing, tensive pain close behind the orbits. (H.) 99. A pinching squeezing in the forehead, as if in the bone, with a feeling as if madness were about to ensueb (aft. 12-24 h. H.) 100, A squeezing in the forehead, over the root of the nose, with a feeling as if the reason were going, aggravated by walking in the open air (aft. 4 h. H.) 101. Shooting and somewhat pressive pain over the orbits, towards the upper jaw, exciting nausea, like what is produced by vomiting from an emetic (aft. 2 h. H.) 102. From the 2nd dil. The most furious headache. Vision obscured,c the pain was chiefly in the upper part of the forehead, pres sing and contractive -head not hot -face swollen and pale,d light or noise increased the pain, lying quiet in a dark room removed the pain. (Z.) 103, Shootings in the forehead, afterwards in the right temple, and then in the left side of the occiput. (Wi.) 104. Pain as if a nail were driven into the forehead, in the warm room.0 (St.) 105, Headache, pulsation in the left side of the forehead, along with attacks of strong blows in the right side of the forehead (aft. 3 h. H.) 106, Violent headache, limited to a small spot above the left supra-orbital ridge. (Z.) 107. Dull pain in the vertex, extending towards the temporal region, increased by stooping (Wz.) 108. Pressure on the vertex, as if a cap were pressing tightly on the head." (Wz. /8.) 109. Headache in the vertex, as if the head were compressed equally on all sides by a pitch cap, removed by motion in the open air. (Z.) 110. Pressure and acute shootings in the vertex. ( Wz.) 111. Pressive pain in the temporal region, followed by jerkings in the occiput, and afterwards confusion of the head and contractive pain. (Rkt.) 112. Headache as if the head were compressed with screws at both temples.' (Z.) 113. Shooting, throbbing pain in the temples. (St.) 114. Stupifying drawing, inward pressing pain in the left temple. (St.) 115. Tearing pain in the left temple. (Ahr.) 116. Jerking, shooting pain in the left temple,5 stitches through the temples into the head. (St.) 117. Tearing pain in the left temple, with roaring in the ears. (St.) 118, Semilateral drawing in the head. (St.) 119. Jerking, shooting, drawing, tearing pain in the right side of the head superiorly. (Ahr.) 120. In the left side of the head, pain as if the head were compressed. (Ahr.) 121. Creeping in the left side of the head, as if from a brush. (Ihg.) 122. Pressure in the occiput. (Z.) 123. Jerking, tearing pain in the occiput.h (Ahr.) 124. A shooting pain in the occipital bone. (HbM.) 125. Painful jerks in the occiput.' (Z.) 1260 Pressive, shooting pain, at one time in the occiput, at another in the forehead. (W1i.) 127. After a mouthful of the tincture of the root. In 5 minutes she was seized with a prickling and tingling down the arms and fingers,J and a painful numbness across the wrists,k the tongue and mouth next felt numb,' then the legs and feet; m then the face seemed to be d Ambr. e Hell. Lye. Mosct Hhus-t. Sulph-ac. ee Berb. Paul. Sulpl f Coc. Coloc. Lye Plat. g Anac. Am. Boy Nux-m. h Anac. Magn. Rat. i Rhus-t. Stram. Spige j Natr-m. k Bov. I Ambr. Bov. Mag c. mAng-v. Kal-c. I~ ____ _~_ __ SYMPTOMS 128 TO 130.] ACONITUM NAPELLUS. 9 Head. n Aeth. Alum. Bar-c. Nice. o Bell. Caus. Cic. Mcz. Lye. Magn-c. Natr-m. Puls. Sabad. Sulph. Zinc. p Bell. Galv. q Fit nearly resembles that caused by Cocc. rArs. Dig. Hyos. Stram. *(?) ss (?) t Ind. u Bell. Camph. Hyos. Lauroe. Spigel. Verat. v Bell. Nux-v. Olean. Op. Sulph. to Cina. Con. Op. x Ars. Chin. yArs. Bry. Camnph. Cann. Chin. swelling," and the throat growing narrow. On looking at herself in the glass the face seemed blue p and indistinct. Then she felt sick but could not vomit. She grew very weak and almost blind in - an hour, though still conscious; the legs failed her on attempting to go up stairs. She was conveyed to bed, where she lay with eyes fixed and protruded, contracted pupils, countenance livid, jaws and face rigid, arms and hands cold and pulseless, legs and trunk much the same; breathing short, imperfect, laborious; heart feebly fluttering. She gave an occasional sigh, tossed the arms backwards above the head, and sought to shift her position by jerks. Rattling and vibration in the trachea. After taking some sulph. of zinc and brandy she had a violent convulsive fit: the eyes were drawn up under the lids, the fists clenched across the throat, and the teeth violently grating against one another, and a thick ropy saliva was forced through the lips. Urine and faeces passed involuntarily.' In 2 or 3 minutes the fit went off, and on tickling the fauces vomiting ensued, which brought back the pulse feebly to the wrist. Afterwards bilious vomiting set in, the pulse again went away from the extremities, dreadful oppression of the precordia ensued. The brain appeared much congested, and the jugular vein was opened with great relief; she felt as if she was whirled suddenly from a close, hot, dark room into a spacious light one. -The symptoms gradually declined, the pulse becoming fuller. She could not sleep for some time afterwards, owing to inability to keep the eyes closed. (Sn.) 128, After taking a drachm of the medicine, which tasted like pepper, he began to vomit, in an hour; the substance ejected was green bile, and he felt like a ball in the scrobiculus that rising up spread a cool air over vertex and occiput.' He then had a paralytic feeling in the left arm and thigh, the power of moving was gone in both, only remaining slightly in the hand. When the left side lost this it came into the right side in the same way, when he could raise the right arm he could not the left, and vice versa." At length he could raise them both. Then he complained that all the bloodvessels in the body were congealed. I-Ie had vertigo, burning in the head as if the skull were full of boiling water,t convulsions of the eyes u and mouth,' and a very violent pain in the jaws, as if they would fall off, causing him to put his hands to them; injected eyes, blue face," black lips.x The abdomen was as if full of water.7 The pulse and disposition changed with the intensity of the symptoms; at one time he des paired of life, and then again he was full of hope, now he was perfectly conscious, and again he raved; he wept and sang alternately. He asked for cold water to drink. He was thrice blind during these attacks, and thrice he affirmed death to be at hand. In 7 hours all these symptoms went off. (Mli.) 129. After eating the root, burning and numbness of lips, mouth, throat and stomach, and violent vomiting; also numbness in arms, hands and legs; no power of articulating, uttered only unintelligible sounds. Great muscular debility, inability to stand. Stiffness and difficulty of moving limbs. Though the eyes were wide open the sight was dim; face and throat almost insensible; sometimes nearly unconscious. Body and extremities cold. Frequently pulled at the throat. Recovered after 5 or 6 hours. (Per. 2.) 130. After a drachm of the plant, tightness of chest, pain in stomach, vertigo with obscuration of vision. He got very weak and thought he would die. Vomiting then set in, and he felt relieved and hopeful, though he still complained of a feeling as if something were still in his stomach. Pain in occiput and throat; he commenced to be delirious and played upon a leaf. The delirium soon went off, and he then complained of pains in stomach and head, in his jaws, in his chest, and here and there in his joints, which in 7 hours became more general; the abdomen swelled as if he had dropsy," the flanks were tense, painful, and felt hard, shoots in the kidneys, suppression of urine, an arm and a leg paralysed," pulse intermitting and febrile. After more vomiting and evacuation of the bowels he complained of pressure and coldness in the stomach as if a stone lay there.b At last he got a very painful inflammation of the eyes, with flow of tears,' the pain was so great that he declared he would sooner die than endure it. All the symptoms went off in 8 hours. (Rd.)! I I SArs. Bry. Camph. Cann. Chin. a Plumb. b Bov. 01-an. Phlis. Zinc. c Bell.. 'c. Camn. Clewm. Con. l)M. Graph. Led. lyc. Phof. PATHOLOGICAL ANATOrY. Head. Ma' cE The vessels of the brain and araclmoid injected, with serous effusion under the meninges, and at the base of the brain. (Bd.) The cerebral vessels distended with blood. (Ot. Pn. Pll.) The brain dotted with black points. (Pn.) ANIMALs. The brain and its vessels congested. Rabbit. ((Est. Zeilsch. 1. c., p. 136.) Arachnoid iniected. Rabbit. (Ibid. p. 138.) I.............., -...- \- I I / 1% 10 ACONITUM NAPELLUS. [SYMPTOMS 131 TO 141 Head drawn backwards, 500, 663. Vertigo, 51-65, 128, 130, 500, 674.,, with undulation in brain, 51.,, with staggering, 53, 56, 65., with confusion of head, 57, 778.,, with falling, 85.,, with headache, 60, 61, 677.,, with stupefaction, 59.,, with loss of sight, 62, 130.,, with heaviness of head, 63.,, with nausea, 63, 65.,, with flickering before eyes, 480.,, on awaking, 720.,, when walking, 482.,, when stooping, 52, 53, 61, 63.,, when standing, 54.,, when lying, 55.,, after dinner, 479.,, in a warm room, 59.,, on shaking the head, 62.,, on rising up, 65. in the forenoon, 57. Staggering, 53, 56, 65. it to the right side, 53. Stupefaction, 679.,, with convulsions of facial muscles and trismus, 679. 1 from tobacco smoke, 66. Confusion, 67, 70, 477, 480, 490.,, with headache, 67, 70, 111.,, with heaviness of head, 69, 778. increased by motion, 69. in the morning, 68. in the evening, 70. Heaviness, 63, 68, 71, 479.,, in the forehead, 71, 481, 778. in the vertex, 479, 480, 778. Fulness, 72,, in the forehead, 71, 91, 92. Muddled feeling, 68, 73, 74. Heat, 75, 76, 749, 754, 756.,, on the vertex, 480. Humming, 77. Crepitation, 78. Ntunbed feeling, 79. INDEX TO HEAD SYMPTOMS. HEADACMHE. General, 80-88, 130, 278.,, as if the eyes would be forced out, 81.,, as if the brain pressed out, 82., as if part of the brain were raised, 83., as if bruised, 84., pulsating, 85., shooting, 85.,, as if the head were tightly bound, 35., as if something rushed into thehead,490.,, as if a hot iron were round the head, 678. as if full of boiling water, 128. burning, 128.,, pressive, 466, 750, 751., dragging, 86. as if drawn up by the hair, 87, 88, 136.,, increased by speaking, 80.,,,, by moving eyes, 748.,,,, by motion, 83.,,,, by drinking, 83.,, by speaking, 83. ",, with pain in limbs, 84. Frontal, 89-106, 481, 781. contractive, 89, 97. tight, 90.,, as if the brain would be forced out,91,92. pressive, 93, 94, 126, 243, 478. shooting, 93, 96, 103, 126, 480. pulsating, 93. out-pressing, 95.,, jerkin, 96. squeezing, 99.,, as if a nail were driven in, 104. right, pressive, 340.,, blows, 105. left, pulsating, 105.,, superiorly, pressive, 102.,, above eyes, squeezing, 98.,, pressive, 782.,,,, shooting, 101.,,,, pressive, 101, 150, 340.,,,, out-pressing, 146.,, violent, 106. Frontal, above nose, squeezing, 100.,, on stooping, 92.,, on walking, 93, 100.,, increased by light and noise, 102.,, removed by darkness and quiet, 102.,, in the open air, 100., with feeling of madness, 99, 100.,, with obscured vision, 102. I with nausea, 101. Vertical, 107-110.,, dull, 107.,, pressive, 108, 110, 478, 480., compressive, 108, 109.,, shooting, 110.,, cool feeling, 128.,, increased by stooping, 107.,, relieved by motion, 109. Temporal, 111-117, 477, 483, 780.,, pressive, 111.,, compressive, 112, 114.,, digging, 650.,, shooting, 113, 116.,, throbbing, 113, 779.,, drawing, 114.,, tearing, 115, 117.,, jerking, 116.,, dragging, 86.,, with roaring in ears, 117. Semilateral, 118-121.,, drawing, 118, 119.,, jerking, 119.., shooting, 119.,, tearing, 119.,, compressive, 120, 243, 477., creeping, 121. Occipital, 122-126, 130, 677.,, pressive, 122, 126.,, jerking, 111, 123, 125.,, tearing, 123.,, shooting, 124, 126.,, cool feeling, 128. Congestion of brain, 127, 475. Paralysis of brain, 128, 129, 130. Brain feels larger, 674. REMARKS.-A specific action on the brain is obvious from the symptoms of both this and the foregoing section. There arn indications of conditions varying from slight irritation to paralysis, from slight congestion up to inflammation of the brain and it meninges. S( 131. Shootings in the right temporal muscle. (Sz.) d Berb. 132. Scalp as if swollen and numb.5 (Z.) e Ahnm.Arg-n. Bar-c. 133. Creeping on the scalp, as if from ants," Led. Ran-b. Sabad. ameliorated by heat. (Z.) 134. Painful tickling of the scalp, especially on the top of the head, on touching the hair. (Sz.) cal Ps 135, On the vertex externally an increase of temperature!. (Wvz.) f Daph-in. Eupat 1360. Sensation as if some one drew him lep.Laur.Magn-s upwards by the hair.Y (St.) g Alum. Coloc. Ind 137. The roots of the hair are felt. (Z.) n-m. osur-a Shooting, 131. As if swelled and numb, 132. ('re ping, ameliorated by heat, 133. Tickling, on touching the hair, 134. INDEX TO THE SYMPTOMS OF THE SCALP. Sensitiveness to touch, 780, Sensitiveness of hair, 137. Heat, 135. Soreness of head, 76. As if drawn up by the hair, 87, 88, 136. As if the hair stood on end, 780. a Mercurial. Crotal. 6 Bell. Berb. Brom. Eyelids. 138. Dryness of the upper lids, causing a lid," with feeling of tension, in the morning c Ferr-ac. Sep. pressure on the eyes' (aft. 5 h. H.) especially. (H.) 139. Heaviness of the lids.b (St.) 141. Eyelids convulsively closed as if from 140. Hard, red swelling of the right upper irresistible sleepiness.' (St.) dOlean.heLhuas-t. __ _ __.._____. SYMPTOMS 142 TO 169.] ACONITUOM NAPELLUS. 11 INDEX TO SYMPTOMS OF THE EYELIDS. Heaviness, 139. As if they would close, 64. Involuntary closing, 163, 679, 687. Convulsively closed, 141. Inability to keep them closed, 127. Drawing up, 88. Itching, 148, 781. Burning, 148, 780. Soreness, 781. Upper lids, tension, 140. Upper lids, dryness, 138.,, redness, 140.,, swelling, 140. Eyes. a Aeth. Agar. Agn. Ar,-n. Am. Aur. Bell. Cale-a. & c. Camph.Caps.Carba. Caus. Chin. Cie. Cin. Colch. Con. Croc. Cupr. Cycl. Dig. Dros. Gran. Guai. Hell. Hydrac. Hyos. Igu.Lactv. Laur. Led.Mang. Mez.Nitr-ac.Nuxv.Op.Phos-ac. Pbac. See. Spig.Squil. Staph. Stram. Tab. Thuj. Ver. b Agar. Axr-n. Am. Are. Bel. Calc-a. Camph. Canth. Chel.Chin.Cie.Cin. Cocc.Daph-in.Dig. Dros. Hyos. Ign. Led.Mang.Mur-ac. Natr. Nux-v. Op. Phos. Phos-ac. Pbac. Puls. Rut. Sec. Squil. Staph.Stram. Strych. Tab. Thuj. Ver. c Aur. Bell. Cann. Con. Ign. Phos-ac. Ran - b. Seneg. Staph. d7 e Brom. Clem. f Seneg. Spigel. fg Guai. Par. h Hep-s. Lach. Led. Mang. MAere - s. Spigel. i Card.Guai. Ip.Lah. Magn-c. Nice. Par. 142. Pupils dilated a (immediately. H.) (Bd. Fg. Wo.) 143. Pupils very much dilated. ( W.) 144. Pupils contracted." (Sn. Fg.) 145. Staring eyes (immediately. H.) 146. Pain in the interior of the eye, as if it would be pressed out a when the lids are opened; the pain extends to the supraorbital region and to the interior of the brain (aft. 21 h. St.) 147. Sensitiveness of the upper part of the eyeball on moving it, as if it were pressed out of the orbit, relieved by stooping,d changing into a dull pain on bending back the head. ( z. /8.) 148. Itching and burning in the eyes and lids, making him rub them, the eyes very sensitive to the air,e but not to the light; the eyeballs feel enlarged,' as if coming out of the orbit and stretching the lids.y (Z. 7.) 149. Pressure in the eyes, most felt on looking down or around," with heat in them. (Rkt.) 150. Pressure and burning in the left eye and over the brow. (Hbg). 151. Sensation in the eyes as if they were much swolleni (aft. 5 h. St.) 152, Burning first in the one, then in the other eye. (Wk.) 153. Sensitiveness of the eyes. (WFst.) 154. (Cold feeling of the eyesJ in the open. air.) (H.) 155. Conjunctiva, especially towards the inner canthi, highly injected." (Schn.) 156. Extremely painful inflammation (chemosis'). (II.) 157. Sharp sight.m (H.) 158. Photophobia*- (aft. 6-12 h. H. 159. Desire for light0 (aft. 3 h. H.) 160. Dimness of vision. (Fg.) 161. Cloudiness of sight with giddiness. (St.) 162. Vision as through a veil. (Wst.) 163. Warmth and undulation in the eyes, j Berb. Cale-c. Lye. Mgrt-n. Pimp. Tab. k Arg-n. Eug. 1 Bry. Morph-ac. m Elec. Nux-v. o (?) with involuntary half-closing of the lids, and a feeling as if it were too dark to read in the well-lighted room. (Ar. 12th day. T.) 164. Black spots floating before the sight.0 (H) * " Probably," remarks Hahnemann, "an alternating symptom with the succeeding one, so that both are primary actions." 0 Chin. Coec. LEec. K - carb. Mere - 9. Mooch. Natr- c. Natr-m. Nux-v. lhos. Sulph. Tab. Tcreb. ThuJ. INDEX TO THE SYMPTOMS OF THE EYES. Orbit, pressive tearing pains, 494. Eyes, cold feeling, 154.,, heat, 149, 163., burning, 150, 152. sensitiveness, 153. sensitive to air, 148. pain, 130. pressure, 138, 149, 150, 782. as if pressed out, 146, 147, 148. as if pressed in, 781. enlarged feeling, 148, 151. undulation, 163. shooting pain, 782. bruised pain, 784. injected, 128, 155. Eyes, inflamed, 130, 156.,, chemosis, 156. yellow, 679. fixed, 127, 145, 500, 745. projecting, 127.,, drawn upwards, 127, 663. convulsed, 128, 501, 664. dull, 677, 679. sparkling, 778., glaring, 278. Look, wandering, 500. Pupils, contracted, 127, 144, 745.,, dilated, 142, 143, 650, 677. Flow of tears, 130.,, from cough, 406. Sight, improved, 157.,, dazzled, 678. Photophobia, 158. Desire for light, 159. Flickering, 480. Vision of sparks, 780. Vision of black spots, 164. Objects appear blue, 127. Presbyopia, 480. Obscuration of vision, 62, 102, 127,129, 130, 159, 161, 162, 163,.180, 500. relieved by bleeding, 127. Blindness, 128, 661, 663. REMA.rK.-We here find symptoms indicative of acute inflammation of the superficial and deep structures of the eye, and many of the subjective symptoms indicative of disturbance of the brain. Ears. 165. Sensation as if something stopped up a Aeth. Anac. Ars. the left ear.' (Ahr.) Mez. Tep. 166, Burning, itching and darting in both ears whilst yawning, worse in the evening and in the open air, better after eating. (Wz.) 167. Tickling sensation in the right ear, as if a worm were creeping in." (Ahr.) & Rait 168. Acute stitch in the right meatus externus. (WWm.) 169. Tearing in the left ear. (11bg.) _ -- _ _IL________C~_C_________l_~-~~~~~~-~~IC~ - 12 ACONITUM NAPELLUS. [SYMPTOMS 170 TO 19" Ears. 170. An occasional burning pain in the left ear and upper jaw, whilst perspiring. (H.) 171. Pain behind the left ear, as if from pressure with the thumb. (Hbg.) S 172. Tingling in the ears (aft. 10 m. St.)... 173. Humming in the ears. (Sz.) INDEX TO THE SYMPTOMS OF THE EARS. Heat, 340, 744. Burning, 166, 170. Tingling, 172. As if a worm crept in, 167. Itching, 166, 167. Shooting, 166, 168, 674. Drawing, 504, 674. Tearing, 169. Hissing, 500. Humrmng, 173, 500. Roaring, 780. Increased sensitiveness to noise, 780. As if something obstructed, 165. Deafness, 661, 679. Eustachian tube, prickling, 242. S burning, 242. Behind ears, pressure, 171. REMAriKs.-Most of the ear symptoms are of a secondary character, indicative of cerebral disturbance, but there are a fe, shewing a primary irritant effect on the auditory organs, as well as their external and internal passages. Nose. a(?) 174. Furunculus at the point of the nose." 177. Stupifying compression on the root of (Sz.) the nose.b (St.) b Cann. Hell. Hyo K-bich. Rut. Sep 175. Epistaxis. (H.) 178. Great sensibility of the olfactory nerve, c Agnr. Au. urB176. Blowing of much bright red blood for bad smells have a powerful effect. (H.) Rhc. Colc. CoI several successive mornings from the nose. Tab. (Ar. T./2/8/1.) Face. a Am-c. Ars. Aur. Doll. Bry. Calc-c. Cham. Chin. Cic. Cin. Con. Cupr. Oual. 11cp. K-carb. Lyc.Natr-c.Nux-v. Op. Phos. Rhus. Spigel.Staph.Tcuc. VcoraLt. a Sep. c (?) 179. Countenance pale and anxious. (Fg.) 180. (Puffy swelling of the faces and forehead.b (H.) 181. Pimples on the forehead. (WA-.) 182. Itching pimples on the upper lip (aft. 24 h. H.) 183. Face red and hot. (A. J.) 184, Glowing cheeks. (JWst.) 185. Glowing heat in the face. (A. J.) 186. Face hot, especially in the evening. (A. J.) 187. Cold feeling of the face, though it is hot to the touch. (A. J.) 188. Sweat on the cheeks, whichever side is lain on." (1i.) 189. Sweat on the upper lip, under the nose. (II.) 1900 Pain in the zygomatic process, as if from an ulcer. (Hi.) 191. On the right supraorbital ridge, a shooting pain, branching out upwards over the forehead to the hairy scalp, sidewards to the temple and downwards to the cheek, and into two or three teeth, increased by pressure, and becoming so excessively violent towards evening, when it was accompanied by constant cough, that all other sensations were thrown into the shade; the following day the supraorbital ridge was swollen. (RI. 15th d.) 192. Creeping pains in the cheeks. (H.) 193. Twitchings of the facial muscles.d (A. J.) 194, Pain in the maxillary joint, behind the zygoma, whilst chewing. (H.) 195. Shooting jerks in the under jaw. (H.) 196. Pressure (aching) in the under jaw. (Wz.) 197. Involuntary pressure of the under against the upper jaw," with flow of saliva into the mouth. (Z.) d Ambr. Ant-c. Ars Calc-c. Lye. Nitr ac. Nux-v. Pho Zinc. c Ign. INDEX TO THE SYMPTOMS OF THE FACE. Diminished sensibility, 129. Protopalgia, 191. Tense feeling, 650. Twitchings, 192, 679. Hot. 183, 184, 1A5. 186. 340, 476, 478, 490, 491, 650, 746, 754, 755, 778, 781. One check hot, the other cold, 745. Cold, 187, 674, 730, 777. Sweat, 188. Red, 183, 478, 650, 748, 749, 750, 751, 753, 754, 778, 781. Palo, 102, 179, 650, 674, 677, 678, 739. Livid, 127. Blue, 128, 728. Blue ring round eyes, 677. Turgid, 778. Swollen feeling, 127, 500. I I I~ LI 77 SYMPTOMS 198 TO 212.] ACONITUM NAPELLUS. 13 INDEX TO SYMPTOMS OF THE FACE (continued.) Swollen, 102, 180, 191, 664. Spots like fleabites, 637. Vesicles, 630. Expression, anxious, 179, 678., Hippocratic, 663., of fnght, 663. S of imbecility, 663. altered, 677, 679. Features, sunken, 739. Forehead, hot, 744, 756. S cold, 736.,, pimples on, 181.,, vesicles on, 630. Cheeks, creeping pains, 192. Zygomatic process, ulcerative pain, 190. Jaws, numbness, 674.,, tingling heat, 500., burning, 170., pain, 130., pain as if they would drop off, 128., rigid, (trismus), 127, 197, 664, 679. Lower jaw, shooting, 195.,, jerking, 195.,, pressure, 196, 243. Maxillary joint, pain, 194. Chin, digging pain, 781. Lips, numb, 129, 215, 216, 278.,tingling, 216.,painful, 204.,inflamed, 204.,hot, 780.,burning, 129, 203, 204, 278.,dry, 208. 762, 780.,, distended feeling, 216.,swollen, 217.,black, 128.,blue, 278. Upper lip, pimples, 182., sweat, 189. REnMARcs.-Besides the facial symptoms indicative of febrile action, cerebral irritation and congestion, we have here (~ 191) a very well marked neuralgic affection of the fifth pair of nerves. Teeth. a Ac-fluor. Ambr. 198. Sensibility of the teeth to the open 200. Pressive toothache in the left upper Cale-c.Cin.K-carb. a a(Z) jaw. (V.) K-nitr. Mgt. Mere. Natr-m.Petr.Phos. 199. Shooting pain in various teeth. (VW. 201. Shooting pain in the molars of the ene Sep. Staph. aft. 36 h.) right side.b Sz.) a Lye. 0-an. Staph. Numb sensation, 674. Sensitiveness to open air, 198. Shooting, 191, 199, 201. INDEX TO THE SYMPTOMS OF THE TEETH. Pressure, 200. Grating, 127. Feel falling out, 500. Spasmodically clenched, 500. II Mouth. a Asaf. Bar-c. Carban. Mur-ac. b Anac. Ant-t. Ars. Aur-m.Canth.Crot. Crotal. Mere - v. Merc-c. Verat. 202. Burning of the lips, with sensation of swelling." (Sz.) 203. Burning of the lips and tongue, as if after eating pepper or smoking. (A. J.) 204. The lips and interior of the mouth burning, painful and inflamed.b ( ER.) 205. Coolness and dryness of the mouth, without thirst. (lbg.) 206. Dryness of the interior of the mouth (immediately. H.) 207. Feeling of dryness in the front of the mouth. (H.) 208, Dry sensation, first in the lips, then in the interior of the mouth, with heat mounting from the chest to the head (without redness of the cheeks).* (H.) * " This parenthetical observation," says Hahne 209. Flow of water into the mouth. (A. J.) 210. Increased secretion of clear watery saliva, almost to the extent of ptyalism. (A. J.) 211. Saliva mixed with red streaks,' and sweet taste in the mouth (for 16 days after leaving off the medicine. (Wst.) 212. Soreness of the orifices of the salivary ducts, as if they were corroded." (H.) mann, LL refers to an individual who when in health had generally very red cheeks, which redness was thus homceopathically removed, as Aconito almost invariably produces redness of the cheeks." o Arn. Are. Clem. Itid. Kal - hyd. Magn-c. Nitr-ac. Nux - v. Staph. Sulph. Thiuj. c d ilyos. r Bell. More. INDEX TO THE SYMPTOMS OF THE MOUTH. Numb, 127, 129, 278. Cool, 205. Burning, 129, 204. 278, 287. Painful, 204. Inflamed, 204. Dry, 205, 206, 207, 208, 778. Convulsions, 128, 501. Palate, prickling, 242.,, burning, 242. p dry, 482. Flow of saliva, 35, 197, 209, 210, 220, 221, 242, 480, 481, 674. Saliva mixed with red streaks, 211.,, frothy, 480.,, thick, ropy, 127. Orifices of salivary ducts, sore, 212. - -- 14 ACONITUM NAPELLUS. [SYMPTOMS 213 To 243. Tongue. a Am-c. Am-m. Arg. Bry. Calc-c. Carban. Graph. K-hyd. K -nitr. Magn -. Martig. Mz. Murac. N atr-m. N i tr-ac. Phel. Phoa. Plumb. Sop, Spigel. Spung. b, Ambr. c Con. Di:. Hell. Mere. Strani. d Bar-c. 213. Burning vesicles on the tongue.a (JWst.) 214. Burning in the tongue. (A. J. Stoe.) 215, Heat and tingling, followed by numbness of the lips and tongue." (Fg.) 216. Numbness, tingling, and sense of distension of the tongue and lips. (Fg.) 217. Tongue" and lips swollen. (Rei.) 218. Smarting sensation in the tongue, towards its apex." (St.) 219, Fine penetrating stitches in the point of the tongue. (ti.) 220. Momentary flying stitches in the tongue, with salivation. (Sloe.) 221. Pricking sensation at the back of the tongue, as if from pepper, with salivation. (H.) 222. Cramp-like sensation at the root of the tongue. (Sq.) 223. Sense of dryness and rawness in the middle of the tongue, without thirst. (aft. 1 h. IL) 224. Yellow furred tongue. (Schn.) 225. Transient paralysis of the tongue./ (H.) SBell. Dule. Hyos. Op. Sec. Stram. INDEX TO THE SYMPTOMS OF THE TONGUE. Numbness, 127, 215, 216. "Tingling, 215, 216, 500. Smarting, 218. Rawness, 223. Prickling, 221. Shl(oting, 219, 220. Cramplike feeling, 222. Cold, 678. Heat, 215, 500. Burning, 203, 213, 214, 482, 780. Distended feeling, 216. Swelling, 217. Dryness, 223. Leather-feeling, 482. Furred, 778. Furred, yellow, 224. Vesicles, 213. Paralysis, 225. Loss of power of articulating, 129, 679. Throat. a Agn.Am-cafn.Argn. Bell. Calc - c. Crot. K-bich. Mercuritl. b Am. (1) Crc. (I) Mere. (!) san. (') e Chin-. d Ctar-v.(lin. Natr4. Nux - v. 'aul. e ( ilco. silt Sll. d4 \ 1. L., r-r f Ar.n. Alum. lcll. K -hich. 226. Redness of the soft palate and uvula.a (i Wk.) 227. Scraping in the throat with difficulty of swallowing. (St.) 228. Scraping sensation, ceasing on clearing the throat. (JWm.) 229. Drawing from the side of the throat to behind the ears. (St.) 230. A shooting, choking sensation in a small spot on the left side of the throat, worse when swallowing and speaking, but felt also when at rest. After - of an hour it passed into the right side, while the pain in the left side ceased; it remained there ~ of an hour and then went away entirely. (St.) 231. Fine darting sensation at the back of the throat, as from the hair of a dog hipb (aft. 1 h. H.) 232. Creeping in the gullet. (H.) 233. Burning and fine shooting pain in the fauces. (H.) 2314. Burning in the glottis and gullet. (Pll.) 235. Warmth and constriction of the gullet. (A. J.) 236. Heat in the gullet. (Ikc.) 23'7. Contractive sensation in the back of the throat, as if from astringent substances. (H.) 238. Transient pressure and tension in the soft palate and fauces, as if these parts were swollen. (Z. Wst.) 239. Pressive sore throat, especially during empty deglutition. ( Jk.) 240. Feeling of dryness, as if something had stuck in the throat.e (Sz.) 241. Dry feeling in the palate and posterior nares. ( 7Wm.) 242. Uvula swollen " and elongated,e the fauces and pharynx injected dark red,r feeling as if an angular many pointed body were sticking in the throat,5 prickling burning in the palate, throat and along the Eustachian tube, increased by swallowing; these symptoms are accompanied by oppression of the chest, headache, increased flow of saliva. The throat symptoms were increased by walking in the open air, and were relieved after eating. (Wz.) 243. After a considerable quantity of the Tinct. taken for several successive days the chief symptoms were: Sore throat, which commenced soon after taking the medicine, its pain was shooting combined with a sensation of swelling in the throat. It lasted all day. It felt as if an angular many pointed body stuck in the throat; the uvula was swollen,d elongated,' and together with the palatial arch and back of the fauces much injected of a dark red colour.t During the day there were always occasional attacks of very annoying and painful pressure in both sides of the head, in the frontal region, on the lower jaw, and most constantly and severely in the right shoulder and right upper arm; a sensation of fatigue and heat in the chest; frequent sighing; attacks of anxiety; sometimes dry cough and contractive shooting pain in the right side of the chest. In the open air heaviness and stiffness of the limbs, especially the lower ones; tired feeling on moving; painfulness of the loins on stepping strongly; several times when heated sudden attacks of constrictive pain in the region of the gall bladder that took away the breath.h Every forenoon, some hours after taking the medicine, there was an increase of the sexual feeling, which however soon went off. After eating, feeling of cold,' exhaustion, sleepiness; increase of heat at night; frequent g K-bich. h 7 i Graph. Nux - v. Sulph. Ii II ii YMPTOMS 244 TO 265.] ACONITUM NAPELLUS. 15 Thro tossing about in bed; sleep much disturbed, full of vivid dreams that remained long in the memory. Occasionally sensation of itching, prickling, burning and scratching in the skin. (Wz.) PATHOLOGICAL ANATOMY. ANIMULS. Axui~ts. The parietes of the fauces shewed red spots, and the oesophagus was traversed by injected bloodvessels. (Rabbit. Oest. Zeit. 1. c., p. 136.) ulling at, 129. imimshed sensibility, 129. umbness, 129, 278. ain, 130, 781. ressure, 238, 239. ension, 238. ontractive sensation, 237. onstriction, 127, 235, 480. wollen feeling, 243, 480. zraping, 227, 228, 272, 480. )rawing, 229. rickling, 242. INDEX TO THE SYMPTOMS OF THE THROAT. Shooting, 230, 233, 242. Uvula, swollen, 242, 243. As if the hair of a dog-hip had stuck there, 231,, elongated, 242, 243. As if something stuck there, 240, 242, 243, 674.,, red, 226, 243. Burning, 129, 233, 242, 278, 676, 678. Tonsils, red, 780. Dryness, 240. Fauces, dry, 674. Hawking of phlegm, 265, 674., red, 242, 243, 780. Difficulty of swallowing, 227. Posterior nares, dry, 241. Choking, 230. (Esophagus, creeping, 232. Soft palate, pressure. 238.,, warmth, 235, 236.,, swollen feeling, 238.,, burning, 234, 287, 663., dry, 241.,, dryness, 476. red, 226,243,780.,, constriction, 482. REnMARKS.-Here we have well marked symptoms both objective and subjective of acute inflammation of the mucous memrane of the soft palate, tonsils, fauces, pharynx, and cesophagus. 244. Bitter taste in the mouth. (H.) 245. Insipid fishy taste, as if from stagnant, putrid water." (H.) 246. It seemed to her as if her mouth filled with air having the taste of rotten eggs.b (St.) aste. 247. Sourish taste with want of appetite. (St.) 248. Insipidity of things that formerly tasted strong and good. (St.) Am. Brom. Magnm. Petr. Sep. Stan. Sulph..weet, 211, 265, 674.,our, 247. 3itter, 244, 477. 'epper, 479, 674, 678. INDEX TO THE SYMPTOMS OF THE TASTE. Insipid, 245. Putrid, 245. Insipidity of food, 248. Rotten eggs, 246. Nauseous, 674. Fishy, 245. Appetite. 249. Anorexia. (H.) 250. Long-continued anorexia and disgust. (H.) 251. Loathing at food, and squeamishness (aft. - h. H.) 252. Uncommon good appetite. (Wst.) 253, Great thirst. (Wk. /1. c.) 254. Thirst for beer,a which lies heavy on the stomach. (H.) 255. Whilst eating severe pressure in the stomach, as if he had eaten something indigestible, with feeling of warmth and tenderness in the pit of the stomach.b (Wst.) b () 256. After a meal, uncommon sleepiness. (St.) 257. (Hiccough after eating0 and drinking.) o nov. Cycl. 0raph. Grat, H11ep. Hlyos. ^(H. ) Ind. Lyoe Natr-m. 258. After taking warm soup, many of the Phoi.Sulph. Thuj. abdominal symptoms are relieved. (Z. Wst.) SPuls. Rhus-t. Spigel. Sulph. Increased appetite, 252. Loss of appetite, 247, 249, 679, 778, 779, 780. INDEX TO SYMPTOMS OF THE APPETITE. Thirst, 253, 476, 477, 638, 754, 778. Thirst, after vomiting, 277. 250, 288, 476, 482,,, for beer, 254. Stomach. 259. Nausea. (Z. Wst. Fg.) then under the sternum, lastly in the throat 260. Nausea and sinking in the pit of the without flow of saliva. (H.) "a Car-an. Car. Hep. stomach, worse while sitting," almost entirely 203. Nausea, as if after eating some disab Grat. removed by walking1 (immediately). (St.) greeably sweetd or fate substance (aft. 1 h. HZ.) d Mre. 261. Nausea whilst walking in the open 264. Nausea, relieved by eating.r (A. J.) bromn. aan-b. o An -v. Mez. Gum- air.0 (H.) 265, Nausea, with sweet taste in the mouth g. ed. Petr. 262. Nausea, first in the pit of the stomach, and hawking of phlegm. (Wst.) _ F I 16 ACONITUM NAPELLUS. [SY~ rToMS 266 TO 290. Stomach. g irl. Orat. Hyos. K -carb. K -chl. Many. M.gt. Nux-v. O1. ruit. Sars. Zinc. hs Bar-c. Natr-c. Pbac. sulpli-ac. i Cina.Coff(?)Crorc.?) Sabail. Sang. (1) k Plumb. I Are. Nitr. im Sulph-ac. 7 Am-rm. a Cnnth. p Ant-t.ClIin-.a.Cupr 1Iyoq. Plhos. Strain. Itrych. 266. Feeling of emptiness in the stomach. (Wst.) 207. Empty eructation. (St.) 268, Ineffectual attempts to eructate, the inclination is felt, but it cannot be done.9 (H.) 269. Eructations with taste of the medicine. (Z. Rg.) 270, Rising of sweetish water,h like waterbrash, with noise in the ears. (St.) 271. Rising of sweetish water," with nausea. (St.) 272. Scraping from the scrobiculus to the throat, with nausea and sinking in the pit of the stomach, as if water were about to flow into the mouth. (St.) 273. Vomiting of lumbrici.' (G'g.)* 224. Vomiting of greenish-grey watery fluid" twice. (W1. 3rd d.) 275,. Vomiting of mucus mixed with blood,' S3 or 4 successive days. ((G. t) 276. Vomiting of bloody mucus,' followed by great perspiration. (Gg. t) 277. Vomiting, followed by violent thirst."" (Mor.) 278. After eating the root, in - of an hour, numbness and burning of lips, mouth and throat, soon extending to stomach, and accompanied by vomiting, at first of food then of frothy mucus." The vomiting was very violent and lasted incessantly for an hour. Extremities cold but chest warm; head bathed in cold sweat; eyes glaring. Violent headache; great trembling. Lips blue;p mental faculties perfect. He expired in a fainting state. (Per. 1) * This symptom occurred in a patient. We should not have retained it wore it not that it has been corroborated by several practitioners at the bedside. Thus Schrin remarked, that when given to children in inflammatory disorders, Aconite often brings away lunbrici. (Ilygea II, 415.) The same author observed in a patient affected with pleurisy, repeated vomiting of lumbrici after Aconite. (Iyg. V, 99.) Maly records the case of a child with a febrile affection, who vomited 21 lumbrici after a dose of Aconite; (H.qg. iXV1I, 50;) and another of a woman affected with cough, who was cured by Aconite, which caused the ejection of 2 lumbrici. (Hyg. XVIII, 505.) t From a patient. From a patient. 279. Pressive pain in the pit of the stomach, changing into constriction of the chest (aft. 2 -h. H.) 280. Pressure in the pit of the stomach as from a stone there, going through to the back, with a squeezing sensation as from a strain; stiffness. (St.) 281. Pressive pain in the pit of the stomach, whilst sitting, walking and standing. (Ahr.) 282. Pressive pain in the stomach, as if from a weight (after 14 h. H.) 283. Pressive stomachache. (Hbg.) 284, Pressive, tensive pain, as if from fulness or an oppressive weight in the stomach and hypochondria (aft. 14 h. H.) 285. Pressive and swollen feeling in the pit of the stomach." (Sz.) 286. Pressure in the stomach, with splashing in the bowels.' (UWl. 5-10 d.) 287. Burning feeling from the stomach up through the oesophagus to the mouth.' (TVl. 3rd d.) 288, Pain in the pit of the stomach, as if it were swollen externally," with attacks of anorexia and dyspncea. (H.) 289. Contractive feeling in the stomach, as if from some astringent substance.t (HI.) 290. Warm feeling in the stomach. (Z. Fg.) p Mercurial q Crot.K-carb.Mang. Natr-m. Nux-v. Poth. r Brom. Ntxu-v. s Bry. Natr-m. t C) PATHOLOGICAI- ANATOMY. Stomach. MAN. The distended stomach contained a moderate quantity of a viscid dark green matter; its mucous membrane had irregular patches of red on it in several places, especially at its fundus and large arch. (Bd.) The stomach was beset with black gangrenous spots. (Ot.) In the stomach traces of considerable congestion. (Pn.) ANrIMALS. The whole inner surface of the stomach, with the exception of the cardiac and pyloric orifices, inflamed. In a dog. (Wepfer, Hist. cic. aquat. &c. p. 175.) lfeat. 255, 290. urning. 129, 278, 287. n( ' dT s. 130. N umbness. 129. Pain, 130. 4163. Sjnimslic pain, 675. Pressure, 255. 2'2. 283, 27.4, 286. Feeling as if a weight lay there, 130, 282,,'Iso. Tihlit feeling, 171. (rntractive feeling, 28)9. Tewhrness, 25.5 417t. INDEX TO THE SYMPTOMS OF THE STOMACH. Emptiness, 266. Scrobiculus, swollen feeling, 285, 288. Fulness, 284. From stomach to back, pressive pain, 280. Swelling, 479. Sinking, 63, 260, 272, 340. Rising and falling, 479. Nausea, 127, 259-265, 271, 272, 480, 674, 679, Scrobculus, pulation, 302. 746, 774, 778, 780, 781., burning, 302, 483. Nausea, as after eating fat things, 263.,, pressive pain, 279, 280, 281, 285,,, with vertigo, 63, 65. 281, 476, 483, 778. Eructations, 480, 481. shooting, 302.,, ineffectual attempts at. 268., scraping, 272., empty, 267, 476, 479, 480, 781., feeling of a ball, 128.,, with taste of the drug, 269. S as if a stone lay there, 280.,, fetid, 246, 674. i - -..-.. - ---- YMPTOMS 291 TO 324.] ACONITUM NAPELLUS. 17 INDEX TO SYMPTOMS OF THE STOMACH (continued). isings of sweet water, 271. eartburn, 463, 679. iccough, 257. omiting, 129, 130, 273-278, 500, 679, 774. 663, 676, Vomiting of food, 278, 678.,, of mucus, 678. S of frothy mucus, 278. S of bloody mucus, 275, 276., bilious, 127, 128, 501. Vomiting of green water, 274.,, of green masses, 677.,, of black matter, 501.,, of fetid matter, 501.,, of lumbrici, 273. REiMmxs.-Though the majority of the stomachic symptoms are of a secondary character, such as accompany cerebral disirbance, febrile action, and derangements of other organs, some shew a specific action on the mucous membrane itself, and the power f Aconite in this way is corroborated by the results of post mortem examinations as given above, where we find evidence of inflamlation, and even gangrene of that part. Abdomen. Dig. Euphor. Ign. Ran-b. Val. SAn. Bar-c. Chel. Gent. Grat. Kal-c. Mosch. Natr - c. Plumb. Tab.Tereb. Berb. Bov. Calc-c. Canth. Carb-v. Crotal. Kal-c. Kalhyd. Lach. Magn-s. Merc-s. Natr-c. 01 -an. Phos-ac. Plat. Plumb-ac. Raph. Sep. Asaf. Lam. Mere. Natr-m.Puls.Thuj. Zinc. 291. Pressive pain, as from a weight in the hypochondria (aft. 11 h..) 292. Feeling of violent constriction in the hypochondria.a (..) 293. Stitches in the liver and bowels, as with needles. (Sz.) 294. Pressure in the hepatic region, obstructing respiration, followed by (pinching) bellyache above the navel. (H.) 295. Violent jerks in the hepatic region," taking away the breath. (Hbg.) 296. Shooting in the spleen whilstwalking. ( W. /1.) 297. A sharp stitch under the ribs on the right side, on laughing. (St.) 298. Dull stitches under the ribs of the left side, on inspiring. (St.) 299. Pains in the epigastrium, with ineffectual straining at stool. (A. J.) 300. Retraction of the navel,d especially in the morning, before eating. (H.) 301. Burning in the umbilical region." (H. W7.) 20.2 Burning sensation in the' umbilical region, which rapidly traversed it and spread towards the scrobiculus cordis, with anxious pulsation' and shooting there; after a short time came a rigor over the whole body, whereupon the hot feeling and the pain left (aft. 1I h. St.) PATHOLOGICAL ANATOMY. Abdomen. ANIMALS. The liver blackish red, the gall bladder distended with bile. In a dog. (Wepfer, 1. c.) The liver large, with dark red spots penetrating into its substance. In a rabbit. ((Est. Z. 1. c., p. 136.) The liver congested, in some parts friable. In a rabbit. (Ibid. p. 137.) The surface and all the parenchyma of the liver covered with red spots, its substance friable, very full of blood, as if granulated. In a guinea-pig. (Ibid. p. 139.) Liver dark brownish red, friable. In a dog. (Ibid. p. 142.) 303. Pinching sensation in the umbilical region. (St.) 304. Compression of the navel, followed immediately by intermitting pressive jerks E in the navel. (St.) 305. Clawing and scraping in the umbilical region. (St.) 306. Pinching in the umbilical region as if from nausea, followed by slight diarrhoea. (WlT.) 307. Drawing bellyache on both sides of the navel, also excited by leaning forwards. (H.) 308. An unpainful feeling above, and to the left of the navel, as if something cold h (a cold finger) were pressing from within outwards. (St.) 309. Flatulent colic in the hypogastrium, as if from having taken a purgative. (H.) 310. Drawing from the left side of the hypogastrium towards the back, with pain on pressure. (St.) 311. Transient colicky pain. (Z.) 312. Burning in the abdomen. (Pil.) 313. Colicky, distensive, stretching and pressive pains in the belly as if from flatulence. (H.) 314. Gripes with swelling of the belly, relieved by expulsion of flatus. (A. J.) 315. Pains in the belly, as if from flatulence. (WT. Sz.) 316. Drawing pains in the bowels here and there. (Z.) 317. Dartings in the bowels as if from needles. (Sz.) 318, Intolerable (cutting) pains in the belly, with tossing about in bed and cries, in the morning (aft. 16 h. H.) 319. Sensitiveness of the abdomen to the touch, as if from slight peritoneal inflammation.J (Ti. 6th d.) 320. Sensitiveness of the hypogastrium to the touch. (IH.) 321. Rumbling and grumbling in the abdomen all night. (H.) 322. Rumbling and grumbling in the abdomen, with sensation of rawness. (St.) 323. Grumbling fermentation in the abdomen. (H.) 324. Rumbling and gurgling in the abdomen, relieved by the expulsion of flatus. (Z.) g Berb. h Phos. (1) Rat. (1) Ruta. lTcrcb. i Nux-v S(0) k Natr-c. c II _____-_ - ___._ __ _ _ 18 ACONITUM NAPELLUS. [SnYPTOMS 325 To 336 Abdomen. I Natr-c. Plumb-ac. m hor. Brom. Magnm. Olean. Phos. 325, Rumbling and gurgling, with shooting and contractive pains here and there in the abdomen. (Z.) 326. Gurgling in the abdomen with itching in the rectum, provoking scratching and call to stool. ( Wst.) 327. The recti abdominis stretched, as hard as a board.' (Schn.) 328. Weakness of the bowels," as if from the abuse of purgatives. (H.) PATHOLOGICAL ANATOMY. Abdomen. MAN. (Esophagus, stomach and intestines very red and inflamed. The bloodvessels, especially the veins of the intestines, very much distended: the inflammation stopped at the ccecum, the mesentery was very much inflamed, there was much serum in the peritoneal cavity. (Pll.) The duodenum and other small intestines contained a quantity of viscid dark green matter, and had on their mucous membrane irregular red patches. (Bd.) ANIMALs. Almost all the inner surface of the intestinal canal inflamed; the abdominal veins distended with blood. In a dog. (JWepfer, 1. c.) Abdomen much distended; on the inside of the peritoneum, injection of the bloodvessels. In a rabbit. ((. Zg. 1. c., p. 137.) Vessels of the peritoneum and mesentery distended with blood. In a rabbit. (OE. Zg. 1. c., p. 138.) The parietal and intestinal peritoneum injected in an arborescent manner. In a guineapig. ((. Zg. l.c., p. 139.) Arnold's experiments on frogs shewed a congested state of the vessels of the stomach, bowels and liver. (Hygea xxi, p. 1.) INDEX TO THE SYMPTOMS OF THE ABDOMEN. Weakness, 328. Swollen feeling, 128, 313. Swollen. 