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HONfEOPATHIC TREATMENT


OF
DIARIJAZA &DYSENT-ERY,~ BY
P. P. WELLS, M.D.,
RE4PRIINTED, FROM ~TH1E'AMERICANf HOk (EOPATHIC REVI E WVOL. Ill
NEW   YORK:
AMERICAN IIOMU O PATHIC RE VIEW PRESS,
JOHN T. S. SMITH AND SONS.
1862.


-3OI NPe~---lS4


7








The favorable opinion expressed regarding these Articles as they
appeared in THE AMERICAN HOMMEOPATHIC REVIEW, has induced us
to reprint them in this more convenient form. Thus without any addition or revision by the Author, this pamphlet is placed before the
Profession by
THE PUBLISHERS.








DIARRH(CEA.
The affections which pass under the above denomination are
exceedingly various in their causes, characteristics, importance, and curative relationships. The object of the present
paper is not to present an exhaustive view of the subject in
these particulars, but to give such an analysis of them as
will facilitate their successful treatment, especially by those
who are.comparatively inexperienced in the practical duties
of our profession. To such, in the beginning, one disease is
very like every other which is called by the same name. It
is only after many painful buffetings, and sore disappointments, that he comes to suspect that nanes are not things,
and finally to see clearly that many conditions, called by the
same name, are so different in their characters as to be essentially different affections.
In his elementary education he has been taught to treat
names, or, as it has been expressed, with a seeming scientific wisdom, " diseases." And for such and such diseases, he is
to do so and so, and he does it with conscientious carefulness,
and confident expectations of the promised result, a cure.
This does not always follow, and repeated disappointments,
by and by, remove the delusion derived from      his master.
Then he has one of two courses before him, either to settle down
into professional skepticism, or, if he be able and willing, to
work out for himself a better faith which shall rest on ascertained truth, can bear him up in his toils, and justify his confidence by a reasonable success. The first expresses the
history of many earnest and honest young physicians, who




2


would have been lights in the world, if they had not, in the
outset, adopted a false faith and attempted to practice upon
a false principle. Upon a discovery of this error, they jump
to the other and greater, that there are no true principles in
medicine. To them, all are equally false. They become the
Micawbers of the profession, the expectants. He who will
honestly follow the second course, will soon discover that the
great duty of his life has been much misrepresented and
misconceived.  He is not to treat diseases, flaf2es, things,
imagined somethings, which have somehow found their way
into live humanity and made it suffer and perhaps are bringing its existence into peril. H-Ie will realize after a while,
though not perhaps immediately, that that with which he has
to do is not an entity which somehow has effected bodily
entrance into his poor patient, like demons into the possessed, though all surrounding and sympathizing friends
regard the matter somewhat so, and fully expect him to exorcise the intruder.
He will find, that what he has to treat is the patient himself, and not an extraneous intruder within him. Till he is
fully master of this fundamental principle, and in its light has
abandoned all thought of treating diseases, as something distinct from the patient, which produces suffering and danger,
he is in no way qualified for the practical duties of the
high calling to which he has devoted himself. He is to treat
sick men, women, and children,--patients, and not diseases.
It may be late in the history of practical medicine to inculcate this principle. No doubt it is.  But its truth and
importance will admit of no longer postponement. Delay
has neither diminished its truth or value. Rightly appreciated, it at once disposes of that complacent piece of arrogance which has asserted a superior science in the old school
of our profession, because that school treats diseases while
ours treats only synmptoms. This principle clearly asserts the
fact, that true science treats patients, and not diseases. It
may be, and probably is true, that the old school treat diseases, or attempt this, and think they succeed, but it is not




3
true of ours, that when we rightly appreciate and practice its
doctrines, we " treat only symptoms."  If there be one more
false" than another among the slanders by which the homceopathic school has been assailed, it is this. When rightly
practiced Homceopathy is cognisant of all those facts in
relation to the patient, which constitute the difference between the man sick and the man in health.
What then is disease? It is only a condition, not a thing. It
is the sum of whatever modified actions of the vital forces, by
which that harmony is lost, which conserves the integrity of
all parts of the living organism. A knowledge of the totality~
of these modifications constitutes the science of pathology.
A knowledge of the results of these modifications, of their
products and changed tissues, constitutes the anatomy of
pathology. To call these the disease, as manyjh-ave done, is
no less absurd than to call the residual contents of the intestines digestion. An analysis of these modifications, a resolution of them into their elements, is the first step in the
process of all-right prescribing. By this'proceeding only can
the elements of a given cas'e be exposed, so that it can be
seen what is individual in it, is characteristic of this member
of a class, and these elements be separated from those which
are generic, i. e., belonging equally to all members of that
class; a distinction without which a life of prescribing for
the sick is a life in the dark. I propose in a future paper
to discuss this matter more fully,,
If this be so, it may be asked, what is the value of a
nomenclature of diseases? Why attempt to name them at all?
The answer is, it is a convenience in the expression and interchange of ideas-indispensable, if you please. By the name
is simply meant to announce a group of phenomena which
are Afound in a given class of affections, and which belong
equally to each member of the class, and which distinguish
it from all other classes. Thus by the term at the head of
this article is meant to express in one word the following
group:
Frequent discharges from the intestines of feculent, secreted




4
or undigested matter. It may be of either alone, or of either
two, or all of them, mixed. We propose in this paper a brief
analysis of these affections, in order to their more ready
homceopathic treatment.
In order to this, we observe that these frequent discharges
are farther diversified by the following peculiarities which
are important to be noted, in the selection of a remedy, for
their cure. They are painful or painless The"secreted discharges are mucous, serous, or purulent.    These and the
feculent are further characterized, by difference of color, as
black, brown, grey, green, red, white and yellow; and by
difference of odor, as of spoiled eggs, putrid, acid, &c.; and,
also, by difference of time and circumstance by which the
affection is either excited or aggravated.
The first element of the above analysis, the painful diarrhceas, are related to cura'tive drugs by this quality, in
different degrees; i. e., some drugs produce diarrhceas with
intense pain, others with less severe, and others again with
pians still more moderate. These distinctions are to be noted
in selecting the curative drugs. Thus, for those with severest
pain we have Ars., Coloc., Jalap, Rheum, Rhus tox., Senna.
For the second class Bryonia, Carbo veg., Caps., Cham.,
Dulc., Mere., Nux. vom., Petrol., Puls., Sulphur and Verat.
For the less painful; Agar., Aur. mur., Anac., Asaf., Asar.,
Spig. The painless diarrhoeas are related to drugs also in
different degrees, i. e., some medicines are more and some
less characterized by them, and so are more or less frequently
required for their cure. There cannot be, as in the previous
class, degrees of this peculiarity, but only a difference in the
degrees of tendency of the drugs to produce this kind of
affection. In the first rank we may place Ars., Fer., Hyos.,
Lyc., Phos., Phos. acid., Stann. Second, Bell., Cham., Chel.,
Chin., Opium, Plat., Sulph.   Third, Borax, Bov., Calc. c.,
Carb. an., Cocc., Dulc., Graph., Hell., Ign., Laur., Mag.
c., Merc., Nit., Nit. acid, Puls., Rhod., Rhus tox., Sec. corn.,
Verat., Zinc.
In a given case to be prescribed for, it is ascertained to be




5


painful or painless, and after reference to the list of drugs
and to their classes, as above, how are we to determine the
one required for the cure? By the continuance of the analysis
to the other elements of the case. And, first, consider the
character of the pain, and, second, the locality of it. Pains
with the diarrhcea may be burning, cutting, constricting,
pressing, dull, excoriating, &c. It would exceed the limits
proposed to go into a statement of all the medicines which
produce these different pains, with their affections of the
bowels. It may be sufficient for the present purpose to point
to them  generally.   Thus, diarrhceas with burning pains
Ars. and its cognates. But Ars. will not cure all cases with
such pains. Neither is it always the best remedy for some
eases which perchance it may cure, ultimately.      If, for
example, the burning be confined to the lower part of the
rectum, and is accompanied by throbbing and sense of excoriation, with pain in the back, continuing after the evacuation,
Capsicum is the remedy, and Arsenic will probably fail to
relieve. This very familiar example is given to show the
necessity of carrying the analysis of the leading features of
eases forward to all their relations if we would secure the
best possible results of our prescriptions with certainty. We
can never neglect this with safety to our patient, or with
honesty of practice.
With cutting pains, Coloc. and its cognates. With Coloc.
the pain is relieved by the evacuations, is very sharp, doubles
the patient up, is accompanied with outcries, and often with
slight nausea; the pains are more paroxysmal than with
Ars., which in relation to cuttings in the intestines it much
resembles, and are rather of a neuralgic than inflammatory
character. With constricting pains, Plumb. and its cognates.
With this remedy, and also with Podophyllum there is not
only a sense of constriction, but a real retraction of the parieties of the abdomen. With pressing or squeezing pains,
Nux vom. and its cognates.   With this remedy the pressure
is more in the upper part of the abdomen and sides. With
pain like excoriation, Sulphur and its cognates, as Ars.,
BelL, Nux vom., &c.