130, 314, 463, 679. As if full of water. 128, 130. Painful to touch, 319, 463. Pain, 385, 478, 764. Violent Ipain, 664. Tightness, 677. Stretching, 313. Contractive pain, 325. Shootings, 293, 317, 325. Drawing. 316. Cutting. 317, 534. Colicky pains, 311, 313, 314, 481. Pain as from flatulence, 313, 315, 531. Rawness, 322. Burning, 312. Coldness, 729. Borborvgmas, 321-326, 340, 478, 677. S ashmin, 286. igastrum, pain, 299. ypochondria, pressure as from a weight, 284, 291. of constriction, 292. Hypochondrium, right, shooting, 297. Liver, stitches, 293, 480., pressure, 294., jerks, 295. Gall bladder, constrictive pain, 243. Hypochondrium, left, shooting, 298. Spleen, shooting, 296. Umbilical region, compression, 304.,, out-pressure, 308.,, pinching, 294, 303, 306, 363, 782.,, clawing, 305. Umbilical region, scraping, 305.,, drawing, 307.,, jerks, 304.,, burning, 301, 302, 751. cold, 308. Retraction of navel, 300. Lumbar region, tense, 130.,, pain, 130.,, hard, 130.,, right, pinching, 480. Hypogastrium, flatulent colic, 309.,, drawing, 310.,, painful to pressure, 310, 320. Abdominal parieties, stitches, 463. Muscles of abdomen, hard, 327, 518.,, drawing pain, 518. REMARKS.-The mucous membrane of the alimentary canal, and also its peritoneal coat, shew decided signs of inflammatory action in the living and the inspection of the dead corroborates this. The liver is also peculiarly acted on, and the extent to which it is involved may be judged of not only by the pains in the organ itself, but also by the symptomatic signs of its derangement in the excretions and skin. (Vide SS. 342, 343, 619.) Rectum and Anus. % r\0 --.", r p.Ciarb-Tv. l,,d \fit h'liml,-i,. "'vp "nit, stlllph-AC. e Am-,. r nl1. Tr. Charn. (hin. Cip r. flirt. r -rr. oit. rllan r. Stram. 3329, Pain in the rectum (aft. 1 h. IT.) 330,. Burning feeling in the hemorrhoidal vessels. ( Wi. 4 d.) 3*11. Itching* and pressureb in the hmmorrhoidal vessels. (Z.) ":T33 Shootings and pressure in the anus. (H3. Bleeding morrhoids.) 33;. Bleeding bhmorrhoids.' (H.) 334. Sensation as if a warm fluid were escaping from the anus.d (m.T. /8/1. Z.) d (?) 335, Frequent itching in the rectum, with discharge of white," hot mucus for 16 days e Bor. Coff. Stan. after leaving off the medicine. (Wst.) 336. Transient paralysis of the anus,r invo- I Bell. luntary evacuation. (HI.) [K SY31PToMs 337 To 363.] ACONITUINI NAPELLUS.~US 19 INDEX TO THE SYMPTOMS OF THE RECTUM AND ANUS. Rectum, itching, 326, 335.,, pain, 329. S heat, 334, 335. Anus, shootings, 332, 480.,, pressure, 332. Anus, feeling as if a warm fluid came away, IlHmorrhoidal vessels, burning, 330. 334.,,,, itching, 331.,, discharge of mucus, 335.,,,, pressure, 331.,, paralysis, 336. Hemmorrhoids, bleeding, 333.,, cramp-like contraction, 412, 480. REMARKS.-The specific action on the haemorrhoidal vessels here evinced cannot fail to remind the practitioner of the utility of Aconite in acute hoemorrhoidal attacks. Evacuations. a Cocc. Plumb-ac. Staph. Sulph. Zinc. b Aeth. Alum. Ars. Bell. Caps. Caus. Coloc. Gran. Grat. Gum-g. Lauroc. Mag-n-c. Magn-m. Mere-c. Mur-ac. Nic. Phos. Scnn. Sulph. Tab. Tax. Zinc. Zinc-ox. 337. Very hot flatus (aft. 9 h. H.) 338. Thinking to discharge merely flatus, there occurs an unexpected evacuation of thin fieces (aft. 4 h. H.) 339. Looseness of the bowels. (Wst.) 340. After two drops, great sleepiness, spasmodic yawning, and the following day in the morning a hurried call to stool, when a copious soft motion was passed with straining.b On repeating the dose, intense yawning without sleepiness, great laziness and feeling of sinking in the stomach, painful rumbling in the bowels and discharge of flatus with relief. Call to stool and copious evacuation, followed by tenesmus. The next day dry cough and loose motion. Another experiment only occasioned slight pressive headache in the right frontal protuberance, spreading towards the orbital border, with flushes of heat, chiefly felt in the face and ears. (Hk. d.) 341. Soft, scanty stools, 3 or 4 times daily, accompanied by straining." (H.) 342. White colour of stool. (H.) 343. White fieces and red urine. (H.) 344. Watery diarrhcea. (H.) 345. Hard evacuation, a few hours earlier than usual, requiring a great effort. (H.) 346. Hard stool with effort. (Hbg.) 347. Very hard ficces. (Sz.) 348. Constipation for several days. (N.) c Agar. Am. Asuar. lill.Di. IIp.lod. Merc. I'ih..luiosac. Plumb. INDEX TO THE SYMPTOMS OF THE EVACUATIONS. Constipation, 348, 494. Difficult, 345, 346. Involuntary, 127, 336, 338. Call to stool, 326.,, hurried, 340. Diarrhcea, 306, 340, 344, 478, 677, 782. Tenesmus, 299, 340. Stools, hard, 345, 346, 347.,, soft, 339, 341., thin, 338, 478.,, watery, 344, 478, 481., white, 342, 343, 370. Stools, black, 663.,, green, 677.,, fetid, 478, 663. Sscanty, 341. Flatus, 314.,, hot, 337. REMAInx.-The evacuations plainly demonstrate the character of the disturbance in the gastro-intestinal system. SS. 342, 343 are evidently connected with S. 625, which seems to have been a case of hepatic disturbance somewhat similar to that of S. 679. I 11 Urinary Organs. a (7) b Nux-v. Pula. SArnm. d (?) a Ign. f K-bich. Sulph. g Bell. Canth. Hyos. Lauroc. 349. A slight sensation of splashing in the bladder while making water. (St.) 350. Pain in the bladder whilst walking (aft. 4h. H.) 351. Burning in the neck of the bladderb when not urinating. (H.) 352. Tenesmus of the neck of the bladder (aft. 4 h. H.) 353, Dull burning in the fossa navicularisd (S.) 354. Single momentary shootings in the urethra whilst walking." (Z.) 355, Shooting and pinching pains in the glans penis whilst urinating.' (H.) 356. Temporary paralysis of the neck of the bladder, involuntary emission of urine. (H.) 357. Frequent urination. (Z. Tst.) 358. Frequent urination; the urine con tains many flocksh and strings of mucus.' 1 nhi-t. (Stoe.)" i',*e. 359. Painful call to urinate, frequent discharge of limpid urine. (St.) 360. Increased discharge of urine, which deposits blood on standing.) (I.) j Carb-an,. sillis-uc. 361. Desire to urinate on touching the abdomen.k (I.) k (I) 362. Anxious desire to make water' (aft. I chan.,. Cirapi. 4 h. 11.) 363. Desire to make water, the urine is uncommonly scanty, is discharged with difficulty, as if it could not escape well, but without pain, with slight pinching in the umbilical region (from the smell of the tincture. St.) "* From a rheumatic patient. 1 --ze II 20 ACONITUM NAPELLUS. [SYMPTOMS 364 TO 388 Urinary Organs. m Camph. Cab - v. Daph. Dulc. Elec. ad. Mosch.Nux-v. Sulph-,ac. Veratrin. n Alun. Am-rn. Bor. Bry. Calend.Canth. Car b-an. Mez. Kreos. Lact -v. Prun -up. Rhod. Rhus-t. 85L Squil. Stram. o Ambr.Arn.Camph. Colch. Kreos. Lactv. Merc-s. Ntr-ac. Petr. Phos. Plumb. Serp. Val. p An. Aur-m. Chin. Chin-s. Cinch-s. Gins. Ipec. Natrm.Natr-s.Op.Phos. Puls. Thuj. 364. Urine passed with anxiety. (Wfl.) 36.5. Urine passed with difficulty (dysuria) (aft. 12, 18 h. HI.) 366. Scanty discharge of urine. (Sz.) 367. Urine thickerm and hotter," its discharge is attended by burning in the urethra. (WV. 3rd d.) 368. Urine brown,0 passed with burning sensation, with brick dust deposit.P (HI.) 369. Urine dark coloured. (Sz.) 370. Red urine q and white faeces. (H.) 371. Urine much clouded. (WL.) PATHOLOGICAL ANATOMY. Urinary Organs. MAr. The kidneys congested, bladder empty. (Bd.) g Ant-t. Ars. Bel Berb. Campt Canth. Carb - Chin-s. Colch. Cor Ham. lod. Ipec Mere-s. Merc-c Nitr. Phos. Pla Plumb. Puls. Bar Sel. Staph. Sulpl Tereb. Thuj. Ton Veratrin. INDEX TO SYMPTOMS OF URINARY ORGANS. Kidneys, shooting, 130. sensitiveness, 527. Bladder, splashing, 349.,, pain, 350. Neck of the bladder, burning, 351.,, tenesmus, 352.,, paralysis, 356. Fossa navicularis, bmnuing, 353. Urethra, shootings, 354, 480. burning, 367, 368, 482, 782. Call to make water, urgent, 363.,, anxious, 362, 364. Call to make water, painful, 359. to on touching abdomen, 361. Discharge of urine, frequent, 357-360.,, difficult, 363, 365. Involuntary discharge of urine, 127, 356. When making water, splashing in bladder, 349.,, pain in glans penis, 355, 780.,, pain in umbilical region, 363.,, burning in urethra, 367, 368, 482, 782. Urine, suppressed, 130, 482.,, scanty, 363, 366.,, increased, 360, 774.,, hot, 367, 780. turbid, 367, 371. dark, 369, 780. red, 370, 482, 778. brown, 368, 478. containing flocks, 358. containing strings of mucus, 358. Urinary deposit, brick dust, 368.,, dirty brown, 478. REMARKS.-Besides the urinary symptoms indicative of gastro-intestinal and hepatic derangement, we find a well-marke action on the mucous membrane of the urinary organs, amounting to great irritation, if not inflammation, of the bladder and urethra The kidneys seem likewise to be acted on directly. Genital Organs. a Phel. b Ang - v. Euphr. Mang. Spong. c (1) d Cann. Pctr. e Arg. Calc-c. Clem. Coce. DMg. Nntr-c. Nitr -ac. Ithd. Sahil. Sabin. Spong. Thul. 372,. Itching in the prepuce, relieved by rubbing,0 but soon returning (aft. 3 d. WV.) 373. Voluptuous itching in the glans penis.b (&.) 374. Slight, not disagreeable creeping in the genitals.e (St.) 375, Retraction of the scrotum.4 (Z.) 376. Simple pain in the testicle, like that caused by a bruise, (aft. 2 h. H.) 377. Bruised pain in the testicles." (Sz. T17.) 378. Fits of lasciviousness. (St.) 379. Greatly increased sexual desire, quickly alternating with an opposite state. (St.) 380. Frequent erections, with increased sexual desire. (Z.) 381. Diminished sexual desire. (H.) 382. Metrorrhagia. (H.) 383. The catamenia which had ceased the day before commencing the medicine, break out anew (aft. { h. St.) PATHOLOGICAL ANATOMY. Genital Organs. ANILu.s. Spermatic cord and testicles injected. In a rabbit. (ME. Zg. 1. c., p. 136.) INDEX TO SYMPTOMS OF THE GENITAL ORGANS. Genitals, creeping. 374. itching, 632. Prepuce, itching, 372. Glans penis, shooting, 355, 780.,, pinching, 355.,, itching, 373. Testicle, bruised pain, 376, 377. Scrotum, itching, 779.,, retracted, 375.,, perspiration, 779. Sexual desire, increased, 243, 480,780. 378; 379, 380, Sexual desire, diminished, 379, 381. Erections, frequent, 380. Recurrence of catamenia after their cessation 383. Metrorrhagia, 382. S REIA.RKs.-Naturally is the symptom of bruised pain in the testicles that occurred in several of the provers. SYMPTOMS 384 TO 414.] ACONITUcM NAPELLUS. 21 Nasal Mucous Membrane. 384. Frequent violent sneezing. (Z.) 385. Frequent violent sneezing, with pain in the abdomen. (St.) 386. Interrupted sneezing from pain in the left side of the chest. (St.) 387. Dryness of the nose. (Z.) 38S. Sensation as if coryza were about to commence. (WVst. ML.) 389. Flow of clear fluid from the nose." (Z. TVst. Sz.) 399. Violent coryza. (S. USt.. TTk.) 391. Attack of catarrh and coryza (between 8 and 12 h. H.) a Am-rm. Coff. Grat. G;uii. Mgt-n.Phos. Siiph. INDEX TO SYMPTOMS OF THE NASAL MUCOUS MEMBRANE. Sneezing, 384, 385, 479. Baulked sneezing, 386. Dry, 387. Feeling of coryza, 388, 479. Coryza, 390, 391, 777, 782.,, fluent, 483. Coryza, with fever, 777, 7S2. Discharge of clear fluid, 389. REMNARKS.-We have here evidence of coryza, and not a few examples of regular catarrhal fever. Larynx and Trachea. a (1) b 01-an. Puls. c An. Carb-v. Dig. Kreos. Lact-v. Natr-m. Sulph. d Am-caus. Ant-cr. Ant-t. Bar-m.Cann. Crotal. Daph. I-ep. Lam. o (1) f Am-caus.Ars.Phos. g Pctr. h (1) 392. Sensitiveness of the larynx to the inspired air, as if its mucous membrane were divested of its covering.a (Z.) 393. Sensation as if the larynx were compressed on both sides." (Sz.) 394. Tickling in the larynx from smoking tobacco. (I/7.) 395. Hoarseness in the morninga (aft. 8 h. H.) 396. Very weak voiced (Fg.) 397. Sensation of numbness in the trachea, under the sternum." (aft. 8 h. Hr.) 398. Raw feeling in the throat, along the course of the trachea, provoking frequent short cough. (Sz.) 399. Short cough. (H.) 400. Cough after drinking.' (I.) 401. (Cough during the heats. H.) 402, Severe cough from tobacco smokes (in one accustomed to smoke. H.) 403. He (though accustomed to smoke) cannot smoke without constantly hemming and coughing, either because the epiglottis permits the entrance of smoke into the larynx, or because the glottis is more sensitive than usual (aft. 6 h. H.) 404. Cough from irritation in the larynx, with expectoration of gelatinous mucus.h (Z.) 405, Short cough from a tickling in the larynx, after midnight,1 every half hour; the more it is'attempted to be repressed, the more frequent and severe it becomes. (H.) 406. Cough bringing tears into the eyes.3 (Jk.) 407. Tussiculation from a tickling at the top of the larynx k (immediately. II.) 408. Hoarse,' dry loud cough. (11W.) 409. Violent dry cough, whereby a little fluid is brought into the mouth, of a sweetish m salt taste like blood. (Z.) 410. Hcemoptysis. (HI.) 411. On coughing, pain in the larynx. o ( rk.) 412, Violent dry cough, with cramplike contraction of the anus.P (Z.) 413. Morbid condition (attacks of paralysis?) of the epiglottis, food and drink easily pass into the windpipe on swallowing,2 threatening suffocation and causing cough.' (II.) 414. Easy choking whilst swallowing saliva. (St.) PATHOLOOICAL ANATOMY. Larynx and Trachea. ANrIALs. Mucous membrane of the trachea much injected. In a rabbit and guinea-pig. (UE. Zg. 1. c., pp. 138, 139.) i Ars. j Cin. Puls. A Caps. Carb-a. I Calc-c. Caus. Cinn. Natr-m. tain. an Lauroc. Sulplh n Lyc. Sep. 811. Stan. o (0) P (1) q Kal-c. Natr-m. P'hol. lhus. qr Nitr. INDEX TO SYMPTOMS OF THE LARYNX AND TRACHEA. Larynx, sensitive to air, 392. compressed, 393. tickling, 394, 405, 407, 476. irritation, 404, 480, 483.,, pain on coughing, 411. scratching, 477. raw pain, 480, 483. Trachea, pressive pain, 483, 512., numbness, 397.,, rawness, 398.,, dry feeling, 483. burning, 483., rattling in trachea, 127. Epiglottis, paralysis, 413. Choking, 413, 414. Weak voice, 396. Inability to speak aloud, 661. Hoarseness, 395, 483. Cougl, 398-409, 413, 454, 403, '176, 479, 180, 482, 071.,, dry, 213, 3,10, 408, 109, 412, 477, 479, 480, 181, '183., short, 398, 399, 105, 407, 176.,, horse, 108.,, loud, *108.,, dull-toned, 483. ( 22 OOw ACONITUM NAPELLUS. [SYrPTOMS 415 TO 463. Chest. a Amyr. Ar. Erom. Ni r- c. Nux - v. Op. P'lumb. Sec. S ongTSq uiLS tram. Tab. c Ath. Am-c. Ant-c. Arg- n. Ar, C;Jeph. Cap,.Con. Evon. G ran. Ilydr-ac. M ur-ac.Op.Plumb. lcan-sc. Sec. sil. d Antt-c. e C:alc-c.Cin.Ferr-m. 0Ip. Plumb. f Chin. 9 0) h Cr) h Cocm. Iact-v. i Brom. Bry. Caua, IpeC. A Arimr. Am. Ara. ('tap. Carlb-v, Croc. Diph.Moz. M erc-d. More -c. Natr- m. Plurmb. Sars. I frn. m Mez. n Carb-a. Me. Phos. Ilhe. Tab. o Seneg. Staph. p Fluor-ac. r Sep. I!r) 415. Slow,a difficult respiration. (Fg.) 416. Short breath in sleep, after midnight.b (IL) 417, Deep sighing." (A..)' 418, Sighing on account of slow circulation and distinct feeling of congestion of blood in the lungs. (Z.) 419. Oppressed breathing. (A. J. Fg.) 420, Inspiration through the nose impeded, especially in sleep. (HI.) 421. Loud,0 noisy' breathing, with open mouth. (IH.) 422, Tightness of the chest, with strong, loud respiration.( (1I.) 423. Sensation as if the chest were contracted. (5t.) 424. Constriction of the chest, to the right of the sternum," a kind of tightness. (St.) 425. Difficult respiration, anxious gaspings for air.' (A. J.) 426. Anxiety in the chest and oppression on the right side, afterwards in the whole chest. (St.) 427, Anxiety, impeding respiration, with warm sweat on the forehead. (H.) 428. Respiration irregular, short and hurried, or deep and sighing. (Fg.) f 429, Factid breath.k (HI.) 430, Oppression of the chest, relieved by deep inspiration.' (A. J.) 431, Oppression of the chest, increased by deep inspiration.? (A. J.) 432, Oppression" and anxiety of the chest on deep inspiration. (A. J.) 433. Oppression of the chest, with raw pain under the sternum o on inspiration. (Z.) 434. Pains in the chest, excited by deep inspiration.P (A. J.) 435. Pressive pain in the chest, relieved by bending the body backwards, but renewed on resuming a straight position (aft. 12 h. TI.) 436. Pressure on the chest, first on the right side, then on the left. (WVm.) 437. Pressive pain on the left side of the chest superiorly,' the part is sensitive to the touch. ( lmn.) 43S. Pressive pain in the region of the second left rib, near the sternum, limited to a spot the size of the palm of the hand, increased by deep inspiration. (Z. T. 6/2.) 439, Pressure and burning under the sternumr.' (8:.) 410. Feeling of weight on the chest, as if the whole chest were compressed from all sides.t ( r.) 441, 'Weight under the sternum, preventing * In C(ourten's experiments on dogs, he particularly noticed a kind of crying and sobbing, like broken sighs. (Pli! Trans. vol. xxvii, p. 488.) t In Arnold's experiments on frogs the rapidity of the rspiratin was first increased, then diminished. (1tmu,',- xxi, 1.) deep inspiration, painful pressure from the sternum to the spine." (UIT.) 442, Weight on the chest, with a quick succession of fine but violent stitches on the left side from without inwards. (W1L.) 443. Contractive pain in the chest, as if the ribs of both sides were drawn towards each other.' (Ahr.) 444. Dull pain behind the sternum." (Wa.) 44.5, Shooting, pressive pain on the right side of the sternum. (W.) 446. Squeezing pain in the chest." (H.) 447. Pressive, squeezing pain in the chest, under the sternum.( (H.) 448, Pressive, tight pain in the side of the chest. (Z.) 449. Stitches in the chest (on breathing). (St. 450. Violent stitches through the chest. (W.) 451, Superficial stitches in the chest" and cardiac region. (Sz.) 452, Stitches in the lower part of the chest towards the false ribs.a (Z.) 453, Violent stitches in the chest, with suspension of the respiration.b (Tff.) 454. Stitches in the chest, with cough.0 (A. J.) 455. Single large stitches in the side, towards the back ' (aft. 24 h. IH.) 456. Stitches from the lowest rib on the right side to the apex of the shoulder blade, through the centre of the chest, accompanying every inspiration, with complaining humour.0 (L.) 457. Shooting in the right side of the chest, with complaining, lacrymose humour. (H.) 458. Painful stitches in the right side of the chest, about the last rib, going through to the back (aft. 10 h. TV.) 459. Pinching,9 scraping pain in the right side of the chest, between the 3rd and 4th ribs, not affected by anything, it goes away of itself. (Aahr.) 460. Dull, oppressive stitches in the left side, near the axilla. (St.) 461. Shooting in the lower half of the left side of the chest, going off on lying down. ( t./Wx.) 462. Shooting, boring,b scraping pain in the left side, between the fourth and sixth ribs, lasting 10 minutes. (Ahr.) 463. After 20 doses of the 2nd dil. On rising in the morning, acute lancinating stitches in the cardiac region, as if in the pleura costalis, that prevent him assuming an upright posture or breathing deeply,' with an inclination to cough; after rubbing the skin and making gradual efforts to breathe deeply, this symptom went off, but that part of the thorax remained sensitive even to external pressure. After dinner, heartburn and pain in stomach. In the evening, flying stitches here and u0) v (1) w(?) z Cin. Phos. Puls. Rhod. Scrof. Seneg. Stau. y Ver. a Caps. a ell. b Bor. Carb-v. c Am-c. Ant-c. Am. Carb - a. Natr - e. Thuj. d Amb. Ant-cr. Asaf. Bov. Camph. Caus. Cocc. Hep. Lact-v. Lye. Mere. Nitr. Ihod.Sulph.Sulphac. Tarax. e (1) f Asaf. Lact-v. g Ran-s. h Rhus-t. i cal - c. Mag I-m. PJct. Puls. i Mbur-ac. -1 A _-------------- SYMPTOMS 464 TO 479.] ACONITUM NAPELLUS. 23 Chest. Aeth. Bell. Chin-s.;Cic. Cupr-ac. "Asaf.Calc-a.Calc-c. Gran. Mez. Mgt. Mgt-n. Nux-v. Plumb - ac. Puls. Ran - s. Spirel. Sulph. Ther. Viol. n K-bich. "Bor. Calc-c. Dros. Mur-ac. Staph. Mgt-n. Am-m. Kreos. Guai. Phos - ac. Seneg. (1) Ars. Bar-m. Bell. Brom. Bry. Cast. Caus. Chin-s. Cic. Ferr - ac. Mgt - n. Nux-v. Op. Rat. Rhus-t. Rut. Sil. Sulph. SMang. Dulc. Lach. t Taras. Galv. Bov. Rat. ) Alum. Amb. Ars. Brom. Calc - c. Carb-v.Crotal.Kalc. Lact-v. Lauroc. Nux-v. Prun-s. Rhod. Rhus - t. Sang. Seneg. Stan. Tab. Tarax. SCic. Cim. Crotal. Bug. Hyos. Lach. Lye. Puls. Rhus-t. Zinc. "- Am-c.Cocc.Nux-v. s Am - c. Bell. Bor. Chin. Dig. Ferr. lod. Phos. Sel. Sil. a Seneg. Staph. i Berb. Caps. Cic. Sep.; Ang-v. Asp. Magnm. Natr-c. Petr. Rhus-t. Sil. Spig. i Am-c. Calc-c. Hep. (1) there in the ribs, the abdominal parietes, the joints, great swelling of the belly, which is painful to the touch.k (Z.) 461. Flying stitches in the pectoralis major' and intercostal muscles of the left side." (Sw.) 465. Pain in the chest like a shooting, interrupting respiration. (H.) 466. Shooting in the side, followed by palpitation and pressive headache with anxiety and ill-humour. (H.) 467. Fine burning shooting pain in the chest." (H.) 468. Pain as from a bruise in the lowest rib, very much increased by the touch,o whereby the patient is very uneasy and complains. (H.) 469. Pain in the middle of the sternum as from a bruise," increased by touch. (iH.) 470. Creeping pain in the chest.' (H.) 471. Crawling in the chest as from beetles.P 472. Feeling of heat in the lungs.? (WYl.) 473. Gnawing pain in the right clavicle.' (Z.) 474. A digging," boringt pain from the right scapula to the front of the chest, increased by deep inspiration, but not by expiration, lasting 12 minutes. (Ahr.) 475, During all the proving, sudden and frequent congestion of the head with anxiety," followed by rigor over the back. Easily tired when walking and especially going up stairs, had to rest on account of dyspncoa and hot feeling iii the lungs,' sleepiness, disinclination for mental labour, moroseness, peevishness, dislike to company and fearfulness. (IWV.) 476. Five drops caused the following symptoms. Tickling in the larynx causing cough;" loss of appetite; empty eructations; pressure in the scrobiculus after eating. Towards evening shoots in the centre of the sternum with particularly good humour. The sleep was very light. A few days after, 10 drops were taken, which caused the same pressure in the stomach, with dryness in the cesophagus and great thirst," the water seemed not to moisten the parts it passed over. Fatigued feeling in the chest,' tussiculation. The next day expectoration of blood and mucus,' with a raw feeling behind the sternum.a In the evening heat of the palms and cheeks. Went to bed very restless and excited, and slept with difficulty. Not refreshed on rising next morning. This state with the fever in the evening lasted for 4 days. (Bm.) 477, After 10 dr. for 3 successive days, confusion of the head, lasting 6-7 hours every day, with shuddering all over the body, and feeling so coldb that he could not get himself warmed beside the stove. The next day 15 dr., which was followed g an hour afterwards by sudden violent palpitation whilst he was sitting quietly,t with a tight feeling in the chest.d He felt as if hot water were being poured into the chest;e immediately afterwards he felt icy cold and nearly fainted. This attack lasted 5 minutes. During the day frequent recurrence of the rigor with violent pain in the right temple; sleepless night. After 15 dr., next day palpitation lasting all day, relieved by quiet, increased by walking.r In the evening, headache that increased to violent pressure in both parietal regions, that kept him awake at night. Constant shuddering. Very weak. On repeating the dose, thirst, prostration, heat and rigor, pressive headache in the vertex in the evening, pulse full, 80-90; restless night disturbed by fearful dreams: the next two days shoots through the chest and a disagreeable scratching in the throat provoking dry cough,' alternation of heat and cold. After 40 drops more, the cough continued for two days, dry heat all over the body;h at night thirst, restlessness, rigor and heat till morning, by day bitter taste in the mouth. More of the medicine occasioned dry heat and exhaustion, violent rigor in the evening and headache lasting till midnight, great oppression of the chest and feeling as if a hundred-weight lay on it. Nights restless. (1L.) 478. After a considerable dose, the chief symptoms for four or five days were: Pressive headache, chiefly in the vertex and forehead, great oppression of the chest, making him breathe deeply,' with flying shoots in it, palpitation of the heart combined with great anxiety and restlessnessJ and pressive pain in the cardiac region," diarrhoea of thin watery and fetid faces' with rumbling in the belly and pain, brownish coloured urine" depositing a dirty brown sediment," flushing of the face and cold hands and feet, especially in the evening. (Ilk. a.) 479. Whilst taking near 500 drops of the tinct. the chief symptoms that occurred were: heaviness of the head, sleepiness. The stomach seemed to rise and sink,0 perceptible to the hand, along with this great anxiety, the heart beat quickly, whilst the pulse was slow, apparently intermitting.P His strength during this symptom sank. The sleepiness increased after more medicine; he could not read, write, or speak for it. His thoughts were distracted, yesterday appeared a long time ago, and he was long before he could collect his ideas; great vertigo after dinner?. After more medicine, painful shocks in the left chest superiorly,' especially on taking a deep breath, difficulty of breathing, feeling as if he would take cold, frequent sneezing with shootings in the chest,' sleepiness even while walking,' anxious dreams at night, great weariness on walking. Next day, after more medicine, feeling of coryza, difficulty of breathing relieved by cough f Phoe. g Ant-c.Graph.Gumg. Krcos. Pctr. Jlhod. Sabad. h Nux-v. Squll. i Agar. Bry. Cnan. Ign. Kal-c. Lac-s. Lact-v. Lob. Petr. Ran-b. Stan. j Asp. Bor. Calc-c. Croc. k Nanr-m. Spicgel. I Are. Iod. Lach. Sec. m Amb. Anr. Campl. Culcli. Kreos, Lactv. Merc-s. Nitr-ac. Pctr. Phos. Plumb. Serp. Val. n Amb. Aur. Cim. Cinch-s. Dig. Val. o (0) p C) q ChamnClnnab.KalC. Mngn-s. Mere. Natr-. Nux-v. Pclr. Plio. See. Sele. Sulphi. r Carb-a. Kll-hivd. Nitr.Spigel.Sulplhac. Zinc. a Croul. Ind. t Nitr. Lach, Lye. M1uNse. - ~I Te - - --' I __ 24 ACONITUM NAPELLUS. [SYMPTOMS 480, TO 482. Chest "u (?) v Cain. Dros. Hell. Rip. Mere. Nux-v. 1ul.Hhus-t, Ruta, Sabin. porng. Tab, Vcrat. w Hal-c. Natr-c. x Krcos. y Carb-v. z Arg-n. Bov. a Am-c. Ant-t. Mcz. Olean. 6 oinv. Bry. Carb-v. Natr-c. Nitr. o (I) d (?) SCon. Prrn-s. / (1) A Ar-n. Bar-a..Gent. A cre-c. slpb. i far-., Carli-. Natr-l. Rho,. line. Spjh. Ph ing, stitches in the left chest, sleepiness, distraction, pain in top of head relieved by washing with cold water, great restlessness, frequent change of position, distraction of thoughts, forgets what he was going to do the next moment. Disturbed sleep. After more medicine, taste of pepper on the point of the tongue, palpitation, heat of body, anxiety, relieved by drinking cold water," but soon returning, he felt as if some dreadful misfortune were going to befall him.' Vertigo. Cough with shooting in chest, pulse full, rapid. Next day, after 80 dr., empty eructations, swelling of stomachic region," which is sensitive to the touch, pain in vertex like a great weight. Sudden vertigo after eating,q periodical stitches through chest,x with dry cough. Restlessness at night, alternate heat and cold. (AM.) 480. After 30 dr. of the tincture; during the day, painful drawing here and there, chiefly in different parts of the thorax, and in the upper and forearms; 7 weariness of the arms and legs; confusion of head; continued pressure in the vertex; scraping and constriction of the throat; oppression of chest, making him sigh frequently;' sometimes stitches through the chest; occasional eructations; sexual desire increased. On going out in the evening from a halfdark room into the street, flickering before the eyes - the lamp light quivered; " he could with difficulty see the face of passers-by; he seemed to see worse at a short than a long distance. Passed a restless night; body very hot; tossed about much, and had excessively vivid dreams. Took next morning 30 dr. with the same results. Next day 40 dr., which occasioned the same symptoms; but more oppression of chest, and on coming into a warm room from the open air, irritation in the larynx and dry cough';b increased feeling of prostration. After 100 dr. more the chest became painful externally on several places, particularly the right side; breathing much affected; must often sigh deeply. Inspiration often prevented by a feeling of compression in the middle and anterior part of the chest,0 or by pinching, especially in the right flank," or violent shoots deep in the region of the liver." Change of temperature caused dry cough, with raw pain in the chest.r Feeling of weight in the stomach, accompanied by constriction in the throat and attacks of nausca.A On walking in the open air an acute pressing pain by fits in the 1. patella,' r. tendo Achillis, and dorsum of 1. foot. After another 100 dr. the throat seemed to swell, with a feeling as if there was a quantity of mucus' there that he could not get rid of by Shawking; flow of frothy saliva into the mouth; eructation of air; frequent dry cough, with raw pain in the chest and larynx; k shoots in the forehead, back, sides of the chest, fingers and back of the hand, like electric sparks.' A sensation like pinching on some parts of the left arm, near the elbow. Itching in several muscular parts, especially the forearms. Great weariness, as if after walking far; tensive, pressive pain in the lumbar and sacral regions. Violent very painful contraction in the anus,;m stitches through the anus and urethra. Constant itching and smarting on several parts of the skin; miliary vesicles arise here and there that fill with yellow lymph, and then dry up. Pressure and heaviness in the vertex; disinclination for mental work. Stiffness and heaviness of limbs when walking, preventing him walking quickly. Nights always restless, and in the morning he felt as if he had been drunk over night. Eighty dr. more increased the cough and raw pain in the chest behind the sternum. These symptoms increased towards evening, with oppression of the chest. The above symptoms continued to shew themselves on repeating the medicine; the most constant were the pressure on the vertex," restlessness at night, increased temperature of skin and thirst. The vertex felt hot to the touch O externally, and the hair bristled up there.5 The oppression of the chest and the dry cough were pretty constant, and so were the drawing, shooting, gnawing pains in the limbs, especially the forearms. Along with these was an anxious, timid disposition. Wine and coffee only removed the symptoms for a short time, they returned again. (Tz.) 481. After taking in all 34 drops in 3 days, during 6 days the chief symptoms were: headache and heaviness in the forehead; liquid stools with some griping; oppression of the chest, causing difficult respiration; inclination to sigh; q palpitation; dry cough, with occasional expectoration of bright red blood;r considerable anxiety; appetite good. (MH-. b.) 482, After 24 drops: burning on the sides of the tongue;' dryness in palate and constriction in oesophagus, not relieved by drinking cold water. Constant flow of saliva into the mouth, frequent rising from the stomach, and no appetite. Vertigo when walking or driving. Tongue felt like leather; t great prostration; increased heat of skin; flying shoots along the sternum and betwixt the ribs. Sleep restless, broken, unrefreshing. Though he drank much during the night he made no water. Next morning he passed red urine, with burning along the urethra;" he felt better after breakfast, but soon afterwards, when in the open air, he had severe attack of rigor over the back and chest, followed by great heat, (with headache,) k Nitr. Rhod. Seneg. I Coloc. Phel.Plumb. mCarb-a. Nux-m. Nus-v. Thuj. no Hep. Natr. o Daph. Eupat. Magn-s. p Hyp. Kal - bich. Mang.Spong.Sulph. q Arg-n. Bov. r Led. Sil. * Ang-v.Carb-a.'Kalhyd. Phos. t (?) a Mere. Plumb. ] li iYMPTOM 483.] ACONITUM NAPELLUS. 25 Chest,;Nux-v. Op. Rhe. ~ Canth. Seneg. Brom.Daph.Nux-j. Natr-c. which the least movement brought back. There came on violent cough, with painful shooting in different parts of the chest, compelling him always to lie on the back, and preventing him lying on the side. The night was restless; perspiration after midnight with relief; urine as before. The next day at 3 r. n. he had another attack of fever. Pulse 96; frequent cough, with severe pains from the shock through the chest; expectoration sometimes brownish-red, rust-coloured.' After this he got better gradually. (Bim.) 483. During 10 days moderate doses of the tincture were taken with the following result: Every night great restlessness; he slept a few hours before midnight tormented with disagreeable dreams, and lay awake the rest of the night, or rather in a kind of half-waking state, with fantastic visions." Great heat all over the body and burning itching, especially on the inside of the thighs and about the knees. On the third day there occurred raw feeling in throat, with frequent secretion of mucus from the larynx, drawing and paralytic stiffness in the r. upper arm. On the 6th day dry cough from irritation in the larynx.x On the 9th day an attack of rigor after midnight, which seemed to arise from the precordia and extend to the limbs. Attacks of this awoke him frequently during the night, and were followed by burning, dry heat, with febrile pulse. In the morning moderate perspiration. On the 11th day violent stitches in the region of the 8th, 9th and 10th ribs, but not affecting deep inspiration. The 12th and 13th days these stitches still continued, and often extended to the loins. The 14th day at night a rigor, followed by excessively copious perspiration, sleeplessness; in the morning fluent coryza; rheumatic pains, chiefly in the knee.' The 15th day another rigor at night, followed by dry, hot skin and perspiration; the coryza went on. The 16th and 17th days dry cough, very violent in the warm room; weight on the chest; bruised pain betwixt the shoulders. The two next days headache in the temples; hoarseness; dry cough; dry feeling in the trachea; expectoration of thin white mucus, mixed with streaks of bright red blood; bruised pain betwixt shoulder blades.t These symptoms continued to increase; the headache became violent; the cough very severe, with a peculiar dull tone,b causing a great strain at the chest, almost dry. Shivering in the evening; constant irritation to cough. The following (21st) day, the trachea was the seat of pressive and burning pains, extending down to the scrobiculus. Headache and violent faceache (v. S. 191) came on. The two following days the cough was severe, and another attack of rigor came on at night. Thereafter the symptoms declined; the cough becoming loose and rare, and in about 5 weeks from the commencement of the symptoms, he was quite well. (Rl.) a Caus. Gran. Hell. Natr-im. Nux -v. Sulph. 6 Magn-c. PATHOLOGICAL ANATOMY. Chest. MAN. The lungs, especially their lower lobes, congested with black blood. (Bd.) The pulmonary parenchyma congested with blood and scarcely crepitating. (Pn.) The lungs heavy, bluish, violet posteriorly, little crepitating and filled with blood. (Pll.) ANrIALs. The surface of the lungs marbled with dark red and vermilion spots, penetrating into their substance, on cutting into them a quantity of reddish brown viscid fluid flowed out. A rabbit. ((E. Z. 1. c., p. 136.) Lungs very red, cedematous, congested, with many ecchymosed spots on their surface. In a rabbit. (O. Z. 1. c., p. 138.) Lungs externally chocolate coloured, internally dark red, their lobes very full of blood. In a dog. (CE. Z. 1. c., p. 142.) Lungs firm, brownish, filled with blood, less crepitating than natural. In a dog. (Orfila, Toxicol., vol. iii, p. 59.) )ppression, 242, 426, 430, 431, 432, 433, 477, 478, 480, 481, 494, 677, 717, 778, 780. Yeight,'440, 442, 477, 483.?ulness, 778.?atigue, 243, 476. -onstriction, 130, 279, 422, 424, 448, 477, 487, 494. ontracted feeling, 423, 443. 3queezing, 446. knxiety, 426, 427, 432. 'ain, 434.?ressive pain, 435, 436, 448. Shootings, 8, 243, 449, 450, 451, 452, 453, 454, 455, 463, 465, 466, 467, 477, 478, 479, 480, 482, 483. )rawing, 480. NDEX TO THE 8YMPTOMS OF THE CHE2 Raw pain, 480. Bruised pain, 467. Creeping pain, 470. Crawling, 471. Heat, 208, 243, 477, 781. Burning, 467. As if hot water were poured in, 477. Lungs, feeling of congestion, 418., heat, 472, 475. Sternal region, weight, 441.,, dull pain, 444., pressure, 439, 441, 445, 447, 782. compression, 480.,, shooting, 445, 476, 482., squeezing, 447. bruised pain, 469. Sternal region, raw pain, 433, 476, 480. S burning, 430. Right thorax, pain, 778. S stitches, 456. 457, 458.,, pinching, 419.,, scraping, 459.,, gnawing, 473. digging, 474.,, boring, 474. Left thorax, pain, 386.,, pressivo pain, 437, 43H.,, sensitive to touch, 437., stitches, 442, 460, 461, 42, 479,674. boring, 462., scraping, 402., drawing, 674. I) - -- -- C 26 ACONITUM NAPELLUS. [SYMrTOMS 484 TO 500 I - I INDEX TO THE SYMPTOMS OF THE CHEST (continued). Left thorax, bruised pain, 781. Chest, externally, painful, 480. Muscles of chest, stitches, 464. The air passages feel wide, 728. Dyspnea, 288, 475, 494, 716, 764. Dread of suffocation, 638. Desire to breathe deeply, 32, 478. Respiration, short, 127, 416, 428, 500, 678. 1 difficult, 127, 415, 419, 425, 481, 490, 679, 782.,, slow, 415, 679.,, through nose impeded, 420. 479, Respiration, loud, 421, 422.,, noisy, 421, 663.,, gasping, 425. " "irregular, 428. hurried, 428. deep, 428. obstructed, 441, 453, 465, 480. quick, 678, 780. superficial, 778. like a goat bleating, 707. Sighing, 127, 243, 417, 418, 428, 480, 481, 778. Mucous rattle, 663, 678. Accompanying respiration, stitches in chest 449, 456. Accompanying inspiration, pain in chest, 434.,,,, pain under sternum, I 433. chondria, 298. 243. Breath, hot, 780.,, fcetid, 429. shootings in 1. hypopain in gall bladder, REMARKs.-These very decided symptoms connected with the respiratory organs shew a power of inducing irritation. congestion and inflammatory action in the whole of the mucous membrane, the parenchyma of the lungs, and their serous membrane Heart and Circulation. "a (1) b Ant-t.Chin-s.Croc. c Ars.Asp. Aur. Bov. Calc-c. Cains. Chin. Croc. Dig. Galv. Graph. K-carb. Liacch,. Mercurial. Nptr.Natr-m.n Ntr. Nitr-ac. Olean. Phos. Prul. Sara. Sep. Spigel. Sulph. Vcr. Vol-u. d Cami. K-chl. Miercuraal. NiLr. Nitr-ac. SpigeL f Dov. Olean. g Am-c. Calc-c. A Ar. CAmph. Cmr.. CritilA. I.m. N trm. rran. Sabad. 484. Slow jerks in the cardiac region, towards the surface of the chest.a (St.) 485. Heatb and disagreeable sensation in the heart. (Gl.) 486,. Slight stitches in the cardiac region. (Schn. Ik. a.) 487. Anxiety in the cardiac region, with contracted pulse and constriction of the chest when sitting after much motion. (Z.) 488. Compression of the chest in the region of the heart. (St.) 489. Anxiety in the cardiac region, with quicker and stronger heart's beat. (Z.) 490. Palpitation, with great anxiety,0 difficulty of breathingd and great weariness in all the limbs; sensation as of something rushing into the head, with confusion and flying heat in the face.e (St.) 491. Palpitation and anxiety, with increased heat, especially of the face." (St.) 492. Palpitation of the heart. (A. J.) 493, Tendency to palpitation, with trembling. r (II.) 494. After taking and whilst taking a large quantity of the tincture, the following symptoms occurred. Tearing in the arms and legs, the knees and elbows for several days; then cessation of these pains and violent palpitation in place of them, that came on at 3 and 8 P. M. Two days afterwards the tearing pains in the limbs recurred and the palpitation ceased. The next two days the palpitation recurred with feeling of tightness on the chest,5 the limbs keeping free from pain. Bowels constipated. The palpitation continued to increase, and was accompanied with great anxiety and oppression of the chest, and sometimes great dyspncea. The tearing in the limbs was occasionally observed afterwards, and occurred at intervals a month after leaving off the medicine. At one time whilst taking the medicine there occurred violent headache, as if it were equally compressed from all sides,5 all over the head, and the orbit was once the seat of pressive tearing pains. (N.) 495. Pulse contracted, full, powerful, febrile, exceeding 100 beats per minute in adults. (A. J.) 496. Slow pulse. (Fg.) 497. Pulse slow and intermitting.' ( Wo.) 498. Pulse small and weak. (Fg. Rei.) 499. The pulse shews diminished frequency and strength in all modifications down to perfect absence of pulse. (A. J.) 500. After taking a considerable portion of the root: First there was a feeling of tingling heat which affected not only the tonguej but also the jaws, so that the teeth felt as if they would fall out.' The cheeks were so irritated that neither those about him nor yet his mirror could persuade him that his face was not swelled' to twice its usual size. The tingling sensation spread gradually over the whole body until it took in all the limbs. He felt unsteadiness in the joints, especially the knees and feet, and jerking in the tendons, so that he could scarcely walk across the room. It seemed to him as though the circulation stopped in all his limbs,m no circulation" at all was felt by him from the wrists to the ends of the fingers and from the ankles to the ends of the toes. Then his bead became giddy, cloudiness came before his sight, the look became wandering, he heard a humming hissing noise in his ears and fell into a faint. The eyes were staring, the teeth spasmodically clenched, hands, feet and forehead covered with cold sweat, no pulse perceptible, breath short and scarcely perceptible. The head was drawn backwards.0 Vomiting restored his consciousness, but he soon relapsed into the fainting state. After a little sal volatile he had a motion of the bowels, preceded by urging, and vomited 2 or 3 times. He then complained of his head being heavy, his strength and spirits exhausted, so that he had to lie down. The pulse became more perceptible, i Dig.Op.Sec.Stryeh Tab. j Mere-s. Plat. Sec. c (1) I Aeth. Alum. Ars. Aur. Bar-ac. Bar-c Calc-a. Cale-c. Daph. Gran. June. Lye. Mercurial. Nic. Sabad. Staph. m Zinc. n Ant-t. Ars. Con. Thuj. o Alum. Bov. Cannin. Cic.Colch.Cupr. Morph.Nux-v. 0p. L _ _.