6


The locality of the pain is not to be neglected in this
investigation. Different drugs affect different portions of the
alimentary track painfully.   Some, as Senna and Jalap,
attack the upper portion, or the small intestines chiefly.
Others, as Aloes, Nux vom., Caps., Mere., the larger; while
still others, as Ars., Colch., Verat, &c., affect the whole
extent of the track. A careful attention to the pathogenesis
of the drugs will enable the student to ascertain the peculiar
local action of each, and to avail himself of this knowledge
in his attempts at specific cures of diarrhceas. This study he
cannot omit, if he is ambitious of the best success in his
pi'actice. Whether the remedies named above or either of
their cognates are to be selected in a given case, is to be
decided after having reference to the above peculiarities of
the pain, by consideration of the remaining elements of the
analysis. And of these, the next to be considered is the
characters of the expelled contents of the intestines. They
may be feculent, mucous, serous, or purulent.
For feculent diarrhceas we have Aloes, Pod. and Rheum,
Aloes has both yellow and brown color.
Pod. yellow and dark green.      The diarrhoeas of this
remedy are often accompanied by prolapsus ani, especially,
in children, and for this complication is one of our best
remedies.
Rlheum-Feces mixed with green slime..Mucous diarrhoeas may be brown, green, red, white, or
yellow.
For the brown we have Ars. and Nux v., the Ars. being
characterized by a mixture of mucus and feces; that of
Nux v. is brown, offensive and slimy.
Green mucus has Ars., Amm. mur., Canth., Cast., Laur.,
Mag. c., Mere., Nux v., Puls., Rheum and Tabac.
The practitioner will use great caution in prescribing for
this class of diarrhceas, in his search into the constitutional
and related symptoms of his cases, if he will avoid disappointment and doing his work twice or thrice over. This is
especially to be observed in the case of the two remedies in the




7


class more frequently prescribed than any others, viz.: Ars.
and Mere. The habit of hasty, and therefore careless, prescribing so easily contracted and so common, may be a sufficient apology for saying that cases requiring either of these
drugs will certainly disclose other and characteristic symptome of the one to be selected, if the examination be diligent,
careful, and intelligent. This is not only true of Ars. and
Merc., but of each of the other members of the class, and the
observation may be-extended to every other symptom of
every other class of this disease. No case is made up of one
symptom, however marked or important, and it is not unfrequent that the controling characteristic of a case-that
element more decisive than any one other, of the selection of
of the curative   drug, is just that which    carelessness
and haste is very likely to overlook. These observations are
made in connection with the two named remedies, because
failure with them, in this class of diarrhceas, is too common.
In relation to the latter this is true to'the extent that some
of our best practitioners have called in question the genuineness of this symptom of Mere, and with some, for this reason,
the symptom is now under observation for its verification or
rejection. If all those capable of helping in this examination will lend their aid, the matter can soon be settled. In
the mean time by the course of examination and analysis
here recommended, disappointments may be avoided to an
extent that approximates certainty.
Diarrhoeas of red mucus are related to Merc., Rhus, Sil.,
Sulph. The distinction of these four remedies in their application to red nmucus diarrhoeas is not difficult, Mere. has
plain red mucus, with the characteristic pain and tenesmus
of Mercurial diarrhoeas. Rhus has a mixture of blood and
slime, with red and yellow mucus, and all rather thin; Sil.
has red mucus with the stool of which it may or may not
constitute the major part; Sulph. has red mucus with fever,
loss of appetite and cutting pains in the bowels.
White mucus diarrhcea has Cham., Dulc., Phos., Pod., Puls.
After a proper consideration of the general symptoms, if




8


there be doubt as to which of these medicines is required for
a given case, it may help to remember that this affection
requiring Cham. is painful, and is more frequently in place
in the affections of childhood than of adult life. That for
Dulc. is attended with prostration of strength; with Puls. the
mucus is acrid;, with Pod. the diarrhcea occurs for the mpst
part mornings or forenoons, the pains in the abdomen and
back are worse during the evacuation and continue after. The
discharges are excited by eating and drinking. With Puls.
the pain is before the evacuation, is likely to be attended
with much rumbling of the bowels, and the peculiar disposition of mind so characteristic of this drug.
Yellow mucus has Dulc., Pod., Rhus, Sulph. acid.
Dulcamara is especially indicated where the color of the
slimy stools frequently alternates between green, white and
yellow,, and the desire to evacuate is attended with nausea,
or where the attack is the result of chill. Podophyllum is
called for when the yellow color is dark, and the evacuation
has the odor of carion; with Rhus the stool is mixed sometimes with blood or red slime, or consists of billious looking
matter, and all very thin.  In Sulph. acid the stools are like
chopped mucus, saffron yellow   and stringy.    The above
examples of the first step in the analysis of the evacuations in
diarrhcea are given not as instances of the completed process
in this first step, but only as illustrative of the mode of proceedure in relation to the two elements of nature and color.
It is not enough that the discharge be mucus, nor that it be
also green or yellow to decide the choice of the curative. We
must know more, even all the peculiarities of the evacuations, and much more than this, as will be seen as we
advance. For it is not to be forgotten that the object of this
paper is not so much to put into the hands of the practitioners
a " short and easy method " by which all cases can be cured
with little or no labor on their part, as to point out the way
in which they may obtain a success worthy of honest minds,
and of the system of medical science we profess to practice.
If our object were otherwise, its folly would be rebuked by