___ SYMiPTOMS 501 TO 512~.] AICONITTUTN I APELLUS. o2 Heart and Circulation, p (7) q Aur-m. Dig. Zincox. r Bell. Hydr-ac. Lye. Merc-s. Nux-v. Op. Sec. though intermitting and irregular, 2 or 3 beats followed rapidly in succession and then came a pause of as long a duration.P` Soon afterwards he experienced cold and rigor, and on being well covered up he broke out into an agreeable warmth and perspiration, fell asleep and awoke quite refreshed. (Ben.) 501. After taking a large quantity of the root, the following symptoms appeared: Three hours afterwards he complained of a general ulcerated tired feeling in the body, great loss of strength and weight about the heart," and though he spoke boldly, had an animated look and was perfectly conscious, cold sweat stood on his brow, the pulse was almost imperceptible. Then his eyes became distorted, the mouth pulled to one side, the nape of the neck stiff, and he fainted. In his faint he had some evacuation of the bowels. On coming round he complained of rigor, vomited fetid," black,' bilious mucus (with s Op. Plumb-ac. relief) and turned as if to sleep. At length t, p. Ver1um. he grew speechless and died. His face was blue, like that of a strangled person. (Ji.) PATHOLOGICAL ANATOMY. Heart and Blood. MAN. Heart collapsed, with very little black fluid blood, larger vessels almost empty. (Bd.) Left ventricle empty, right filled by a gelatinous coagulum. (Pn.) Unusual fluidity of the blood. (3Me.) ANIMILs. The auricles and ventricles filled with black coagulated blood. In a rabbit. ((E. Z. 1. c., p. 136.) In the pericardium much pale turbid serum; in the right ventricle some fluid and much coagulated blood; the left ventricle almost empty. In a wolf. (WVepfer, 1. c.) Heart collapsed, containing thick clotted blood. In a dog. (Orfila, 1. c.) "* Hahnemann has rendered this erroneously, see S. 415 of his schema of Aconite. From Schroen's experiments on frogs it appeared that on giving them Acon. their circulation was much quickened. (Hyg. xiv, 232.) From Arnold's experiments with Aeon. and Aconitine on frogs, it appeared that the number of the heart's beats is first increased, then diminished. An intermitting pulse was frequently observed. Sometimes the contractions of the ventricles only amounted to half those of the auricles. (Hyg. xxi, 1.) INDEX TO SYMPTOMS OF THE HEART AND CIRCULATION. Oppression of precordia, 127. Precordial anxiety, 487, 489, 494, 638, 677, 716. Cardiac region, disagreeable feeling, 781., weight, 501., pressure, 478., compression, 488. cramped feeling, 781. stitches, 451, 463, 486. sensitive to touch, 463. jerks, 484. heat, 485. Palpitation, 8, 466, 477, 478, 479, 481, 490, 491, 492, 493, 494, 650, 778, 781. Fluttering, 127. Heart's beats, quick, 479, 489. S strong, 489, 781.,, irregular, 678. As if all the blood-vessels were frozen, 128. As if the circulation stopped in the limbs, 500. Loss of circulation in extremities, 127. Throbbing of temporals, 779.,, carotids, 779. Pulse, intermitting, 130, 479, 497, 500, 782. Sfebrile, 130, 483, 495.,, quick, 477, 479, 482, 495, 663, 675, 679, 777, 778, 779, 780, 781. Pulse, slow, 479, 496, 497, 678, 781. full, 479, 495, 778, 779, 780, 781, 782.,, contracted, 487, 495, 778.,, strong, 495, 778, 780. Ssmall, 498, 677, 781.,, weak, 498, 501, 675, 677.,, not to be felt, 499, 500, 663, 676, 677. ir, regular, 500, 678, 679. hard, 778, 781.,soft, 781. 11 REMARKS.-We have here the most satisfactory evidence of great power over the heart's action, from the slightest increase in the circulation up to the most tumultuous action of the heart and down to almost complete paralysis, as in S. 501. There is also evidence of an inflammatory action on the substance of the heart itself or its serous membranes. S. 494 reads almost like a case of rheumatic endo or pericarditis. Back. a (1) b Graph. c Bor. Gran. Graph. Merc. 01. Puls. Ran-b. Rhod. Sang. Staph. Ver. d Canth. c Bry. Croc. Gent-cr. 502, Pain as if the flesh were separated in the nape, with a feeling as if the neck could not support the head; on moving the head, shootings in the nape.b (St.) 503. Rheumatic pain in the nape,e felt only on moving the neck (aft. 5-9 h. IH.) 504. Drawing pain to the left of the nape and in the scapula on moving the neck.d (Z.) 505. Drawing pain in the neck into the ear0 and shoulder. (UWm.) 506, Single stitches in both sides of the nape. (Rkt.) 507. Fine shootings in the neck externally. (H.) 508. Stiff feeling in the nape of the neck in the evening. (Sz. W1n.) 509. Stiff feeling in the nape, with chilly hands and feet. (7Wm.) 510. Stiff and bruised feeling in the left side of the neck, to the left shoulder joint and a portion of the dorsal muscles, worse on lying, better on moving. (TVl. 5th d.) 511, Pressive pain in the left side of the cervical vertebri-. (IV.) 512. Pressive pain in the neck, as if with the point of a finger inwards towards the trachea.' (Ahr.) (1) - - - I-- I _ 28 ACONITUM NAPELLUS. [SYMPToMS 513 To 550. Back. g Con. z (?) h Dulc. i (0) j (?) k Am. Apaf. Bry.;arb-v. ('ast..y. Mfatn-n.M,.rc.M t. Ntr. N I r.N itr-ac. en itc 'il. ulph. aVtT,. I \Ian-m... ) 513. Stretching in the cervical musclesg on turning the head. (Z.) 514. Crawling pain in the back, as if from beetles.' 515. Creeping as of insects over back, arms and thighs. (Z.) 516. Shootings in the back. ( Wz.) 517. Violent shooting, digging pain on the whole of the left side of the spine to the small of the back," so much increased by inspiration as to bring tears into the eyes'; this lasted 4 hours. (Ahr.) 518. Violent drawing pain on both sides of the spine, along the m. m. sacrolumbalis and longissimus dorsi, increased by pressure, and rendering every movement difficult; this went off after 5 hours, but passed into the antagonist muscles, the recti abdominis, which were stretched as hard as a board.) (Schn.) 519. Burningk gnawing' pains on the right side of the spine. (tW.) 520. Pain in the loins like labour pains, whilst walking.' (1H.) 521. Pain in the loins. (Sz.) 522. Pressive pain in the small of the back. (Sz. W7. WT.) 523. Painful boring on the left side of the small of the back.m (HI.) 524. Pressive pain on the left side of the small of the back. (Hbg.) 525. Painful stiffness in the small of the back" and hip joint,o as if paralytic, on movement (aft. 2 h. H.) 526. Numb sensation in the small of the back P into the legs. (A. J.) 527. Sensitiveness of the renal region. (WT.) 528. Paralytic pressure in the small of the back,' relieved by movement and bending forwards. ( W. 3rd and 5th d.) 529. Shooting and creeping in the small of the back. (WTV.) 530. Tension' and drawing in the lumbar region, compelling him to bend backwards. (Z.) 531. Tensive pressive pain in the lumbar vertebrae, or as if bruised,' with gripes as if from flatulence. (I.) 532. Pain as if bruised in the last lumbar vertebra, at its junction with the sacrum, the back feels as if beaten. (H.) 533. Pain as if from a bruise from the loins through the back into the nape of the neck (aft. 4 h. I.) 534. Cutting pain extending from the spine over the left hip round to the abdomen.' (H.) 535. Stitches between the scapulae. (A. J.) n Ars.Carb-v.Kal-c. Lye. Petr. Puls. Rhus-t. no Mgt-n.Rhe.Sulph. p Carb-v. Spong. q Cocc. Hyp. r Berb. Grat. Nux-v. Zinc. s Hell. Rhus-t. But. t Dulc. ni () Stiffness, 280, 510. 'ain, 76t4. Squeezing, 280. Slootrings, 480, 516, 517. Cutting. 534. Gnawing, 519. Drawing, 518. )igging, 517. Crawling, 514, 515. Bruised feeling, 510, 533. Pain as if from a strain, 280. Burning, 519. Neck stiff, 510.,, pressure, 511, 512.,, shooting, 507. INDEX TO SYMPTOMS OF THE BACK. Neck, drawing pain, 505., stretching, 513. Sbruised feeling, 510. Nape of neck, stiff, 501, 508, 509.,, pain as if flesh were separated, 502.,, weakness, 502. shootings, 502, 506., rheumatic pain, 503., drawing pain, 504. bruised pain, 533. Betwixt shoulders, stitches, 535, 780. S bruised pain, 483. Scapulae, drawing pain, 504. Loins, sensitiveness, 243, 527. Loins, pain, 521.,, tensive pain, 480, 530, 531., pressive pain, 480, 531., like labour pains, 520.,, drawing, 530., bruised pain, 531, 532, 533. Sacral region, stiff, 524., numbness, 526., pressive pain, 480, 522, 523, 528., tensive pain, 480. shooting, 517, 529. S digging, 517., boring, 522. paralytic feeling, 528., creeping, 529. Superior Extremities. a Droi. Gran. S.Almn. T.Irh. AMn.n-: ( 4 \rn. \XiT-n Ntr. Str! U,'r.i. 536. Pain in the left shoulder joint. (Ibg.) 537. Pain as from a contusion in the shoulder" (and hip) joint, after sleeping, as if the bed had been too hard. (II.) 538. Tearing pain fiom the shoulder down the arm to the wrist and fingers," on every motion; whilst the pain continues the hand is blue' (aft. 1, 14 h. H.) 539. Tumour in the muscles of the shoulder extremely painful to the touch, as if bruised' (aft. 4 h. II.) 540. The shoulder is painful, and feels as if about to sink. (St.) 541. Flying shootings hi the left shoulder. ( 11. 7.) 542. Tingling down the arms.d (Fg.) 543. The arms feel bruised and sink down powerlessly. (St.) 544. Coldness and insensibility' of the arms. 545. Pinching as if with blunt forceps on some spots of the left arm' (JFz.) 546. Single shootings in the middle of the right upper arm,g anteriorly, whilst at rest, not changed by motion or pressure. (Ahr.) 547. Sudden drawing and shooting pain in the right upper arm, posteriorly. (Ahr.) 548. Drawing pains in the elbow joints. (St.) 549. Drawing, tearing pain in the elbow joints. (N.) 550. Violent shootings in the elbow joints e Sec. f (1) g Arn. Guai. Samb. 3YMPTOMS 551 TO 579.] ACONITUM NAPELLUS. 29 Superior Extremities. SAlum. Aur. Croc. Lauroc. Mgt-n. Mgt-s. Phos-ac. Spgel. pong. Sulph. Teuc. Canth. down to the wrist, on the outside of the arm, on flexing the hand upon the wrist joint. (St.) 551. Sensation of weight in the arms, from the elbow to the fingers,h they feel as if they would fall, with sensation in the fingers as if they were asleep, on grasping anything. (St.) 552. Drawing tearing pain in the forearm. (N.) 553. Pain in the forearm, as if from a violent blow. (St.) 554. Drawing, shooting pain in the bones of the forearm,' excitable by movement. (H.) 555. Paralytic feeling in the right forearm and hand (on writing), relieved by violent motion, but returning whilst writing or at rest, but less severely.J (Ahr.) 556. Drawing, tearing pain on the outside of the right forearm. (Ahr.) 557. Acute pain in the right forearm along the flexor tendons of the little finger, increased by movement. (Z. /2.) 558. Cramp-like pain in the whole of the left forearm, not relieved by anything. (Ahr.) 550. Undulating tearing pain in the upper end of the left forearm. (Ahr.) 560. Jerking, drawing pain in the lower end and internal surface of the left forearm, over the wrist to the palm of the hand. (Ahr.) 561, Shootings in the wrist joint, as if from needles. (A. cJ.) 562. Drawing, paralytic pain in the right wrist joint.k (T.) 563. Tearng pain in the wrist. (H.) 564. Trembling motion in the wrist' on moving the hand. (Rkt.) 565. Icy coldness of the hands." (A. J.) 566. One hand becomes ice-cold and insensible, as if benumbed (aft. 2 h. H.) 567. Cramp-like pain in the right hand. (T.) 568. Cramp-like pain with fine shootings in the right hand, relieved by moving it. (Ahr.) 569. Cold sweat on the palms." (H.) 570. A few pulsating shootings in the hollow of the right hand, as if from a sharp needle. (Ahr.) 571. Morbid contractive pain in the hollow of the left hand,0 so that the fingers can scarcely be extended. (Ahr.) 572. Creeping pain in the fingers. (H.) 573. Creepings in the fingers, felt also whilst writing. (Hbg.) 574, Numbness in the points of the fingersp and toes. (Z.) 575. Cutting pressive pain on the side of the right forefinger next the middle finger, during motion and when at rest. (Ahr.) 576. Paralytic pain in the thumbs.q (St.) 577. Pain as of dislocation in the right thumbjoint' on moving it. (H.) 578. Jerking pains in the right thumb." (Ahr.) 579. Painful drawing in the left thumb. (T1.) k Asar. I Olean. Op. m Ambr. Carb-v. Chin. Mgt. Phosac. Sep. n Nux-v. Rhe. o Stan. p Ant-t. Are. Cann. Crotal,.Elcc.Graph. Lach. M gt-n.Magn. m. Phos-ac. See. Spong. Staph. q Prun-s. Rhod. r Ipn. iIgt. Mpt-n. Natr-in.Nltr. Pctr. Phos. Prun-e. Puls. Shod.epicgl.Sulph. Vcrat. Verb. 8 Sulph-ac, J INDEX TO SYMPTOMS OF THE UPPER EXTBEMITIES.;eneral, itching, 781. tingling, 127, 542, 678.,, creeping, 515, 651. prickling, 127. shooting, 651, 678.,, pinching pain, 545., tearing, 494. 538. bruised feeling, 84, 543, 650, 781. coldness, 127, 129, 278, 478, 509, 544, 678, 730. heaviness, 243, 777, 778. stiffness, 129, 243., weariness, 480, 490, 656, 659., weakness, 543. difficulty of moving, 129., paralytic feeling, 128, 650., paralysis, 130. insensibility, 544., drawn convulsively inwards, 663. trembling, 678. Shoulders, pain, 536, 540. S pressure, 243. S shootings, 541. S drawing, 505. tearing, 538., bruised pain, 510, 537, 539, 581., stiff, 510. painful tumour, 539. Jpper arm, pressure, 243., shooting, 546, 547., drawing, 480, 547. Upper arm, paralytic stiffness, 483. Elbows, shooting, 550.,, pinching, 480. S tearing, 494, 549.,, drawing, 548, 549, 604. Forearms, pain, 557. itching, 480. shooting, 480, 550, 554. gnawing, 480. drawing, 480, 552, 554, 556, 560. tearing, 552, 556, 559. weight, 551. cramp pain, 558. undulating pain, 559., jerking pain, 560., pain as from a blow, 553., paralytic feeling, 555. Wrists, numbness, 127.,, tearing, 538, 563., shooting, 550, 561.,, jerking, 560.,, drawing pain, 560, 562. Sparalytic pain, 562. Hands, shooting, 568.,, cramp pain, 567, 568.,, coldness, 565, 566, 692, 746.,, paralytic feeling, 555. Sinsensible, 566.,, benumbed, 566., want of circulation, 500. Hands, blue, 538,728., spots like fleabites, 627.,, trembling, 564. S convulsively clenched, 663. Palms, shooting, 570.,, contractive pain, 571. drawing, 560. Sjerking pain, 560. Shot, 476.,, cold sweat, 569. Sinsensible, 663. Back of hand, shooting, 480. Fingers, numbness, 574., as if asleep, 551.,, creeping, 572, 573.,, prickling, 127., tingling, 127.,, shoots, 480., heavy, 551.,, coldness, 736., paleness, 736. S painful red pimples, 631. Forefinger, cutting pain, 575., prssive pain, 575. Thumbs, drawing pain, 579.,, paralytic pains, 576. S dislocation pain, 577.,, jerking pain, 578. S convulsively doubled into palms, G63. Nails, blue, 677. --I 30 ACONITUM NAPELLUS. [SnrPToMs 580 TO 624. Inferior Extremities. a Caust, Fluor - ac. Magn-m. Mur-ac. Natr. Natr-m. Rut. Sulph. Zinc. b Ant-c, Calc-c.Caps. Carb-v. Lcd. Pctr. Plumb - ac. But. Tereb. \ c Euphr. Evon, d Kal-c. Petr. TbuJ. 580. Drawing pain in the border of the left hip-bone. (Z.) 581. Pain as if from a contusion,a or as if from lying on a hard bed, in the hip (and shoulder) on moving after sleep. (H.) 582. Drawing pain in the hip jointb on moving it. (Win.) 583. Painful pressure in the hip joint whilst walking. (Z.) 584. Powerlessness in the head of the femur, or inability to walk owing to an indescribable, intolerable pain, almost like a crushing of the head of the femur, which sometimes declines and sometimes increases, and occurs after lying down and after sleep (after 5 h. H.) 585. Powerlessness and pain in the head of the femur, producing unsteady gait. (H.) 586, Drawing pain in the head of the left femur,c whilst standing and sitting, but still more whilst walking. (St.) 587. Tired feeling in the lower limbs during repose. ( Wm. Z.) 588. Sensation of heaviness in the limbs, as if they were asleep. (A. J.) 5890. An almost paralytic powerlessness in the legs and thighs after sitting. (H.) 590. Bruised pain in the limbs, especially in the knees. (Sz.) 501. Stiffness and heaviness of the limbs.4 (.Vz.) 593. Numbness in the thighs and legs. (A. J.) 593. Drawing pain, especially in the joints of the limbs. (Z.) 594. Drawing in the tendinous expansions of the lower limbs. (Z.) 595. Drawing pain in the left lower extremity here and there. (Z.) 5900. Tight pressure in the thighs, as if from a tightly drawn bandage, with great fatigue whilst walking. (Rkt.) 597. Fine shootings, as if from needles in the muscular substance of the thigh. (St.) 598. Drawing pain, first in one thigh, then in the other, then in both together, only whilst moving. (Win.) 599. Raw pain in the thighs when touched. (7im.) 600. Unsteadiness of the knees, they bend whilst standing or walking. (H.) 601. Unsteadiness of the knees, especially of one, it bends under the body whilst walking (immediately and aft. I b. I-.) 602. Deep, slow shooting over the right knee. (St.) 603, Jerking tearing in the inside of the knee. (St.) 604. Drawing in the knee, calf and elbow. ( Wst.) 605. Shootings in the left knee. (Sz. WT.) 606. Icy coldness of the knee,5 alternating with flying shootings. (Wst.) 607. Painful drawing in the leg, from the knee to the heel and back again. (St.) 608. Violent shooting from the heel to the popliteal space. (WIF. from olfaction.) 609. Paralytic drawing in the right leg and tendo Achillis to the heel. (St.) 610. Drawing in the tendo Achillis./ (Wm.) 611. The lower part of the legs and feet are as if numb and asleep. (St.) 612. Heaviness g and tension in the calves. (Z.) 613. Pain in the calves as if from cramp. (Sr.) 614. Pain in the ankles, with despairing thoughts and contemplation of death. (H.) 615. Tearing pain in the left outer ankle," going upwards (aft. 14 h. A7%r.) 616. Sensation in the ankles as if they were tightly tied with a ligature,' in the morning. (H.) 617. Horrible pain in the ankle, relieved by compression (aft. 7 h. H.) 618. Coldness of the feet to the ankles, with sweat of the toes J and soles. (H.) 619. Coldness of the feet, particularly of the toes. (Rkt.) 620. Heaviness of the feet (immediately. H. 621. The feet feel as heavy as lead. (A. j. 622. Paralytic drawing in the feet. (A. J.) 623. Pain in the right heel, principally when treading. (A. J.) 624. Sleeping of the toes of the right foot whilst walking. (A. J.) e Berb. Coloc. f Berb. Graph. Gumg. Mur - ac. Val. Zinc. g June. Rhus-t. Stan. Staph. Teuc. Val. h Brom. Canth.Carbv.Con. Dulc.Magnm. Nitr. Rhod. 01 -an. Samb. Stron, Zinc. i retr. j Am. Sep. Squil. i INDEX TO THE SYMPTOMS OF THE LOWER EXTREMITIES. General, tingling, 678.,, creeping, 651., shooting pains, 608, 651, 678. drawing pain, 595, 607, 609. tearing, 404. "bruised feeling. 84, 590, 650. coldness, 127, 129, 278, 478, 509, 678, 730, 781. weariness, 480, 490, 656, 659. S stiffness, 480, 591., heaviness, 480, 588, 591, 777, 778.,, as if asleep, 588, 611.,, numbness, 127, 526, 592, 611.,, paralytic feeling, 609. paralytic weakness, 589, 650.,, paralysis, 130. General, trembling, 663, 678., in perpetual motion, 663., convulsively drawn inwards, 663. Hip-joint, stiffness, 525.,, cutting pain, 534.,, bruised pain, 537, 581.,, drawing pain, 582.,, pressive pain, 583. Hip-bone, drawing pain, 580. Head of femur, crushed pain, 584.,, drawing pain, 586.,, powerlessness, 583, 584. Thighs, tight pressure, 596.,, itching, 483.,, creeping, 515.,, shootings, 597. Thighs, drawing pain, 598.,, raw pain, 599.,, burning, 483.,, numbness, 592.,, paralytic feeling, 128. Knees, itching, 483. shooting, 602, 605, 606, 676. drawing, 604, 674.,, rheumatic pains, 483. tearing, 494, 603., erking, 603.,, bruised pain, 590. coldness, 606. burning, 483.,, cracking, 654. unsteadiness, 500, 600, 601, 674. YMPTOMS 625 TO 638.] ACONITUM NAPELLUS. 31 INDEX TO THE SYMPTOMS OF THE LOWER EXTREMITIES (continued) atella, acute pressing pain, 480. alves, drawing, 604., heaviness, 612., tension, 612.,, cramp-pain, 613. Scramp, 675, 677, 736.?endo Achilis, pressing pain, 480., paralytic drawing, 609. S drawing, 610.,, shortened feeling, 782. nkles, pain, 614, 617., tearing, 615. Ankles, as if tied with a ligature, 616. Feet, pain, 764.,pressing pain, 480. paralytic drawing, 622. Sheaviness, 620, 621.,coldness, 618, 619, 741, 746.,, numbness, 127, 611.,, want of circulation, 500. as if asleep, 611. Heel, paralytic drawing, 609.,, pain on treading, 623. Soles, cramps, 736. Soles, sweat, 618. Toes, sweat, 618., coldness, 619., sleeping, 624.,, numbness, 574. Tendons, drawings, 594.,, jerkings, 500., shortened feeling, 782. Joints, drawing pains, 593. Nails, blue, 677. REMARxs.-The muscular, tendinous and ligamentous structures of the trunk and extremities, as also the various joints are 11 subject to the action of Aconite, as seen in the above symptoms, and that not merely sympathetically as indicative of febrile disirbance, but also idiopathically. Skin. Ars. Bell. Bry. Cane. Chin. Cop. Crotal. Cupr - ac. Dig. Grat. Hep. Mere. Nitr - ac. Nux - v. Plumb. Plumb -ac. Sulphac. Tab. Tax. nt-t. Bell. Calccaus. Dulc. Graph. "Mez. Sec. Stram. Con. Ant - c. Cale - a. Canth. Caus. Con. Graph. Led. Magnc. Mez. Mur - ac. Nitr. 01-an. Phos. Stron. Cycl. Lye. Mez. Phos. Plumb-ac. Arn. Canth. Carbv. Gran. Graph. Kal - c. Magn - m. Natr. Nic. Nitr-ac. Sep. SAgar. Coloc. Hell. Mez. Sep. Sulph. 625. Jaundice.a (H.) 626, The skin appears peculiarly elastic and smooth.b (Z.) 627. Spots like flea-bites" on the hands, face, &c. (H.) 628. Red pimples, filled with acrid fluid, all over the body." (Stw.)} * 629. Broad, red, itching pimples all over the body. (Ste.) f 630. Several days after taking 20 dr. of the tinct. there appeared chiefly on the face," forehead,' nape, and various parts of the body, isolated vesicles, the size of a pin's head, containing a serous fluid, and attended with itching; successive eruptions appeared for a fortnight, which dried up and fell off gradually. (Glw.) 631. Painful red pimples on the fingersg of both hands. (St.) 632. Itching all over the body, especially on the pudenda.h (StC.) t 633, Creeping, itching and desquamation' of the skin, especially on the affected parts. (H.) 634. Sensation in the skin as if the epidermis were separated from the cutis by an intervening layer j-a kind of wandering creeping and running all over the body, with uncomfortable shuddering feeling. (Z.) 635. Sensation as of something running over the skin and biting,' especially on the hairy parts of the body, with the exception of the head, as if from fleas, making him scratch. (Z.) 636. Fine pricking, as if from needles, here and there on the body. (St.) 637. Single long-continued dartings here and there, mixed with a raw sensation, and at last ending with pain as of a wound. (H.) 638, From a portion of the juice getting into a wound on the thumb. Immediately horrible pain throughout the arm, and especially at the wounded spot; cardialgia; anxiety about the heart; fear of suffocation; fainting; internal heat and thirst; and other dangerous symptoms, so that he thought he would die in the night. The arm became bright red, much swollen;"m the pain so intolerable that he nearly fainted. The inflammation went on to suppuration, and the patient was well at the end of a fortnight. (Re.) PATHOLOGICAL ANATOMY. Skin. ANnMAL. On the inner surface of the skin, great venous injection. In a rabbit. ((E. Z. 1. c., p. 136.) k Staph. I Natr. Phos. Sulph. m BeU. * From a patient with sciatica. SFrom a patient with rheumatism. From a patient with sciatica. t Itching, 243, 480, 632, 633., on pudenda, 632. "Creeping, 633, 634, 635. Prickling, 243, 636. Shooting, 637. Scratchmg, 243. Smarting, 480. INDEX TO SYMPTOMS OF THE SKIN. Raw feeling, 637. Wound-pain, 638. Biting, 635. Burning, 243. As if epidermis separated from cutis, 634. Desquamation, 633. Smooth, 626. Yellow, 625, 679. Redness, 638. Swelling, 638, Inflammation, 638. Suppuration, 638. Spots like flea-bites, on hands, 627.,, on face, 627. --- -- *1 _ _ 32 ACONITUM NAPELLUS. [SYMPTOMIS 639 TO 663. INDEX TO SYMPTOMS OF THE SKIN (continued). Miliary vesicles, 480. Vesicles, various parts, 630.,, on face, 630.,, on forehead, 630. Vesicles, on nape, 630. Pimples, red, all over, 628.,, broad, red, itching, all over, 629., on forehead, 181. Pimples, painful red, on fingers, 631. Funmculus, on nose, 174. RELMLKs.-The action on the skin is not very great, but bears a marked resemblance to some of the milder forms of acute cxanthematous diseases. S. 638 is not of any great value, as the same effect might follow the application of almost any irritant. a Bor.Lact-s.Lact-v. I Glands. 639. (Increase of milk in the mammary glands. H.) General Symptoms. a Arar. Am. Ars. Aur. nBell. Camph. Chin.K-rarb, Natr. J',tr. Sop. 811. dpi. 0el. TIhuj. ab Colch. o Ant-c. Mgt. Sec. d Arg-n. Cic. June. Mang. * (1) [ 640. The whole body is sensitive to the touch,' the child will not allow itself to be moved; it whines." (If.) 641. Impaired sensibility of the surface." (Fg.) 642. Sensation as if she had just recovered from a severe illness, or risen from a sick-bed (aft. 6 h. HI.) 643. Most of the symptoms are accompanied by shivering, shuddering aud anxiety. (A. J.) 644. Sensation of swellingd of many parts of the body, generally accompanied by shuddering, cold or rigor. (A. J.) 645. Creeping, and as if insects were running here and there, with uncomfortable feeling of shuddering and anxiety.(Z.) 646. Numbness and tingling over the body. (Pg.) 647. A peculiar feeling over the whole body, to be compared with that experienced in a vapour bath when the steam falls rapidly on the skin, and drops are felt on it.0 (Z.) 648, Drawing pains wander over the whole body in rapid succession, no where lasting longer than two minutes. (Z.) 649. Bruised pain on many parts of the body. (A. J..) 650. Paralytic and bruised pains in the arms and legs, with violent trembling all over the body, especially in the extremities, which prevents walking; with very pale face; dilated pupils; faintness; palpitation; cold sweat on the back; and digging headache in the temples. Soon followed by burning heat of the face, with a sensation of tension and redness of the face, and sleepiness after dinner (aft. 46 h. St.) (Secondary action?) 631. Trembling and creeping in the limbs, accompanied by shooting pains. (A. J.) 01.-, Drawing here and there in the joints. (lt,,. Z.) 063. Weakness and unsteadiness in the ligaments of all the joints (aft. 46 h. HI.) 654. Painless cracking of all the joints, especially the knees. (H.) 655. General feeling of illness. (Z.) 656. Weariness in the limbs, especially the legs, with constant sleepiness and ill-humour. (H.) 657. Great muscular debility. (Fg.) 658. On awaking in the morning, such great exhaustion he was unwilling to get up, it went off however on rising. (H.) 659. Weariness and exhaustion of all the limbs, with stretching and straining. (Z.) 660. Syncope. (H.) 661, Frequent attacks (almost every other hour) lasting for a - of an hour at a time, of extreme weakness and insensibility, so that he can stir neither hand nor foot, and cannot sit up in bed; he does not feel his former pains; cannot see nor hear, nor even speak aloud; the legs are stretched out' (aft. a few h. H.) 662. General muscular tremors. (Fg.) 663. After swallowing by mistake about 40 grammes of the tincture the greatest restlessness ensued, he complained of his throat and of a burning along the oesophagus. His anxiety and fright rose to a great pitch, and he was not able to sit still an instant. The lower extremities were in perpetual movement,5 even when he sat down. His limbs trembled as he walked. He had excessive fear of death. (Vomiting followed emetics.) In about 3 hours he was unable to keep himself upright, and was attacked by convulsions. The upper and lower extremities were drawn inwards, the fists clenched and the thumbs doubled into the palms,h so that he could not open the hand. The face covered with cold clammy sweat; the eyes turned upwards, so that only the whites could be seen. The radial and temporal arteries could not be felt. This attack lasted 3' and was succeeded by faintness. He felt as if his last hour was come.' His consciousness was undisturbed, f (7) g Bell. Cham. Sulph. h Aeth. Are. Cocc. Hyos. Sulph. i Bell. Hell. Magn-s. Phos. Sep. 3YMPTOMS 664 TO 678.] ACONITUM NAPELLUS. 33 General Symptoms. ' Aum.Bov.Cann-in. Cic. Colch. Cupr. Morph. Nux-v. Op. Aeth. Am-m. Asaf. Bar-c.Croc. Graph. "Kal-c. Mag n-m. Natr-s. Nic. Puls. Sup. Stron. Cycl. Ferr. Graph. Mere. Samb. Sep. Stan. Tarax. i Acth. Dig. SCaus. Sulph. SCamph. Magn-m. GCams. Cocc. Coff. Puls. Rhus-t. 7 Anac. Ars. Cale-c. Crotal. Magn-m. Op. Pule. Rhod. Thuj. Val. r Ars. Bar-ac. Bell. Berb. Crot. Hyos. Plat. Ran-s. Straw. Vcr. a Ars. Bell. but his vision was gone. He could distinguish nothing. Two hours after this the sight returned, but the fits became more violent; the temperature of the skin sank lower and lower. He had rigors, and felt icy cold; face hippocratic; head drawn strongly backwards; the joints crack during the convulsions; the respirations become stertorous; mucous rale audible at a distance. He was still conscious; he felt no pain. The palms of the hands have been quite insensible since the first fit. In 2 more hours the pulse could again be felt (he had had mustard plasters over the body and Iodine internally); he vomited; the warmth began to return and he felt comfortable. In another hour he looked better; copious perspiration ensued; pulse 125; sensation returned to both palms. Two hours afterward a clyster was given, which brought away black and very fetid faeces. Urine small in quantity and dark. He gradually got well, and in 3 days nought remained but an appearance of fright and imbecility. (Dv.) 664. A child, 21 months old, ate some leaves and flowers. In an hour its gait was unsteady, the face swollen, and it could not stand. It soon complained of violent pain in the abdomen; afterwards the eyes became convulsed, trismus and opisthotonos and general convulsions ensued, and it died. (Sp.) 665, The nervous, paralytic and venous congestive symptoms disappear in the open air,k on motion, on drinking wine or coffee, and recur in the warmth of the roomn, and when at rest. (A. J.) 666. The rheumatic and also the inflammatory chest symptoms and the febrile symptoms are diminished or disappear entirely in warmth" (in a room) or when at rest, but are aggravated by motion 0 in the open air,P and by partaking of wine or vinegar. (A. J.) 667. In the open air the head feels free, and all the symptoms become ameliorated. (St.) 668. She hates movement and prefers sitting. (St.) 669. She must lie down (aft. 2-5 h. I.) 670. Invincible inclination t9 lie down (from 2 to 5 h. H.) 671, Lethargy. (Fg.) 672. Exacerbation of all the symptoms in the evening. (A. J.) 673. Periodical occurrence of many symptoms.q (A. ~C.) 674. After taking for a considerable time a very large quantity of the tincture, which for long caused little besides general prostration, coldness of the face,' dryness of the fauces, and restless nights; after an enormously large dose: nauseous sweet taste* in the throat, causing him to hawk up viscid mucus; sensation as if tough mucus hung from the uvula,t causing inclination to vomit; taste of pepper, commencing at the root of the tongue and gra dually spreading all over the tongue; increased flow of saliva; dryness of fauces, with repressible inclination to cough." A kind of numb sensation spread from the teeth over the jaw bones' to the external canthus, and then over the whole body. The brain felt bigger than usual," and as though it pressed upon the cranial bones; with rigor over the back and coldness and paleness of the face. The numb feeling in the extremities, felt when at rest, goes off when walking. Great prostration of the limbs; shaking of the knees; general laziness; frequent fetid eructations,x which relieved a tense feeling in the stomach; vertigo, as from slight intoxication, with great distraction of the thoughts, which made him anxious. Aggravation in a confined space and when at rest, amelioration in opposite circumstances. The 2 next days transient slight drawing shooting pains in the left thorax, the left ear, and afterwards in the left knee. After another dose, in addition to the above, inward rigor from the back over the lower limbs, where cold sweat appears; the face feels icy-cold; symptoms of catarrhal fever came on at night. (lRg.) 675. After taking, during 4 days, the tinct. from 5 to 10 dr. twice or thrice a day: on the 5th day the extremities became cold; the surface cold and clammy; pulse 130, feeble; cramps and pains in the legs, and spasmodic pains in stomach. He died on the 7th day. He had expressed his opinion that death was at hand. (Me.) 676. After a fatal dose: burning in throat; vomiting; cold sweat; apprehensiveness; anxious tossing about; fainting; small pulse; gradual cessation of respiration and circulation. (Pn.) 677. Rapid sinking of the forces, with an equal prostration of the mind; very pale face, with altered features; blue rings round the dull eyes; dilated pupils; vertigo with headache, especially in the occiput; painful tension in the abdomen with borborygmus; vomiting of green masses,' with diarrhoea of the same appearance;' feeling of oppression and anxiety in the chest; general cold rapidly increasing, especially on the extremities, with blueness of the nails of the fingers' and toes; cramp in the calves; pulse small, weak, occasionally not to be felt.b (Bd.) 678. After 5 grains of the extract: In I of an hour he felt a trembling and tingling in the limbs, accompanied by shooting pains. These pains increased, and the trembling passed into convulsions. Taste of pepper in the mouth; vomiting of all the food. During the convulsions loss of consciousness. Eyes dazzled on coming to himself; a fixed headache, like a hot iron round the head.d Copious sweat followed the convulsions.' Pulse unequal and slow. Five hours after taking the drug: pale face, with expression of anxiety and restlessness; u Caus. Kal-hyd. bur-ac. 01-an. Pctr. v Gran Rut. w Bell. Cinch. Dale. Natr-m. x Ant-t.Bell.Carb-a. Cinch-s. Coco. Con. Ferr. M ur-ac.Olean. Raph. ThuJ. y Crotal. Op. Plumb. Pula. Raph. Rhod. a Am-rn. Arg-n. Bell. Chain. Dule. Grat. Gum-g.IIep.Mugiic.Magn-m.blMerc-. Puls.bulph-ac.Tab. a Chilu-a. b Ant-t. Are. Bell. Cic. Morph. Ver. SAnt-t. Ar.. CGin. Plumb. cil. d (0) e See. E 4B t.. L 34 ACONITUlM NAPELLUS. [SYMPTOMS 679 TO 70o General Symptoms. e lga Mere.Phos-ac. SBell. Colch. Galv. K-chl. A irom. Bry. Chin. Crotal. lHp. Nitrac. Plumb. Plumbpc. i Are. Arn-h. Bell. Con. Crotal. Gran. lod. Phos. j Anr.Bell.Bry. Cane. Chin. Cop. CrotaL Cupr-ac. Dig.Grat. Ilep. blere. Nitrac. Nux-v. Plumb. iPlumb-ac. Sulphac. Tab. Tax. eyes very moveable; disposition impatient; very restless; he speaks much and rapidly;e cold tongue,' as in a cholera patient; burning in throat; vomiting of mucus; orthopncea, 25 respirations per minute; pulse 54, unequal, soft and full; mucous rattle in chest posteriorly. The heart beat but once in every 3 pulsations against the chest. The left ventricle was consonant with the pulse, but the right auricle seemed to be in a convulsive state.5 The limbs began to grow cold. In the evening reaction came on, and next day he was well. (Pya.) 679, Whilst taking enormous doses of acon. the following occurred: The 3rd day no appetite; the skin h and eyes' become yellowish. The 5th day the jaundice J more marked. The 6th day the skin yellower; nausea, cardialgia and anorexia; inability to leave the bed. The 7th, nausea, vomiting and delirium at night; the expression altered; the look extinguished; difficulty of hearing. The 8th, very restless during the night; got out of bed without being able to get back again; she was tied down; great anxiety; she lost all power of speaking; lay in a stupified state, the eyes closed, the facial muscles convulsed; trismus; slow difficult respiration; pulse quick, irregular; skin burning hot. (V. S.) The 9th day, jaundice a little diminished, but all the other symptoms increased. Abdomen swollen (buffy coat' and soft coagulum of blood drawn). She fell into a state of coma, and died next day. (Ot.) k Bell. I K-bich. INDEX TO THE GENERAL SYMPTOMS. Creeping, G45. Tingling, 500, 646. Sensitiveness, 640. Drawing pains, 648. Ulcerated feeling, 501. Bruised feeling in all the limbs, 84, 649. As if drops were falling on him, 647. Swollen feeling, 644, 781. Stiffness, 745. Numbness, 674, 781. Diminished oensibility, 641, 661. Unsteadiness, 728. Tired feeling, 243, 475, 477, 480, 501, 596, 659, 780. Weakness, 127, 129, 130, 477, 479, 501, 657, 661, 664. Prostration, 477, 480, 482, 500, 674, 677. Exhaustion, 658, 659, 779. Desire to lie down, 669, 670. Dislike of movement, 668. Inability to move a limb, 661. Faintness, 477, 650, 735. Fainting, 278, 500, 501, 638, 660, 676. As if recovered from a severe illness, 642. Feeling of illness, 655. Sickly appearance, 782. Stretching, 659, 682, 780. Trembling, 278, 493, 650, 651, 662. Tossing about, 243, 318, 676. Tossing of arms, 127. Convulsions, 127, 663, 664, 678, 700.,, opisthotonos, 664. Joints, pain, 130. Sshootings, 463.,, drawing, 652.,, weakness, 653., cracking, 654, 663.,, unsteadiness, 653. REMARKs.-The convulsions caused by Aconite agree with the action on the brain, before pointed out. In SS. 675-678 w have exquisite pictures of some kinds of cholera. In S. 679 the medicine was pushed to much too great an extent to enable us t form a precise idea of its specific action, but the phenomena of the first few days show a remarkable effect on the liver and gastro intestinal organs. Sleep. a Lye. Phos. Stan. b Lach. Lye. Moch. Nitr. e Op. d Con. 680. Interrupted yawning," she cannot yawn enough. (H.) 681, Yawns often without being sleepy. (St.) 682. Yawning and stretching of the limbs. (8st.) 083, Yawning with sleepiness. (Sz.) 084, Sleepiness and laziness, uncommonly sleepy even whilst walking.b (iH.) 685. Sleepiness, sleep (aft. 2 h. H.) 686. Sleepiness towards noon. (Z.) 687. Great sleepiness in the afternoon; the eyes close involuntarily; he wakes, however, readily at the least noise, but always falls asleep again. (St.) 688, Falling asleep whilst standing. (Z.) C89., Inability to keep awake. (Mor.) * 690. After cating uncommon sleepiness. (St.) 691. Tendency to stupor. ( Wo.) 692GS. He cannot be awoke; C his hands are cold ' and he is senseless. (Mor.) 693, Light sleep (from I to 5 h. H.) * Hahnemann has here improperly " slumber." 694. Sleeplessness (aft. 4 h. H. A. J.) 695. Frequent waking, with excessive wakefulness. (J m.) 696. He sleeps sitting, with his head bent forwards. (H.) 697. In the morning he sleeps on his back, the left hand laid under the back of the head.e (H.) 698. He felt as if he were sleeping in the air and had nothing under him. (Bm.) 699. On lying down at night, shuddering. (H.) 700. Frightful convulsive movements on falling asleep.! (Sz.) 701, Frequent starting out of sleep.h (WlI.) 702, He starts up in a fright, moves much and talks in his sleep. (H.) 703. She starts up in her sleep and says some one is holding her. (H.) 704, Very restless nights. (A. J.) 705. He cannot lie on the right side nor on the back, he turns in bed from one side to another with pain. (H.) e Nux-v. Phos. Puls Rhe. Sulph. Ver. f Lact-v.(?)Mosch.(?, (g) h Agn.Anac. Lauroc. Magn-c. Merc-s. Nitr. Rhus-t. Rut. i Camph. Rep. Nitrac. Nux-v. Puls. 1 c r ~,.c,.,, ~ ~ ~~~ I o r S L ~L C II ~ ~ ~~* ~ I I~ _ __. ___ SYMPTOMS 706 TO 739.] ACONITUIM NAPELLUS. 35 Sleep. J (?) k (?) 706. Slow breathing when asleep. (HI.) 707. (Inspiration with a double jerk, like the bleating of a goat, whilst asleep) (IH.) 708. After lying down at night and whilst sitting during the day, he is in a state of waking dreaminess and imagines erroneously that he is far from home. (H.) 709. Sleep full of dreams of a confused and vivid character. (St.) 710. Long confused dreams. (IFc.) 711. Dreams, in which he spoke much. (H.) 712. He has a very vivid dream towards morning, and obtains an accurate explanation of a circumstance that was a riddle to him whilst awake k (aft. 20 h. H.) 713. He dreams half the night of a single subject, which also occupied his attention for many hours after he awoke, so that this subject alone is in his mind (like the fixed idea of a monomaniac), which is very troublesome and disagreeable to him.' (II.) (!) 714. Dreams of subjects that for 8 years had been foreign to his thoughts." (M.) am Bov. Cic. Graph. 715. At night anxious dreams and occasional waking with a start. (Rkt.) 716. Long dreams with anxiety in the chest, taking away the breath and causing him to awake (night-mare.)" (H.), Magn-m. Tab. 717. Anxious heavy dreams with oppression of the chest.0 (Sz.) o Hep. Lach. Lact-s 718, Vexatious dreams. (H.) it. zine. 719. Vexatious, memorable dreams, which excite his anger, in a half waking state. (Gi.) 720. On awaking in the morning, dizziness in the head.P (H.) p Arg-n.Phos.Rhus 721. On awaking in the morning, it appears t.an. Sulph. to him as though his breath were fetid. (I.) 722. Shiveringq and frequent yawning on q Kreos. Mcrc-o. rising in the morning. (St.) S. I Yawning, 681, 682, 683, 722, 780.,, convulsive. 340.,, baulked, 680. Sleepiness, 340, 475, 479, 656, 683, 690.,, at noon, 686. S in the afternoon, 687., after eating, 243, 650. Half waking state, 483, 708, 779. Stupor, 691, 692. Coma, 679. Sleep, disturbed, 243, 477, 479, 480, 482, 483, 704, 782. Sunrefreshing, 482. During sleep, breathing like a goat bleating, 707.,, slow breathing, 706.,, short breathing, 416, 716. INDEX TO SYMPTOMS OF SLEEP. During sleep, precordial anxiety, 716.,, convulsive movements, 700. S starting, 701, 702, 703, 715. S talking, 702, 710. S as if he lay in the air, 698. Night-mare, 716. Dreams, vivid, 243, 480, 709, 712, 719, 782. S long, 716. extravagant, 779.,, fantastic, 483., confused, 709., disagreeable, 483., anxious, 479, 715, 717., vexatious, 718, 719. S frightful, 477., of one subject all night, 713. Dreams, about events of the day, 782., of subjects long past, 714. Light sleep, 693. Frequent waking, 695. Sleeplessness, 127, 477, 480, 483, 674, 694, 695, 779, 782. Decubitus, dorsal, 482, 697.,, with hand under head, 697.,, impossible on back or right side, 705. On awaking, yawning, 722.,, shivering, 722.,, feels as if drunk the night before, 480.,, vertigo, 720. fetid breath, 721. Febrile Symptoms. a (?) b Con.Merc-s.Nux-v. 723, She is cold and shivers. (St.) 724, Shivering for several hours, as if between the skin and flesh, especially over the back and abdomen, felt even when perspiring from rapid walking." (Z.) 725. Anxious cold feeling (aft 3 h. H.) 726. Shivering on the slightest movementb (aft. 10 h. IH.) 727. Shuddering from the middle of the spine to the lumbar muscles of both sides, as if from a chill. (lWl.) 728, After taking for some days a large quantity of the tinct.: rigor along the spine, with goose-skin creeping along the galea aponeurotica; hands" and faced blue, he seeks the heat of the stove, he loses the feeling of steadiness while standing, the legs seem as if they would rise up, he falls asleep while standing" for an instant. He feels while breathing as if the air passages were very wide, so that the air passed in and out very readily.r (Z.) 729. Coldness in the belly.Y (St.) 730. Constant coldness through the arms and legs, and shivering even in the face. (St.) 731. She shivers from below upwards to the chest. (St.) 732. Rigor over the back and arms. (St.) 733. Shivering in the evening, especially in the hands and feet. (iWm.) 734. Shuddering on lying down at night." h' Ar. Mere-s. Nair. IT ) Sabiu. Siara. Staiph. 