9


the first glance at the nature of the case. The object of the
practitioner is to find in the pathogenesis of a drug the simillimum of the sum  of aberrations of the vital forces in a
given case from that state of harmony we call health. These
are so various in their nature, importance and combinations,
and so numerous withal, that any attempt to make the
labor of an exact practice " short and easy," i. e., to find this
simillimum, could hardly be otherwise than absurd in the
extreme. The number of possible elements in any case is
great, and may be very great, and the variety of combinations they are susceptible of is scarcely less than infinite. It
is evident, hence, that there can be no such method of ascertaining from the scarcely less infinite record of facts of which
our Materia Medica is composed, the parallel of a given
case, except by the exercise of patience and diligence. How
to direct these, by pointing the way through the medium of
the more general and common elements of cases, is our present endeavor, and in its furtherance we proceed to consider:
Watery diarrhoeas, which are found to be black, green,
grey, yellow; and nearly allied to these, are the brown fluid
and black fluid.  Black watery diarrhceas have Ars. and
China.   At this point these remedies are in close resemblance; so near that from the black water alone, no man can
tell whether the one or the other is required. But a careful
consideration of the other elements will render the selection
easy. As a general truth, the prominent effects produced
by Ars. are characterized by violence, and, among them, this
is eminent in its effects on the alimentary canal. Now the
difference between these members of this class of diarrhoeas,
which decides the choice of the remedy between Ars. and
China is in the violence of the symptoms to be considered.
The pain, burning, restlessness, prostration, cold sweating,
&c., are all greater in cases requiring Ars.
Black fluid diarrhoeas have Stann. and Ars.; the latter
burns like fire.
Brown fluid have Arn., Asaf., Graph., Magn. c., Nux., v.,
Psorin., Squill.




10


The discharge which in this class is peculiar to Arn.
resembles yeast or lees of beer. In Asaf. the evacuation is
extremely and nauseatingly offensive. In Graph. it is in part
made up of half digested substances, and of insupportable
fetor. Magn. c. has a liver-brown colored discharge, with
tenesmus, followed by burning in the anus. It is characteristic of this, and all the varities of diarrhcea produced by
Nux v. that the evacuations are small in quantity, they are
more frequent in the morning and after eating, and are for
the most part accompanied by tenesmus and pain in the back
of a drawing character. In this variety there is also smarting and burning in the anus. In Psorin. it is dark brown,
very thin, and offensive. In Squill. it is dark brown or even
black, slimy, very offensive, and ejected in frothy bubbles, by
flatulence, and sometimes with ascarides and whitish shredsGreen watery diarrhceas are met by Cham., Gratiola'
Magn. c., and Sulph. acid. It may not be out of place to
remark here, in relation to this class of the affections under
consideration, that it is perhaps more frequently misunderstood, and, therefore, more frequently wrongly treated than
any other. Much of the disappointment necessarily consequent on such a course, may be avoided by remembering, in
the first place, the too often overlooked, but vastly important,
necessity of making the first prescription a right one; and in
the second, that Ars. does not cure this variety of diarrhceas.
If there be any exception to this, they are cases where the
remedy accomplishes the result by virtue of its characteristic
relationship to the constitutional symptoms of the case. Of
this we may have more to say hereafter. It has not been an
unfrequent experience of the writer, to sep cases of this
variety of diarrhcea, in consultation, and among them, the
most intractable to treatment have been those which had
Ars. as their first medicament. That this has often proved a
serious embarrassment to the subsequent successful management of these cases, he has no doubt. The frequency of this
false prescription is, perhaps, explained by the force of habit.
Ars. cures so many forms of diarrhoea, that the frequent
**-**.... * \




11
demand for its use, creates a kind of habit of prescribing it.
Against this we protest.
The cases for Chanm are for the most part those of early
childhood, during the process of teething and from taking
cold. The green watery passages are often mixed with feces
and mucus. The green and frothy evacuations of Grat, may
be watery or thin fluid or slimy.  It is a remedy worthy of
more attention, in diarrhceas, than it has generally received,
especially with those of children, in the summer season.
Those of Magn. c. are preceded by pinching pains in the
bowels, especially in the right side, with distended abdomen,
are mostly in the forenoon, and may be both sour smelling
and frothy. Sulph. acid is frequently the right remedy in
this variety of diarrhcea. In the absence of the characteristic signs of the other medicines, it may be given in preference, and especially if there be great prostration of
strength with irascibility of temper.
Yellow watery diarrhoeas are met by Ars., Chin., Grat.,
H-yos. They may be found in the pathogenesis of a few
other drugs, but the four above-named are the principal
remedies, and rightly used will succeed with most of these
cases. Here, as in the brown variety, Ars. and Chin. are
near together. Both have attacks more frequent at night
and after eating and drinking, with great prostration. But
Ars. has tenesmus, Chin. has not. Ars. has thirst with
diarrhoeas, Chin. has not.  Ars. has a painful constriction
above the anus, extending to the loins. With Ars., in this
variety, the discharges are small, while in many others they
are copious. But if, as is not at all unlikely, the peculiar and
distressing restlessness so characteristic of Ars. be present in
any case, there need be no hesitation in the choice between
the two drugs. The yellow watery diarrhoea of Grat. is
painful, copious and frequent, preceded by rumblings and
cuttings in the abdomen, and. nausea.     The pain is not
relieved by the evacuation, but is by the escape of flatulence.
Opposed to this is Hyos., which has similar discharges,
without pain, often involuntary, and unnoticed in the bed,