735. Attack of faintness with shivering. (H.) 736. First coldness, rigor and paleness of the finger ends, then of the fingers, thereafter cramped sensation in the soles of the feet and calves, and finally coldness in the forehead (aft. % h. I.) 737. Cold over the whole body. (f.) 738. Continual diminution of temperature. (Ws8t.) 739. Shuddering, with paleness and sunken features. (Z. Ar.) c Spong. d Sulph. c Mercurial. Nitr-ac. f (?) g Ambr.Campb.Grat. Hell. K - carb. Lauroc. Mg-t-n. Meny. Phel. Phos. Plumb. Sec. Tercb. t I ----------- 36 ACONITUM NAPELLUS. [SYMPTOMS 740 TO 778. Febrile Symptoms. i (,)! j Chain. Lye. k Art. Bcll.Coff.Ipcc. Tab. / Ipec. m (?) n Ban-b. Brom. o Natr. Morph-ac. Potr. Strom. p Mosch. q Bry. Chin-s. Cupr. Mblgt-n. Nux-v. r Dros. Led. Staph. SAmn. Phos. Raph. D Bry. Ign. u Calc-caus. r Krro,. w Bry. agn. y Ant. 740. Coldness under the skin,' slight frequently repeated rigor, not followed by heat. (Sw.) 741. Coldness in the hands and feet, shuddering over the back whilst the head and body are warm. (Z.) 742. At night, after a short rigor, cpntinued heat. (lk.) 743. Alternation of coldness and heat. (M.) 744. Fever: coldness of the whole body, with hot forehead,J hot ears, and inward dry heat.k (7.) 745. Fever: coldness and stiffness of the whole body, redness and heat of one and coldness of the other cheek,' with open fixed eyes and contracted pupils m which only dilate slightly and slowly in the dark. (IH.L) 746. Towards evening, rigor and coldness of the hands and feet, then nausea felt about the middle of the sternum, which continues even when partaking of food, that tastes well, although there is neither appetite nor dislike for food; after eating, the nausea goes off" and is followed by heat of the face0 accompanied by sad and despairing thoughts. (1H.) 747. Cold shuddering from the crown of the head down the back to the sacrum, followed by an agreeable sensation of warmthP in the skin. (I17.) 748. Alternating attacks (aft. 3, 4, 6 h.): Either along with redness of the cheeks childish merriment, with sensation of heat all over the body, and headache on moving the eyesq upwards and sideways; (HI.) 749. Or, along with redness of the cheeks" and heat of the head,' shuddering all over the body, with proper taste in the mouth; (H.) 750. Or, along with redness of the cheeks,' rigor, with weeping and pressive headache; (ti.) 751. Or, along with redness of the cheeks, an obstinate disposition, burning in the region of the navel, and pressive headache. (H.) 752. After the siesta, which usually makes him warm, feeling of rigor throughout the body and cold of the upper arm. The cold feeling persisted even while walking, and in the evening gave way to a short disagreeable feeling of warmth, like a catarrhal fever. (Rg.) 753. Extreme redness of the cheeks, with a discontented, complaining, lacrymose disposition (aft. 3 h. IH.) "754. Towards evening, burning heat in the head" and face," with redness of the cheeks" and out-pressing headache, at the same time rigor over the whole body and thirst (aft. 14 h. St.) 755. Towards evening, dry heat in the face with anxiety. (IL.) 756. Heat in the head,0 forehead hot to the touch,' with rigor over the rest of the body on the slightest movement. (H.) 757. Sensation of heat, first in the hands, then all over the body, even in the chest, without perceptible external heat' (aft. 4 h. H.) 758. Attack of heat in the back. (St.) 759. (Heat and throwing off the clothes. H.) 760. General heat and thirst. (H.) 761. During the heat, moderate desire for beer.? (H.) 762. (She drinks little during the heat, yet has dry lips. H.) 763. (During the heat, the cough is troublesome. H.) 764. (Great heat from 10 in the evening till after midnight, with dyspncea; she would like to cough, but cannot, and speaking is difficult; at the same time there is the greatest restlessness, and complaints about pain in the bowels, feet, abdomen and back; she stamped with her feet, and would not allow herself to be touched. H.) 765. Perspiration with febrile rigor (aft. 3 h. H.) 766. Moderate perspiration all over the body. (H.) 767. Febrile perspiration. (H.) 768. Sour smelling sweatb all over the body. (H.) 769. Cold sweat. (A. T.) 770. Surface cold and covered with clammy sweat.0 771. Skin inclined to transpiration. (A. cT.) 772. General warm sweat. (A. J.) 773. General sweat, especially on the forehead and precordia. (Gl.) 774. Nausea, vomiting, thirst, general heat and copious perspiration, with diuresis. (Gg.) * 775. Exhalation and sweat all over the body. (Stoe.) 776. Nocturnal transpiration. (A..J.) 777. Internal rigor from back over the legs, with cold sweat; the face feels ice-cold (in a sunny day and a warm room.) This lasted four hours, till evening, when heat and rapid pulse and symptoms of coryza came on, with general laziness and heaviness of the limbs. (Rg.) 778. After 105 drops in 5 days, there occurred the following symptoms within the 24 hours: weight and pressure in the vertex and forehead, nausea, painful heaviness of the limbs, pressive pains in the scrobiculus, head confused, giddy, face hot, hands and feet cold, pulse contracted, hard, moderately frequent; the face grew redder, turgid, the eyes sparkling, the mouth dry, tongue furred, no appetite, great thirst, oppression of chest, superficial respiration, sighing, feeling of fulness in the chest, palpitation and anxiety. Pulse strong, full and hard, skin warm, urine clear and reddish. The heat and restlessness increased; a Bism. Rhus-t. 01- an. a Nux-v. Puls.Rhust. Spigel. Sulph. b Arn. Br. Carb-v. Caus. Colch. Fluorac. Galv. Graph. Hep. Hyos. Ind. Ipee. Led. Lye. Mere-s. Natr-m. Nitr-ac. Nux-v. Rhus-t. Sep. Sulph. Sulph-ae.Ver.Zinc. c Ant-t. Ars. Dig. Tab. * From a patient. I SYMPTOMS 779 TO 782.] ACONITUM NAPELLUS. 37 1 Febrile Symptoms. Ign. Stan. Am-c. Bar-c. Am-c. Bor. Lyc. Am-m. Am. Calcc. Natr-m. Sabad. Sulph. pain in the right side of the chest. These symptoms then gradually declined. (Hk. c.) 779. After 20 drops, increased warmth all day, with exhausted feeling and loss of appetite. The heat increased towards evening, and the pulse became full and quick. He felt the beating of the temporal and carotid arteries while sitting. Disinclination to go to bed; he could not sleep when he went to bed; the heat of the body increased, especially of the extremities: perspiration appeared on the inside of the thighs and on the scrotum, accompanied by great itching; he scratches till the blood comes. He was in a kind of half sleep, tormented by the most extravagant dreams till morning. The itching of the scrotum continued next day, and the following night he was hot and sleepless; the next night still restless, but less so. (PRg.) 780. After a large dose (400 drops): Burning in the tongue, increasing in intensity for 4 hours; the soft palate, tonsils, and fauces reddened, with feeling of warmth and dryness of lips. Rigor commencing in the legs, then going to the arms, with goose-skin;d it seems to be betwixt skin and muscle, worst when at rest; great fatigue, indifference, irritability, no appetite, food creates nausea. The rigor continued to increase in the afternoon, and he became icy cold, no coverings suffice to warm him. The hair seemed to bristle,0 and the scalp was painful to the touch on several spots, and sensitive to cold air.' Burning in the eyes, twitching and vision of sparks; roaring in the ears, great sensitiveness to noise. Breath hot,s breathing quickened; on breathing deeply, oppression, anxiety, and painful stitches betwixt shoulders, pulse strong, full, quick; much yawning and stretching of the limbs. In the evening, warmth and slight perspiration came on, with excessive salacity, after which all the symptoms went off, except that for 3 days there were violent shoots in the glans penis while making water,h and hot darkcoloured urine was passed. (Sw.) 781. Forty drops caused the following effects: Headache in the forehead and temples, heat on and in the chest, eructation of air and nausea, going off after breakfast, violent palpi tation, with disagreeable feelings in the cardiac region, itching on the skin of the left arm, cold feeling running down from the middle of the thigh, especially on the knee and leg, digging pain in the chin. The legs got very cold in an hour, worse when in a warm room and when walking. 40 drops more caused an increase of headache, feeling of swelling all over, especially in the left side, with bruised pain in the ribs and arms, with crampy feeling about the heart'; the swollen feeling changes into a numb feeling. In the afternoon rigor all over the body in a hot room; glowing heat of the face and redness of cheeks,J pain in the throat, itching and soreness of eyelids, pulse 67, small and soft. The pulse after this rose in an hour to 102, was full and hard, then an agreeable warmth came over the body, followed by perspiration, the legs all the time continuing cool.k A pain came into the eye as if it was pressed into the orbit and bruised.' The heat of the body and face, and the pain in the head and eyes, lasted all the evening, and the heart's beats were very strong. The night was good, and the next day the abnormal symptoms were gone. (Gl.) 782. After taking a pretty large quantity of the tincture, the following were the chief symptoms for 3 weeks: At first pressive and shooting pains in the front of the eyeball, then all the symptoms of having caught cold; coryza, rigor down the back, especially in the evening, oppression of breathing, pressure under the sternum, flying heat, full pulse, restless nights with vivid dreams about events of the day. On taking a fresh dose 3 days later, pinching about the navel, followed by painless diarrhoea, pressive headachb over the right eyebrow, increase of febrile symptoms towards evening. This febrile state lasted several days, the difficulty of breathing increasing, with intermitting pulse; 5 beats were hard, full, in rapid succession, the 6th could not be felt, even at the heart. General sickly appearance. Burning in the urethra when urinating. The symptoms then became chiefly confined to the tendinous or muscular structures, such as shortened feeling of the tendons of the ham and of the tendo Achillis. (Ar.) i Eal-c. Phos-ac. j Bry. Ign. k Ars. Nux-v. Pwon. I Ant-t. Ilcp. Lyc. Nux-r. Sulph. boose-skin, 728, 780. ligor, 302, 477, 501, 634, 643, 644, 645, 663, 722-728,731,739,740, 749,750,752,754,781. ligor, in the morning, 722. Sat night, 477, 483, 699, 734, 742, 782., as if betwixt skin and flesh, 724, 780. inward, 674, 777.,, over abdomen, 724., over chest, 482, 731., over the back, 475, 482, 674, 724, 727, 728, 732, 735, 741, 747, 777, 782.,, over arms, 732, 780.,, in hands and feet, 733, 746.,, over the legs, 777, 780. INDEX TO SYMPTOMS OF FEVER. Rigor, followed by heat, 742, 747, 777.,, with thirst, 754. Swith heat of head, 754, 756. Swith heat of face, 754, 756. Coldness, 129, 243, 477, 644, 663, 675, 677, 723, 725, 737, 738, 744, 745. Icy coldness, 780. Coldness, of forehead, 736.,, of face, 674, 730, 777.,, of tongue, 678.,, of stomach, 130. S of abdomen, 729. S of arms, 127, 129, 278, 478, 509, 544, 678, 730, 752. Coldness, of hands, 565, 566, 692, 741, 746, 778. S of fingers, 736. S of legs, 127, 129, 278, 478, 509, 678, 730, 781.,, of knees, 606. S of feet, 618, 619, 741, 746, 778.,, of toes, 619.,, under skin, 740. not followed by heat, 740. Hect, 477, 479, 482, 483, 679, 748, 757, 774, 779, 782., at night, 243, 477, 480,483,742, 752,759, 764, 776, 778, 779, 780, 782. - --~- -~ ~ - --- -- -~ 38 ACONITUM NAPELLUS. INDEX TO SYMPTOMS OF FEVEB (comtinued). Heat, internal, 638, 744., of ears, 340, 744.,, of face, 183-186, 340, 378, 490,491,650, 746, 754, 755, 778, 781.,, of forehead, 744, 756.,, of back, 758., followed by perspiration, 781. During the heat, dry lips, 762. S thirst, 760, 774. S desire for beer, 761. S cough, 401. S cough worse, 763. During the heat, dyspncea, 764. Alternate heat and cold, 477, 479, 743. Perspiration, 663, 678, 766, 767, 771, 772, 773, 775.,, on forehead, 773., on chest, 773., on scrotum, 779., on the thighs, 779., sour smelling, 768. in the morning, 483. at night, 482, 483, 780. after vomiting, 276. Perspiration, with rigor, 765. Warm sweat, on forehead, 427. Cold sweat, 674, 676, 769, 770, 777., on head, 278., on forehead, 500, 501., on face, 663. on back, 650. on hands, 500., on feet, 500. on palms, 569. Clammy sweat, 770. RErMARKs.-Nothing is better marked than the power of Aconite to produce fever of the pure synochal type, whether idiopathically or sympathetic to inflammatory action of different parts, and this power has been shewn in a much greater degree by the re-provings of the Austrian Society than it exists in the original records of Hahnemann. We find in the foregoing, states exactly analogous to synochal, catarrhal and rheumatic fever in all their stages. CONDITIONS OF THE SYMPTOMS. PnODUCTMON On AOGnAVATION nY: Light-headache, 102. Noise-general, 29. Music-general, 30. Swallowing-choking, 413, 414. S sore throat, 230, 239, 242. Eating-vertigo, 479.,, hiccough, 257.,, pressure on stomach, 255, 476., pain in stomach, 463.,, heartburn, 463.,, exhaustion, 243.,, slcopiness, 243, 256, 690.,, cold feeling, 243. Drinking-headache, 83.,, hiccough, 257.,, cough, 400. Taking wino-rheumatic and chest symptoms, 666. Smoking tobacco-stupefaction, 66.,, tickling in larynx, 394.,, cough, 402. Speaking-headache, 80, 83. Ssore throat, 230. Laughing-pain in right hypochonder, 297. Sneezing-pain in chest, 479. Deep inspiration-oppression of chest, 431, 432, 780.,, pain in chest, 431, 463, 474, 479, 780.,, pain in back, 517, 780. Yawning-earache. 166. Perspirig-cearache, 170. Shaking head-vertigo, 62. Moving head-pain in neck, 513., pain in nape, 502, 503. S pain in scapula, 604. Moving eves-headache, 748. Motion-head svmptoms, 69, 83.,, pain in 6ack, 525.,, pain in arm, 538, 554, 556.,, pain in thighs, 598.,, pain in hip, 525, 581, 582.,, rheumatic and chest symptoms, 666.,, tired feeling, 243.,, shivering, 724, 726. Motion-heat, 482. Walking-vertigo, 482.,, headache, 93.,, sore throat, 242., nausea, 260.,, pain in spleen, 206.,, pain in bladder, 350., pain in urethra, 354., palpitation, 477., backache, 243, 520.,, pain in hip, 583, 586.,, cold legs, 781.,, trembling of limbs, 663.,, sleeping of toes, 624. S sleepiness, 479, 684.,, fatigue, 596. Rising from seat-nausea, 65. Stooping-vertigo, 52, 53, 61, 63.,, headache, 61, 92, 107. Leaning forwards-bellyache, 307. Assuming an erect posture-pain in chest, 435, 463. Standing-vertigo, 54.,, sleeping, 688. 728. Lying-pain in neck and shoulder, 510.,, tired feeling in legs, 587. Sitting-nausea, 260.,, sinking, 260.,, palpitation, 477.,, sleeping, 696. Rest-numb feeling, 674.,, nervous and paralytic symptoms, 665.,, rigor, 780. Writing-distraction, 43.,, pain in arm, 55. Pressure-pain in back, 518. Open air-flickering before eyes, 480.,, sore throat, 242.,, pain in limbs, 243.,, rheumatic and chest symptoms, 666.,, rigor, 482. Warm room-vertigo, 59.,, headache, 104.,, cough, 483.,, cold legs, 781.,, nervous and paralytic symptoms, 665. AMELIORATION OR REMOVAL Y: Darkness-headache, 102. Eating-earache, 166.,, sore throat, 242. S nausea, 263, 781. S pain in abdomen, 258. Expulsion of flatus-bellyache, 314.,, rumbling in bowels, 324, 340. Coughing-dyspncea, 479. Deep inspiration-oppression of chest, 430. Bleeding-dim vision, 127. Motion-headache, 109.,, pain in neck and shoulder, 510. Spain in back, 528.,, pain in arm, 555.,, pain in hand, 568.,, nervous symptoms, 665. Sparalytic symptoms, 665. Walking-nausea, 260., numb feeling, 674. Getting up-exhaustion, 658. Stooping-pain in eyes, 147. Bending forwards-pain in back, 528. Bending backwards-pain in chest, 435. Lying down-pain in chest, 461. Sitting still-vertigo, 65.,, nausea, 65.,, headache, 93. S palpitation, 477. Rest-rheumatic and inflammatory chest symptoms, 666. Pressure-pain in ankles, 617. Rubbing the skin-pain in chest, 463. Cold water-headache, 479., anxiety, 479. Open air-headache, 109, 667.,, nervous symptoms, 665., paralytic symptoms, 665. Warm room-rheumatic symptoms, 666.,, inflammatory chest symptoms, 666. ~ THERAPEUTIC USE. THE following are Hahnemann's observations with respect to the medicinal uses of Aconite. "Although the following symptoms are far from expressing the whole value of this most valuable plant, yet they give the reflective homeopathic physician a means of affording aid in morbid states in which the old school of medicine employed her most dangerous appliances, e. g. copious bloodletting, and the whole complex array of so-called antiphlogistic means, often in vain and almost always with sad after-effects. I refer to what is called pure inflammatory fever, in which the smallest dose of Aconite renders all those antipathic methods hitherto in vogue superfluous, and cures quickly and without after-sufferings. In the measles, the purpura miliaris, and in acute pleuritic fevers, &c., its curative efficacy is truly wonderful, when it is administered in the dose of a thousandth part1 of a drop of the decillionth development of potency, alone, care being taken to avoid all other medicinal substances, even vegetable acids, and the patient being kept rather cool. It is rarely necessary to give another such dose 36 or 48 hours after the first. "But in order to abolish from our conscientious treatment all routine practice, which is but too apt to direct its treatment to mere names of diseases that are often quite imaginary, in all morbid states for which Aconite is to be given, the chief symptoms of the disease whether acute or chronic must be found among the symptoms of Aconite. Then the result will be wonderful. 1 That is, a small sugar globule, the size of a poppy seed, moistened with it, more than a thousand of which may be moistened with one drop of spirits of wine, and which are so small that 300 of them weigh only one grain. 11 " In those very cases, such as severe, acute inflammatory fevers, whereon allopathy plumes herself most that she alone is capable of saving life by means of bold and repeated bloodlettings, and that therein she is infinitely superior to homceopathy, it is in those very cases that her boast is most misapplied. Those are the very cases in which the infinite superiority of homceopathy is manifested, as she does not require to shed a single drop of that precious vital fluid, the blood, (which the allopath often drains off in streams to an irreparable extent,) in order to transform this dangerous fever into health, not unfrequently in as many hours as the allopathic, life-depressing system requires months for the complete recovery of those whom death does not in the meantime cut off, or at all events in the chronic maladies it artificially excites. " In those cases of acute disease an intermediate homoeopathic medicine is sometimes necessary for the other morbid symptoms that remain after the first dose of Aconite has acted 12 or 16 hours, but it is very seldom necessary to administer a second dose of Aconite after this intermediate remedy. " In as short a time as four hours after such a cautious administration of Aconite in the morbid states in question, all danger to life is past, and the excited circulation then returns from hour to hour to its more tranquil course. "Although on account of the short duration of its action (which in such small doses does not extend beyond 48 hours) Aconite might seem to be capable of being useful in acute cases only, yet in the most obstinate chronic maladies it is indispensable as an accessory remedial means, where the state of the system requires a diminution of the so-called tenseness of the fibre (the - I I 40 ACONITUM: NAPELLUS. 40AOITM AELS strictum of the ancients), on which subject I cannot now dwell more fully; its efficacious employment in such cases is apparent from the symptoms it produces on the healthy person, and which are in part detailed below. "Aconite is also the first and chief remedy, in the small dose above mentioned, in inflammation of the windpipe (croup, angina membranacea), in several kinds of inflammation of the throat and fauces, as also in the acute local inflammations of all other parts, especially in those cases where, besides thirst and quick pulse, there are present an anxious impatience, an uncontrollable agitation and agonized tossing about. " It develops morbid states similar to all those that occur in persons who have had a fright combined with vexation, and is also the most certain and rapid remedy for those states. " In the selection of Aconite as a homoeopathic remedy, we ought to pay especial regard to the moral symptoms, and see that they in particular resemble those produced by the medicine. " Hence it is indispensable after fright or vexation in women during the catamcnia, which without this excellent sedative are easily suppressed by such mental shocks, often instantaneously. For this end it suffices to allow the patient to make a single momentary olfaction in a bottle containing a single globule the size of a mustard-seed moistened with the decillionth potency of Aconite (which may be kept in a well stoppered bottle for years for this object, without the globule losing anything of its curative power). " Most of those symptoms of Aconite detailed below which seem opposed to one another are merely alternating states, by means of either of which it can be remedially useful, still it is most so in respect to those that have a tonic character. " Vegetable acids and wine remove its effects, and so do other medicinal substances that correspond palliatively or homcopathically to the troublesome symptoms it may give rise to, in consequence of too large a dose or the administration of it being unhomccopathic." The above remarks of iHahnemann indicate a portion only of the morbid conditions for which this valuable remedial agent is specific. An examination of the symptoms in the foregoing schema, and our clinical experience in the use of the drug, shew that it is applicable in the commencing febrile condition of almost all exanthematous fevers, and in some, as measles and miliary fever, as Hahnemann has remarked, it often suffices of itself to effect a cure. It may be looked upon as specific in catarrhal fever, and in the catarrhal symptoms occasioned by cold, damp, or the like, which it will often cut short. In acute rheumatism and rheumatic fever its virtues have been extensively shewn. It is indispensable also in traumatic and puerperal fever, and generally for the fever accompanying all local inflammations. The inflammations to which it is particularly suitable are those of the serous membranes of the lungs, heart, abdomen and brain; it has also decided power over inflammations of the mucous membranes, the various tissues of the eye, the joints, the muscular substance, tendons and ligaments; in fine, acute inflammations of all structures are more or less within the sphere of its influence. Active congestion of the brain or lungs indicate its use. Active hemorrhages of the nose, lungs, uterus and bowels demand it. It has been successfully employed in the first stages of Asiatic cholera. It is, moreover, useful in neuralgias of many kinds, even such as are unaccompanied by symptoms of accelerated circulation. Over excitement of the nervous system frequently demands its use. Inflammation of all parts of the respiratory apparatus are especially under its power, including croup, laryngitis, tracheitis, bronchitis, pneumonia and pleuritis. In fact to enumerate the diseases for which it is suitable would be to mention the acute inflammations of every possible organ and tissue in the body; and if it be not for all of these the sole remedy, it is almost always useful either previous to or in alternation with another remedy which has perhaps a more specific relation to the part affected. Our clinical records teem with instances of its successful application in all such affections, and the following resumd of the cases and affections for which it has been found serviceable, given by Trinks in his Materia Medica, to which I have made a few additions, will I doubt not be acceptable to the practitioner. Diseases of stout and full-blooded children. (WIDNMANN, A. h. Z. xxii, p. 107.) Very painful rheumatism of the joints, with violent fever; stitches in the chest; violent, quick and wide extended heart's beats. T. Acon. gtt. v, twice a day, cured it in 4 days. (ICRAnExR, Hyg. x, 505.) Rheumatismus acutus fclrilis. (FRANK, A. iZ.. xxi, 290.) Aconite is suitable only for that form of febrile rheumatism where the genius morborum or the individuality tends to the true synochal-inflammatory diathesis. (KuaRTz, A. h. Z. xxvi, p. 89.) Rheumatismus acutus articulorum; tearing and shooting in the limbs, which were swollen; moderate inflammatory fever, increasing towards evening; thirst; anorexia. T. Acon. gtt. iv, in Aq. 3 iij, a tablespoonful every 3 hours. (WERBER, Hyg. viii, 294.) Chronic rheumatic gout, when the patients I I I THERAPEUTIC USE. 41 have been made weak and irritable by abuse of medicine, so that they cannot bear the smallest doses of homceopathic medicines without aggravation of the sufferings. In some cases the chronic affections changed into acute, and a true irritation fever was stirred up; in those cases Aconite moderated the pains and the debilitating perspirations, and procured sleep, by means of which the patients recovered, and were cured by the employment of other appropriate medicines. (ARNOLD, Hyg. i, 64.) Acute arthritis, affecting all the joints, with fever. (HEICHELHEIM, Hyg. v, 206.) Arthritic fever. (KRAMER, Hyg. i, 18.) Frightful pains in the joints that would not allow the slightest touch, with strong fever. Acon. 4, gtt.j, twice a day, cured in 7 days. (HEIIELHTEDM, Hyg. v, 206.) Very violent ebullitions of blood, with great redness of face, anxiety and restlessness; after which inflammation of important parts used to occur; cured by a few doses of Aeon. 12. (STArF, Arch. ii, 3, 84.) Congestions: Rush of blood to the head, with constant vertigo, causing falling; severe headache; stupifying pains in the forehead; confusion; momentary loss of consciousness; flickering before the eyes: in two strong plethoric men who used formerly to be bled several times a year. (KIRAMER, Hyg. i, 24.) Nervous over-excitement in acute diseases, with attacks of weakness and faintness. (HARTnAN on Aconite.) Attack of illness after fright, in a delicate, weak-nerved girl of 10 years. (HEICRELHEII, Hyg. v, p. 207.) Convulsive attack recurring every evening at 8 o'clock, and lasting 3 hours: crying out for help; pale face; loss of voice soon afterwards; alternate tonic and clonic spasms of all the limbs, then all at once springing up like lightning (an extatic state), fearful cries and bellowing; eyes fixed and wide open, eyelids immovable; angry morvements, with inflamed countenance and many imposing, earnest attitudes, alternating with sardonic laughter and trismus; motions so strong that 4 men could not hold her; towards the end, quiet sleep; on awaking, no recollection of what had happened; before the attack, burning in the heart and severe stitches in the chest, whereupon loss.of consciousness ensued: in a girl of 18 years of age. After fruitless employment of Cicuta, cured by Aeon. 30, 3 doses. (SCUDEM, Hyg. vi, 473.) Diminished the severity of the symptoms of scarlet fever, shortened its duration, and when given as a prophylactic appeared to have the effect of rendering mild the subsequent disease. (MiULLER, Arch. i, 8.) Measles in a girl 12 years old: Skin burning hot; pulse hard, very quick; great anxiety; breath hot, short; very much oppressed respiration; dry, metallic-sounding, barking, very troublesome cough; painfulness of the throat along the trachea, on being touched; great thirst, with painful swallowing; extraordinary photophobia, with excessively red conjunctiva, and constant lacrymation. (WATZKE, G(Et. Zeitsch. i, 2, p. 236. Acon. 1, every, hour.) Measles: The skin was cool, covered with sweat; the face and whole body pale; the pulse thread-like, uncountable; breath short, rapid, hooping; constant groaning and lamenting; automatic motion of the left hand, with which she frequently hit herself in the face; jerkings with the left leg; frequent grinding of the teeth, the eyelids fast stuck together; nostrils stopped up with brown crusts: in a scrofulous girl, 1- year old, in whom the eruption disappeared several times from the skin. Acon. 3 every 5 minutes, brought the exanthema again upon the skin, and cured the other nervous symptoms. (WATZKE, 1. c., p. 237.) Measles, with predominant affection of the fauces and bronchi; also, irritation of the intestines; diarrhaea of fermented-like, greenish, frothy and clayey stools; interstitial erythema between exanthematous patches. (HARTTNmN, Acute Dis. i, 299.) Epidemic of measles; as chief and in many cases sole remedy. (OzANNE, B. J. of Horm vi, p. 61.) Measles. (HEICHELHEIEM, Hyg. iv, p. 423.) Miliaria puerperalis. (HAnTMAN, Aconite, p. 22.) Intermittent fever; when the quotidian (as frequently happens with children) approaches synocha in character, or when, independent of the type, the accompanying symptoms indicate Aconite. (GERSTEL, (E8t. Ztsch. i.) Intermittent fever in children; in whom the heat was the predominant symptom of the fit, and the disease was recent: Acon. 24, repet. (ScHwAD, Hyg. i, 76.) Intermittent fever that resisted all ordinary remedies, even Sulphate of Quinine in large doses, was soon cured by Acon. 3, given shortly before and during the attack. (EVERARD, Horn. Viert. i, p. 289.) Indispensable remedy, where to the primary affection of a single system or organ a general febrile disturbance has associated itself, which is distinguished by a previous intense rigor, followed by local or general heat, generally lasting long, by hot, dry, more or less red skin, which feels burning to the touch, rapid, full pulse, headache, sparkling eyes, violent continued thirst, anorexia, fiery urine, prostration, delina of more or less severity, with well-marked remissions and paroxysms. (SCulOEN, Hfyg. v, 98.) Ephemera, irritation fever, without local affection, especially in children. (GourioN, Arch. xix, 2, 8.) Aconite not only supplies the place of the whole antiphlogistic apparatus, bleedings, neutral salts, mercurials and fomentations, but is much superior to them in cer tainty and innocuousness. (SciRO.E, 1. c. 97.) Synocha in a fullblooded girl of robust constitution: Excessive general heat; glowing red hot face; febrile rigor; oppression of chest; dyspncea; violent delirium; hard, full, slow pulse: cured by the 30th dil. in 18 hours. (TIETZE, A. h. Z. iii, 115.) Synocha, with rheumatic, gastric affections: Fantastic visions; heaviness of head; pressing out at forehead and temples; painful drawing in the hair; stiffness of the nape; tense feeling on face, which is red and turgid; painfulness of the eyes, which are red and inflamed; oppressed breathing, with full feeling in the chest; frequent stitches through the left side of the chest; inclination to vomit; tension in the hypochondria; distension and rumbling in the abdomen; pains in the limbs, sacrum and back; diarrhoeic stools, burning hot skin; rigor over the body in the morning; febrile pulse; anxious, hurried speech: in a man, 46 years old, after a chill and vexation; cured by 2 doses of Aeon. S1. (MESSERscannMr, Arch. v, 2, 49.) Violent inflammatory fever of children, with twitchings, starting and connected convulsions. (GOULLON, Arch. xix, i, 38.) Synochal fever: Constant restlessness; complete sleeplessness; constant sobbing sighs, interrupted by starts; refusal of the breast, but drinking of much sugared-water: in a new born infant; cured with 1 dose of Aeon. 24. (BIGEL, Arch. iv, 3, 42.) Phlegmonous inflammations, where the arterial system is chiefly involved. (IlcmIELHEnI, Hyg. v, p. 203.) Traumatic fever and pains after surgical operations, especially of the eyes; and when, after forcible delivery by instruments, there comes on inflammatory fever, with shooting pains in uterus, and great restlessness. It also prevents traumatic fever after amputations of the limbs and breast, and takes away the pain. (WuERZLER, A. h. Z. xxi, 6.) Puerperal fever: Shooting, cutting pain in the swollen abdomen, increased by motion and pressure; diminution of the lochia and of the milk; sparkling eyes; much thirst; not very full, rapid pulse; hot skin; excessive restlessness; anxiety, with fear of death; complete sleeplessness, with deliria. (SCHROEN, Hyq. v, 100.) Dentition lever of children. (KRAMEitý, iHyg. i, 19.) Vermicular fever. (MALY, rHyg. xviii, 50.) Fixed idea of impending death in a pregnant woman, who, on the 9th day after delivery, got violent congestion of blood in the chest and extraordinary oppression of the chest, so that she was like to be choked, with intermitting pulse, cold, clammy sweat; she took leave of her relations, raved about the speedy occurrence of death, and pointed with an air of great anxiety to her heart. In a woman, aged 20, who had already had one child; complete cure after one dose of Aeon. 30. (GRoss, Arch. vii, 3, 43.) In a woman, aged 22, first pregnancy: sadness, laconism, complete joylessness and dejection, every thing affects her to tears; expectation of certain death during delivery. After delivery: metrorrhagia, of which she fully expected to die; cold sweat; anxiety; loss of consciousness; convulsions of the arms. One dose of Aeon. 24, cured her completely. (BETIfMAN, Arch. ix, 1, 115.) In a girl of 18, fear that she would die on a fixed day, caused by a prophecy. Alternate laughing and weeping delirium. In the night tossing about in bed, climbing up the wall, endeavours to run away. By day, as if deaf and dumb, will not answer. Acon. removed these symptoms. (ATrromn, Arch. xi, 2, 109.) Mania after delivery: the patients believe they cannot survive delivery, they lie quiet by day, are apathetic, give no reply to questions and only stare at the questioner, and then break out into laughter and weeping, refuse food and drink; their lips are dry, pulse full and frequent; the nurses have a difficulty in preventing their jumping out of bed at night. Starting out of sleep and repeating the same endeavour to run away. (HAnRTMNN, 1. c., p. 28.) Typhus, with great heat, inflammatory state of the organs of the chest and abdomen. Aeon. 8, in repeatec doses. (STRLECKKE, A. h. Z. xvi, 277.) Typhus, with great excitation in the arterial system and swelling of the parotid, and in pleurisy. (BAERTL, Arch. xx, 3, 94.) Typhus, with the symptoms of an inflammatory fever. (Bos.on, llyg. xxx, 4.) Profuse, unalleviating, debilitating sweats in rheumatic gouty affections. (ARNOLD, HIig. i, 65.) Prevention of sanguineous apoplexy. (ScnunBERT, Arch. v, 3, 107.) Paralysis of particular parts after over-heating followed by a chill, with great painfulness of the affected parts to the touch, an great excitation of the vascular system. (H-AirrTMAN, 1. c., p. 28.) CongestionM to the head, especially in apoplectic constitutions, with vertigo and failing, roaring in the head and transient unconsciousness. (St'ntnKS, Ilyg. 102.) Congestions to the head. (HAIInTaNNs. 1. c., 25.) State of irritation of the brain and lungs: Aeon. aided by Bell. (DIEv, 11//y. xviii, 253.) Inflammation of the brain in children, aided by Bell. (Iiecv..LIIEIM, 1. C.) A girl of 14: severe rigor, followed by heat and headache, nausea, vomiting. Next day on sitting up, vertigo and vomiting; constant frontal pain; raving; much torpor; wakiug with cries; opens the eyes wide and stares at different parts of the room, during which she talks delirious nonsense; face at one time red, then pale; skin dry, hot; much thirst; no appetite; no stool for 3 days. Acon. 30, 14 doses in 3 days, cured the patient. (WEUEU, Arch. xvi, 2, 4.) A boy, aged 5: II__ 42 ACONITUM NAPELLJS. In the evening, sudden attack of severe xi gor, followed by, heat, headache at both sides, vomiting of food, drink and mucus, slumber with starting up from it. Next day, red turgid face, sparkling eyes, single jerkings in the extremities alternating with trembling in them; on lifting the head, nausea; when he Jays down the head again, vomiting of mucus arid water; the sparkling eyes are either staring at some point, or are. clos-ed in restless sleep, from which he often starts up deliriou~s; skin dry, hot; much thirst; pulse rapid, full and hard. Aeon. 30, every hour, cured in 3 days. (Id. L c.) A girl, aged 10. Heat and redness of all the body, especially the head; red eyes, with contracted pupils9; complete unconsciousness; raving; dry tongue; verdigri-coloured vomiting; obstinate constipation; jerking of the tendons; hurried respiration; pulse 120-130, small; grasping at the head]. Aeon. 18, removed the most of the symptoms, the rest fielded to Jiry. ((i,%SrrTP EuxnD, A. It.Z. xxiv, 114.) Head affections of children during dentition: crossness, disinclination to play, laying down the head as if it were too heavy to be hleld up; unusual warmth of head; red conjunctiva; dilated pupils; circumscribe-d bright red spots on the hot cheeks; moderate appetite and tendency to vomit; inactive bowels. MI I F LOE N, ilfg.v, 102.) Inflammatory affection of head, throat and cheost; th4robin-g pain in the hack of the head; violent thirst, with dryness in the throat; redness of the palate and throat; slight swelling of the tonsils; shooting pain on swat lowing; loss of voice; on breathigdelinclination to cough and shooting in the side and betwixt th heu~rs; dry cough; taii in the wrist; fingers stiff and swvollen; at niiilit, buirning heat of thie whole body without subsequent perspiratin;sleplessness, for scveral nights; aggravation of all the sufferings in the evening. Cured by Acon. 3. (WATZKE, Born. Beke/trunysco., 105.) A kind of tetanus in a boy 6 years old. He woke up early, asked for something to drink, but could not take it because the jaws were sipasmodically closed. This was followed by contortions of the eyes, lie is alternately red and pale, and lies as if dead. Cured by 2 doses of Acon. (I-UDLtuo, A. h. Z. i, 147.) Myelitis: a man, aged 26i, of gouty (liathiesis but well for 2 years, spent 2 nights dancing and drinking; gocingf home lie fell to the ground and remained 2 hours exposed to the(ol of winter. Birouglit home, hie began to be convulsed antid delirious. Next day lie complained of weight and stupefaction of hecad, vertigo, roaring in the ears, general heat, burning and shooting pains in the spine, lie must always lie on his back. Towards noon, convulsions of the whole body, with cold extremities, complete apnhonia and scarcely perceptible pulse. After this, bright red face;-red eyes; dry tongue; laborious breathing, interrupted by sighing; te whole body stiff the slightest touch of the spine causes violent convulsions, lasting 4 or Jt an hour. When he tries to drinik water it returns by the nose; ineteorism, stools and urine suppressed. Aeon. 3, a drop every houir, continued for 13 days, caused marked benefit in all respects; the most dangerous symptoms went off. The remaining symiptomis of vertigo, lheadache, roaring in the cars, weakness and fits of heat, were cured by Nux vom. (Howik.NEU, Archiv, xx. 1, 121.) Ophlitalniia from a foreign body penetrating the eye, (HARTMANN, L1. 0 15,) and other niechanical injuries. (T~iuSs in mnany eases.) Taraxis and chemnosi-s. (HAaLTMANN, 1. e., 15.) Ophthi. neonatorum in the first s~tage. (ilAnnIANX, 1. C., 15.) Ophith. neonatorum in its comnmencenient. (Gitoss, Arch. x, 2, 63.) Rhleumatico- traumatic ophith. (GouLLoN, 1. c.) Inflammation of both eyes; the great swelling of the upper lid entirely covered the lower; groat. photophobia; burning shooting pains, much increased at night; copious secretion of thin muco-purnlent matter; cured by Aeon. every 2 hours, and a dose of Ti. Sulph. in the eveniing. (WArraxa;, (L~t. A. Zeech. i, 2, 116.) Ophithahn-ia: redness and swelling of the lids, with Pains and lacrymation; cornea dim and whlitish; in a young mnin with gonorrhmca. Acon. 30, internally, and Amn. 1, in water, externially, cured; Cannabis cured the clap and dimnne-ss of tho cornea. (Luii.'UeK, Hyg. iv, 411.) Bturn of the eyes: tilhs swollen and red; cornea without brilliancy and covered with. a whitish s4kin; conjunctiva iiiflnnied; photophobia and violent pains in eve, blisters on several parts of the face. Compresses moistened with -vasolution of Tr. Aeon. applied to the e-ye, cured in 3 days. (Bnou, mk.red. JN~qr, Aug. 18410.) Burn of the eye with a candle, cured by Aeon. V. (lnrx riI.. 1. ofi. vi, 214.) 0btalm-benn1rma Rheumatic face and toothache of throbbing and shooting character;also in pains of other kinds, especially of sensitive persons with a tendency to turgesconce of the blood, when wine and other heating things increase the pain; also when mental emotions or vexations have caused them, Aeon. 12 or 24, several drops in repeated doses. (J. W. AnNOLDHyg.i, 65.) Prosopalgia of inflamnmatory nature with inflammatory swelling, and also of' a purely nervous nature, with creeping burning pains coming on in jerks, as if dependent on an ulcer. ([Asernuixz, 1L c.) Throbbing toothache, with great rush of blood to the head; burning heat of the face; quick, hard pulse; great mental and bodily restlessness; great redness of the cheeks, especially after taking cold rn sharp, dry east wind. (B36NNINGRAUSENN Arc/i. xv, 2, 5.) Toothachie, throbbing and shooting, with congestion towards the head. (Uta&nTrANN. 1. c.) Frequently recurring toothache: burrowing in the teeth, proceeding from the shoulder of the affected side and extending into the temple and head, most violent at nighit; at the same time, congestions. to the head, heat and redness of the cheeks. Cured with 3 doses of Aeon. 30. (AsHrs,.H~yg. i, 335.) Epi staxis of younq plethonec persons, subject to congestions. (WEnan, Arch. xvi, 2, 13.) Epistaxis, frequently reeurring, extremely exhausting at the period of decre~pitude in women, caused by congestions towards the head. Aeon. 3. (SeanoEN, Eg. v) 10 1.) Inflammation of the tongue, with violent inflammatory fever and affection of the throat in cattle. (SHMioGEa, Egg. ii, 275, cured by Tr. Aeon. gtt. 60, in 2 chopins of water, i/5Bth every 3 hours.) Rheumatic sore throat with slight redness of the fauces and pominent muscular pains. (GoULLoN, 1. C.) Cynanehe tonsillaris. (HA0RT3UN, 1I. C.) In one ease it averted the impending suppuration *in cynuanche, which Bell. and Mere. were unable to do, in doses quickly repeated. (SCnaOEii, Ilyg v, 01.)(Esphagitis: violent pains intn cardiac region extending from the nuddie of the chest to the back, increased by corporeal exertion and by swallowing, with tile sensation as if the morsel swallowed stuck in the cesophagus or cardiac region; at the same time fever and complete absence of all abnormal symptoms about the heart: a few doses of Aeon. 12 cured it in 2 days. (SEcw, hElyg. x.viii, 53.) Gastritis. (Wonrsorrx, Egg. v, 457.) Nausea and vomniting of all1 food and drink in the first half of pregnancy cured by one drop of Tr. Aeon. (GAsPRni, Animal. d. h. Hi. i, 150.) Vomiting in cholera asiatica after the removal of all the other symptoms. (RIuhrEL, Arch. xii*, 2, 123.) He patitis: burning shooting pains in the hepatic region, with synoehal fever. (HARTMANN, 1. e.) 4i ntei-itis. (WOLrsOHNx, Hkg..v, 456.) Inflammation of the bowels: acute, burning, tearing pain, with very great tension, heat, distension and excessive sensitiveness of the whole abdomen to the slightest touch; violent, synochal fever; obstinate constipation; anxious restlessness; despahring anxiety, as if in the death agony; constant thirst; sleeplessness. HmTMX,1 e)Gs tro-enteritic symptoms dependent on vermicular irritation. (GEaSTEL, (Est. Ztseh. i.) Inflammatory affection of the peritonaeum and bowels in a puerperal woman, after suppression of the loehia, from fright, cured by Aeon. 30. (SarrincaR, Ifyg. ii, 194, and Scanoax, Ilyg. v, 100: in the latter cae there were also present anxiety with great fear of death, sleeplessness and deliria.) Violent abdominal pains of a drawing ehiamecter, with clawing, pinching and retraction of the navel; at the same time frequent white evacuations; shooting and pressure in the anus; general heat; painful prostration of the whole body; yellow skin and sclerotic; violent thirst and dry mouth: cured by 6 doses of Acon. 6. (Turnum, A. h. Z. xxii, 202.) Tearing and shooting pains in the abdomen, increased by pressure and deep inspiration, with alternate rigor and heat and sleeplessness: cured by 4 doses of Aeon. 6. (WVoLFsOHN, H1gg. v, 460.) Peritonitis puerperalls, along with Dry. and Puls. (Riu, JVerth d. H. 202.) Peritonitis puerperalis after a chill, with watery diarrhex, which latter yielded to Cham.; the inflammation was cured by Aeon. 4 every 3 hours. (Dncz, 1. e., 102.) Cholera asiatica with gastro-enteritie symptoms. (B~ARTEL, A. A. Z. vwiii, 165.) Cholera asiatica. (Hicauza, App. to N. Amer. Horn. Jour. No. 2.) Non-febrile worm ailments. (MALY, 1L C.) Inflammatory strangulated hernia: violent burning pain as if red hot coals lay in the hernial sac, that did not allow of the slightest touch;, constant nausea; bitter, bilious, "gras0 ts-gen vomtin; geanxit;gnrlcl wa;sal ___ Ll THERAPEUTIC USE. 43 or not, when given in their incipient stage: a dose every I hour. (MADDEN, Brit. Jour. of Hom. ix, 497.) Epidemic catarrhs of children that tend to go into bronchitis catarrhosa. (HARTMANN, A. h. Z. vi, 69, and GRIESSELICH, Hyg. iv, 312.) Grippe. (HEMPEL, 1. c.) Aeon. is not only often able to check the development of commencing croup, but it also supports the action of Spong. and Hep. in the stage of plastic exudation when given alternately with those remedies. (SCHaOEN, Hyg. v, 99.) Rheumnatico-catarrhal and nervous form of croup: at the commencement of the north-east wind, or on the change of the east wind into south or west, it begins with slight, short cough, which, generally towards midnight, turns into hoarse, crowing cries; rare, crowing, hollow cough; very rough, hoarse or whispering voice, re sembling the vox cholerica; whistling, booping, loud respiration; suffocative spasm: Aeon. removes the urgent danger and keeps off the disease till daybreak. Towards morning perceptible remission with perspiration, also with bleeding at the nose, rarely with vomiting of viscid phlegm. The following night the same scene is repeated, which render necessary the repetition of the Acon. The next aggravation, on the 3rd day, the wind still continuing in the east, is always slighter and more easily relieved. Then the disease is permanently relieved and changes into frequent loose cough. In this laryngitis, caused by the peculiar atmospheric tension, Aeon. from the 24th to the 2nd diL in rapidly repeated doses is sufficient; whilst the fully developed true croup, which never attacks any other but scrofulous children, who are subject to strumous thyroid gland, ozcena-like coryza or tubercles of the lungs, requires quite different remedies. (GouLLON, Arch. xix, 2, 1.) These observations exactly coincide with Dr. Trinks' experience. True croup requires Spong. or lod., whilst the above-mentioned laryngitis is cured by Aeon. alone, by the allopaths by Calomel. (TiuNKS, Mat. Med.) Shaking nocturnal spasmodic cough (in great tobacco smokers) caused by a tickling irritation in the larynx. (HARTMANN, 1. c.) Hoopingcough in the first stage. (HArTMANN, 1. c.) Commencing hooping-cough corresponding to the congestive stage in the mucous membrane of the bronchial tubes in a peculiar condition of atmospheric pressure. (BErHMANN, Annal. d. h. M. iv, 289; HAMUOLD, A. h. Z. i, 146; MALY, Hyg. xviii, 512.) HEmoptysis caused by tubercles. (HmEICELHEIM, Hyg. v, 206.) Hxemorrhagia pulmonum. (HAnTmAx, 1. c.) Pure inflammatory affections of the respiratory organs. (SCHmoEN, Hyg. v, 99.) Pneumonia: during the rigor, oppression, stiches in the chest; fever with the character of synocha or erethism with remitting type; face red, hot, puffed; eyes sparkling; swelling of the veins of the neck; short respiration; marked, crepitating respiratory sound; oppressive, compressive, dullshooting pain in the chest, only permitting recumbency on the side, accompanied by attacks of anxiety; short, dry, irritating cough, or coughing of blood; raw pain in the region of the last ribs, caused by the succussions of the diaphragm. (BUCHNEsm Hyg. xv, 503.) Pneumonia with great dyspncea; brownish-red face; bloody expectoration; and violent shooting in the left side. (ScHLEIucER, Arch. xv, 2, 328.) Inflammation of the lungs with shooting pains deep in the chest, and pulse 100. (SCHUELER, Arch. xiv, 3, 120.) Pneumonia and pleuritis in all stages [?]. (HEICIELHEDI, Hyg. v, 204.) Inflammation of the lungs with gastric nervous symptoms. (SCHOLZE, Arch. xx, 3,115.) Peripneumonia. (VEUSEMEYER, Arch. xi, 298.) Pleuropneumonia: Aeon. always removed the fever and inflammation, so that Bry. had only to be used for the afebrile, shooting pains. (DIEZ, 1. c. 96, in many cases.) Pleuritis costalis with shooting pains, increased by touching the thorax and breathing, with dry cough, fever, &c., Aeon. 9 in repeated doses cured. (DIEZ, 1. e. 94.) Pleuritis and pneumonia. (QUADRm, Arch. viii, 2, 165.) Pleuritis. (TRINKS, Annal. d. i. Xl. ii, 227, and 1, 21; ROTIIANSEL, IHyg. xviii, 485; MARTINI, Annal. d. A. Kl. i, 26.) Pleuritis: after severe rigor, burning heat and shooting in the right side, cough with expectoration streaked with blood, difficult respiration, pulse full, hard, intermitting, not quickened, Aeon. 6 made the chest and breathing freer in 5 hours, cure on the 4th day. (RAU, Werth. d. H. 200.) Pleuritis. (WoLFsonX, Hyg. v, 452.) Pleuritis of the left side with distinct pericarditis. (GouLLox, Arc/. xix, 1, 44.) Pleuritis with violent febrile symptoms: it has no action on the effusion. (Wumpin, Hyg. xii, 29, and B.. of Horn. i, 50.) Frequently recurring inflammatory states in consumptive patients, which give evidence of their existence by shooting pains in the affected parts, severe cough with bloody expectoration, severe violent fever with greater distinctness of the' redness of the cheeks. (HARTMANN, I. c.) Inflammatory irritations in florid phthisis, in the tuberculous as well as the pituitous form. (Hl-ImccmELlE.M, IIfjg. v, 207.) Inflammation of the heart in the first stage. (HARTMANN, 1. c.) Pericarditis rheumatica: tearing shooting pains in the foot and hands; violent shoots in the cardiac region; furred tongue; increased thirst; quickened respiration; pulse full and normal; percussion-sound normal; heart's beats stronger; blowing sound in the left ventricle durming the systole: in a girl, 24 years old, after a chill. Aeon. 3, every 3 hours, and cold compresses to the joints. (ROTHANSEL, Iyg. xviii, 480.) A similar case was cured by Aeon. and Spig. alternately. (SCrnoEN, Hyg. xv, 490.) Palpitation of the heart from mental emotions. (HARnnANN, 1. c.) Frightfully painful palpitation of the heart, with peculiar pains in the joints. (STArr, Arch. ii, 3, 32.) Asthma humidum, aided by Stan. (HARTMAxx, L c.) Inflammation of tho diaphragm. (LarTMANN, 1. c.) Violent tearing and shooting in the right upper arm and the same side of the chest, with redness and swelling of the upper arm, painful on every motion; boring shoots in the chest on breathing; pulse quick. (FLEISCHM3AN, Hyg. viii, p. 467, Aeon. 6, every 3 hours, with compresses of cold water.) Violent shooting pains in the hip joint, extending into the left knee. (EmnRcie, Arch. xiv, 3, 109.) Cutting shooting pains in the right knee joint, worst at the external side. Aeon. 30, every 4hours, cured it completely. (WEmhER, Arch. xvi, 2, 11.) Rheumatic inflammation of the knee joint, with tearing pain. (KNomms, A. i. Z. v, 21.) Rheumatic inflammation of the hoof in horses. (REuE, A. h. Z. vi, 205.) ANTIDOTES.-In cases of poisoning by large doses of Aconite, the drug should be removed from the stomach, if possible, by large draughts of warm water and irritation of the fauces, or any of tlhe more ordinary emetics, or the stomach-pump. When the arternal system is in a state of great excitement, vegetable acids, such as vinegar or lemon-juice, mixed with water should be given. For the paralytic symptoms the remedies are: Cocculus, Agaricus, Rhus, Nux vomica, Arnica, Wino, Coffee. When there is a state of sopor, exhausting sweats, and dilated pupils, Opium is the proper remedy. Arnica is indicated when there are obstinacy, hot face and headache. The extremely peevish and irritable state often induced by it, demands wine. For the other symptoms caused by Aconite, antidotes may be sought among the following: Belladonna, Bryonia, Chamomilla, China, Digitalis, Ignatia, Hyoseyamus, Nux vomica, Sepia, Veratrum album, Spigelia. ALLIED REMEDIEs.-Arnica, Belladonna, Bryonia, Digitalis, Hyoscyamus, Ignatia, Ipecacuanha, Mercurius, Nitrum, Nux vomica, Opium, Phosphorus, Pulsatilla, Rhus, Sepia, Spigolia, Stramonium, Sulphur, Veratrum. DosE.-Although Hahnemann recommends the 30th dilution as the best dose of this and of all other remedies, most homoeopathic practitioners agree that it is unnecessary to give this remedy in such minute doses, especially in acute diseases, indeed that it acts much miore promptly and certainly in such cases in the lower dilutions, from the 1st to the 6th dilution, and that it may be advantageously administered at much shorter intervals than those Hahnemann prescribes, from every 12 hours to every quarter of an hour, according to the acuteness of the case. For the neuralgic affections in which Aconite is indicated, the higher dilutions, from the 12th to the 30th, given at longer intervals, seem to have been often employed with recmarkublo success. ARSENIC. ARRANGED BY FRANCIS BLACK, M.D. ARSEnmicuM Album, Acidum Arseniosum,-- English, Arsenic, white Arsenic, Arsenious Acid: French, Arsenic, Acide Arsenieux, Oxide blanc d'Arsenic: German, Arsenik, Arsenige Siure. Arsenious Acid, known generally under the name of Arsenic, is a rare mineral, found at Andreasberg in the Hartz, and at Joachimothal in Bohemia. That employed in medicine and for other purposes is procured by roasting various kinds of arsenical iron, Mispickel. The metallic Arsenic of the ore is converted by heat into Arsenious Acid, which rises in the shape of vapour, called Flowers of Arsenic (Hiittenrauch), and is then conveyed into condensing chambers, where it is deposited in the form of Rough Arsenious Acid, or Poisonflour (Giftmehl).. The rough acid is refined by sublimation, and when condensed into iron pots assumes a glassy form, Glacial white Arsenic, Weissen Arsenikglas. There are various manufactories in Bohemia, Silesia, and Saxony. In this country it is manufactured in Cornwall from the white Mundie, or Mispickel found with the tin ore. Arsenic thus prepared is in large heavy masses, sometimes white, at other times yellowish. At first it is transparent, but after exposure to the air water appears to be absorbed, and to render it more or less opaque. Transparent Arsenic, sp. gr. 3-798; opaque 3-620. Mr. Taylor considers that both are equally soluble, Guibourt found the opaque variety more soluble. Various statements have been maderegarding its solubility: according to Mr. Taylor water boiled for an hour on Arsenic dissolved 1'2 of its weight; this water on cooling retained 1l4o of its weight; and water at ordinary temperature dissolved from Ifso to Il'oo of its weight. It is less soluble in pure alcohol, and oil. Hahnemann (Ueber die Arsenik Vergiftung) observed that at the temperature of the blood, a thousand parts of water dissolve ten parts with the aid of ten minutes' agitation. He further shewed that its solubility is much impaired by the presence of organic principles. According to Dr. Christison, Arsenic has little or no taste, if any a faint sweetish one. It is occasionally mixed with lime or chalk; this adulteration is readily detected by heat, Arsenious Acid being entirely sublimed by heat. The Arsenic employed for homceopathic preparations should be purified by subliming the common Arsenic, or a better form is the minute crystals which are procured on cooling a boiling aqueous solution of Arsenic. These crystals when perfect are of an octahedral form. In order to prepare the various dilutions Hahnemann orders one grain of Arsenic to be placed in a test tube with one drachm of distilled water: the test tube is to be exposed to the flame of a spirit lamp, until the Arsenic is dissolved, taking care to add water in proportion to the evaporation. One drachm of alcohol is then to be added. This is then labelled 9; 1 drop of this added to 1000 drops of equal parts of water and alcohol forms No. 1: and 10 drops of No. 1 added to 90 of alcohcl/ ms \ No. 2; the succeeding dilutions are made on the centesimal scale. The dilutions may also be made by triturating 1 grain of Arsenic with 99 of sugar milk; this constituting No. 1-and so on with the remaining dilutions. No. 1 made in this way is not so soluble as that prepared by heat. Physiological Effects.-Arsenic is one of the most deadly poisons, and used with such frightful frequency that the numerous, and sad reports, of its fatal effects afford abundant materials from which to elucidate its physiological action. Through whatever channel Arsenic is introduced into the living economy, very marked effects are produced, and these extend their range over almost all the tissues D --------- -- -- -- --- - -- 2 ARSENIC. 2 ARSENIC. of the body. In man the specific effects are as evident when the Arsenic is applied to the skin (case 14 (1)), to the vagina or rectum (case 11), to the bronchiae (cases 12, 13), as when introduced into the stomach. According to Jaeger's experiments on animals, Arsenic is most active when injected into a vein, or applied to a fresh wound, or introduced into the sac of the peritoneum,-- it is less powerful when taken into the stomach; it is still less energetic when introduced into the rectum, and it is quite inert when applied to the nerves (quoted by Dr. Christison on Poisons, edit. iv, p. 292). That in man it acts on the nerves is shewn in the marked and violent toothache, &c., excited when it is applied to an exposed dental nerve, resulting soon in anaesthesia of the nerve. In cases of poisoning it is observed when the dose of Arsenic is large, when it is in little masses, or when it is in a state of solution, or inhaled in a gaseous form, that the effects are shewn powerfully on the cerebrospinal, the ganglionic, and vascular systems. There may be vomiting and violent abdominal pains, but the striking feature is the sudden prostration of strength, and collapse, closely resembling a similar state in malignant cholera; the features rapidly alter, the skin is pale, sometimes of a violet hue, and covered with cold sweats; icy coldness of the body; pulse small, frequent, thready and often not to be felt; extreme precordial anxiety, great tendency to syncope, oppressed breathing, gradual sinking, and in a few hours death closes the scene, sometimes preceded by convulsions. In some such cases the poison proves fatal without exciting any violent and well marked symptoms, unless it be great feebleness and tcna -icy to faint (cases 1, 2, 3, also ~ 398, 899). Again when the dose is smaller there are symptoms of violent irritation of the alimentary canal, and sometimes of the mucous membranes, accompanied with great general depression (cases 4, 5). Again when the dose is still smaller, or given slowly, after signs of irritation of the alimentary and other mucous membranes, a very marked class of symptoms referable to disorder of the nervous system appears. It is this class of chronic poisoning which tlhrows the most light on the physiological action of Arsenic. When slowly introduced into the system one of the most marked and constant symptoms is the disorder of the alimentary canal, presenting various stages from acute gastro-enteritis to chronic dyspepsia, impaired appetite, thirst, nausea and vomiting, extreme irritability of the stomach, the tongue then shews signs of redness at the tip, excessive burning heat in the epigastrium, a relaxed condition of the bowels attended with more or less pain, the motions often watery and abundant; then the irritation extends to the nervous system, tremors and twitches are experienced, and frequent violent cramps of the legs and arms (cases 14, 15); constiphtion is a less frequent symptom (cases 14, 18). Then appears irritation of other mucous membranes, there is lachrymation, the conjunctiva inflames (case 16), the face becomes cedematous, also the cellular tissues of other parts, the sclneiderian membrane inflames and ulcerates (case 5); the irritation extends down to the larynx, there is hoarseness, sense of heat in the bronchiie, oppressed breathing, dry hacking cough, and this state may increase to bronchitis, or to dyspncea and asthma (cases 8, 9). The urine becomes high coloured, some6 times increased in quantity, more or less strangury, even blood may be passed (cases 8, 12). The genital organs shew signs of congestipn andinflammnation (case 4). As the system becomes more affected there is feverishness; the pulse is at first quick, hard, and then becomes weak and irregular. The skin hot; a sense of burning all over the body; itching, with perspiration; nmiliary eruptions appear, especially about the upper part of the chest, sometimes pustules, and at other times small blisters like those arising from nettle-stings (cases 14, 16, 17). Great anxiety, palpitation of the heart, and cardialgia with syncope; the derangement even running into endocarditis (case 13, 17). The countenance becomes sallow and pale, and then presents a sorrowful and anxious look. There is often headache, chiefly over the eyebrows and lower part of the forehead; giddiness and want of sleep: and this cerebral disorder may amount to stupor, insensibility and delirium (cases 14, 15, 16, 17). Again the general derangement becoming more acute, the disorder takes on the appearance of typhoid fever (case 17 and ~ 882). The whole body emaciates; the hair falls out; the nails drop off. The limbs become painful, weak, and trembling; there is excessive general weakness; more or less loss of power; and at last complete paralysis: this local palsy attended (') The cases refer to those reported in the preface; g to the symptoms in the schema. ___ _ __ ARSENIC. 3 ARSNI. with lancinating pains, and sometimes periodical, being the most frequent of the effects of Arsenic on the nervous system (cases 8, 9, 13, 15). Or again, the nervous symptoms take on the appearance of chorea, epilepsy, tetanus, and affections resembling hysteria. IHahnemann published, long prior to his Materia Medica, a very fuill and able work on the action of Arsenic, a treatise which has been favorably noticed by recent writers. In this book he thus describes the symptoms of secret Arsenical poisoning as arising from the notorious Aqua Toffana: " they are a gradual sinking of the powers of life, without any violent symptom; a nameless feeling of illness; failure of the strength; slight feverishness; want of sleep; lividity of the countenance; and an aversion to food and drink, and all the other enjoyments of life. Dropsy closes the scene, along with black miliary eruptions and convulsions, or colliquative perspiration and purging." (Ueber die Arsenik Vergiftung, 63.) Applied locally, even to the sound skin, Arsenic is rapidly absorbed: by some its topical effects have been regarded as that of a chemical caustic, but it possesses no corrosive power, and the local action must be considered as purely dynamic. It has a powerful antiseptic effect, and is therefore very useful in preserving anatomical preparations: but Arsenic not only arrests the putrefaction of bodies;-it produces a remarkable series of changes, in which the corpse is converted into mummy-like or adipocerous matter. Arsenic is poisonous to all classes of animals; it is equally injurious to vegetable life, with perhaps a few exceptions, such as Mucor imperceptibilis, and an algaceous plant of the genus either Septomitus or Hygrocrocis. (Pereira, Mat. Med. i, 636.) For a long period it was found impossible to detect Arsenic in the animal tissues and secretions of those who had taken it. To Professor Orfila the honor is due of having shown to the Parisian Academy of Medicine, 1839, that Arsenic is absorbed in such quantity, in cases of poisoning, as to admit of its being discovered, by an improved process of analysis, in various parts of the body. The largest quantities are met with in the liver, the spleen, and the urine; but especially the liver, which according to M. Flandin contains nine-tenths of the whole quantity carried into the circulation: but though found in these organs, and in less quantities in the blood, its physiological effects appear to spring more from parts where the poison is less fixed; for example, the tissues of the stomach, the heart, the spinal and ganglionic nerves. So that though it is evident that Arsenic acts through the medium of the blood, it also acts through the nerves. That such is the case is also borne out by the undoubted action of infinitesimal doses. Arsenic is eliminated from the system, principally by the urine according to Orfila, while according to Flandin it passes off by the liver, and pulmonary, and cutaneous exhalation. Various periods have been assigned for the elimination of the poison, varying from ten to fourteen days, and Dr. Taylor quotes, with a mark of exclamation, " that from the experiments of M. Bonjean of Chambray, it would appear that Arsenic was detected in the urine of a patient who one month before had taken in twenty-four days only three-quarters of a grain of Arseniate of Soda." (On Poisons, 24, original source, Ann. d'Hyg. 1846, ii, 155.) A more extraordinary statement is made in the New York Journal of Med. 1850, to the effect that the urine, on the fortieth day after swallowing the poison, was found to contain Arsenic estimated at 1,170,000th part; traces of it were no longer detectable three months after this. When a powerful impression has been made by Arsenic on the system, it generally continues through life; shown in chronic dyspepsia, oppression of the chest, or paralytic symptons. Hahnemann assigns thirty-six to forty days as the duration of action of small doses in chronic diseases. Such a statement appears premature: it cannot be founded, on physiological experiments, because, if so, a much greater duration should be assigned; it must, therefore, be deduced from therapeutical,bservations: and the very nature and fallacies 6f such observations at once denote the immense difficulty of assigning the duration of action of a dose, varying as it must in every disease, in every patient, and in the same patient at various times. Very careful physiological experiments, confirmed by clinical observations, may give general data as to whether the action of a remedy continues for a shorter or longer period, and thus from these rough approximations as to the duration of action, throw light on the repetition of the dose: but they cannot be expected to assign a specific number of days. The action of Arsenic on the brain, as shown by the headache, vertigo, mental depression, and apprehension, resembles-Anac., Agar., Aur., Dig., Cocc., Cupr., lod., Lach., Mere., Nux v.? Puls., Rhus, Sep., Ver. D 2 I --------- --- - - 4 ARSENIC. 4 ARSENIC Its action on the spinal system of nerves resemblesAgar., Alum., Arg., Arg. n., Carbo v., Cocc., Cupr., Lach., Plat., Plumb., Rhus, Sabad., Sec., Ver., Zinc. Its action on the alimentary canal, in connection with the ganglionic system, resembles-Ant., Camph., Canth., Caps., Carbo v., Chin., Cocc., Col., Cupr., Elat., Jat. cure., Ipec., lod., K. b., Kreos., Lach., Mez., Mere., Puls., Phos., Sec., Spig., Tabac., Ver., Zinc. Its action on the respiratory organs resembles-Brom., Bry., Hep. s., lod., Ipec., K. b., Lach., Mere., Phos., Samb., Sen., Spon., Sul., T. e. It action on the heart resembles-Bar. c., Dig., Lach., Spig., Tabac. Its action on the skin resembles-Ant., Calc., Graph., K. b., K. c., K. h., Mere., Rhus, Sul., T. e. In febrile diseases of a typhoid character it resembles -Bry., Carbo v., Lach., Rhus, Ver. In febrile diseases of an intermittent type it resembles -Bry., Chin., Ign., Ipec., Lach., Nux v., Puls., Sabad. In more sthcnic forms, such as in the exanthemata, it resembles-Acon., Ant., Bry., Mere., Sul., T. e. It appears to have little or no effect on the osseous tissues, or on the glandular. Its action on the genito-urinary organs resemblesAcon., Bell., Berb., Camph., Cann., Canth., Cinn., K. b., K. n., Kreos., Mere., Nux v., Petros., Phos. ac., Sab., Sec., Tereb. Dose.-In ordinary practice it is administered in doses from 1i/th to 1/eth of a grain; but at such doses it rarely fails before long to excite injurious physiological effects, demanding the suspension of the remedy. Owing to the insolubility of Arsenious Acid, it is in ordinary practice generally given in the form of Arsenite of Potash, Fowler's Solution; dose, from four to five minims, gradually and cautiously increased. In Homoeopathic practice the various dilutions from 1 upwards are employed. It has by some practitioners been given in the highest dilutions in cases of collapse, and great prostration of vital power, under the impression that the lower dilutions were injurious; but the very complete and carefuily recorded experience of several writers show that low dilutions are in such cases peculiarly usefill. Drs. Russell and Drysdale, in their treatises on malignant cholera, reconunend it in the lowest dilutions and in frequent doses. Dr. Tessier treated the same S disease in St. Margaret's, Paris, with the 6th dilution, a fourth or sixth of a drop every five to twenty minutes, or longer. (Recherches Clinique, p. 293.) In typhus Dr. Brenfleck gave with great success the 2nd, 3rd, and 4th dilutions, about a drop every three hours. (Brit. Journ. of Hor., vol. i, p. 74.) Dr. Fleischmann uses in typhus the 2nd and 3rd. Dr. Schmid in typhus gives the 2nd (5 to 100), two to six grains in twenty-four hours; the more violent the disease the greater the dose. (Brit. Journ. of Hor., v, 278.) It is a remedy from which the practitioner may occasionally find physiological action excited even in the higher dilutions. I have used it with benefit locally, either in the shape of ointment, or dissolved in water in the proportion of 2 to 3 grs. 3rd trit. to g vi to x as a collyrium, and as a lotion to scirrhous and irritable ulcers. I have also employed it with advantage in cases of inflammation, and ulceration of the cervix uteri, as an injection, in the proportion of 12s to 11/4 of a grain to a quart of water. Dr. Drysdale applies it with success in similar cases, by blowing a few grains of the 1st or 3rd trituration through a tube inserted within a speculum. Arsenic has also been administered on the recommendation of Dr. Drysdale in the shape of Arseniuretted Hydrogen, given as an inhalation. In his hands it proved very useful in the collapsed stage of cholera: and this mode of administration may prove highly advantageous in cases of asthma, or in such cases where Arsenic is indicated, but where the patient is under the influence of strong medicinal action arising from ordinary remedies. The following is Dr. Drysdale's mode of administering it. " The chamber consists of a common large milk-bottle, with the top aperture sufficiently large to allow a full stream of air to pass, so as to allow breathing comfortably: into the large side aperture is fitted a common flexible tube with a mouth-piece and ball valve. When used, a few fragments of purified Zinc are put into the chamber, and on this poured half-an-ounce of water, with one drop of strong Sulphuric Acid. This is sufficient to disengage a small continuous stream of Hydrogen; and when that begins to rise, pour in five to ten drops of the 3rd centesimal dilution (aqueous) of Arsenious Acid. In about a minute this will be combined with the Hydrogen and diffused (the top aperture being for the time closed with the finger) through the chamber and tube, and may be inhaled in a few inspirations. When used as above directed, the glass bottle can be held in the operator's hand, while with the other he applies the -- -- I ARSENIC. 5 ARSENIC. 5 mouth-piece to the patient's mouth. When used several times in succession within an hour or two, the Zinc and Acid may be kept in action, and fresh portions of Arsenical solution added at each inhalation. Especial care must be taken to have both the Zinc and the Acid quite pure, as in the ordinary state both these substances often contain Arsenic in considerable quantities." (Brit. Journ. of Horn., vol. vii, 559.) Antidotes.-If vomiting has not been excited by the poison itself, then an emetic of Sulphate of Zinc, or powdered mustard, should be administered, and its action promoted by mucilaginous drinks, especially milk, which appears to be the best substance for enveloping the powder, and so procuring its discharge. Various chemical antidotes have been recommended, but most of them have been abandoned, as though they may render the Arsenic less soluble in water, they have not that effect when the poison is exposed to the juices of the stomach. The hydrated sesquioxide of iron is regarded by many as a true antidote. Dr. Christison (On Poisons, p. 365) considers that its utility can scarcely be called in question, whatsoever may be its precise mode of action. Prof. Orfila has called in question the absolute efficacy generally ascribed to the sesquioxide of iron. Devergie (Med. Ligal. ii, 475) states that the oxide of iron, unless taken in a dose equivalent to thirtytwo times the weight of the poison, does not prevent its action as such: thus it would require a pound of iron to antidote three to four drachms of Arsenic, a common dose. Dr. Taylor (On Poisons, pp. 89 and 334) states that this substance does not fulfil any of the indications which are necessary for chemical antidotes. In the majority of cases he places not the slightest confidence in it; he considers that too much importance has been attached to its effects, and too little assigned to nature, and the simultaneous employment of other means such as the stomach-pump, and emetics. Hydrate of magnesia has also been recommended; but the arsenite of magnesia is soluble in diluted muriatic acid; the acids of the gastric juice might therefore suffice to dissolve it, and thus bring a soluble poisonous compound in contact with the mucous membrane of the stomach. This circumstance, and the enormous bulk in which it is necessary to give the magnesia in order to render it efficacious, induce Drs. Christison and Taylor to state, that if of any use at all, it only acts, like charcoal, by covering the arsenical particles with its fine insoluble powder, and so prevents the poison coming in contact with the stomach. It appears, therefore, that after evacuating the poison from the stomach, little dependence is to be placed on chemical antidotes. The after effects excited by the Arsenic are to be met by antiphlogistic regimen, and by remedies homceopathic to the various symptoms, such as Merc., Canth., Cupr., Camph., Ver., Acon., Bry., &c. In the after effects of Arsenical, as of other mineral poisons, the various appliances of Hydropathy are well calculated to assist in the elimination of the poison from the system. This is quite in accordance with the views of Orfila, who from experiments has shewn that the Arsenic is gradually discharged by the secretions, especially the urine; he therefore recommends the employment of diuretics: but with many of the hydropathic appliances we can secure a copious secretion from the skin and kidneys, and at a much less cost to the constitution than by the employment of medicinal diuretics. Frequent packing in wet sheets, the dry vapour bath, and the use of the abdominal water bandage, appear to be the best for securing this end, together with moderate drinking of pure water; excess of liquids should be avoided, as they distend the irritated, and inflamed stomach. i I i __ __ __ CASES OF POISONING ILLUSTRATrNG THE ACTION OF ARSENIC. CAstE 1st.-A stout middle-aged man swallowed a large quantity of arsenic in fragments, and died in a few hours. He experienced nothing but great fcchleness, and frequent tendency to fainting. The stomach and intestines were not in the slightest degree affected during life: and no morbid appearances could be detected in them after death. (Reported ry Prof. (Cltauier, Orfila, Toxicol. Qndcrale, i, 397.) CAnE 2nd.-A young woman was caught in the act of swallowing little fragments of arsenic, and it afterwards appeared that she had been employed most of the day in literally cracking, and chewing lumps of it. When first seen her countenance expressed chagrin, and melancholy, but not suffering. After being forced to drink, she vomited a good deal, but without uneasiness. Two hours afterwards her countenance was anxious, but she did not make any complaint, and very soon resumed her tranquillity. Five hours after the last portions of the poison were taken, she became drowsy, then remained perfectly calm for four hours more, and at length, on trying to sit up in bed, complained of slight pain in the stomach, and expired without agony. A clot of blood was found in the stomach. (J-ournal de Mid. lxx, 89; reported rby Laborde.) CAs 3rd.-Dr. Christison gives an abstract of several similar eases; the principal symptoms being excessive weakness, tendency to fainting, and sometimes stupor. (On Posons, 4th edit. p. 306.) CASE 4th.-" A lady was poisoned by her maid with fly-powder and wite arsenic: the symptoms were as follows. After suffering for two days from retching and vomiting, colic pains and purging, these symptoms suddenly became more violent, and attended with oppressed breathing and hoarseness, so that she could hardly make lierself be heard; with vesicles on the palate, burning pain m the throat,. and excessive difficulty in swallowing; with spasm, and pain of the bladder in passing water; and with extreme feebleness of the pulse. Three days afterwards the symptoms increased still more. She complained of intolemblo burning, and spasms of the throat, which as well as the mouth was excessively inflamed; of violent burning pain in the stomach and bowels; of barning in the fundament and genitals, both of which wore inflamed even to gangrene; of indescribable anxiety and anguish about the heart: and she died the following day, death being preceded by subsultus, delirium, and insensibility." (Christison, loc. cit. p. 331.) CASE 6th.-I" On two successive evenings, immediately after taking some gruel which had been prepared by the poisoner, Mr. Blandy was attacked with pricking and burning of the tongue, throat, stomach and bowels, and with vomiting and purging. Five days after, when the symptoms were fully formed, he had inflamed pimples round his lips, and a sense of burning in the mouth; the nostrils were similarly affected; the eyes were bloodshot, and affected with burning pain; the tonge wTas swollen, the th troat red and excoriated, and in both there was tormenting sense of burning: he had likewise, swelling, with pricking and burning pain of the belly; excoriations and ulcers around the anus, and intolerable burning there; vomiting and bloody diarrhcea; a low tremulous pulse; laborious respiration; and great difficulty in speaking and swallowing. In this state he lingered several (ays, death supervening nine days after the first suspected basin of gruel was taken." (Clristison, loc. cit. p. 331.) CA tAit, t.-A girl swallowed a drachm of arsenic, and was in conseqennco attacked violently with the usual symptoms of irritation in the whole alinm'rntary canal. After being ill for twenty-four hours, she experienced several distinct remissions, and some repose, attended with fainting. In twelve hours more sho began to improve rapidly, the pain subsided, her strength and spirits returned, and the stomach became capable of retaining liquids. So far this patient laboured under the common effects of arsenic. But a new train of symptoms then gradually approached. Towards the close of the second day she was harassed with frightful dreams, starting from sleep, and tendency to faint; next morning with coldness along the spine, giddiness, and intolerance of light; and on the fourth day with aching of the extremities, and tingling of the whole skin. These symptoms continued till the close of the sixth day, when she was suddenly seized with convulsions of the left side, foaming at the mouth, and total insensibility. The convulsions endured two hours, the insensibility throughout the whole night. Next evening she had another and similar fit; a third but slighter fit occurred on the morning of the tenth; another next day at noon; and they continued to return occasionally till the nineteenth day. For some time longer she was affected with tightness across the chest, and stomach complaints: but she was eventually restored to perfect health. Case 7th.-On the evening of the 24th of August 1821, William Mitchell, a robust man, aged 45, consulted Mr. Marshall on account of the following symptoms. Pain and heat in the region of the stomach and lower part of the chest; occasional uneasiness in the abdomen, and sometimes ineffectual efforts to go to stool; thirst, with hoarseness; soreness of eyes, which had the common appearance of inflammation; shifting pains in his extremities, particularly the arms, which had not their usual strength; great restlessness; anxious expression of countenance; pulse frequent 100-110, not strong. This illness commenced with sickness the Sunday preceding (19th) on his way to church, about 10 A.m.; he soon after had thirst, and headache; and on his way home, between 3 and 4 r.M., he was seized with vomiting, which occurred often during the next four or five days, especially on his trying to quench his thirst. In the early part of the week he was heard to complain of pain in his stomach, eyes, throat, breast and arms; he was observed to void his urine frequently; and about this time he pointed out to one of his sisters a hollow between his breast and belly, into which, according to her expression, " she could have laid her arm." His illness had scarcely at any time confined him to bed; and on coming to Mr. Murray he rode six miles. On Wednesday 22nd, he took a dose of Epsom salts. On the 24th a blister to the stomach, and an opiate at bedtime. On the 25th he was found nearly as before; his countenance exhibited a disturbed and anxious expression; the redness of the eyes and hoarseness were increased; small, roundish, white, accuminated prominences were observed on the palate and uvula; seemingly the membrane covering the palate bones, and velum pendulum detached at parts by a whitish liquid. He took a dose of castor oil. On the evening he got up to drink, on returning to bed he uttered a deep groan; after which he lay motionless and quiet, and very soon expired. CASE 8th.-J. Mitchell, aged 52, a few minutes after breakfast on Sunday the 19th August had a feeling of sickness, but, notwithstanding, went to church soon after, when he felt dimness of sight with a continuance of the sickness, which by 2 r.M. had increased to such a degree that he was obliged to leave the church. On his way home, he vomited repeatedly a reddish sort of matter; he had thirst, and a burning sensation all over his belly. With difficulty he got home, when he opened a window in his room, and stretched himself on the floor. The feeling of heat within did not leave him for a week, and he vomited occasionally the same length of time; while he was at times so distressed with heat of skin, and overpowering faintness, that he went to a small stream and plunged his arms and head into the water. In the early part of the week, he felt his throat a little sore, and had uneasiness over his whole body, iI f _ CASES. 7 especially in his arms and legs. On the 22nd he voided with pain his unne, which was red; and about this time lie had some uneasy feeling in his eyes. During the week little passed from his bowels, but he had repeatedly ineffectual calls. When first seen, 25th August, he complained of little but pain in his arms, particularly the left, of which he had in some measure lost the power; pulse natural in frequency but intermitting. On the 29th he complained of imperfect vision, and difficulty of breathing; still pain of arms, and left more powerless; pulse natural; pupil of left eye contracted. All these symptoms soon disappeared, excepting the affection of the arms; and in all other respects he is now quite well. The motions of the hands are much less impaired than those of the arms and forearm; in particular the power of bending the foreann is almost entirely lost. CASE 9th.-Mary Mitchell, aged 50, was seized almost immediately after breakfast on Sunday the 19th August with very heavy sickness, soon retched violently, but little was vomited. She suffered much from thirst, and vomiting recurred at times for several days. During the week she had some soreness of the eyes and throat, with heartburn, and pain in most parts of the body; had then tenesmus; but with the exception of one minute portion of very hard faices, nothing whatever passed from her bowels from the beginning of the illness till the following Sunday, when she took castor oil; after which her bowels were moved. When first seen (25th August) she complained of her throat, bones, and colicky pains, with unnatural feelings, and some want of strength in her legs and feet; pulse 120. A few days after she had swelling of the feet, difficulty of breathing, with numbness and creeping in the inferior extremities. At present has numbness and paiin m the'arms and legs, without any other complaints; pulse 96. CASE 10th.---Helen Mitchell, aged 48, had somewhat the same symptoms as her sister; but she had more ihoarseness, inflammation of the left upper eyelid, withnumbness and pain of the arms and legs; and during the space of a week she had purging, with great weakness and tendency to faint All these symptoms abated except the loss of muscular power, which assumed the form rather of great general debility than that of a partial or paralytic affection, and in November existed to such a degree that she professed inability to walk. In December she still complained of a little weakness, and unusual sensations in her extremities; pulse 96. These four individuals, cases 7, 8, 9, 10, were all in good health and breakfasted together on the morning their illness commenced on porridge, of which William partook largely, but James sparingly; the sisters had their usual quantity. The brother-in-law of this family confessed to having put arsenic into the salt which was used in making the porridge. (Beported by Mr. Murray in the JEdin. Med. SurgJ. ourn., vol. xviii, p. 167.) CABE llth.-One morning after the conjugal embrace, a fanner introduced a mixture of flour and arsenic on the point of his finger into the vagina of his wife. About 3 in the afternoon, while enjoying good health, she was suddenly seized with shivering, and heat in the vagina; then with acute pains in the stomach, and incessant vomiting; she then became delirious, and died in twenty-one hours. After death, grains of arsenic were found in the vagina, although frequent lotions had been used in the treatment; the labia were swollen and red; the vagina gaping and flaccid; the os uteri gangrenous; the duodenum inflamed; the stomach natural. (Christison, to. cit. p. 324.) CASE 12th.