12


and is wanting in the extreme offensiveness of those of Ars.
and Chin. It is so like one form of diarrhoea frequent in
abdominial typhus that the most careless can hardly overlook
it as a remedy of prime importance in this most dangerous
malady. In such cases the choice will probably be between
Ars., China, and Hyos. In Ars. the evacuations are small,
and perhaps painful, burning and offensive. In Chin. they
are more copious, and in the elements common to the two,
less in degree, and Chin. lacks the restlessness already spoken
of; while IHyos. is almost the opposite of both in all, except
that the three have in common, the yellow, watery discharge.
In this form of typhus, if the general symptoms, and especially those of the intelligence, delirium, &c., are like those of
Ilyos., this remedy should certainly be given, and not soon
changed for any other, but for the strongest reasons. To the
above may be added Thuja as worthy of attention in these
diarrhceas, especially when copious, with gurgling, like that
when a full vessel discharges its contents from the bunghole, great prostration, short and difficult breathing, anxiety,
intermittent pulse, pressing pain in the back, opposite the
epigastrium, and rapid emaciation.
Grey or owhitish watery diarrhceas have Cast., Mere., Phos.
and Phos. acid.
Cast. preceeded by rumblings, gurglings, croakings, with
pinchings and cuttings in the bowels, for the most part in the
evening and night; Mer. with cutting and tenesmus; Phos.
with great exhaustion and Phos. acid with little or none.
Purulent diarrhoeas are met by Ars., Bell., Calc., Canth.,
Chin., Cocc., Kali c., Lach., Lye., Merc., Puls., Sep., Sil.,
and Sulph. and some others.  The most important of these,
in this class, are Ars.. Canth., Lach., Lye., Merc., Puls.,
Sulph. With Arn. there is a mixture of blood and pus. Lach.
has also mixed pus and blood with gnawing, shooting, cutting pain in a hard swelling in the abdomen. Mere. chill
betwteen, and flashing heat during the stools.  Tenesmus
characterizes most diarrhoeas by this drug, and there is also
great uneasiness before the stool, and with many cold perspi



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13
ration on the face, anxiety and trembling before and heartburn and bitter eructations after the stool. The pains, especially those in the back, and tenesmus are continued after
the stool. Sulph. has mixed blood, mucus and pus, and the
blood is likely to be in streaks. The above brief analysis of
the nature and color of the evacuations in these different
examples of diarrhcea, is given only as an illustration of the
method of proceeding in the first step of an attempt at
making a specific prescription.
We have spoken of the nature and color of the evacuations, we now consider the odor.
This may be either simply offensive, or it may be characterized by a specific quality, capable of more specific
designation.  Of those diarrhoeas which are simply offensive, some are more, and others less so. Those in which
this charateristic is most intense are met by Arsenicum,
Asaf., Carbo v., Graph., Puls., Sec. corn., Sil. and Sulph.
Ars. is characterized as like stiznking ulcers and as putrid.
Asaf. as brown and disgustingly ofensive. Carbo veg. like
putrid flesh. Graph. is light or brown colored, half digested,
thin, and intensely stinking. Sec. corn. has extremely offensive, colliquative diarrhceas. Sil. small, liquid, putrid. Sulph.
on the contrary is copious and putrid. All the secretions,
under the action of Sulphur, are likely to become offensive
in the odor. The same is true of the carbons. The class of
diarrhceas which are less offensive are met by Bry., Cale. c.,
Cham., Chin., Dulc., Nit. acid, Nux-v., Pod., Squill., Staph.,
Stram. Bry., like spoiled cheese; Cale. carb. and Cham.
like putrid eggs; that of Cham. being hot and excoriating.
Nit. acid, putrid, with putrid flatulence. Nux v., putrid.
Pod., ptitrid, dark  yellow  slime.  Squill., brown slime
expelled in bubbles
Acid smelling have Calc. c., Cham., Graph., Mag. c.,
Mere., Rheum, Sep., Sulph.     Of these, Calc, and Cham.
belong especially to the diarrhoeas of children.  That of
Graph. is accompanied by burning in the rectum. Mag. cn,
different varieties of diarrhoea of children.  Rheum   has
papescent, acid evacuations, with shuddering, and followed




14


by renewed inclinations and gripings in the bowels. Sep.,
acid and green, with children.
frothy diarrhoeas, have for their cure Calc. e., Canith.,
Coloc., Mag. c., Mere. or Pod., Rhus, Sulph. and Sulph. acid.
With Gale. the evacuations are involuntary. Canth., liquid,
feculent. Coloc., thin, yellow and mouldy smelling. Mag.
c., green and frothy.   Mere., dark green.    Opium, has
fluid, frothy evacuations, with itching burning of the anus
and tenesmus. Pod., frothy and slimy. Rhus, thin, yellow,
odorless, painless and involuntary. Sulph., nights, and with
tenesmus. Sulph. acid, with burning in the rectum.
Involuntary diarrhceas have Am., Ars., Bell., Bry.. Colch.,
Fer., Hell., iyos., Lach., Laur., Mur. acid., Nat. mur., Nux
v., Phos., Phos. acid, Rhus, Sec. cor., Staph.,. Sulph., Verat.
Of these the most frequently called for are Ars; with this
remedy the evacuation is both involuntary and unnoticed.
Chin., it is thin, yellowish and slimy. Phos., Phos. acid, it
is pappy, bright yellow, and is passed with a sensation as if
wind were about to escape.  Verat has also this last peculiarity of unnoticed evacuation with the escape of wind. Of
the other remedies named above, Am. has involuntary evacutions at night in sleep. Bell. and IHys. both have this variety
as if from paralysis of the sphincter ani. Colch. has watery
diarrhoea, the evacuations of which escape without sensation
to the patient. Laur. has unnoticed and involuntary evacuations, and in this symptom is very like Bell. and Hyos.  It
has actual paralysis of the sphincter. Rhus has sudden, thin,
yellow, frothy, odorless and painless, involuntary as from
paralysis of the sphincter.  Staph. has thin, unnoticed discharges, with sensation as if gas were to escape. Sulph., the
stool escapes suddenly and without control, the patient has
hardly time to leave the bed.
Undigested food, passed with alvine evacuations, is found
for the most part in cases which come within our definition of
diarrhcea, and which are related to Ars., Bry., Chin., Fer.,
Mere., Oleand, Phos., Phos. acid, and Pod., and in a less
degree to some others. There are cases in which undigested
substances are evacuated and which may be subjects for




15


medical interference, which do not come within this scope.
With these we are not at present concerned.   But in cases
which do, how a're we to decide which is the right curative?
By a reference to the Materia Medica the mention of this
symptom is found to be so nearly in the same words, in the
record of many of the above medicines, that if this alone be
depended on, there can hardly fail to be not a little embarrassment and frequent disappointment.    Take three of the
principal of them, i. e., those more frequently prescribed and
successful than many others, viz.: Ars., Chin. and Fer., the
one word undigested is all, with the first and third, while
with Chin. it is added especially at night and immediately
after eating. Under Bry., Mere., Phos., Phos. ac., and Pod.,
the phraseology is the same as with Ars., and there is no
additional help from the mention of any circumstance or
condition which in any respect characterizes the symptom as
manifested by either of these drugs.     In the record of
Oleander it is said that the food eaten the evening before is
passed undigested while it seemed as though wind only was
about to escape.  If its administration be limited to cases
thus characterized, its use can hardly be frequent.
How then are we to proceed? By a careful consideration
of the other elements of the case, giving especial attention to
those which are general or constitutional, i. e., the symptoms
outside of the elements of the diarrhoea. For it is never to '
be forgotten that we are prescribing for the man, not merely
for that group of phenomena we have, for convenience, consented to call diarrhoea.  It is not uncommon-that the fact
which removes all difficulty, and decides, beyond doubt, the
selection of the right remedy, is found outside this group.
In this statement is an important principle in practical medicine, which we hope to elucidate more fully on a future
occasion. On this, it will be enough if we can establish the
truth in the minds of all, that true prescribing can only rest
on a thorough analysis of all the elements of a case, both
general and special, no one excluding others, though, as
above stated, one symptom may so far throw light on others
as to remove doubt in the choice of a remedy. This is not to




16


say that all symptoms are equally important in their bearing
on the selection of a curative, but that none are to be overlooked, for till considered carefully in itself and in its
relations, we must be in ignorance of the true value of any,
and perhaps of every, symptom. A careful consideration of
the constitutional symptoms, and general conditions, is not
limited to cases of undigested evacuations.  It is a duty
which is integral in every true prescription.
Acrid diarrhoeas, those in which the evacuations irritate
the external parts with which they are brought in contactare a class too important to be passed without notice. They
are related to many drugs, in the action of which this quality
of the evacuations is evinced in different degrees. The most
acrid are from Ars., Chin., Ign., Mere. and Puls.  The next
in severity are, Ant. crud., Cham., Dule., Fer., Graph., Kali
c., Nux vom., Phos., Staph., Sulph. and Yerat. And in still
less severe are Acon., Alum., Nat. mur., and Sabina.  This
difference in the intenseness of a symptom is often of great
importance and never to be overlooked. With some drugs
intenseness seems to characterize most of their actions on the
organism, and this goes far at times in individualizing those
drugs. Ars. is an eminent instance of this; and no one need
fail to distinguish between the painful rawness of the surface
around the anus, characteristic of the drug, and the slighter
and comparatively insignificant irritation of Aeon. Rightly
to appreciate this quality of symptoms, and always to give
it its just place in a prescription, is an accomplishment of the
master, and with him it is an element of great power. It can
be cultivated by all, and be carried t6o a degree the tyro is
not likely at first to suspect.
There are however other differences in connection with
this symptom,, expressed in the pathogenesis of some of the
above drugs, which are so far our guides, though often we
may be left to the significance of general or other special
elements of the case. Thus Ars. has black, burning, excoriating evacuations, with restlessness. Mere., dark green with
pressure in the abdomen. Puls., soft evacuations in the
morning.