-" Once," says Otto Tochenius, " when I happened to breathe incautiously the fumes of arsenic, I was surprised to find my palate impressed with a sweet, mild, grateful taste, such as I never experienced before. But in half-an-hour I was attacked with pain and tightness in the stomach; then with convulsions; difficult breathing; an unspeakable sense of heat; bloody and difficult micturition; and finally with such an acute colic as contracted my whole body for halfan-hour." (Hippocrates Chymicus, c. xxiv, p. 213.) CASE 13th.-Dr. Christison reports another similar ease, which came under the notice of Balthazar Timseus. An apothecary of Colberg, while subliming arsenic, had not been careful enough to avoid the fumes; and was soon after seized with frequent fainting; tightness in the precordia; difficult breathing; inextinguishable thirst; parched throat; great restlessness; weakness and pains in the feet. He had afterwards profuse daily perspiration, and palsy of the legs; and several months passed before he got well. (CUhristison, loc. cit. p. 325.) CAss 14th.-The following case is related by Desgranges. A chamber-maid rubbed her head with an arsenical ointment in order to destroy vermin. Though the skin was perfectly sound, the head began to swell in six or seven days after; the ears became twice their natural size, and covered with scabs, as were also several parts of the head; the glands of the jaw and face enlarged; the face was tumified, and almost erysipelatous. Her pulse was hard, tense, and febrile; the tongue parched; and the skin dry. To these were added excruciating pain, and a sensation of great heat; vertigo; fainting; cardialgia; occasional vomiting; ardor urine; constipation; trembling of the limbs; inability to stand; and delirium were also present. In a day or two after, the body, and especially the hands and feet, were covered with a considerable eruption of small pimples with white heads. She finally recovered, but during the convalescence the hair fell off. (Orfia, Toxicol. Genrale, i, p. 338.) CASE 15th.-A labouring woman, on the 5th August, 1830, partook in company with her husband, mother, and several others, of cabbagesoup (the salt with which the soup was made having had arsenic added to it). They were soon all seized with weight at the stomach; acrid taste in the throat; nausea, and vomiting. On the evening they all again partook of the rest of the soup; the symptoms returned with greater severity, and continued during the night. On the 7th all experienced an excessive heat in the stomach, like burning fire in the throat and stomach, but no vomiting. As the woman, whose case is to be reported, took now her meals out of the house, she gradually got better; but at the end of August was unable to work. But about this time she unfortunately eat some stewed prunes, to which arsenic had been added by her uncle: in less than ten minutes she was seized with convulsions and complete loss of consciousness, with vomiting, and horrible colic. She thus passed several days dangerously ill, and was only able to leave her bed eight months after, but only to pass a miserable existence. Her features are much altered,-she bears the stamp of premature old age; her digestion is difficult; and she experiences constant pains in the stomach. The flexor muscles of the four fingers of each hand and of the five toes of each foot are so contracted that the two last phalanges are bent on the first, and the points of tie fingers and of the toes touch the palms of the hands and the soles of the feet. This unfortunate woman walks with great difficulty, standing upright causes pain, and she experiences acute pains in the lower part of the spine. In fine, she presents the symptoms of chronic gastro-enteritis, and of a great morbid alteration of the nervous system. (Laclmsa, Annales d'Hygia~nepublique, tom. xvii, p. 336.) CABE 16th.-A man, from 35 to 36 years of age, much addicted to drinking, swallowed a year ago half-an-ounce of arsenic, but immediately vomited the half of it. The author found the pulse quick, irregular, weak, and contracted; breathing heavy, and often interrupted by sighing; expression wild; his eyes projected far out of his head, they were bathed in tears, which excoriated the cheeks; the facial muscles were from time to time convulsed; the voice trembling; tongue dry, and the lips covered with small black spots; burning pain in the bowels; unquenchable thirst; belly very tense, and painful; copious, watery, and burning involuntary evacuations at stool; urinary secretions suppressed; stinking sweat all over his body; his reason left him from time to time. He took frequently oily drinks, and fat broth. Death seemed inevitable. When after these symptoms had continued five days, on the sixth a great miliary eruption canm out all over the body, with general amelioration. The eruption recurred several times in the course of a fortnight, and terminated at length in bran-like scales. Ulcers (abscesses) appeared on both heels, an ichorous matter was discharged, and the patient recovered. Nothing remained but greater weakness than before, general trembling, and frequent attacks of ophthalmia. (Guilbert, in Jour. de Mcd., vol. iv, part 5, pp. 353, 356.-1756.) CASE 17th.-Francois Ragot, aged 28, robust, of a dark complexion, was seized suddenly with vomiting after partaking of a dish to which three spoonfuls of arsenic had been added by mistake as flour. First day, 28th January, 1839.-The vomiting was frequent; latterly mixed with green bile, it became less frequent, and ceased on the fourth day; no pain at the epigastrium nor at the abdomen; no evacuations; skin cool; pulse small, but not frequent. 20th.-Weight of head; skin hot, without being dry; pulse quicker; tongue dry, without redness; slight sensibility of the epigastrium and the left iliac region; thu vomiting continues; no stool; moves easily. 30th.--Ccsation of these symptoms with the exception of thie vomiting. On the two following days complained of weight in the hcnd; the expression dull; skin hotter; pulse quicker; abdomen painful only on pressure; no stool. February 2nd.-Aggravation of these symptoms; cyes fixed; no headache; stupor; slight delirium; he strives to remove the cold cloths applied to his head; eyes injected; pulse 88; tumultuous beating of thime iart. February 3rd.-Restless night; slight delirium; dull look; intelligence confused, but able to answer questions; no headaoho; action of __ _1~ ~__ r- _ _ 8 CASES. heart strong, without any murmurs; pulse 90, jerking, full and strong; skin hot, and dry; he has experienced for some days a sense of laceration in the b fisophagus; the tongue dry, without redness; a pustular eruption (which in its appearance and course was analogous to small-! pox) has,appeared on the forehead, around the eyes, on the cheeks, the shoulders, upper part of the arms, and upper part of the chest. Some of tihee pustules are isolated, the greater number confluent; they wcrc replaced by thick scabs, leaving behind very evident cicatrices. Almost complete loss of motion of the limbs, especially of the left side; the snsawtion a little dull. Cold was applied to the head; he was copiously ble-d, the blood shewing a buffy coat, and according to Prof Orfila's analysis containing traces of arsenic. February 4th and Gth.-More restless nights; cerebral symptoms more marked, but without headache; delirium, with great agitation, especially during the night; he is restless, and speaks incessantly of a confessor; pupil dilated, to which much importance was not attached owing to the darkness of the room; action of the heart more tumultuous, strong pulsations, with distinct bellows-murmur; pulse 110, full, and jerking; appearance of copious sweats, which continued till the beginning of March. Demulcent drinks, leeches applied to the cardiac region, and digitalis administered, also a small enema of mercurialized honey. February 7th.-Consultation with M. Orfila. Stupor; delirium lias ceased; continual somnolence; pulse slightly diminished in force; pulsations of heart strong, and sounds attended with distinct bellowsmurmur; copious sweats; eruption begins to disappear. Cold lotions to the head, and the digitalis continued to the 14th. On the 11th the pulse was 100, and the bellows-sound still existed. From the 12th to the 15th he was improving; diminution of stupor; great prostration of strength; pulse upwards of 100, weaker, but still strong; the bellows-murmur has ceased; sweats less abundant; tongue clean and moist; after a simple enema, soft fetid stools. From the 15th to the 20th aggravation of the symptoms; his appearance risembles that of a patient labouring under typhus; constant somnolence; marked stupor; dull look; noise in the ears; no head. ache; flushings of the cheeks; slight ophthalmia; decubitus dorsal; relaxation of the limbs; clammy skin; great emaciation; the pulsations of the heart are readily felt when the hand is applied to the cardiac region, but not beyond that; slightly increased dulness on percussion of this region; heart's sounds normal, except that they are strong and sharp; pulse 95 to 100; no tenderness of the abdomen, which is so much retracted, appearing like a hollow surrounded by the ribs and pelvis, that the pulsations of the aorta and course of the vertebral column are quite evident; borborygmi; no diarrhoea; incontinence of urine, which continued to March 10th. He was again bled, and the blood still afforded traces of arsenic; tepid baths and emollient drinks were given. By the 4th of March he had improved. From the 5th to the 17th he gradually gained strength; facies.hypocratica; the movement of the limbs became easier; the incontinence of urine had ceased; and he was able to partake of more solid and nourishing food. March 21st (53rd day of the illness).-The patient can sit up; sleep natural; expression good; appetite has returned; the noise in the ears only experienced when sitting up; pulse compressible, 88; the abdomen less retracted; slight tenesmus; a few watery stools; free movement of the arms and legs, but unable to use the fingers and the toes; the hand is always flexed. June llth.-The patient was ordered to the country. The left hand can be extended, but not the right; the finger of the left hand can be slightly moved; they can be flexed about two-thirds, but he is quite unable to extend them. When he lies on his left side, he can move his whole right leg from within outwards, the foot being inverted; this movement can scarcely be made with the left leg. The voluntary extension of either foot is quite impossible; he experences acute lancinating pains like the shootings of needles in the hands and feet. By the 19th of July, 1840, under the use of strychnine, douches, friction, aromatic vapour baths, &c. he gradually gained more power over the limbs, but the motions were still imperfect, and he was unable to extend or flex the toes. (Jowrn. des Connazssances MEd. Chir., t. xii; reported by Orfda, loc. cit., t. i, p, 329.) r i i i II j i i / I i i i 1 I i i i ii i i i; r ' i i ---~.----- --- ~I "- --I SCHEMA OF ARSENIC. This Schema is based on that originally drawn up by Hahnemann. After consulting as far as possible the original sources quoted by Hahnemann,.nd when unable to do so, guided by the admirable investigations of Dr. Wurmb, I have excluded many symptoms as drawn from doubtful sources:: have also added many symptoms, the sources and full history of which are given in the preface. Symptoms without any mark affixed are taken "rom Hahnemann's own proving. The abbreviations denote the names of those who assisted in the proving: Stf., Stapf; Fr. H-n, Frederick Hahlemann; Lhr., Langhammer; Myr., Meyer; Gss., Gross; Bhr., Baihr; Hbg., Homburg. Cocc.Sil.Lach.Spig. Dig. Arn.Rhus.Op.Lach.; Bell. Lach. Nux v. I Ver. Head. 1. Vertigo coming on every evening when the eyes are closed, obliging one to seek support. Vertigo on being seated.1 He is seized with great vertigo and desire to vomit on lying down, and is obliged to rise in order to get relief. (Stf.) Vertigo, only on walking, as if he would fall to the left side. Giddy and stupid, feeling in the head, especially the forehead when walking in the open air, a sort of intoxication, staggering from side to side, and threatening to fall every moment. (iLr.).. ' Complete loss of sensation and consciousness, so that when put to bed he lost all knowledge of what happened to him. (1) (Pyls. &ammlung, viii, pp. 98, 105, 109.) 5. Stupidity, and confusion in the head, weakness of memory. Weight in the head, depression, dull look, obtuseness, continued somnolence, noise in the ears.b(2) (Case 17, vid. ~ 382.) Delirium.0 (3) (Cases 4, 9, 12.) The pulse hard and febrile, skin dry, tongue parched, severe cardialgia, occasional vomiting, fainting, great heat, ardor urine, constipation, inability to stand, trembling of the limbs, and delirium. (Case 14.) The pains cause such weakness in the head, with so much squeamishness, and weakness at the epigastrium, that she feels very ill.1 Head. Headache, giddiness, and want of sleep. (Pereira, Mat. Med. vol. i, p. 639.) 10. Great obtusion of the head, in the evening. After sleeping, sensation of heaviness in the head. Weight and headache, as if from insufficient sleep, occurring from 11 A. M. to 6 P.m. Internal uneasiness accompanied with a stupified feeling in the head, as if he had done much work very hurriedly. Anxiety, inquietude, with pains in the head, the abdomen and knees. e (Richard, bei. Sc/tenk, lib. vii, obs. 211.) 15. Headache after dinner, with a disposition to sadness and melancholy.r) t During several days, headache and vertigo. (From the fumes of arsenic, G. W. Wedel, Diss. de arson. Jen. 1719, ~ 10.) Great heaviness in the head with humming in the ears, it goes off in the open air, but returns again as soon as he enters the room. When he comes in from the open air he is seized with a chill, followed by hiccough which continues a long time, then with general perspiration, to which the hiccough again succeeds. Great heaviness in the head, as if the brain were oppressed by a weight, with humming in the ears, felt in the morning on rising, and especially when standing or sitting.' o Sep. f Nux v. Lach. Sul. Puls. g AconJIcll.Bul.Arn. (1) The loss of consciousness is not a common symptom in man, but with the lower animals such as dogs there is occasionally absolute nar-,otism. When in man loss of consciousness and stupor occur it is under much circumstances as case 3; in ý 4 it supervened on agonizing colic, vomiting and diarrhoea. Vid. also under Fever, ý 381, 382. (2) The patient could be roused, but somnolence and obtuseness were very marked, giving him the appearance of a patient in typhus. (3) The delirium arises only in acute cases of poisoning, and often along with convulsions usher in the closing scene; it therefore cannot be considered as a symptom of much value. Ars. has been recommenled in delirium tremens; and Mr. Moore writes " that if shut up to 3ne remedy for delirium tremens his choice would fall on Arsenic."(British Journal of Hom agoathy, vol. viii, 496.) I doubt much if this remedy will be found useful in cutting short a fully developed paroxysm 3f delirium tremens; but anticipate benefit from its employment in an earlier stage, when the disease is the result of long continued intempe ranco, or the sudden withdrawal of these stimuli, when the premonitory symptoms are irritability of the stomach and vomiting, costiveness or diarrhma, oppression at the heart, great anxiety, trembling, especially of the hands, weak quick pulse, short and broken sleep, great exhaustion. I would anticipate good from its employment in such diseases as the chronic alcohol disease of Huss of Copenhagen. (J) I do not agree with Dr. Wurnib in his disparagement of this remedy in headaches. The kind of headache in wlich it is indicated is shewn in @ 29, 15, 18, 20, especially 19, 30; often attended with nausea and great depression, often tending to appear periodically. Hence in ague browacho I have found it, as also C hina and Coloc., useful. Additional indications will be an irritable, emaciated, weak patient, suffering from disease of the heart, or digestive organs, especially when marked by great irritability of the alimentary canal. Vid. cases in Brit. Journ. of ionuopathy, vol. v, pp. 336, 438; also a case of periodical clavus, voL viii, p. 298. Ars. has been recommended in chronic hydrocophalus.. E I - 10 ARSENIC. A K. b. BRhs r. Sep. i Arg. j i. Bell. Nux v. (CCe. I'ug. Puls.Sep. I gn. Va r. k K. h. Arg. n. Phos. Glo. lp. Plat. / Salbn. Sep. Puls. lAch, Bell. Nux v. mi Sep, Thuja Head. Stupifying pressive headache, especially in the right frontal region directly over the eyebrow, with pain like of ulceration on knitting the brow.h (Lhr.) 20. Drawing pressive pains in the right temporal, and frontal region.' (Lhr.) Stupifying pressive pains especially in the forehead, with fine stitches in the left temporal region near the outer canthus, when walking and standing, going off again when sitting. The stitch-like pain ceases on touching the part. (Lhr.) Headache, consisting of tearing and heaviness, with drowsy faintness in the day-time. Drawing headache under the coronal suture, a few hours every afternoon. In the morning on getting up, hemicrania, pain as if one side of the head were bruised. Pain as if bruised or sore, over the nose, and in the forehead, going off for a short time by rubbing. 25, In the night, about two o'clock, during a sweat which breaks out, sharp hard beating as if from blows of an axe on the head, the head feels as if it would burst. Violent beating in the whole of the head, especially the forehead, on moving or when raising himself in bed, with desire to vomit.) Pulsating headache in the forehead, immediately above the root of the nose. k (Vid. ~ 61.) At noon and at midnight, painful hammering in the temples, lasting half-an-hour, after which she felt her body as if palsied for two hours., Dull beating pain in one half of the head, extending to beyond the eye. Sensation during motion as if the brain moved and beat against the skull.' 30, Superficial pinching pain over the eye, tearing stitch-like pain in the left temple.m Sensation of a sort of cracking in the head above the ear, on walking. Bruised pain of the scalp, increased by touch; the hairs are painful when touched." Creeping on the skin of the occiput, as if the hairs moved.O ~() PATHOLOGICAL ANATOMY. Occasionally slight congestion (vid. Fever); sometimes the brain is bloodless, but in general the structure of the brain; and its membranes are not at all affected in poisoning by arsenic. Eyes. pain of the right eye, with violent shooting pain when turning it, so that she was scarcely able to do so. a 35. At night pressive pain under the right eye, lasting for hours, causing so much anxiety that she was unable to remain in bed. Jerking in the left eye. b Burning in the eyes. c Smarting round the eyes, and the temples, as if pricked with an innumerable quantity of red-hot needles. Sensation in the left eye as if it contained sand.d 40. Watering, smarting and itching of the eyes; in the morning there is a little mucus. e (Fr. 11-n. Lhr.) Continual trembling of the upper eyelids with lachrymation. Lachrymation (Fr. H-n), the tears excoriate the cheekt (Case 16.) The eyelids stick together, in the morning. The tarsi are painful, and when moved the eyelids feel dry and rub against the eyeball.5 Redness,. extravasation and inflammation of the eyes; inflammation of the conjunctiva. h (2) (Hahnemann, Christison, Orfila, and many other sources.) 45. A tendency to frequent attacks of ophthalmia. (Case 16.) Burning paih in the nose, the mouth and.:the eyes, the eyes were bloodshot, the mucous membrane of the throat red and excoriated. (Case 6.) On reading by artificial light, dryness of the eyelids, which seem to rub against the eye. Contraction of the pupil,I (Lhr.) uneasy feeling in the eyes, imperfect vision, pupil of left eye contracted. (3) (Case 8.) Spots or blue points float before the eyes.) 50. Vision obscured, he sees objects black, during the first hour, he does not know those who are round him. (4) (Richard, loc. cit.; Baylies in Samml. br. Abh. f. p. Arzte, vii, 2.) Eyes dull, and face haggard.*k Complains of heaviness and pricking sensations about the eyelids, with flashes of light before the eyes when they are closed, and after a time the eyelids become puffed and droop, a Aeon. Agar. Amt Bell. Puls. Spig. b Am. c. Agar. Cale Croc. Plat. Nit. ac Ihus. Stam. Sul. c Bell. Bry. Canth Lach. Phos.,Ruta Sulph. Thuja. d Bel.Dig. Hep.Ign Puls. Rhus. Spig Sul. Thuja. e K. b. Mere. Puls Stap. f Bell.Dig.Euph.Iot IK. hydr. K. c. Lee Spig. Stap. g Aeon. Alum. EuplHep. Puls. Rhm Vet. h Aeon. Bell. Canti Euph. Hep. Iot K. b. K. h. Mere Pule. Spig. Stapi Sul. i Agar. Ac. Phos Camph. Calc. Cic Cocc. Nux. ve. r. j Agar. Dig. Bel Mere. Phos. Spig Ruta. k Phos. Dig. n Aeon. Bar. Mere. Spig. Bell. o Avg. n. Agar. K. b. Laeh. Sabad. Bar.c. Acon. Eyes. 34. Drawing pain in the eyes, and twitching in the eyelids. Pressive pain over the left eyelid, and also in the upper half of the eyeball, increased by looking upwards. Deep internal (2) The action of Arsenic on the eye is very marked, and is confinec principally to the conjunctiva: it is indicated in catarrhal ophthalmia in scrofulous ophthalmia, with photophobia and copious lachrymation. In ulceration of the cornea it is one of the best remedies. When inflammation affects all the tunics of the eye as in purulent ophthalmia, or the fibrous as in rheumatic, or the iris as in iritis, Ars. holds an inferior place to Aeon., Bell., Puals., Hep., and especially to Mere. The conjunctiviti of Ars. very closely resembles that of Iod. and Kali-hydr. Dr. Dudgeor recommends Ars. in ophthahnia attending the exanthemata, in ophthalmia hOmmorrhoidalis, and ophthalmia menstrualis: he quotes some ver characteristic cases in Brit. Jour. of Hom., vol. iv, pp. 248, 249; vol. vi p. 319. (3) There is hardly sufficient evidence to determine the action of Ars. on the iris. (4) This occurs in the last stage of acute poisoning, and is not therefore of much value. (') The symptoms which lHahnemann gives as referable to the scalp have here been omitted, as they are attributable to the local application of ArAirnic to the head. ARSENIC. 11 I Agar. Anac. Ruta, Spig. a Anac. Bell. Mere. Puls. Spig. Thuja. b Alum. Bell. Coloc. Mang. sac. c Agar. Ign. Laur. Mang. ac. Nus v. Puls. imhus. d Acon. Arn. Bell. Agar. Camph. Plat. Led. Spig. Sul. Bar. c. a Aur. Aeth. Camph. Coloc. Hoep. K. b. K. h. Thuja, Zinc. b Agar.Aur. Arg. nit. Hiep. K. b. K. h. Led. Mere. Nitr. a, Ran. Sab. Thuja. c Ambr.Agar.Camph. Ipec. Nux v. Sab. Ver. d Asar. Agar. Bry. Cale. Cic. Eupho. Mar. ver. Mere. Rhus. Stap. Ver. e Arg. Cale. K. h. Cor. r. Sab. Spong. Scil. Ears. giving the countenance a peculiarly melancholy and care-worn appearance.1 (Lond..ied. Gaz., May 5, 1843.) PATHOLOGICAL ANATOM3Y. Frequently vascularity of the conjunctiva, and spots of extravasated blood. Ears. 53. Heat in the external ear, in the evening. Cramp-like pain in the external ear. Shooting tearing pains in the ear and also externally. Drawing tearing pain behind the ear, down the neck, extending to the shoulder.a 55. Tearing lancinating pain in the meatus auditorius, within outwards, especially in the evening.b Voluptuous itching in the right meatus auditorius. (LZr.) Agreeable formication deep in the ears, for ten days.e (Fr. H-n.) Dulness of hearing, as if the ears were stopped. On swallowing, sensation as if a body stopped up the ear from without, causing dulness of hearing. Humming in the ears with every new paroxysm of pain. l) 60. Buzzing, tinkling, rushing, as if of water or a noise of bells in the ear. d (Lhr.; Thiomson; Case 17, where it occurred along with typhoid symptoms; vid. ~ 17, 18.) (2) Nose, 61. Shooting in the bones of the nose, pain at the root of the nose.a (Vid. also ~ 24, 27.) Inflamed pimples round the lips, and a sense of burning in the mouth; the nostrils were similarly affected; the eyes were bloodshot, and affected with burning pain; the tongue swollen; the throat red, excoriated, with tormenting sense of burning." (Case 5, five days after taking arsenic.) Dryness of the nasal cavity. 0 Frequent sneezing without coryza.d (LZr.) 65. Frequent sneezing with running coryza. O (Lhr.) (3) Stuffing in the head with coryza, the watery Face. nasal mucus causes a burning, and smarting at the nostrils.f Coryza with sneezing, every morning on waking, going off speedily.g Great coryza with hoarseness, and sleeplessness.h Face. Face red and puffy; swelling of the lips. (Stf.) Puffing of the face." (Fr. H-n.) 70. Paleness of the face, with dulness of the eyes, and distortion of the features." (.Magault in Samml. br. Abhandl.f. p. Aerzte viii, 1, 2.) The countenance is commonly collapsed from an early period, and almost always expressive of great torture, and extreme anxiety or dispair.b ('ristison on Poisons, p. 303.) Swelling of the face, particularly round the eyes, and of the head.c (Siebold, Hufel. Journ. iv.) Inflamed pimples round the mouth, ulceration of the lips and nostrils. d (Vid. also ~ 62) ' The facial muscles were from time to time convulsed, the voice trembling, tongue dry, and the lips covered with small black spots. Burning pain in the bowels, unquenchable thirst, belly very tense, and painfully burning, involuntary, serous evacuations.0 (Case 16.) 75. Blueness of the lips and tongue.' (Kaiser and Bailies, loc. cit.) Smarting in the upper lip, as if pricked with innumerable burning needles, extending as far as the nose; next day swelling of the upper lip above the red part.8 (Vid. ~ 38.) () A kind of pinching, jerking sensation at one side of the upper lip, especially when going to sleep. Teeth and Gums. Jerking continuous toothache, extending as far as the temple, relieved or disappears by sitting up in bed. Stitch-like pains in the gums in the morning. 80. Tearing pain in the teeth, and also in f Hep. K.. h. Mere. Nux v. Puls. Scil. g lod. Natr. h Bry. IIep. Mere. Spon. Staph. a Bell. IIep. Mere. Lach. Sil. Staph. b CamphCol.Col upr. Carbo veg. China, Canth. Lach. Op. Rhue, Ver. c Aur. Cina, Eupho. Colch. Canth. I lil. lold.K.c. Bry. Rhue, Laur. Spig. Vcr. d BlcU. Caps. Carbo v. K. b. Lach. Sil. Stram. Nit. ac. Mere. e Camph. Cupr. Op. Iod. Laur. f Sabad. g Staph. Thuja. (1) Hahnemann remarks that it is a special property of Ars. to excite other symptoms during the paroxysm of pain. (2) In tinnitus aurium, a symptom often so troublesome as the sequelm of fever, or as occurring in old people, it is worthy of trial: compare with Aeon., Am., Bar. c., Sul. (3) Ars. is well indicated in coryza, as in, 65, 66, 67, or in severe cases such as i 62. The coryza is especially characterized by a copious flow of thin, clear mucus, often lachrymation, and great weakness. It is useful in the irritated condition of the schneiderian membrane, attendant on what is called hay-fever. In ozcena Ars. is useful, especially in strumous habits when other mucous membranes are affected. When the disease is of a syphilitic taint, and the bony tissues are involved, then Aur., Mere., K. b. are more indicated. (4) In lupus Ars. is one of the best remedies, as also in schirrous ulceration of the lip. (Vid. Skin, note 4.) (5) Prosopalgia is not distinctly marked in the proving, merely shadowed out in 38 and 76. In practice it is very useful in this diseause; I havo found it so especially when the pains were seated in the isulip'.rljital and infraorbital region, and occurring in connection with influenza. Dr. Buchner of Munich reports a very speedy and complete cure: the pimin was throbbing, confined to a small spot over the supraorbital regiin, it occuiTed every forenoon and lasted until 3 or,4. a.; thi. 'countenaLncl expressive of much suffering. (Brit..Joru. of Jlhn. vol. ii, p. f04.) Dr. Quin has also reported a vecv interesting case with well nmarked indirations: tho pain was principally above the root of the nhone and rmiii the orbit, as if hot needles were darting to and fro5, and tearing, &C., a sensation of red hot needles being thrust upwards into tie pailnto: thloi general symptoms were also characteristic. (Brit. Journ. of Hum. vol. iv, p. 39.) OWJ I _.~ ---------------- - --~ -- -- _ I _ 12 ARSENIC. 1 - - - - -- a Stan. b Arm. c. Ifep. Merc. Naor. Nit.nc. I'lum. Nux v. Carbo v. c Cina. Mere. Vcr. d Acon. Bell. Stram. a Anac. Ill. Carbov. Lact.. train.Cham., lry. Ver. kcc Me.re. l Argt. Bell. Carnph. Ilyor.Carbov. Kb. Pliol. c Aeon. Arg. Ang, Am. c. Ac. mur. Chamn. Calc. Caps. Bor. Thia. Niux v. atbad. ILch. PIala. Mere. d Chain. K. b. Bell. Spig. e Chn. Per. Led. Nus v. Sabad. f Eupho. Laur. Mec. Hoil. Rian. Soneg. Rhod, Camph. g K. b. Mere. Coce. Beln. Cnth.S,'tram. Saibad.Vcr.Am.c.{l) Teeth and Gums, the head, driving her almost to frenzy: she strikes her head with her fists; shortly before the menstrual period.? Nocturnal tearing pain about the canine teeth; this is intolerable as long as he lies on the affected side, but ceases by the warmth of the stove: on the morning following the nose is swollen and painful to the touch. Pains in some of the teeth, in the gum, as if they were loose and would fall out; the pain is not increased by chewing.b Painful looseness of the teeth; they feel sore, especially when chewing: the gums are likewise painful to the touch, and the cheek becomes swollen. " Grinding of the teeth.c (Kaiser, in Hart. laub's and Trinks' R. A. M1. L. No. 24.) 85, Convulsive grinding of the teeth:d the teeth all fall out.d (Van-Eggern, Diss. de Vaccillat Dentium-Duisb, 1787.) Mouth and Throat. 80. Great dryness of the mouth, and acute thirst; she drank incessantly, and when she did not drink she felt as if she were to die of thirst. a Sensation of dryness of the tongue, and of the mouth, with frequent and violent thirst; he drinks however little at a time.b (Stf) Extreme thirst during the day, but not at night. (Fr. H---n.) Sensation as if the tongue were covered with vesicles, causing a burning pain.0 00, Boring pain in the right side of the tongue, while half-asleep. Tongue clean and red, resembling raw beef. (Vid. ~ 137.) Pain in the root of the tongue, on swallowing and turning the head, as if a fish bone had stuck there.0 Burning from the throat down to the stomach. r (Various authoities.) On the second day oppressed breathing and hoarseness so that she could hardly nrake herself heard; with vesicles on the palate, burning pain in the throat, and excessive difficulty in swallowing; extreme feebleness of the pulse. Three days afterwards intolerable burning and spasms of the throat, which as well as the mouth was excessively inflamed; inflammation of the bowels; indescribable anxiety and anguish about the heart. () (Case 4.) Mouth and Throat. 95. The throat sore and red, the expression anxious; on the tenth day the soreness was greater, affected the mouth and nose also, and was attended with excoriation of the lips and nostrils, swelling of the glands of the throat, dimness of sight, and great exhaustion. (Christison, p. 319; a case of slow poisoning which died on the 15th day.) Redness of the eyes and hoarseness: small roundish white accuminated prominences were observed on palate and uvula; seemingly the membrane covering the palate and velum pendulum detached at parts by a white liquid.h (Case 7.) Internal inflammation of the throat: (from the external application of Arsenic to the head. Rau, Acta. N. C. ix, obs. 37.) Gangrene of the fauces, from the external use of an arsenical plaster. (Feldman, commerc. lit.; Norimbergense, 1743, p. 50.) Scraping sensation at velum pendulum palati, felt without any effort to swallow. 100. Long continued feeling of roughness in the palate.J (Lhr.) Painful deglutition, the pharynx (oesophagus) feels constricted (Neue Med. Chir. Wahmehm. vol. i, Altenb. 1778).; also with incessant thirst. (Preussius, Epph. Nat. Our. Cent. iii, obs. 15.) (2) Sense of dryness, heat and tightness of the throat, accompanied occasionally with suffocation, and convulsive vomiting at the sight of fluids.k (Christon, ldc. cit. p. 301.) Paralytic condition of the pharynx and oesophagus; bread went down with great difficulty, as if the oesophagus had not strength enough to swallow it; he heard it fall down with a rumbling noise.' He is obliged to spit often: copious flow of saliva.m 105, In the morning the spfita are green and bitter. PATHOLOGIAL ANATOMY. A. The gums, the internal surface of the cheeks, the palate and soft palate, the tonsils, are of a bright red colour. The tongue swollen, of a suburral appearance; deprived of its epithelium, especially on its superior surface, and under the frenum: swelled red papillre. (Orfila, obs. 8, p. 326.) A K. b. Merc. K. ch. Bor. i K. b. Ver. Sabad. Hep. Bell. j Ambra, Bell. Cale. Camph. Hell. Dig. Mere. Staph. k Sabad. Canth. Ver, Lach. Chel. I K. b. Alum. Arg. Nux v. m Cham.Camph.Dig. Nit. ac.,ux v.Ver. Mere. Rhus. Sabad. Spig. r, I () t 9t to 98 indicate strongly the administnrtion of Ars. in severe cac4 e'"f stmiamtitis., and phagedenic ulceration of the mouth and throat, maigqmnt son) thront with tendlency to gangreno. In these respects it hrary a rrr.-mblance to Lach. and Bell., but still stronger to Mercuriusm with thEr litter there ia more atfection of the teeth and gums, its general actio n i more t thenic, whereas with Ars the typei is very asthenic. D)r. WVmnnh nrmtco)r ends the alternation of these two remedies when it is dlilicult to give a preference to either. I have seen Am. c. cure a very severe case of sloughing sore throat in malignant scarlatina, where Ars., Mere. and Lach. failed to give any relief. (2) 0 101, 102 hear a close resemblance to Bell., presenting one of the features of hydrophobia, and coupled with g 397, vid. general symptoms, may merit attention in that formidable disease when Bell. fails. Similar symptoms are observed in Canth., as also in Lach. and CheL; but only in Ars. and Canth. have we, at least as far as the provings go, the convulsive vomiting at the sight of fluids. All may be usefl in dysphagia. The action of Lach. appears to be very much like that observed in hysteria, when the least pressure on the windpipe excites the sense of choking, dysphagia, globus hystericus; in none of the others is this found. -r~ '_-_-" ---~ -_---------- = _ I ARSENIC. 13 -- Taste and Appetite. B. Redness of the throat and gullet, sometimes even down to the cardia, but more general redness at the upper part, and purple streaks of ecchymosis towards the cardia. (Christison, loc. cit. p. 336.) Taste and Appetite. 106. He seems to have no taste, as if his tongue were burned and deprived of feeling. Woody taste and dryness of the mouth. Sour taste in the mouth, the food seems sour also. Putrid, and fcetid taste of spoiled meat, in the morning. 110. Bitterness in the mouth without having eaten anything; the saliva which he spits has a bitter taste, the phlegm is greyish. Bitter taste in the mouth after eating, bitter eructations and risings of greenish bitter mucus. The food has a salt taste. Every second day a bitter taste, after eating, in the throat, though the food has on other days the natural taste: like a tertian fever. No hunger, nor appetite, during ten days. 115, A nameless feeling of illness, failure of the strength, slight feverishness, an aversion to food and drink, and all the other enjoyments of life. (Vid. ~ 391.) It is impossible for him to swallow food; the smell of boiled meat is unsupportable. Great desire for acids, sour fruits. Great desire for coffee, great desire for.milk, which at other times was repulsive to her. In the evening disgust for food, with sensation of fulness and pain in the stomach after eating. Stomach. 120. Squeamishness about 11 A.M. and 3 P.M. Frequent nausea with a sweetish taste in the mouth, not exactly after eating. Nausea, felt principally in the throat, with accumulation of saliva in the mouth. a Long continued nausea, with sense of fainting; general trembling, heat all over the body, followed by shivering. (1) Nausea and desire to vomit, obliging one to lie down, occurring in the forenoon, accompanied with tearing round the mallcoli and instep.c 125, Nausea when sitting; flow of water into the mouth, as in water-brash; the nausea disappeared on going into the open air, and was followed by copious pappy stools.5 (Lhr.) Stomach. Nausea with anxiety.0 He vomits immediately after every meal, without nausea. (Fr. HI-n.) On sitting up in bed great squeamishness, nausea, and frequently sudden vomiting. Excessive and most difficult vomiting of the drinks he had taken, and of yellow green mucus, and water with bitter taste in the mouth, which continued still along time after. (S2ff.)Y Violent vomiting and purging, with severe abdominal pains.f (Vid. ~ 137, 171, 172, 189.) 130. Vertigo, fainting, cardialgia, occasional vomiting. h (From applying arsenical ointment to the head; case 12 and case 9.) Horrid cries accompany the vomiting, which continues day and night. (From external use of Ars.; Heinrich, Acta. N. C. 11, obs. 10.) Great internal heat, burning, thirst and vomiting. (Alberti, loc. cit.) Nausea, and violent vomiting of a brownish mass, often mixed with blood; of a thickish dark-brown substance, accompanied with violent efforts, increase of pain in the stomach, followed by great debility.' (Kaiser, loc. cit.) Irritability of the stomach, attended with constant vomiting of food, continuing for a long period.j (Christison, p. 316; also from application of Ars. to an ulcer on the leg, Salzb. M. at. Zeitung.) 135. Vomiting of blood and of sanguinous mucus.k (Neue Wahm. loo. cit.; Keller in Bussl. Samml. 1727.) Discharge of blood upwards and downwards.' (Gerbitz in Eph. N. C. Dec. iii, ann. 5, 6, obs. 137.) Constant pain and nausea after eating food; frequent vomiting; tongue like raw beef; intense thirst; pulse 100, small, and feeble; sense of constriction of the throat; copious flow of saliva; gastric cough, with a frequent raking of the throat and fauces, and expectoration of a muco-purulent secretion mixed with blood; distension of the abdomen, and considerable tenderness; frequent griping of the bowels; constant aesire to eat; motions white, watery and frothy; want of sleep, owing to the irritable state of the bowels; urine high-coloured, scanty, and passed with an effort; there was much pain and tenderness of the spine, with frequent muscular tremors; crampy feeling of lower extremities, with partial loss of motion and sensation, they were swollen, of a livid colour in places, and showed a tendency to slough; great emaciation.(3) (n (Taylor on Poi e Am.Ver.Mere.lBell. Dig. Tab. lRhius. f Cham. Lach. Ant, MerceNux v.Kreos. Ver. Ipec. g Ver. Bell. Cupr. Mere. Sec. Ipec. Phos. A Arg.Ver.Tab.Phos. Dig. i Ant. cr. Canth. Camph. Ver. Cupr. IIcU. Mez. Phos. Colch. T. e. j Ac.phos. Coce. Bell. Cham. Dig. Ipcc. Puls. Nux v. Ver. Arg. n. Canth. k Aeon. Am. Canth. Bry.Mcz.Laur.T.e. Nux v. Ferr. Tab. "Sec. 8ul. Ver. Ipec. K.b. I T. e. Coloc. Ipec. m Aeon. Bell. Cnnth. Ver. Mez. Cupr. ac. Mere. corr. Zinc. Phos. T. e. Nux v. z Eupho.Colch. Ipec. Sab. Mez. Vcr. Sul. ac. ) Asar. Arg. Chcl. Euphorb. Cauth. Camph.Nux v.Plat. Sabad. T. o. Kreos. Plat.;Merc. Ant. cr. i Ancn. Canth. Bry. (1) Dr. Schroen recommends it in the sickness of pregnancy, when the attacks of morning sickness pass into fits of faintness, and the patient has on an empty stomach retching and bringing up a bitter watery mucus, preceded by a feeling of burning in the gullet. (IIygea, ii, 423.) (2) The vomiting of Ars. differs from that of Ipec., T. e., and (Coc., iii being according to lalhnemann more of violent efforts ti vomit than0 actual vomiting: thus again in practice Ars, uanwers well in suich cases4 as ý 127, whereas with the above mentioned medicines there is generally nausea before and after the vomiting. (3) In whatever way Ars. is introduced into the system, the effe'cts on the digestive organs are the most marked and constant symptonss: ainl - --- ----- --- - -- -- .1 I - 14 ARSENIC. n FPrr.Bry.Vcr.Led. Alui.rOk-an. taUph. RS",l. Spig. Canth. I IIep. Carbo v. Calc. bu. ac. p Agar. Ac. sul. Bell. Bry. Canth. Cic. ('oce. Cul(r. Staph. EIupho. I1op. Niux v. Verb. 'cr. Stan. T. c. q Ambra, Ign. China, Chanu. r limhn, China, Ac. mil. Annc. Caps. a Capm. China, Colch. Chel. Ver. Ign. Grt. Ac. aul. 8pon. Stomach. sons, p. 315, occurring in a lady with cutaneous disease, after taking from 5 to 15 drops of liquor arsenicalis, 3 times a day for a month.) Wraterbrash about 4 P.r., a little before and after dinner, with desire to vomit." Frequent eructations, especially after eating and drinking; acid eructations after dinner.0 140. A quarter of an hour after breakfast and dinner, sense of pressure for three hours in the stomach, accompanied with empty eructations, followed by general langour and nausea. After a meal, frequent hiccough, followed by eructations' Convulsive hiccough.P (Vid. ~ 397.) At night on rising, hiccough with a rough disagreeable taste in the mouth. P Long continued hiccough at the hour when the fever ought to come on. 145. Violent empty eructations with confusion of the lead, in the morning. While eating, sensation of compression in the chest: after eating, pressure at the cardiac orifice and in the esophagus, as if the food was arrested there, followed by eructations.q On speaking, pressure on the anterior part of the stomach; severe pressure above the epigastrium. After eating, yawning and weakness, which obliges him to go to bed and sleep.' After eating, great distension of the abdomen, without pain, obliged to lean back in order to get relief. 150. Towards the evening, cold sensation in the chest and epigastrium, continuing even after supper; these parts feel warm to the touch.' Sensation of heat, pain and pressure at the epigastrium, with similar feeling in the precordial region. t After eating anything, insupportable pressure in the stomach, coming on not immediately, but some time after eating. u Disagreeable sensation in the stomach, which soon becomes a pressive tearing, and continued spasmodic pain. u In the evening when sitting, draving pain. I commencing in the pit of the stomach, and extending round under the left ribs, as if something were violently torn away. 155. Spasmodic pain in the stomach about 2 A.M. w Anxiety at the epigastrium during the night.2 Burning pain all round the epigastrium. Burning pain in the stomach, often attended with pressure and gnawing. Heartburn. y Cardialgia. PATHOLOGICAL ANATOMY. v Ang. Colch. Mere Ruta. w Ambra, Plum. Nu v. Cupr.Bell.Thuja Cocc. Ferr. Carbo v z Cale. Cann. Cap; Lach. Bar.c. China Dig. Mez. Sabac Thuja. y Caps. Carbo v. Eu. pho. Mang. Arg. n Canth.Camph.Phos Laur. Sabad. 