17
The above arie the chief elements of analysis of the nature
and character of the evacuations in the different forms of
diarrhoea.  We have next to look at the time, the circumstances, &c., by which attacks are excited or aggravated.And first as to the time. In the morning are Aloes, Ant.
crud., Alum., Aur., Am. carb., Borax, Bov., Bry., Carb. an.,
Dig., Grat., lod., Kali carb., Lyc., Mag. c., Mur. acid, Nux
v., Phos., Puls., Sec. cor., Staph., Sulph., Thuja.
With Aloes the evacuations are copious and pappy.
Alum., semi-fluid, preceded by colic. Am. carb., small,
with excoriating and bruised pain in abdomen.     Borax,
painless, followed by slimy and bloody discharges.  Bov.,
pain in the abdomen like that of ulceration.   Carbo an.,
pinchings in the abdomen, before and after, burning in the
anus like fire. Kali c., watery, preceded by colic. Lyc.,
three to four o'clock, with colic and tenesmus.  Mag. c., followed by burning in the anus.  Nux v., small, dark, excoriating. Phos., semi-fluid with rumbling. Puls., soft, excoriating, with smarting. Sec. corn., four o'clock. Staph., after
cuttings and nausea. Sulph., at four and six o'clock, and
also on rising from bed, the desire is sudden and urgent, and
admits of no delay. This is characteristic. Thuja soft.
In the forenoon: Carbo an., Kali c., Kali nit., Mag. c.,
Mur. acid, Stann., Sulph.  Carbo an., soft, green, with colic.
Kali c., watery, preceded by rumbling. Mag. c., soft. Stann.,
soft. Sulph., thin, with pressure in the stomach.
At noon: Alum., Borax, Mag. mur. and Sulph.     Alum.,
semi fluid with previous colic.  Borax, thin, with rumbling
and movements in the abdomen. Mag. mur., severe urgency
to stool, which is fluid. Sulph., frothy, feculent, with much
flatulence.
In the afternoon: Aloes, Am. c., Alum., Borax, Carbo
an., Dulc., Hell., Kali c., Lye., Mag. c., Mur. acid, Phos.,
Stann. Sulph. acid. Am. c., first part is hard, the latter soft,
with shootings in the anus. I Alum., soft and small. Borax,
with much flatulence.   Carbo an., soft, green, pain in the
bowels before the evacuation. Dulc., with flatulence. Kali




18


c., semifluid, scanty, with colic, arid followed by tenesmus.
Phos., semi-fluid, scanty, escaping with force.
Evening: Aloes, Alum., Bov., Carbo an., Dig., Dulc.,
Indigo, Kali c., Kali nit., Lach., Mang., Mere., Mur. acid, 01.
an., Phell., Stann., and Zinc. Aloes, very thin, deep yellow,
with undigested food. Alum., soft, flatulent, with burning
in the anus, followed by tenesmus. Dig., with ascarides.
Dulc., acid smelling, copious, thin, relieves the pain, while
the patient feels weak.  Lach., great urgency to stool, with
throbbing in the anus after the evacuation. Mang., preceding
shootings in the bowels. Mur. acid, severe burning in the
anus after the evacuations. 01. an., soft feces, with cuttings
in the bowels before, during and after the stool, followed by
burning in the anus like fire. Stann., with sensation after
the evacuation as if there were still more to pass. Zinc,
first a little solid, then scanty, soft evacuations.
At night: Arn., Ars., Aur., Bov., Bry., Cast., Caust.,
Cham., Chel., Chin., Graph., Grat., Kali c., Mag. c., Mere.,
Nat. carb., Puls., Sil., Sulph., Tabac. Aur., with much burning in the rectum. Bov., with tearing pains in the bowels
and tenesmus. Bry., with burning in the anus. Cast., semifluid, feces extremely offensive with stinking flatus. Cham.,
with cuttings in the bowels which double up the patient.
Mag. c., before midnight and painless. Puls., unnoticed,
watery, in sleep.  Sil., painless.  Sulph., frequent, fluid,
frothy, with tenesmus.
The next element to consider is the exciting cause of the
attack. If it be from
Acms.-Ant. crud., thin with pain in the rectum. Ars.,
Lach., attacks are slight. Phos. acid.
TAxING CoLD.-Bell., with vomiting. Bry., Caust., Cham.,
Dulc., watery, at night, with pains in the bowels, in summer,
or with prolapsus ani. Nux mos., Nux v., watery. Phos.,
with cutting and drawing pains in bowels and loins, as far
into the thighs. Sulph.
DRINKING.-Ars., Caps., of slime. Rhod., painless.