1. c Lye. Sep. s Arg.Ant.Cupr.Dig Plumb. Ver. Stomach. ~ Nux v. Dig. Mere. A. Redness of the inner coat of the stomach; but however severe the inflammation of the inner membrane of the stomach may be, inflammatory redness of the peritonceal coat is seldom found. Dr. Christison gives one case, and Spurgel found it in animals. Turgescence of the external veins, sometimes so great as to make the stomach look livid, has been erroneously put down as inflammation of the peritoneum..B. The inflammation is principally confined to the mucous membrane, which is unnaturally soft, as if maccerated, easily torn, and separated from the muscular coat which preserves its normal appearance, C. This same action, by increasing, causes loss of substance of the villous coat, much more rarely of the other coats, by producing gelatinization. The breach in the membrane being surrounded by gelatinized tissue, and not by an areola of inflammatory redness. () 2D. In other cases the loss of substance is owing to ulceration, the little cavities having a notched irregular shape, and being surrounded by a red areola, and a margin of fine tissue. B. Complete perforation of the stomach exceedingly rare. F. The mucous secretion is increased: sometimes it is thin and viscid, as in its natural state; but sometimes it is both abundant and solid, as if coagulated. A sanguinolent fluid, or even actual blood in the cavity of the stomach. (Christison and Orfila.) u Astaf.Ac.phoa. Arg. Alm.l.BDry.Bis. China, Cocc. Nux v. Puls. Ferr. Mere. where recovery takes place from poisoning, the patient is too often a sufferer through life from dyspepsia: Ars. thus proves one of the most useful remedies in diseases of the alimentary canal. 0 137 is an excellent picture of chronic gastroenteritis: the symptoms arose after the administration of Fowler's solution. This is the only symptom I have taken where such a preparation was used, but here the symptoms are so well known as that of pure Arsenious Acid, that the mode in which they are grouped has led me to select this case. The state of the tougue, the great irritability of the stomach, the vomiting of food, the state of the bowels and pulse, and. 142, 151, 152, 157, 158, are very useful indications in adv plpsin. The cachectic condition produced points to its utility in low gastric fevers. Again, the complication of gastroenteritis with extr.,inr tenderness of the spine, as in. 137, is often met with along with piAinig of tube-like mucus (rid.. 181 to 188) from the bowels in cases of spinal irritation, and uterine disorder: in such cases Ars. is one of the best remedices. In carses of long standing dyspepsia where ulceration of the stomach may jlustly hx supposed to exist, Ars. hlas proved very useful. In schirrus of this organ it has also been usefil as a palliative. (') This process of destruction by gelatinization and ulceration is a purel3 dynamic, and not a chemical action. If Ars. has any chemical action or the tissues, it is to harden, and condense, rather than to dissolve, ant corrode them. Dr. Wurmb remarks, that in reading in Cruveilhier the pathognomonic signs of softening of the stomach, one can scarcely avoic thinking that they might have been drawn up from the phenomena o Arsenical poisoning: Dr. W. therefore thinks it ought to be one o the chief palliatives in that disease (loc. cit. p. 258). Drs. Arnold ant 86gin report that in an epidemic gastromalacia attacking children, anc which could not, according to the general opinion, be cured but in the first stage, they tried Ars. 30. The vomiting, purging, &c., and postmortem examination, strongly indicated this remedy. The vomiting anc diarrhoea were sensibly diminished, but only for a short time; they soor returned, except in one case when they did not reappear for eight days but on the reappearance Ars. was of no avail. Ver., Cham., Bel, Puls. Sul., Carbo v., were less useful than Ars. They then gave Kreosote 1, ir doses of 10 drops, morning and evening, and saved two cases, when the disease was far advanced and well marked. (Beauvais, Clin. Horm t. iv p. 243.) Might not a lower dilution of Ars. have proved more lasting ir its effects? --- --- - -- - ARSENIC. 15 ARSENIC. 15 a Spig. b Carb.v. Cocc.Coloc. Sul. Plumb. Bell. Nux v. Alum. o Zinc. Puls. Arm. Chin. d Nux v. Sabad. e Arg. Zinc. Cycl. f Ac. mur. Mosch. Paris, Euphorb. Colch. Bry. g Bry. Bell. Cupr. Sabad.Verb.Nux v. Hyos. Lach. h Acon. Camph. Mez. Bell. Bry. Sabad. Stan. Ran. Arg.K.c. Phos. Canth. Lach. i Cupr.Cocc.Sec.T.e. Ver. Camph. Tab. Jatr. Abdomen. In the evening on going to bed, sensation as of spasms, and pinching in the abdomen, with sweats, then discharge of flatulence, followed by a liquid stool. a () 160. In the evening after going to bed, and in the morning after getting up, pinching cutting pains in the intestines; the pains dart through the inguinal ring (as if a hernia would protrude) into the spermatic cord and perineum, when the colic ceases borborygmi are heard.' In the evening shortly after going to bed, shooting tearing pain in the left side, under the false ribs. " (Vid. ~ 153.) A pinching, increasing to a cutting pain, especially deep in the hypogastrium, preceded, and followed by loose stools. These pains do not cease after each stool, nor do they excite them. In the morning; loud borborygmi, then a cutting twisting pain in the intestines, followed by three loose stools: borborygmi early, on waking.. Every morning, flatulent distension of the abdomen; after some time this disappears. Discharge of much wind of a putrid smell, preceded by botborygmi. (Lhr.) 165. Frequently spasmodic' jerks from the epigastrium to the rectum, causing him to start. i Sense of restlessness and anxiety in the hypogastrium, but only during repose. f Boring pressive pain in the right side of the abdomen. (Hbg.) Sensation as if a great stone lay in the lower belly; with hiccough and excitement.6 ( Vid. ~215.) On stooping, a stitch-like dislocating pain in the right inguinal region. 170. The sense of internal heat did not leave him for a week, and he vomited occasionally the same length of time: h while he was at times so distressed with the heat of skin, and overpowering faintness, that he bathed his head and arms in a small stream.(Case 8.) () Swelling, and burning pain throughout the abdomen." (Case 5.) Violent colic, frequent vomiting, and collapsed countenance.' (Roux, Medicine Operatoire.) (3) Abdomen. Difficulty of breathing, thirst, pains in the belly, and purging. (Christison, loc. cit. p. 321.)(") Acute pain in the region of the stomach, and throughout the abdomen, frequent vomiting of bilious matter mixed with the food and drink which they had taken. In addition, lie had acute pains in all the limbs, vertigo, with impossibility of sitting up; a little later he had convulsions. (Lachese, Ann. d'Hygiene publique, t. 17, p. 337; vid. ~ 194.) 175. Pain as if the epigastrium were cut off from the hypogastrium, accompanied with great anguish, and lamentations about his pain.J (Alberti, loc. cit.) Violent distension of the abdomen after a meal, without pain; he had to lean his back against something, in order to be relieved. k (Myr.) Retraction of the upper part of the abdomen.' (Case 7.) The belly is commonly tense, and tender; sometimes also swollen, though not frequently; sometimes even on the contrary, drawn in at the navel.m (5) (Christison, loc. cit. p. 301.) Jaundice." ( Vid. ~ 388; also Majault in Samml. Abhandl.f. p. Aerzte, viii, 1, 2.) 180. Pains in the abdomen with constipation. (5) (Hartlaub and Trinks.) Constipation.0 (Hahnemann gives various authorities.) Obstinate constipation. (7) ( n various cases reported by Lachese, loc. cit. p. 339; vid also case 14.) j Aeon. Nux v.Anac. Aur. k Con. Asaf. Val. Alum. Am. Bell. Grat. Carb. v. Lye. Zinc. Sul. I Grat. Zinc. n Mcz. Cycl. Scill. Hell.Canth. ihtmb. Acon. Bcll. Mere. Lach. a Mere. Cnpr. Chini Iod. Dig. Lach. o Ntix v. Sul. Op. Plum. Zinc. Paint. Bry. Lach. Sep. Graph. Vcr. ulcer in a girl's breast. The symptoms closely resemble an attack of cholera, for remarks on which vid. General Symptoms. (4) This arose from applying Fr1re Cosmo's powder to a fungoid tumour on the temple; death ensued in four days. (5) The swelling is the result of tympanitis from the inflamed state of the intestines, and is not a swelling dependent on ascites. I have been unable to procure any case shewing that this disease is produced by Ars., but in practice it proves an admirable remedy, especially when the ascites is attributable to disease of the heart, or liver, to allomnIal venous congestion. The proving shews that it excites serous effusion into the pleurms, pericardium, and cellular tissue. Vid. Notes to "espiratory Organs, Heart, Skin, and Urinary Organs. (0) I have been unable to examine the original source from which Hahnemann quotes Majault, so that I am prevented giving the attendant symptoms. In the case given at 0 388 there was with the jaundice, diarrhoea, tenderness of the epigastrium, hiccough, and suppression of urine. The liver was found of an indigo-blue colour, and the gall-bladder distended with bile. Jaundice is a very rare symptom in Arsenical poisoning. It is a remedy which is worthy of trial when Mere., 3China, Nux, or Dig. fails: or especially if the jaundice is attendant nn disease of the heart, or inflammation of the duodenum: also in cachectic persons, and as a sequelh of periodic fevers. Dr. Gross narrates a case whero Ars. was very useful in removing a jaundice which was dependent on organic disease of the liver, when other remedies had failed. (Arch. Hlmo. vol. xv, p. 100, 1835.) IIahncmann recommends it in disease of the liver: the proving furnishes no marked hepatic symptonms, the thl-apeutic indications must be drawn from tihe general character of Ars. and the symptoms of deranged digestion, &c. (7) I am unable to state under what circumstances constipation is manifested. Ialinemann recommunends it in this disease: I have found it useful when other remedies had failed. Judging from several such ese.s, I would point out as indications * 182, 183, 181,185; irritation ior chronic inflammation of the stomach anti intestines, especially if attended with vomiting of acid fluids; anxiety; disease of the heart and liver; also tlie general symptoms of Ars.: these distinguish the cnstipation of Ars. (1) It is rarely given in ordinary colic, but it is worthy of trial when such medicines as Coloc., Bell., Carbo or Coce. have failed, and especially when the colic is attendant on chronic inflammation of the mucous membrane, the pains burning, with great thirst, and such ~ as 166, 170, 172, 174, 175, 177. (2) This sense of burning, and great thirst are exceedingly characteristic, and stand in strong contrast to the gastro-intestinal derangement of Puls., which is so often marked by chilliness and want of thirst: the somewhat similar symptoms of Nux are characterized by severe headache and restlessness, but this last symptom is often attended with great mental irritability and extreme impression to external agents, whereas in Ars. there is with the restlessness a sense of anxiety, depression, and extreme weakness. (3) This arose from applying, for a single night, Arsenical paste to an it i -- 16 ARSENIC. p N'nx. v. Laeh. Rata, bSL Olead. Lye. q Canth. Mere. Mcz. Nut v. C:aps. In. Zinc. Con. Colke. Alts, bul. r Mere. Irn. Ant. er. Rutab,.uL Ltc. Sep. S Caucit. Cn:. Cale. Ver.Ign.Plat.Tbuj. I Lach. Iod. il, Ant, u Mere. Spig. Canth. Ithul, I'uI. I'ltumb. Diwr. Nux v. SiiL Htan. China, Vcr. Grat. v Nux m. Ver. Dig. i Aeon. nry. Nux v. Cantl. Conc. Mere. Sntl.Itbh.t rpc.Carbo v. Phunb. z Croton, ElatLCanp. Veratr. Ipcc. Cupr. Jatr. Chan. Sec. y Alum. Splg. Plat. Pultz. Sahad. Carbo v. Cina, uthus, Sul. Graph. Zinc. lep.s. Ign. Lye. Nit. ac. Abdomen. During the week little passed from his bowels, but he had repeatedly ineffectual calls. p (Cases 7 and 8.) Burning, and pain in the rectum, and anus with continual pressure, tenesmus as in dysentery. q Straining, and pressing with spasmodic pain, which causes prolapsus recti.r 185, After having been at stool, burning in the rectum, with great weakness, palpitation of the heart, and trembling of the limbs; he is obliged to lie down.' The stool is coated with serous blood. Diarrhoea alternating with constipation; frequent discharge of scanty, watery stools, followed by tenesmus, with severe colic round umbilicus.' (Stf.) t') Between the evacuations, discharge of shreds of mucus, accompanied with tenesmus, and cutting pain in the anus as of blind piles. " 2) After pains in the abdomen, scanty evacuations with tenesmus, first of deep green matter, then of mucus of the same colour. U 190. Violent burning pains in the stomach and bowels, burning in the fundament, excoriation of the anus, vomiting, and bloody diarrhoea, with a low tremulous pulse and laboured respiration, indescribable anxiety, and anguish about the heart. (Cases 4 and 5; vid. ~ 170.) Numbness and pain in the arms and legs; during the space of a week she had purging, with great weakness with tendency to faint. (Case 10.) After much agitation, and colic, liquid black stools; the anus feels as if burning. (Richard, loc. cit.) Violent colic, dysentery.w (T arious sources.) Frequent evacuations of viscous yellow stools, during two days. (Pfann, loc. cit.) 195. Cramps of the legs and arms are often peculiarly severe and frequent in the diarrhoea caused by Arsenic. x (Christison, loc. cit. p. 312.)() Itching, scraping, chapped-like pain at the anus; the anus when touched causes pain as if it were raw. ' (4) Burning at the anus.z (Cases 4, 5; vid. ~ 190, 192.) On going to stool, painful constriction immediately above the anus, which extends to the sacrum. a Blind piles, with pain which resembles pricking with a red-hot needle. b 20c.Haemorrhoidal tumours of the anus, causing a burning pain, especially in the night, not permitting him to sleep; during the day the pain becomes more severe, and increases to violent shooting pains, which are worse when walking than when seated or when lying down.b HIemorrhoids with lancinating pains whether seated or walking, without going to stool. PATHaoooGcAn. ANATOMY. A. Great congestion of the abdominal venous system. B. Redness of the mucous membrane of the intestines. The signs of inflammatiofi are seldom distinct much lower down than the extremity of the duodenum, and they do not often affect the colon, though the rectum is much inflamed. (Christison, p. 345.) (6) C. The jejunum, the ilium and the rectum are affected with inflammation, which hardly affects the coecum, and the colon. (Orfila, p. 343.) (0) D. The duodenum inflamed. (Case 11, where the Arsenic was introduced per vaginam.) In case 7, the inner coat of the duodenum was dark-red, puffy, thickened, easily separated, and one spot as big as a crown-piece; both the inner, and the muscular coats were wanting. E. Ulceration of the bowels, met with in lingering cases. F. Extraordinary contraction of the colon. (Iloulton, Lon. Med. Gaz. xiv, 712.) G. The rectum red, excoriated and ulcerated. H. Inflammation of the peritoneum, rare. Abdomen. z Canth. Carb. an. Led. Natr. m. Nitr. ac. Nux v. Phos. Puls. Sep. Sul. Euphr. a Camph.Lach.8tap. Nux v. Ign. b Carb.v.Caust.Acon. Graph. Lach. Lye. Nit.ac. Aloes,Puls. Nux v. Sul Sul. ac. Thuja. -j I. ~ ~~-- --~~ from that of Nux, lach., Op. and Sulphur; the constipation of Ver. and Zinc. resemhles that of Ars. (1) In such conditi on, generally consequent on chronic inflammation of the hbowels, Ars. and iul. are very useful. (1). 187 to 195 indicate the kind of diarrhoea and dysentery in which Ar" is sn useful: in pnrctice it is also found valuable where there are copionls watery motions without iain, lbut attended by great prostration. In asthenic dysenteryn it is one of the Iest remedies; compare with Carb. Th'' diartrhrc anil dysentery of Ars. closely resemble cholera. 1 VWhen there is mnch frritation of the alimentary canal, and this has rexi-tril p some tinim, convulsive motions often occur. At first they are ct,,tined to the trnmk, afterwanns they extend over the whole body: they are *'lWom violent, and geierally consist of nothing else than tremors and twitche,*. (i* In irritatiln of the alimentary canal attended with ascarides or lnmuriri, Ar. is well indicated: in such diseases, the irritation, as is ohberred in Ar'., is pirincipally shown at the mouth, nose, and anus, together with the sympathetic symptoms of grinding of the teeth, wake fulness and emaciation: compare with Sul., Cina, Spig. and Mere. It is also useful in chaps and fissures of the anus, given internally and applied locally: see Dose. The action of Sul., Nux and Ars. on the hammorrhoidal vessels is very similar; and though Mere. has also a powerful action on the rectum, as shown by the tenesmus, still it is not found in practice so useful as these other remedies in haemorrhoidal affections. (5) The morbid anatomy, together with ~ 171 to 175, and g 187 to 195, well indicate the employment of Ars. in inflammation of the intestines, especially of the mucous coat of the small intestines and the rectum. In such diseases attending low fevers, it is one of the best remedies. (6) Though the coecum is less generally affected, I have found Ars. very useful in a case of chronic inflammation of the coecum, which had been a month treated homoeopathically, then a month allopathically, but without benefit. In a very few days Ars. gave speedy and permanent relief: the indications were tenderness over the coecal region, and burning pain. ______ _ ARSENIC. 17 z Dig. K. n. Cop. Cie. Phos. ac. Nux v. Mere. Mur. ac. Kreos. Lye. Scil. Staph. Rhus, Mar. Alum., Cann. Cauth. K. c. Nux v. Kreos. Spig. Lach. Phos. Nit. ac. Sep. SCalc. Cham. Dig. Puls. Phos. ac. i Cina, Con. China, Puls. Petr. Hep. Lach. Boy. Bell. Hyos. Lach. Ver. Zinc. " Acon.Camph.Cann. Canth. Alum. Dulc. Puls. Nux, Mere. Tereb. Staph. Sul. Ver. K. n. ' Cann. Canth. Cinn. Cop.Merc.Petr.Sul. Urinary Organs. 202. Frequent desire to urinate, with emission of much urine. a (Lhr.; also case 7; and Sherwin, Mem. of Med. Soc. Lond., vol. ii, No. xxxv, 1789.) He is obliged to rise three or four times in the night to make water, and each time much urine is passed; this continues for several days. b (Hahnemann.) (1) After passing urine she experiences great weakness at the epigastrium, which causes trembling:' while urinating, constrictive pain in the left groin. 205. Involuntary micturition; the urine flowing suddenly from her, but only in small quantities. d Incontinence of urine, lasting 25 days, commencing and attended for some days with a typhoid state. (Case 17.) ') Burning in the bladder, and every minute calls to make water. f SArdor urine.' (Case 14, from external application to the head.) Pain of the bladder in passing water, the urethra being highly inflamed. (Case 4.) 210. Harrassed with frequent, painful, and difficult micturition, swelling of the penis, and pain in the region of the bladder. g. (Cthristison, loc. cit. p. 302.) Urine scanty, high-coloured, and passed with (1) Does Ars. increase or diminish the secretion of urine, was a point nuch debated at the trial of Mad. Lafarge; various conflicting opinions were given, the evidence being drawn principally from experiments on Lhe lower animals. From g 202 and 203 it appears to excite a slight liuretie action: Sherwin's experiments were performed on himself with small doses. The increase of urine is sometimes attended with strainpury: when this irritation increases, inflammation of the urethra and?robably of the bladder is excited, then the urine becomes diminished, and sometimes mixed with blood, or wholly suppressed: also when there "s inflammation of the smaller intestines, the urine becomes scanty and nigh-coloured. Again: when a sudden and violent impression is made n the system, as in 2 214, 215, the kidneys are powerfully acted on, and "he symptoms much resemble an attack of nephralgia or acute nephritis, ind closely assimilate the great congestion of the kidneys and suppression )f urine observed in some cases of low fever, but especially in malignant 3holera. Ars. is indicated in acute nephritis, especially when it occurs "n cachectic persons, or in the course of low fevers; or when there is sudden congestion of the kidneys with great depression of the vital powers, and suppression of urine, as in malignant cholera: see Notes to General Symptoms. In acute albuminaria, when Mere., Canth., Hell., Bry. and Sul. fail, it is worthy of trial; but the presence of some symptoms, such as great effusion into the serous cavities, especially the pleurme and pericardium, may give Ars. and Dig. a prior claim to these other remedies. In the chronic and much more fatal form of this disease, where there is granular degeneration of the kidney, Ars., if it cannot be:onsidered as curative, is at least a very useful palliative. Had the urine in such cases as ý 209, 210, 215, been examined, it might have proved albuminous; but at present we have no positive evidence that Ars. produces albuminous urine, as is known to be the effect of Canth. and Mere. corr. Though albuminous urine is a marked feature in Bright's lisease, still to the other elements of this disease Ars. is closely homoeopathic, such as the pallid cachectic appearance of the patient, the disorder of the stomach and the frequent diarrhoea, the frequent complication of disease of the heart and respiratory organs, also the serous effusion into the shut cavities and cellular tissue. Mr. Philips has published an interesting case of this disease, treated in the Manchester Homoeopathic Hospital; Dig. and Ars. entirely removed the anasarca. (Brit. Journ. of Horn. vol. ix, p. 154.) He finds these two remedies very useful in this affection; I have seen relief afforded, but unhappily no permanent cure. Urinary Organs. an effort; coexisting with gastroenteritis. (Vid. ~ 137.) Scanty urine, which causes scalding when passed; in the morning, burning at the point of the urethra on commencing to make water. Great irritation of the urinary organs, so great as to be attended with total suppression of urine. h (Case 16.) Suppression of urine, lasting seven days, attended with jaundice and general anasarca, and great depression.' (Vid. ~ 388.) 215, In three hours after inhaling half a cubic inch of Arseniuretted Hydrogen (oneeighth of a grain of Arsenic), he became affected with giddiness, and soon afterwards with an uneasy sense of pressure in the region of the kidneys, passing gradually into acute pain there, and upwards along the back. General shivering ensued, with coldness of the extremities, and gouty-like pains in the knees, shoulders, and elbows. The hands and lower half of the forearms, the feet and legs nearly to the knees, the nose, and region of the eyebrows, felt as if quite dead, but without any diminution of muscular power. There was also acute pain in the stomach and belly generally, painful eructation of gas, and occasional vomiting of bitter, greenish-yellow mucus. The most tormenting symptom was the pain in the kidneys, which soon became attended with constant desire to pass water, and the discharge of deep reddish-brown urine mixed with clots of blood. The whole expression of the countenance was altered, the skin became dark brown, and the eyeballs sunk, yellow, and surrounded by a broad livid ring. Warm drinks brought out a copious sweat, and removed the sense of numbness: but next day there was little change otherwise in the symptoms, except that the urine was no longer mixed with clots, and that the hair on the benumbed parts had become white. On the third day the pains had abated, and the urine became clear; but there was hiccough, an excited state of the mind, and a feeling as if a great stone lay in the lower belly. In seven days he was much better. In the third week the whole glans and prepuce became covered with little pustules, which were followed by small ulcers. It was not till the close of the seventh week that he recovered completely. (Christison, loc. cit. p. 326, extracted from Buchner's Report: fur. die Pharmaci, lxix, 271.) Genital Organs-Male. Violent itching of the glans, without erection. a Nocturnal pollutions, sometimes with, sometimes without lascivious dreams, followed by long continued erections. b The glans penis is of a bluish-red, swollen, and excoriated. (Pfann. le. cit.) The glans A Canth. Camph. Tcreb. i K.b.Stram. Nitrous ac. vapours. j Canth. Tereb. K. n. Lyc.Puls.Sep.Phos. ac. a (ann.Croc.Conpih. Mere. Nux v. ep.l b Canth.Camphl. Ar. Mure. Thuj, Nux v. I, ! - t i r i 18 ARSENIC. - e Cor.Cinn. llep.Nit. at. Sep.Thuj.Merc. d Canth. * Aur. Paul. Clem. a Chin. Plat. Phos. Cnlth. Nux v. Ver. b Ambr. IBell. no. Calc. Chin. FIerr. IIwc Nux v. Croc. 1'lt Chai. lircos. Yul. c Chin. Nit. ac. Sab. I'l"ho. Cop. 'ran. Alum. Canth. d Krepo. Mere. Phoi. Aluwr. ThuJa, iSelp. tl. lod. Con. btb. Cham. 8ul. r Phos, i/ SahThtua,8ul.Con. 9 Thija, Mere. K. b. Sep. Ambrn, Kros. Canth. Genital Organs-Male. and prepuce covered with little pustules, which were followed by small ulcers. c (~ 215.) 1) Extremely painful swelling, inflammation, and even gangrene of the genital organs.d (Case 4; also J. II. Degner, Act. Nat. cur. vi; Sauhl, Opusc. C7tym. Phys. MLed. ~ 454.) (2) 220, Swelling of the testicle: from the internal use of Ars.0 (Alberti, loc. cit.) Smelters of Ars. are occasionally affected with cancerous disease of the scrotum, similar to that which attacks chimney sweeps. (Paris Pharmacology, 7th edit. vol. ii, p. 96.) Genital Organs-Female. Increase of sexual desire. a Menses too early, and too profuse:" during the catamenia, lancinating pain in the rectum, extending to anus, and vujvre. t) During the catamenia, pinching cutting pain from the scrobiculus cordis down to the hypogastrium, also in the back and side of the abdomen; the pains force her to bend double, with loud moaning and tears, also eructations. t2t. After the menses, discharge of sanguineous mucus. Leucorrhmca, a cupful in 24 hours, thickish and yellow, excoriating the vulve, lasting 10 days. " Leucorrhcal discharge, and flatus while standing. o Stitch-like pains extending from the iliac region, and hypogastrium to the labia. Burning pain of the vagina, swelling, and excoriation of the labia. (Bachmann's Essay, p. 41.)(4) Genital Organs-Female. PATHOLOGICAL ANATOMY. A. The penis and labia have been found distended and black; the external parts of generation in a female gangrenous.h (Case related by Bachmann.) B. The outside of the uterus, and fallopian tubes were inflamed. ( Christison, p. 347, quoted from Pyls. collection.) Respiratory Organs. 230. Great coryza with hoarseness, and sleeplessness. 60 In the morning, roughness of the throat and hoarse throat; dryness of the larynx. Heat and uneasiness of the throat, with hoarseness. a (Case 7.) Great difficulty in speaking, and swallowing, laborious respiration, attended with violent inflammation of the fauces, probably, of the larynx. b (Cases 5, 4.) (0) Sensation of roughness and rawness in the chest. 0 235. Much pain in the chest: stitches at the superior part of the right lung, felt especially on a full inspiration; a sort of pressure which terminates in stitches, violent stitches at the left side of chest, felt only on expiring, which renders expiration difficult. (Lhr.)4 On drawing a deep breath, stitches on the left side of chest, which excite cough; on stooping, dull stitch-like pain in the chest. d Pressure on the chest. o Sense of tightness across the bottom of the chest, with pain also darting through the upper part of the chest.f (Chkristison, loo. cit. p. 302.) Pain and heat in the region of the stomach and lower part of the chest; uneasiness in the abdomen; sometimes ineffectual efforts to go to stool; thirst; difficulty of breathing; heat and uneasiness of the throat, with hoarseness; inflamed eyes; shifting pains in the extremities; and weakness. (Case 7.) 240. Burning in the right side of chest, extending to the iliac region, where he feels pressure; great heat in the chest to above the diaphragm. (Hbg.) Burning in the chest, the same feeling under the sternum, continuing a long time; dry, fatiguing cough, h (Storck, loc. cit.) Frequent, dry, short cough, excited by a A Canth. i Canth. Sab. a Dros. K. h. Mang. Mere. Bell. Bry. Hep. Ant. Cham. Arg. n. Spon. Sul. Lach. Stan. b Acon. Bell. Canth. Mere. Iod. K.b. Br. Phos. Spon. Hep. Bry. Bar. c. c Bry.Merc. Spon.Br. Bell. Alum. T. e. K. h. K. b. K. n. Ran. Seneg. Stan. Sul. Colch. Lach. d Ang. Arg. a. Bell. Bry. Aeon. Ran. Rep. Stan. Sep. Sul. Phos. Lach. K. n. K. h. Scil. Am. c. e Bry. Bis. Sep. Plat. Sul. Arg. Sab. lod. K. c. Aur. Anac. Asaf. Phos. f lod. Am. c. Sen Puls. Phos. K. b. K. n. Lach. Kreos. Sul. Aeon. Colcb. Ver. g Canth. Mere. Bell. lod. A Alum.Ant.T.c.Arg. Bry. Dig. Eupho. Dros. K. n. Mang. Mez. Mere. Nux v. Ran. Sabad. Sen. Carbo v. Sul. Lach. lod. t i i ~c' - "~ (I) Dr. Wurmb. relies much on Ars in ill-conditioned, easily bleeding, and spreading venereal sores, attended with a burning pain, and where large doses of Mercury have been given without benefit. (JBrit. Journ. of IIom. voL iv, p. 265.) (2) Dr. Ehrhardt of Morseburg recommends Ars. in neglected phimosis with gonorrhea, when the prepuce is greatly swelled and covered with dark bluish spots. (Amer. lorn. Exam. vol. ii, 197.) (3) IIahnemann recommends it in profuse menstruation. (See also Note.4.) (4) Arm. is one of the few medicines which have been pushed to that extent, and under such circumstances as to manifest very marked effects on the uterus. From experience of it in several cases ofinflammation of the uterus and ulceration of the cervix, I recommend its employment in such cases, giving it both internally, and applying it externally. (See IAws.) In a case of induration and ulceration of the cervix where Ars. prmved very useful, the indications were great weakness, frequent occurrnce nof 22s, also. 223, 224, 226. Ars. has also been used in ordinary practice n similar case: for example, a case of chronic inflammation of Sthe utenu of three years' standing was radically cured; the prominent sinmptnms were a bearing down pain, with a constant pain and burning, vrarving in severity, in the lower part of the sacrum, the left groin, and undn:r the pubis. (1Ll Hunt, Jled. Chir. Bev. Oct. 1838, p. 372.) Mr. Hunt a1i re*prts the cure of six cases of menorrhagia, which were Sattended with great debility, much irritation of the mucous membrane tf the bowelsR. Ilis dos,.e were in one case about four drops of Fowler's ohlution three tiues a day, and in another the twentieth of a grain of SAr. once a day tfr five weeks. (6) Under Nose, reference has already been made to the.coryza of Ars. (0) From all the symptoms under this section, it is evident that this medicine exercises a very powerful and characteristic action on the respiratory organs: the symptoms referable to the larynx are not so well marked or so numerous as those originating in the bronchia, and rank much below Hep., Spon., K. b., Br. and Mere. Still Ars. is very useful in epidemic catarrhs affecting the trachea and bronchis; and it may be resorted to, when the above remedies fail, in cedema glottidis,-for inflammation with tendency to serous effusion into the cellular tissue is a marked effect of Ars. I c - ---------- ------ -~--- - ---- ~ ARSENIC. 19 -- Lach. K. b. Iod. K. h. Hep. Sen. Spig. Aeon. Chain. Cmna, Sabad. Mere. Ver. Sul.Seil.Calc.Am.c. Am. e. Ipec. Mere. lod. Nux v. Par. Ver. Nic. Pule. Hyos. Sul. Stan. Mago. m. Verb. Aeon. Lach. Bell. T. e. SAeon. Lach, Phos. Hep. Dros. Bry. Bry. eBry. K. n. Scil. Aeon. Sul. Soil. Sen. K.b. T.e. Ipec. SAeon. Am. c. Arn. Ipec. Phos. Ferr. Puls. Nit. ac. Mere. Led. Dig. K.h.K.n. lod. Sec. Respiratory Organs. feeling of choking or constriction in the larynx, as if from sulphur vapours. Desire to cough from irritation of the larynx, without expectoration; constant tickling in the whole larynx, which excites cough even when not breathing. (') Cough after lying down in bed; in bed, cough which lasts some minutes, attended with nausea, and desire to vomit. Deep, dry, continued cough after midnight, the cough wakens him; violent paroxysms, in which he fears to choke, with swelling of the neck. He is obliged to sit up at night when the cough comes on.J 245. Cough in the evening directly after lying down, she has to sit up: afterwards contractive pain in the region of the stomach, scrobiculus cordis; this pain excited a fatiguing couigh.J - Violent cough in the morning, sometimes coming on after taking tea (as accustomed to do). Cough especially after tdrinking.k Dry coug onr moving the body; the cough frequently puts himi suddenly out of breath. 'Twisting, thi:ihip, which seems to excite a dry cough. Cough on' goiginto the cold 'air"; '-when walking in the opden air he experiences a sensation of suffocation, which obliges him to cough. 250. After severe coughing, much water flows into the mouth, as in waterbirash.1, Coughing causes stitching pains in the chest, and also in various parts of the abdomein.m Much viscous mucus in the chest, Which is very difficult to expectorate. n Streaks of blood in the expectoration; mucous expectoration streaked with blood, afterwards desire to vomit.0 (2) After having ate, a sweetish taste of blood, with a cutting scraping pain in the throat, as if he had swallowed a bone, for a quarter of an hour; after which haemoptysis, at first coagulated, then nausea, after two hours' anxiety. (Myr.) 255. Frequent paroxysms of short difficult respiration, with dry cough, and pain of excoriation in the epigastrium to the middle of the chest. Respiratory Organs. Frequent anxious oppression of the chest, and short respiration, in all positions. Oppression of the chest on coughing, walking quickly, or going up stairs. P During eight days, difficulty of breathing, and oppression about the region of the sternum, on drawing a deep breath.q Pain under the epigastrium, which takes the breath short, with pains in the hypogastrium, difficulty of breathing, as if the chest were constricted. He immediately loses his breath in the evening, though cautious in entering his bed and lying down quietly, feels constriction of the trachea, when a fine wheezing rAle can be heard.r 260. In the evening, dyspncea and dry cough. He long retained tightness of the chest with dyspepsia. (Case 6.) Constant tickling cough and constriction in the chest; his chest felt so constricted that he could hardly speak, and was almost about to faint.8 (Hartlaub and Trinks, 10, 11, and 12.) Oppression at the chest, and difficulty of breathing. (Cases 8, 9, 12, 13.)t (3) On walking, sudden asthma and loss of breath, with weakness and extreme exhaustion. t (Majault, loc. cit.) 265. Suffocating catarrh. (Misc. Nat. Cur. Dec.' iii, 9, 10, 5, ~ 390.) At night, catarrh which threatens sudden suffocation. u (4) Dyspnoea more or less for a few years, death arising fromrhydrothorax. ( Vid. ~ 392.) ( PATHOL0OGICAL. ANATOMY. A The mucous membrane of the windpipe is sometimes affected with inflammatory redness. Jaeger has found it so in animals. (De Effectibus Arsenici, p. 40.) B The trachea, and epiglottis presented marks of inflammation. (Vid. Path. Anat to ~ 362.) C The patients had obvious pneumonic symptoms during life; and in the dead body the lungs were found so gorged, that on being cut into, p Aeon. Aur. Mere. Pule. Ipec. T. e. Ambr. SciL Plat. Ran. Nux v. Phos. Sul. er. Stan. Zinc. Thuja, Br. Bry. q Cina, Mere. r Alum.Canth.Camp. China, Vcr. Lach. Con. Ipec. Puls. Mosech. s Aur. Aeaf. I pc. Caps.. c. Sod. Acon.Fer.Lach. Br. t Am. c. Aur. Ipec. Bry. Nux. v. Puls. Sanb. Cann. PIhos. Sen. Lach. Lob. Carbo v. Sul. Rlan. T. c. Sep. u Cocc. T. c. Cupr. Ipec. Spon. Sen. Blar. c. (1) The cough is generally a short, dry, fatiguing cough, excited by Iryness, and itching in the trachea, with rawness, sense of heat, and 3ften constriction of the chest. But it is also well indicated in such loose coughs as ý 265. In senile catarrh it is very useful: compare with T. e., Sen., and Bar. c. Again; there is a cough of Ars. dependent on gastric irritation. (2) Dr. Unhardt relates a case of hemoptysis in a pregnant female with delicate lungs, where Aeon. had given no relief, and which was speedily relieved by Ars. The special indications appear to have been the burning and coldness in the chest; dry, burning heat of the skin; great anxiety; and palpitation of the heart. We are not aware of its having been much used in haemoptysis, but its pathogenesis indicates it strongly in haemoptysis consequent on valvular disease of the heart, and disease of the right ventricle retarding the pulmonary circulation, producing more or less pulmonary apoplexy. Vui. 263, '255, 273, 276, and Path Anat. to this section E, F. (3) There is no medicine which manifests so frequently and so closely the symptoms of asthma; and in practice it proves an admirable remedy when this disease is owing to spasm of the bronchim, to turgescence of the bronchim, or to disease of the heart, but especially in the two latter kinds. It is difficult to give the special indications; the principal are the attacks coming on at night, restlessness, and great anxiety. (4) I cannot agree with Dr. Wurmb when lihe considers Are. as not so suitable in acute bronchitis as many other remedies. In that occurring in old people, in that attending influenza, and various exanthemata, I regard it as holding the first rank. (8) Dr. Wurmb, in his valuable paper on pleurisy (Brit. Jounr. of Horm. vol. i, p. 51), considers Ars. the first remedy in serous pleurisy, as contrasted with Sulph. in plastic pleurisy. But in practice these distinctions are often difficult to make: 1 would therefore say that in the majority of acute cases, Acon. and Bry., followed by Sul., are generally sufficient; but when the effusion is great, and not yielding to Sul., when thero' i much dyspnoma, disease of the heart, or great weakness and depression, then Ars. is well indicated. It is also well indicated when the effusicni is more of a chronic character, or arises under such circumstances as when it is styled hydrothorax, or subacute hydrothorax. v 2 - - -- ------ -- -- x 20 ARSENIC. Respiratory Organs. nothing could be seen but clotted blood in their cellular tissue. (lHenke's Zeitsckrift fur die Staatsarzneikunde, i, 32.) (1) D The lungs were in the highest state of inflammation, and so congested as to resemble a lump of clotted blood. (Christison, p. 346.) E The lungs do not collapse on the chest being opened. When cut, the lung is red, gorged with blood, scarcely crepitates; the cut portion barely swims in water. The two lungs are gorged to the same degree in every part. The lungs cannot be inflated. There are certain points of a uniform violet colour, as if there had been capillary haemorrhage, pulmonary apoplexy. (Orfila, vol. i, p. 327.) F Both lungs completely gorged with blood, and presenting all the characters of pulmonary apoplexy. (From external application of Ars. to a schirrous tumour of the breast, Ann. d'Hygiane Publique, xi, 461.) See Note 2, p. 19. G The pleura, pericardium, and whole lungs of animals deeply inflamed. (Sproegel, quoted by Christison, p. 346.) See Note 5, p. 19. HI The lungs sound; two pints of red serum found in the pleura. (Vid. ~ 398.) Heart. a CantIh.Olcan. Agar. Ambr. Tab. b Croe. Tab. Cupr. Carbo v. Acon. Aur. Cale.lar.DAg. Asaf. lod. Cann. Nat. m, 8pig. lach. Phos. Puis.Ver.Sul.Merc. 267. Great anxiety and agitation, feeling as if the chest were constricted. Anxiety at the epigastrium. (tHby.) (2) Indescribable anxiety and anguish about the heart. " (Case 4.) Dyspnmea when vexed; dyspnmea when fatigued, as if from anguish. 270. Excessive troublesome palpitations. When he lies on the back the heart beats quicker and stronger. b (Stf.) Towards 3 A.M., irregular beating of the heart, and so violent that he believes he hears them, attended with anxiety. b Palpitation of the heart readily excited. b (Chrit 'ison, p. 313.) (3) Heart, Seized with frequent fainting, tightness in the pericordia, difficult breathing, unextinguishable thirst, parched throat, great restlessness, wakefulness, and pains in the feet; these continued for some time, especially the wakefulness and tendency to faint. c (Case 13,from exposure to Arsenious fumes.) (2) Vertigo, fainting, cardialgia, trembling of the limbs, and delirium. (From external use, case 14.) 275. Heavy expression, dulness; violent tumultuous action of the heart; pulse 90, strong and jerking. On the fourth, fifth and sixth days, great agitation; delirium; pulse 100, full and jerking; violent and tumultuous beating of the heart, attended with a loud bellowsmurmur.a " (Case 17.) () Pulse small, feeble and rapid; sometimes intermitting. (Many authorities.) Weak, irritable pulse; violent and tumultuous beating of the heart. e (Kaiser.) PATHOLOGICAL ANATOMY. A Left cavities of the heart are of a mottledred colour. In the left ventricle, and principally on the columnm cornese, are small spots of a bright crimson colour: on cutting down on these spots, it is found that they are not limited to the surface, but penetrate into the fleshy substance of the heart. The right cavities present spots of a much deeper red, almost black.(") (The body was examined by Depuytren, Petit and Orfila; Oftla, loc. cit. p. 319. Similar appearances observed by M. Godard, Nouv. Bibl. Mddicale, 1829, i, p. 395; and by M. Mollet, Arch. Gdndr. de Mdd. fevr. 1823.) B The coats of the arteries do not seem altered, though they may be here and there stained with blood. C The blood is fluid. (Sir B. Brodie.) Henk says it is black, semigelatinous, and sometimes pultaceous. Novati alleges that the blood is without exception black and liquid, as after cholera, and without any trace of coagu c Lach. Nux m. Ver. Am. c. Ambr.Anac. Tab. d Acon. Spig. Mere. Lach. c Carbo v. Dig. Oxal. ac. Ver. Lach. Spig. Tab.;J () Among the chest symptoms there are many which are met with in pneumonia; but in this disease occurring in a purely sthenic form Ars. has been little used. With the exception of the cases referred to at C and D, the symptoms of which during life I have been unable to procure, the state of the lungs after poisoning is more approaching to congestion of the lungs, or that half-developed inflammation observed in old, or broken-down constitutions, in typhoid fevers. It is in such cases that Ars. i.s so useful: states marked by great debility, sinking of the vital powers. (2) # 247, 273, 27A, 291, 292, 314, 325, 326, 327, indicate its employnent in angina peectoris (compare with Spig.), not only when the pain'is confined to the heart and chest, but also when it extends up the neck, or down the left arm to the fingers, or even to the lumbar and femoral re-gions If the angina is sympathetic of disordered stomach, Ars. is also uefnil in this case: Nux v., Puls., Lach., Arn. and Ver. are also indicated. (1) In this provinz the action of Ars. on the heart is very strongly marked, and it holds the first rank in the treatment of cardiac disease, It is us.eful in periicarditis and endlocarditis, along with Aeon., Bry. and Spig., wocalionnAly Mpre; anrl is especially indicated in the former disease when effusion has taken place. In organic affections of the heart, espe cially when there is dilation or valvular disease, it is the best remedy: and it is worthy of note, that under its use the various pains, the distressing palpitation, the dyspnocea, are relieved in a marked manner, and that while the organic change remains unchanged: in such cases it may be compared with Dig., Lach., Bar. and Spig. Dr. Hope (Dis. of the Heart, 158) states that lie has seen the same series of symptoms arise from poisoning by Arsenic as result from inability of the heart to transmit its contents, as in effusion into the pericardium, &o. In palpitation depending on inorganic causes it is also useful, but in a less degree. When the palpitations are attended with noise in the ears, rush of blood to the head, or confusion of sight, then Lach is more indicated than Ars.; when the palpitation is attendant on ancemia, then Ferr., Chin., Mang., Sep. and Puls. are to be preferred; when dependent on inervation, such as from venereal excesses, then Phos., Phos. ac. and China are to be compared: again, for this affection occurring along with disorder of the digestive organs, Ars. holds an equal rank with Lach., Spig., Nux, Carbe v., Puls., Aur., Ver. (4) Dr. Christison states that, at a meeting of the Acad. Roy. de M6d at Paris, it was distinctly proved that such appearances arise from various causes, and are therefore not characteristic of Arsenical poisoning. I - I ARSENIC. 21 Rhus, Vr. Bell. Bry. Puls. Dulc. Anac. Cocc. I-n. Bar. c. Lach. Dig. K. c. Staph.,Rhod. Sul. Canth.Carb.v. Hep. K.c. Bry.Puls. Nux v.Sul.Lach.Natr.m. Chin. Guiac. Arn. Bry. Phos. Rhus, Nur v. Nux m. Ver. Agar. Led. Thuja, Ruta, Aeon. Puls. Lach. Alum. Sul. Ruta. Ap. Mag. n. p. Mere. Ruta, Cocc. Aeon. Bry. Canth. Alum. K. n. Mere. Puls. Ambr. Nux v. Vcr. Cocc. Rhus, Arg. n. Bell. Lauro. Alum. Anac. RutaDi.Sil. Dulc. Sabad.(?) Cupr,(l) Neck and Back. lation. (Christison, loc. cit. p. 348.) The pericardium generally contains serum. ( Wibmer, Die Wirkungen der Arzneim. und Gifte, &c. 1831, vol. i, p. 325.) Neck and Back.S' 277. Tensive stiffness of the neck. (Bhr.) Stiffness of the nape of the neck, occurring morning, and evening, as if bruised or sprained, with a similar pain felt over the hips. a External swelling of the neck, without pain. (Stf.) Drawing pains between the scapula, which oblige him to lie down. Drawing from the sacrum to the shoulders, with stitches-in the side: flatulence moving about in the abdomen, and pressing upwards, then eructations which give relief. b 280. The small of the back is painfully stiff during the whole day. Loss of power in the loins. Bruised pain in the sacrum, the back, and over the shoulderblades, as if from blows. Drawing pain in the back during the morning. Pains in the back, with agitation and anxiety.d (Buttner, Unterricht uber die TodteslicLkeit der Wunden, p. 197.). Distinct quivering movements of the muscles of the left side of the back, only when lying -on the right side. o (LAr.) Stitch-like pain in the region of the kidneys, on inspiring or sneezing., 285. Standing upright causes great pain, she experiences great pain in the lower part of the spine: chronic contraction of the toes, so that they touch the sole of the foot. (Case 15.) Pain and tenderness of the spine with frequent muscular tremors, crampy feeling of lower extremities, with partial loss of sensation and motion. ' (Vid. ~ 139.) Upper Extremities. 287. Tearing, lancinating pains in the right armpit: at night, in bed, tearing in the elbow and wrist: every evening, drawing pain in the bones of the wrist.0 (2) Pain at night in the arm on which one lies. Tearing shooting pain in the bones of the hand and the little finger. b 290. Drawing pain in the middle finger; tearing drawing pain, early in the morning, in the fourth and fifth metacarpal bones b Tearing twisting pain extending from the points of the fingers to the armpits. Cramp in the fingers when they are extended, painful cramp in the last articulations of the fingers: from the morning till noon, cramps in the ends of the fingers, in the calves, and the toes.; He was attacked at night with a violent cramp in index finger of right hand, successively invading the other fingers, and lastly the thumb; then attacking the other hand in the same manner, and finally the feet; the pain in the hands subsiding as the feet became affected. The whole duration of the cramp was about 30 minutes, after which he fell into a sound sleep, which continued until morning. When he awoke he felt free from pain, but on attempting to rise was surprised to find that he had lost the use of the affected parts, and was in fact perfectly helpless. This paralysis has continued unchanged to the present time, accompanied with a feeling of heat, and numbness which invaded the upper extremities from tips of fingers to a point about three inches below the elbow, and the legs from the toes to a point a little below the knee. He also has lancinating pains in these parts, regularly commencing about 5 p. m., and continuing until midnight. (New York Jour. of Medicine, 1850.) () Great formication in the hands at night. " 295, Coldness of the hands.0 (Stf.) Shifting pains in his extremities, particularly the arms, which had not their usual strength.' (Case 7.) Uneasiness over his whole body, especially in his arms and legs. Some days after he complained of little but pain in his arms, particularly the left, of which he had in some measure lost the power; pulse natural but intermitting. For days after this he complained of imperfect a Mere. Rhod. Aur. Sep. K.b. K.n. Sul. Plum. Stron. Cycl led. Rhus, Rhus r. Ruta. Led. Lach. Lye. Guiac. Zinc. b Sab. Rhus, Rhus r. Bar.Aur.Arg.Ruta. K.h. K.b. Sep. Lye. Spig. Zinc. Ouiac. AmI. c. c Ambr. Cale. Cupr. Cham. Mere. Arg. Arg.n. Ruta, Stron. Aur.Phos.Spig.Scc. Vcr.Nux rv. Camph. Am. c. d Agar. Phom. Rhod. a Ac.sul. Coc.Ambr. Gupr. Nux v. Spig. T.o. Chin. led. Dig. K.n.K.c. Phos. Bar. / Stron. Pul. Am. Am. c. Plum. Boll. Cycl. Zinc, Coco. Stan. PATHOLOGICAL ANATOMY. A The brain and spinal chord are found in the normal state, except that the latter is sometimes congested, especially the vessels of the cauda equina. (Wibmer, loc. cit. p. 326.) (') This section should embrace all the symptoms referrablo to disorder )f the spine, but following an arbitrary arrangement to which homceopathists who consult the B.. A. M. L. have become familiar, I shall limit the remarks, and refer for further information to General Symptoms. The pains which may be referred to the muscular tissue are drawing, attended with stiffness, and appear periodically morning and evening; they are also attended with a characteristic symptom of Ars., viz., restlessness and anxiety. I am not aware that Ars. has been much used in lumbago. I have found it useful in such cases as are described under the name of spinal irritation, attended by more or less tenderness of the spine, pain or numbness radiating to the arms or down the lower extremities, or affecting the chest and stomach, especially when there is dyspncea, great tendency to nausea and vomiting, costiveness, or often alternately costive and relaxed, and not unfrequently tubes of mucus passed from the intestines. In such cases, generally so difficult to cure, this remedy bears comparison with Cocc., Agar., Nux, Bulph., Sil., Bell. (2) The characteristic pains in the arms aro tcaring, they are worst at night, occasionally periodical; often attended with general uneasiness and restlessness, and in severe cases with powcrlessness of the extremity, and contraction of the flexor tendons of the fingers. Tlhe character of these pains points more to disorder of the nerves than to rheumatism or gout; it has been little used in such affections. Dr. Gross reconunends it in arthritis. (Arch.f. lIm. /I. ix, 144t.) In ncunrlgia, attended with loss of power and contraction of the tendons, it merits attention. (3) '1 his patient was a sailor, who had accidentally swallowed Arsenic. After recovering from the primary effects of the poison he remained quite well, when the above symptoms appearedc, and continued for nearly seven months; but even at the end of that time lie liad peculiar sensations in the fingers on the approach of stonny weather. "--------` : --`-e - -- "-----"1-3-----------~---------- 22 a Ntx v. pBlL Ver. Coc. Plumb. bil. sec. 3Merc. h Mere. Plum. 8ee. Lach. (?) a Cau4t. Ran. K. b. Miz. Aeon. Am. c. Nux v. 8tront. Arg. n. Plumb. b Chin. Mere. K. e. Lach. Led, ihod. c Plumb. Rnta,Anac. Stron. Ptds. Am. c bloezAnt.ct.Moemh. d Rhus.Plum. Nux v. Bell. Cham. Alum, Ambr. Slap. Ver. Spig. ARSENIC. Upper Extremities. vision, and difficulty of breathing; still pain of arms, and the left more powerless; pulse natural; pupil of left eye contracted. All these symptoms soon disappeared, excepting the affections of the arms. The motions of the hand are much less impaired than those of the arm and forearm, in particular the power of bending the forearm is almost entirely lost. g (Case 8.) (') The flexor muscles of the four fingers of each hand, and of the five toes of each foot, are so contracted, that the two last phalanges are bent on the first, the points of the fingers touch the palm of the hand, and the points of the toes the soles of the feet. h (Case 15, vid. ~ 285.) The joints of the fingers are painful when moved. Lower Extremities. 300. In the morning after a sleepless night, violent drawing tearing pain in the hips and the left foot." (1lartlaub and Trinks.) Violent tearing pains, here and there, which force one to cry out; drawing tearing pain, like of dislocation, extending from the right calf to the heel. " Drawing tearing pain in the forepart of the thigh, extending to the knee and to the ankle, felt on walking. a Tearing lancinating pain apparently in the periosteum, along the whole lower extremity down to the point of the big toe. b Tearing pains throughout the whole lower extremity, from above downwards; he was unable to sit or lie down, obliged to shape the limb to and fro day and night, or else to linmp about, unable to sleep: much worse at night. Drawing pains in the foot, which he is unable to keep at rest. () 305, Pressive pain in the calves: the calf of the leg is hard, and as if pressed flat, with excruciating pain, like cramp, but more severe, forcing her to cry out for an hour and a half: the foot became cold, insensible and stiff, so that she was unable to move it; there remained a sense of tightness in the calf, and a sort of palsy of the thigh. d Tearing pains in the calves, relieved by warm Lower Extremities, cloths, then swelling of the limb at above the calf. (3) Violent tearing in the arms and legs, with impossibility of lying on the affected side, much increased by movement of the pained part. (4) Weight, lassitude and drawing pains in the limbs, with bending of the knees, especially in the morning.0 Pain in the left knee as if sprained and bruised, especially on rising from a chair, excessive weakness of the knees.e 310, Tearing and shooting pains in the articulations of both feet; on walking or standing up experiences pain as if sprained; the ankles when touched excite a pain as if raw.' Tearing, drawing, jerking pain from the ankles to the knees; the ankles are painful to the touch. In the morning cramp-like pain in the foot, which changes into a tingling sensation.5 Tearing pains in the heels. (Bhr.) The heels are painful at night, as if they were pressed against a hard body.h Frequent lancinating pain in the soles of the feet; on standing up a pain shoots from the left heel.up the thigh.1 815. Swelling of the.ankles, without being red, causing a tearing pain which is relieved by external heat.? Shining swelling and heat of the feet, extending above the ankle, with round red spots which cause a burning pain and itching.' Nunib pain through the whole left side of the body; in the right foot there is a similar pain; when seated the foot cannot be raised except with the hand. (Bhir.) Pains and shootings in the knees.m Tension in the popliteal region, as if the tendons were too short, felt on sitting or standing up, but not on walking. Sensation around the knees as if the legs were tightly bandaged." 320. Formication in the limbs, as after being benumbed.o Jerking, perceptible to the touch, as if something alive ran in various parts of the muscles of the thigh and leg, with spasmodic pains in them, coming in paroxysms.P Paralytic weakness of the limbs, daily at a certain hour, like a febrile attack. Partial loss of sensation and motion of the lower extremities; () they are swollen, of a livid e Camph. Colch.V Phos. Plum. Nux Anac. Chin. Ru Led. Puls. Me Staph. Cupr. Du. Ign. Sul. K. b. f Colch. Rhus, Am. Teucr. Ruta, MeStron.Ver. Sab.V Puls. Zinc. Caust "g Sul. Nus v. N" Camph. Agar. Ca Eupho. Mere. Sta A Colch. Led. Pu K. b. Zinc. Me Am. c. Euphor. i K. b. Acon. Sab. k Led. I Aeon. Bell. Ar Rhus,Bry.Led.Sa Puls. Sabad. m Aeon. Petr. Sta Sul. Puls. Mer Spig. Led. Iod. K. Calc. Sil. Sul. n Sul.Spig.Aur.Lac Am. m. Am.c. Ana Natr.m.Fer.Ant.e Cocc. Stan. Chin. o Thod. Puls. He Alum. Ant. Nux Spig. Stron. Ci Guiac. Stap. Arg. p Puls. K. c. Nux Am. c. Olean. Ar Bell. Ant.cr. hu Spig. Merc. (') This lno of power resembles in some measure that produced by Mercurius, but wants the marked trembling which accompanies the latter, and which in a less degree attends, and always precedes the palsy of l'umbum. Plumb. affects more the extensor muscles, and is not attended with that extreme contraction of the flexor tendons met with in Ar'. (J) The action of Ars is more marked on the lower than the upper extremities, and, as remarked under upper extremities, the pain may ho more Justly considered neuralgic than arthritic. The characteristic pains are tearing and shwoting, relieved generally by motion, and attended with rcatlceqncs and desire to change the positron; and Hahnemann states that it is very rarely that the pains of Ars originate on moving, or are increern- b, movement, or relieved when at rest. The extreme restlesne". " the t1dgets" of the lower extremities, often a painful attendant on several diseases, yield to Ars.: in such cases to be compared with Anac. (3) 301, taken in connection with the uterine symptoms, indicate i employment in phlegmasia alba dolens, especially mn weakened cor stitutions; and from its utility along with Pulsatlla in varices, it ma he regarded as a remedy acting powerfully on the venous tissues. I cedema and ulceration Ars. is an excellent remedy. (See Skin.) (4) The paralytic condition of the lower extremities is so well markei that this medicine merits a more general trial in paraplegia than it hl hitherto met with: it is, however, not indicated in hemiplegia. S() In inflammation, and ulcers taking on a sloughing character, Ar. is very useful. It is also indicated in dry gangrene, such as gangren senilis; in one case of this disease I have found Ars. very beneficial: i this respect it closely resembles Sec.; Am. c., Lach. and Euphor. ar marked as doubtful, because there is not sufficient physiological evidence Illlllllll---CI-------L~IC)I~--II --- ARSENIC. 03 Ow< ARSENIC. 23 q Sec. Lach. (?) Am. c. (1) Eupho. (1) Mere. Carbo v.(l) r Nux v. Cocc. Sil. Rhus, Arg. See. Plumb. * 1 298. t Ruta, Anac.Plumb. Mez. Stan. Alum. Ver. Spon. Cham. Bar. Dig. Croc. Caust. Plat. u Lach. Nux v. Cocc. Agar.Ambr.Camph. Euphor. Nic. Chel. Plat. Aeon. Laur. Plumb. v Lach. Plumb. Natr. Iod. Sabad. Ver. to Plumb. Lach. Sil. K. c. Con. Graph. Dig. Rhod. Kreos. Sep. Mere. Sec. z Rhod. Lach. Iod. K. c. Am. c. Ireos. Bry. Dulc. Mere. a Graph. Petr. Sep. Cham. Sul. Amn. Carbo v. Ant. cr. b Carbov.Merc.Rhus, Canth. Caust. Sul,. Bell. Cic. Sep. Hep. K.b. K.n. K.c. K.h. Euphor. Iod. Codeine. c Flat. Alum. Led. Sabad. d Hep. Lye. Vinca, Calc. Graph. Sep. Olean. Cic. K. b. K.. Petr. Mere. Phos. Sul. Lower Extremities. colour in places, and show a tendency to slough. ( Vid. ~ 137.) Great difficulty in moving the joints of the limbs, slight flexion, but quite unable voluntarily to extend the foot or the leg; attended with pains like shooting of needles in the foot, and the hands.r (Case 17, vid. also ~ 293.) 325. Great contraction of the flexor muscles of the toes; she walks with great difficulty, standing upright causes great pain, and she experiences great pain in the lower part of the spine." (Case 15.) Great restlessness and pains in the feet;t afterwards he had daily profuse perspirations and palsy of the legs. Several months elapsed before he got well. Case 13.) Swelling, of the feet, difficulty of breathing, numbness and creeping in the inferior extremities. oSbme weeks after she had still numbnessU," and pain in the arms and legs. (Case 9.) Feet feel so heavy that they can hardly be raised. - Feet constantly 'old on remaining any time quiet t; they can hardly be warmed in bed; coldness of- the-knees and the feet, with cold sweat; it is difficult to keep these.parts warim." 330. (CEdematous swellings.. I.,,., " Shin. 331. Violent itching of the' arms, the lower part of the abdomen, and the thighs., Gnawing itching at the perineum, especially on walking. Gnawing itching at the forearmand on the hand; gnawing itching at the groin and the inside of the thighs in the evening on undressing. (Lhr.) Smelters of rich arsenical ores generally suffer from rawness of the parts where they perspire much, as in the axilla and between the thighs, and are troubled with itching.a (Iflinge, Hufeland's J., vi, p. 903.) Burning itching; insufferable burning of the skin." (Case 8, vid. ~ 170.) 335. Pricking of the skin, as if with needles.' Pustular eruption on the head, the temples, and between the eyebrows, causing painful itching as if from a sore; the whole scalp itches, and is painful to the touch, especially at the occiput.d (Lhr.) (1 Skin. Eruptions, principally about the lips and nose." (produced by exposure to arsenical fumes, Pereira, /Mat. M3ed. i, 375.) ) Appearance of black pustules, which cause a burning pain. (Pfann. loc. cit.) Pustules on various parts of the body, which cause burning pain and great anxiety. Pulse 110, white pustules, some isolated, the greater part confluent, appear on the forehead, round the eyes, the cheeks, the arms and shoulders, and upper part of chest; they terminate in thick crusts, and leave well-marked cicatrices.a (Case 17.)(2) 340. Closely studded eruption, about the size of millet seed, and smaller, of the natural colour of the skin, attended with smarting pain which is worst at night.y (Fr. H-n.) A copious eruption of miliary vesicles appeared, and continued fifteen days, attended with perspiration and abatement of the other symptoms, terminated at last in bran-like scales.A (Case 16.) The body and especially the hands and feet were covered with a considerable eruption of small pimples with white heads.; (Case 14.) A papular eruption on the hands, which continued five days." (from Arsenic applied to the hand by mistake it also produced great swelling of the head and face, followed by erysipelas of the face, neck and belly. (Wibme-, Wirk. der. Arzneimittel, i, 241.) The hair drops out, and the cuticle desqua.mates, accompanied occasionally with great tenderness of the skin.' (Hahnemann, ueber. die Ars. vergiflung 61.) - 345. Dropping off of the nails. (Hahntemann loc. cit.). Old ulcers previously indolent become sensible, and painful; the edges become raised, and the sore furnishes black clotted blood; burning pain in the ulcers, followed sometimes by itching.k (3) An ulcer with inflamed edges, and covered with a greyish scab, appears on the limb; strong fetid smell, secreting very little; burning pain in the neighbouring parts; at the same time lassitude, and desire to sleep during the day.k A painful ulcer on the hand, covered with a thin scab, discharging a little bloody serum, e Merc.K.b.K.h.Led. Cic. Hep. Graph. Sep. Sul. Bor. Aur. Alum. f T. c. iRbus, Mere. Anm. Sul. Carbo v. Ant.cr. Graph.K.b. K.h. g Aeon. T. e. Ant. cr. lpee. Dulc. Mere. Bry. Puls. Sul. Ver. h Ant. cr. T. e. K. h. K. b. K. ch. Sep. Led. Mere. Zinc. Mur. ac. i Mez. Am. c. Bell. Iod. nihut, Olcan. Dulo. Mere. bhos. Plum. Sabad. k Lnch. Carbo v. Sil. K. b. IFl. c.Mere. Sop. Sul. Natr. (1) From the provings it cannot be concluded that the cutaneous action of Ars. is shewn in one region more than another, unless it be in the face. Arsenic has long been considered useful in skin affections, generally when chronic, especially lepra and psoriaris, also in eczema, but perhaps less so in pustular eruptions. In ordinary practice, from the dose in which it is given, even the cautious administration as recommended by Mr. Hunt, it Is contra-indicated when the lungs or heart are diseased, irritable mucous membrane, inflammatory tendency, tendency to sudden nervous exhaustion, dyspepsia; but these conditions rather indicate its employment in the doses used by homoeopathic practitioners. The general indications are often more useful than those drawn from the skin. It is less useful when the eruption depends on a syphilitic taint, than when they arc attributable to or co-exist with disorder of the mucous membrane of lunHg or digestive system, hence in urticaria it is one of the principal remedies. Cases of ichthyosis and elephantiasis are said to have been benefited by it. (2) It is also well indicated in various acute skin diseases, such as miiary fever with gastric derangement, small-pox with bronchitis, cnapare with Tart. emetic; petechine with cxhaustion of the vital powers, as in typhoid fevers: compare with Carbo v., Lchl., Ithu and Bry. D)r. Wurmb and Weber reconunend it in erysipolas nciieotoruim. (3) It is one of the best medicines in ulcerations, s sccially those of Ule legs dependent on varices: comparo with Lach.; the ulcers of Are. art irritable, often phagedenic, thosu of Carbo are imure of an indolent clintracter. I' ~ ~~~~~~---~~-~ --~-c; - '-- --I I ..m 24 ARSENIC. k Latch. carbo v. Sil. K. b. t. ame. Mere. Sep. SuL.Natr. I Lah. K. b. Cic. Mlre. Lli.Carth v. Hep.a.Nlt.ac.Caps. m Iar.h. Con. See. Me:re. n Dry. 1 -d. Dulc. Mere. IJig. Convol. IIll. K. c. K. h. Apocyn. Can. a Acon. Bell. Iyos. Cof. Mosch.Nux v. Thuja. Skin. attended with shooting pains when at rest, relieved by standing up, but especially when walking.k Ulceration of the lips and nostrils. (Case 5.) Gnawing ulcer on the lip, which in the day, during exercise, and at night on going to bed, excites tearing smarting pain, preventing sleep; pinching like from burning needles of the upper lip under the nose; next day the lip is swelled.1' 1 350. Smelters of arsenic are occasionally affected with cancerous disease of the scrotum similar to that which affects chimney sweeps. (Paris, Pharmacology, 7 edit. ii, p. 96, stated also by Schcfler, Gesundheit der Bergleute, 1770, p. 149, 190.) CEdematous swelling of the legs, which are partially palsied; patches of a livid colour, with a tendency to slough.m ( Vid. ~ 137.) General cedematous swelling of the body. Great swelling of the face, and of the rest of the body."(Christison, p. 304). Dryness of the skin, increased secretion of urine, relaxed bowels, feverish condition of the body, great languor, inaptitude for employment, and want of sleep, accompanied with or followed by redness of the eyes and certain swellings, especially of the face, cedema arsenicalis,1) (Pereira, 1fMat. Med., vol. i, p. 635.) Sleep. 354. Sleeplessness, all the night much heat, and restlessness, attended with pulsations in the head, preventing sleep: he does not sleep, but tosses about, and experiences a sense of crawling over the hypogastrium. Sleeplessness, with feverishness, and great languor.a (Vid. ~ 71.)(3 Sleep. 355. Desire to sleep which is disturbed by distressing, and terrible dreams, and great restlessness, great tendency to sleep alternating with agitation. (Kaiser, loc. cit.) Starting of the limbs when falling asleep; disturbed sleep with frequent waking in a fright, and starting of the limbs and of the whole body.b Movements of the hands, and fingers during sleep. Frequent cramps in the calves of the leg, and in the fingers, especially at night in bed.0 Dreams full of anxiety: he is desirous to cry out, but is unable to utter a word, and then wakes suddenly by that noise which he yet hears.4 360. He often wakens with burning heat through all the veins: after midnight anxious sensation of heat with desire to uncover oneself.0 Grinding of the teeth when asleep-' He sleeps on his back, with his left hand under his head.6 During the morning sleep he hears the least sound or noise, and still continues to dream. After waking he is in bad humour, tosses the bed clothes about, and dislikes seeing or speaking to anyone. 365. On waking, general heat, perspiration on the face, dryness of the anterior part of the mouth without thirst. In the morning in bed nausea, then vomiting of white mucus, with a bitter taste in the mouth. Fever. 367. Towards the evening chilliness, with drowsiness and disagreeable feeling of being unwell, throughout the whole body, as in ague when the attack is wholly or only half terminated; after midnight profuse sweat on the thighs: the attack returns at the same hour two days afterwards.? In the afternoon, stretchings, and drawings in the limbs, with shuddering at the scalp, as when one is seized with sudden fear, followed by chilliness, and cutis anserina, from 8 to 9 P. M. Heat over the body, especially in the face, without sweat; cold hands and feet. Feverish shivering of the whole body, with heat of the face, and forehead, and coldness of b Bell. Nux v. Puls. Chain. Ambr. Cupr. Sul.T.e. K.c.Acon. Stram. Ver. Zinc. Coff. Bar. c. Dros. Hep. Am. c. c Cham. Camph.Zine. Calc. Cupr. ac. Ver. See. d Nux v. Puls. Aeon. Stram.Sil.Sul.Laur. Lach. Phos. Ver. Dig. Bell. Aur. Bar. c. e Aeon. Bar.c. Am.c. Mere. Phos. Puls. Nux v. / Cina. g Dig. Nux v. Puls. Sul.Ver. Plat. Chin. T. e. K. ch. Aeon. (1) In many cases of severe and obstinate ulceration, such as lupus, it is useful; it has long been extolled as a specific in cancer, and though I doubt if it ho curative in true schirrus, I have seen it useful, as is the experience of others, in retarding tho progress of the disease, along with Carbo an., Sil. and Con., and in many cases of open cancer it gives great relief to the harrassing pain. It merely palliates in true schirrus and medullary tumours; it is, however, curative in cancroidal tumours, as Dr. Bennett calls them, or, according to Mr. Paget, " epthclial tumours, the specific character of which is, that they are chiefly composed of nucleated cells or scales, like those of such epithelium as covers the mucou1 s memrmane of the hunman fauces, and pharynx, which cells are colleted together in mas.ses or layers, or in wart-fike growths, and are held together by tissues in which'blood-vessels are distributed among the'."' They are seated principally on the lower lip when the disease is rc.arlcdl as cancer of the lip, and in front of the leg; they are allied to malig-nant tumours in their tendency to spreading ulceration, and in indncing disease in the neighbomring lymphatic vessels and glands. In 'ncl caes, along with the internal administration, a lotion made with a few rinps- of the 1st or 3ril may le applied to the sore with advantage. (I) The drojp-y of the celltlar tissue produced by Ars. corresponds with that existing in broken-down constitutions, such as after intermittent fever. almbu of Cinchna, Alcohol, &c., organic disease of the heart and liver, di-re,,Ao,if venous trunks, and lymphatics. Allusion has already Iwen malec ito drlpy dependent on lirights disease, Vld. urinary organs. (i) The wakefulntes of Ars. generally depends on some pain or irritation in some part of the body. # 354, 355, 356, 360 may be considered as characteristic indications. It is more an inability to sleep from pain or restlessness than the wakefulness as if no sleep were needed, as in coffea and green tea, or from cerebral excitement, as in Aeon., Bell., Hyos. Stram. (4) The intermittent fever of Ars. is a marked feature, and no remedy has proved more useful in practice. Its special characters are the cold, stage coming on in the afternoon or evening, partially developed attacks, that is the cold or the heat, the thirst or the perspiration are wanting, also 370, 371, 375. The thirst is felt between the cold and the hot, or during the sweating stage, but not during the cold or the hot stage. ---------- --------,:- ---- --- - - ------------ ARSENIC. 25 a Bry.gn.Diad.Puls. Sabad. Ver. Mere. Rhus,Carbo v. Am. Staph. Thuja. Carbov. Chin.Ipec. Ign. Nux v. Puls. Sabad. Ver. Dros. a China, Lach. Lye. Ign. Ipec. Bry.Nux v. Puls.Rhus, Diad. Sabad. Ver. Aeon. Mere. Bry. Chamin. Bell. Fever. the hands; not followed by thirst or heat. (Lhr.) In the morning shivering alternating with heat; in the forenoon sweat, weight of the head, noise in the ears and trembling. 370. External coldness of the limbs, and internal heat, with restless agitation with weak, and irritable pulse. (Alberti, loc. cit.) Coldness of the legs and feet, even at the hypogastrium; feels cold all over the body without being cold to the touch, or he complains of heat, though no part is hot when touched, unless it be perhaps the palms of'the hands. An attack of fever which comes on at the same hour every day; every night towards 3 A.M. chilliness with sense of hunger; after eating the chilliness was increased. The shivering always returns towards 5 P. M.; every evening feverish shivering." Fever- every second day: the first day towards 6 p. i. chilliness, lassitude, and feeling as if the limbs were bruised; on the third day, about 5:P.M.,.feels a desire to lie down, then cold and geieral shivering, wittout thirst, then heat 'with pressive frontal headache, but no thirst. b Every time the fever ceases the sweating commences, but only after.. 375. Quotidian intermittent fever (after taking five grains ofArs. in twelve'days. Traits des Fidvres Intermittentes, par,. C. M. Boudin. Paris, 1842.) Sometimes increase of't" *rength and frequency of the pulse, whi ien diminishes. M. Biott has remarked as. of periodicity in these changes of the pulse. (Boudin, loc. cit.) Sensation as if the blood were too hot, and flowed rapidly with a small and quick pulse: 10 P. m., general heat of the body w"' -' ness; after the heat perspiration. (Stf. During the feverish shivering, tearings in the legs; during the pain, cold and shivering; after the pain thirst. Eruptive fever like small-pox. (Vid. 339.) 380. Febrile condition of the body, dryness of the skin, increased secretion of urine, relaxed bowels, sometimes with griping, great languor, inaptitude for employment, and want of sleep.d (Pereira, Mat. Med., vol. i, p. 637.) After a day of bilious vomiting and purging, great restlessness, indisposition to answer questions, numbness of the lower extremities, whilst the arms were in continual motion in the air as if picking at something above the head; the skin was hot, but not dry; tongue dry and brown, great thirst, throat dry, breathing quick and audible, the pulse 125, but not hard; the heart acted forcibly, no murmur. Next day the breathing and pulse are rapid, unconscious, throwing the arms, legs and body about in every manner; tongue and lips dry, cracked and covered with blood and sordes. The boy Fever. died next day, the peculiar movements of the arms continuing up to the time of his death.0 ) (Edin. Med. Surg. J., No. 168, p. 43.) At first sight he appears to be suffering from typhoid fever, constant somnolence, great stupor, dull look, ringing in the ears, redness of the cheeks, slight ophthalmia, limbs relaxed, decubitus dorsal; great emaciation, clammy skin, action of heart strong, pulse 100; tongue clean, and not dry: no pain on pressure over the abdomen, great retraction of the belly, so that the pulsations of the aorta are visible; borborygmi, incontinence of urine.'/2 (Case 17.) PATHOLOGICAL ANATOMY, as presented in one of the children mentioned in ~ 381. A. Head. Sinuses, and veins congested; a tablespoonful of serum in the ventricles, and about the same quantity at the base of brain. B. The trachea, and epiglottis presented marks of inflammation. C. Lungs, especially the right, congested with bloody serum; the bronchii red, and injected, and covered with red mucus. D. The rugm of stomach red and vascular; punctiform, and ramified redness at the splenic and pyloric ends. E. Commencement of duodenum red, like the stomach. A few patches of redness existed in the jejunum, and the lower part of the ileum was discoloured for about twelve inches, when the solitary glands appeared unusually large, and numerous. Coecum dark-coloured, and congested. F. Liver slightly enlarged, presented exteriorly many yellowish green patches, and was internally of a uniform slate colour; bile in the gall bladder, copious and dark. Moral Symptoms. 383. Extreme anguish, and agitation."11 e Bell. r. NuBr r. Zinc. Rhus, lyos. Mere. Straim. Am. Vcr. f Op. Lath. Camph. Cupr. China, Ver. Rius, Carbo v. a Aeon. Cant Calo.Bar.P '. uj Droe. Ho al Lach. Gram [I S ep.M MrC.8,.,!,: () It is very beneficial in typhoid fevers, either with bronctiil abdominal complications; not so much in the early stages, when r Bry., Bell. and Rhus may be more indicated, but when there i,: debility, insomnolence, or dull, stupid, sub-comatose condition, s' and hot, tinnitus aurium, dulness of hearing, mouth and tongue. with sordes, together with bronchial or abdominal symptoms, at under these sections. Dr. Watzko considers it well indicated isi i cachectic individuals, and when the fever runs a slow course; als a the disease takes on much of the nervous type, then after Hyos. it useful. The indications are well marked under 0 381, imperfectli cases are reported. They are cases of slow poisoning by water acmuuntally impregnated with Arsenic. Two of the first tufferers were actually treated for malignant fever. Dr. Fleisclmann depends almost entirely on Ars. in typhus. Dr. Wurnb, again, doubts its usefulness and its homcoopathicity, but ~ 381, 382 clearly show the latter, and there is much satisfactory evidence in support of the former. ( Vil. Dr. Bronfleck, Hi/gea, xlvii, 63; also in Brit. Journ. of 1orm. i, 74; also Rothansel, Brit. Jorn. of orn. iii, 203; and Mr. Kidd, Brit. Journ. of 1om.) (2) Useful in cases of hypochondria, and melancholia. Dr. Weber gives a very interesting case where the indications, such as 0 383, 385, 389' were strongly marked, and where the cure was very decided. (Brit. Jourm. of Hom. iv, 362.) The depression of Ars. is marked by great anxiety and O ~--~~~-- - ~------- I ---- --~ I r 1 26 ARSENIC. Moral Symptoms. a rrn.cn.,,. Hy Ipochondriacal anxiety, similar to that exCa., B;ir, f,,:1 1. A Ir Dr. r. i. 1. perienced after sitting alone in a room; it apS. P.M,.p. pears to come from the upper part of the chest, Swithout palpitation of the heart. In the eve"ning in bed he is troubled with sad, disquieting Ihouthts; dreads some misfortune to his relations.a 385, Continual anxiety, with a disturbed conscience, from a vague idea of having comritted some crime, without knowing what.' Is chilly, weeps, and imagines that nothing can save him from dying; afterwards general Irostration. V r, nn. co. r Excessive sensibility, depression, sadness, i...h.,.i..., te(lars; tlhe l east trifle vexes her. She desires Iho. va. lmore than shle needs; she eats and drinks more than is'good for her; she walks further than lier strength permits." IHe is vexed about every trifle, and constantly talks about other people's faults. e Ac-nn. N,.,. [. i, Capricious, impatient humour, vexed about i n. It. lJ. ri grS'e t illt ne A,,r. (Ktl,. 4ir,, itrifiles, great restlessness. General Symptoms. V. v a Natr. im. a Vf-r. T'ib. Nsnx m. Lich. Di). I, Mrr. Icot.V,'r,' Diif. General Symptoms. 390, Great fatigue, with anxiety, excessive weakness, tendency to faint." (Various authorities.) A gradual sinking of the powers of life, without any violent symptom; a nameless feeling of illness, failure of the strength, slight feverishness, want of sleep, aversion to food and drink, and all the other enjoyments of life. Dropsy closes the scene along with black miliary eruptions and convulsions, or colliquative pers)pirations and purging.(1 b (Hahnemann, Ueber die Arsenic Vergifrnng, 63.) She becomes emaciated, earthy-like complexion, blue streaks round the eyes, great weakness of the limbs, disgust for every occupation, and constant desire to lie down.C Great weakness (Stf.); paralytic weakness of the limbs, recurring every day at a certain hour, in the same manner as a fever. Trembling throughout the whole body.c (Case 16. Hahnemann gives various authorities. Vid. S7.) 395. Spasms and convulsions. (Various authorities.) Second day she was harrassed with frightful dreams, starting from sleep, and tendency to faint, coldness along the spine, giddiness and intolerance of light; on the 4th day aching of the extremities, and tingling of the whole skin. These symptoms continued till the close of the 6th day, when she was suddenly seized with convulsions of the left side, foaming at the mouth, and total insensibility. The convulsions endured two hours, the insensibility throughout the whole night; next evening another similar fit; a third, but slighter fit occurred on the morning of the 10th, another next day at noon, and they continued to return occasionally till the 19th day.d (Case 6.) An epileptic fit every evening about the same hour, which returned after an intermission of eight days, and frequently for months afterwards." (Mr. Marshall, Edin. Med. and Surg. J., 517.) Immediately after the second inhalation he was seized with ernfusion, giddiness, faintness, and shivering, passed a stool, as well as 2 oz. of bloody e, but without any pain. Pains in the limbs rbllowed, and in two hours vomiting, and dull pain in the stomach; pulse 90, skin cold, and the voice feeble. 2nd dayFren': ont vomiting, and dull pain in the stomach, " "J face copper coloured, the rest of the dy greenish; no fever, tenderness of the epigastrium, and hiccup. 3rd day-Diarrhoea, still no urine, jaundice has disappeared. 4th day-Somnolency, breath ammoniacal. 5th day-Skin deeply jaundiced, face cedematous, no urine passed, bladder empty on introduction of the catheter.c (2) Died on the 7th. (From inhaling Hljydrogen accidentally impregnated with Arsenurated Hydrogen. Dublin Journ. lled. Science, xx, 422.) A stout healthy man, who in the forenoon c Bar. m. Bell. Cic. Cocc. Agar. lod. Natr. Phos. Merc. Plumb. Nut v. Lach. Arg. n. K. c. d Cupr. Lach. Sil. Zinc. Hell. Stram. Nux v. Ign. Cocc. Cic. Agar. Hyos. Stan.Plat.Arg.Ver. Sec. e K. b. -1 I - I -- physical restlerqness, it closely resembles that of kur., Anac., Lach., Ver. and Sitl.; differing from that of Bell., IHeI. and Hyos., which act more directly on the brain, in not being attended with maniacal excitement or delirium, ( I r1. Jtad). Again, Ars. differs from Ign. and Puls. in having more irritability with the depression, and not that sudden alternation of ipirits fron high to low. Ars. and Mere. are very useful in the blue ievil., an ailment indigenous to our insular position., 1) Tlhii los- of stre'ngth and sinkinu of the vital power is very chatristic of ArS., hence it proves adlinirally useful in diseases of ani thenic chirrcter. This sinking of the vital power when the dose has "en itre,.lrenents all the chatlrctceristics of collapse, as witnessed in tlinant chlrt. Ir ndetril, so closely do tie cfl ects of Arsenic corres-,it with an a ttacik of chtll,era thfat tie ditliculty in distingafishing them I o-fti In twon lnde the.round of dit1,ne, in trials for poisoning. 398 is y ati:nililitNs to:s'tit of tile types of mialignint cholera. In this An,. l Jr11,i prive'd a most vnlua le remedy, especially in the epii-,nic. of ISl t, 1S'1. It is cppcialliy indieated in tie stage of collapse, "whin i thr r ' r. hlarl ly a 'uy a'ipto'ns present except coldness, lividity, ritir, a tinhtt rin- pitle, or no pule a:nd great npprehiension of immediate 1 ait. It i- thi arkfld;lp'nartnc'e of nim'ti.nitv which;formn the special ili! '-tiom 1.1 Aris. in cikr1i,,f iitl ai this fnturro is nmore suddenly proiI;. i.t '. i r t inttniy in cases of pro-ving by Arsenurated I i!,.-:. lrt. Irv-d!;l3 hit )'s rmnrlya recommentdecd its eimployment. ip' r,n its it in l -.-)4. where, tlihe ctllapseo sets in very soon, and asp a i- i 1 le.u:. i' t-,k sic two or three timeae at intervals of a o.ir, r nft i ',', a rpInd (It' i ht A rI or Uny thiTer rnmedyv if thlien indica.ted 'n - ci i n,:' e lirvary tini I o, iin t1i Nomitinm and retching i di'r, n. t}- inrl ai,, r:i-T ht ' u1-cd two or threre tim 'cs. ilc o J)e (2) IHahnemanm is to a certain degree right when he considers that the convulsions arising from Arsenic are of a secondary character, and merely the precursors of death. But there are many cases on record in which the convulsions may be justly viewed as primary and well marked symptoms of Arseni c; they arc observed generally after the appearance of inflammaitory symptoms. The nervous affections vary, the most formid"able, and the rarest is coma; the slightest, an imperfect palsy of the legs or arms, like that from lead; and between these are observed epileptic fits, tetanus, and an affection resembling hysteria. Vid. obs. 6, and sympt. 431. ~--------- ---- ARSENIC.:7 f Ver. Camph. Cupr. Sec. General Symptoms. had freely, and for some time exposed himself to the steam from a vessel where he was boiling several ounces of orpiment in water, was attacked at night with sickness, and next morning with extreme weakness, and some difficulty of breathing. These symptoms were greatly relieved by an emetic. But towards evening the extremities became ice-cold and very stiff, the breathing much oppressed, the pulse very hurried, and imperceptible except in the neck; the mouth and throat dry, and the tongue rigid; but the mind remained clear, though anxious, and afraid of impending dissolution. His state of collapse was removed in twelve hours by fomentations, and in no long time he recovered entirely, except friom the dyspncea, which continued more or less till a few years afterwards, when he died of hydrothorax.' (1) (Journal der Praktischen Heilkuwde, Lxxii, v, 134.) 400. In the morning in bed sudden tearing jerking or stitches, which become burning pains, in the thumb and the big toe. In the evening in bed a drawing pain in the index finger, and in the foot. General Symptoms. Drawing pains in the joints of the feet and hands, and in the knees. Arthritic pains in the limbs without inflammation. Indefinable pains, and very disagreeable g K.- led. Cror. "*.1. i ' i* i / Krcos..M ere. S:ibait, pains throughout the limbs; every limb feel s c zinc. p ill, whether on walking or on lying down. Pulsations in the limbs, and also in the head.j H-ere and there pinching pains like of h Spig. gar. Sit. needles; the skin of the whole body is painful and tingles.h 405. The symptoms increase, and appear 1 1 Aa'r. Aur>Lt-:ito. while lying down, or being seated, but diminish T. c. I.lch. pl,,;. either in standing up or walking about. AIun. lMere. Ar-i,. The nocturnal pains are not supportable unless he walks; they are unbearable when he remains seated, and especially if he lies quietly down. Very slight symptoms, and otherwise of little consequence; are attended often with a sudden, and complete sensation of loss of power. During a paroxysm of pain other independent symptoms appear. The pains are described as principally burning. 410. Many of the symptoms appear only in the evening on going to bed, especially the starting of the limbs; some appear a few hours after midnight, many in the morning after i getting out of bed, and a good number after dinner. Pain at the suffering part, as if the bones were swelled. ()Hahnemann, in a note to epilepsy, as a symptom taken from a case of Arsenical poisoning related by Cruger, considers this simply a consecutive effect, and precursor of death. He says it was not probably a true epilepsy, but a state similar to the convulsions of other authors, @ 399, 397, however, shew that true epilepsy is an effect of Arsenic; and in ý 397 it assumes a periodic character. 'A. / I A. tj ~ / f A I tvitd 24 19Q5 3 9015 02005 1531 -01