19
EATING.-Ars., Borax, with rumblings or weakness in the
joints and legs, relieved by walking. China, Coloc., with
colic after the least nourishment.  Fer. mag., Rhod., painless. Verat, after the least ingesta.
FRUIT.-Ars., Chin., Cist., Rhod., with sensation of weakness in the stomach and nausea while walking.
MILK.-Lyc., Nux mos., Sep.
In prescribing for attacks from the above causes the applicability of those remedies here named, without symptoms, is
determined by their general characteristics, or by the special
analysis and ascertained resemblance of their symptom to
those of the individual case. The same principle governs in
treating the cases of
LNFANTS.-For which Cham., Jalap., Rheum, Sena. and
Sulph. acid are more frequently required than other remedies,
although it may be remarked of Jalap. that its passages are
watery, and accompanied with intense cuttings in the bowels;
of Rheum, there are mixed feces and slime; of Senn., dark
colored water, with cutting pains also, but less severe than
those of Jalap. and more or less flatulent. And also in those
of infants while
TEETHING, for which we have Colch., Carbo., Cham., Graph..
Mere. sol., Nux mosch., Pod., Sulph. In selecting a remedy
from among these, it may help, to bear in mind the resemblances and differences of the symptoms of these medicines.
Cale. and Graph. are alike in these particulars: both have
very  offensive discharges, but that of,Calc. is yellow,
Graph., dark, half digested. Both have acid discharges, that
of Graph. is only soft; Calc., thin; Calc. has undigested,
hard or thin; Graph. half digested.  It is also quite characteristic of Graph. that the discharges are followed by great,
but transient prostration.  Calc. and Cham. have much
similarity of some symptoms, but the differences of others
make the distinction between the two not difficult. Both
have the smell of bad eggs, those of Cham. with this property are also excoriating.  With Cham. the passages are
often green, with Calc. never. The diarrhoea of teething


A




20
infants, for which Nux mosch. is appropriate, is attended by
an indomitable disposition to sleep. The little patient sleeps
all the time. The discharges are likely to be very offensive
and rather copious. It is a remedy of greater value in teething diarrhoeas than is generally supposed.   Pod., painful,
with grinding of teeth. This, of course, can only occur in
cases of the last teeth in the series.  Sulph., the discharges
are slimy for the most part, brown, green or white, and often
are marked with slight streaks of blood.
The above are only a few of the distinguishing symptoms
of these drugs, not given as a complete analysis, but only as
showing the mode in which distinctions are arrived at in
classes of cases where one of a class of similar remedies is to
be selected, by which that most unsatisfactory practice of
giving one remedy of a class, and, if not successful, another,
and so on through the series, may be avoided.
PREGNANCY is often attended with obstinate and sometimes
fatal diarrhceas.  For these cases we may find a remedy in
one of the following: Am. carb, Dulc., Hyos., Lye., Petr.,
Phos., Sep., Sulph. In these cases, in addition to the careful
observation of the elements of the diarrhcea, the constitutional symptoms are to be most rigidly studied, for these,
not unfrequently, are decisive of the choice of the remedy.
"Without a thorough knowledge of these, the prescriber must
often be quite in the dark as to his curative, and his patient,
consequently, in a very unsafe condition. These remarks are
equally true of the diarrhoeas which arise at
Lyma-IN.-For these we have Ant. crud., Dule., Hyos,
Rheum.    There may be cases requiring other drugs, but
these can hardly fail of being detected if the analysis and
comparison insisted on be faithfully carried out. The above
remedies are only named, because so frequently      called
for, that they may claim our first attention in cases where
the characteristics of other drugs are not prominent.  They
are never to be given merely because named here, or elsewhere, as possibly appropriate in this class of cases.
It may facilitate the treatment of diarrhceas to study




21
them in groups. Thus Ars., Chin. and Fer. have the closest
relationship.  In these Ars. occupies one extreme and Chin.
the other, Fer. falling between. In the element of pain,
Ars. has extreme severity, Fer. less, and Chin. less still. In
that of copiousness, with the exception of yellow watery, in
which Ars. represents the scanty, the same relation obtains.
It may be borne in mind that cases of an obstinate character
sometimes occur where those remedies act beneficially in
succession. Thus, in cases in which Fer. has followed Chin.
with benefit, but has not proved sufficient for a complete
cure, Ars., if at all appropriate, seldom fails to effect that
result.  Verat may be added to this group in the study of
watery diarrhceas, and in the elements of copiousness and
pain takes place next to Ars.
Another most important group is represented by Ars.,
Squill., Graph. and Nux vom., viz.:' the dark, fluid, offensive
and painful. In these elements the four remedies agree.
They differ however in so many of their symptoms that there
can be no serious difficulty in selecting the right for a given
one, if it be borne in mind that Ars. among these has the
most copious evacuations; Nux v. the least, and always
small. The pain of Ars. and Squill. is in the bowels, Ars.
the most severe; those of Nux v. and Graph. in both the
bowels and back, Nux the most severe, with this further
difference that the pain of Nux is higher, in the loins.
Graph in the sacral region.  With Nux the pain is drawing
and is relieved by the evacuation.   Graph. pressing and
continued after. It may not be amiss before leaving this
group to say that Nux vom. has been too much neglected in
the treatment of diarrhoeas.  The frequent successful use of
the drug in constipation may have so occupied the minds of
prescribers as to limit, in their apprehension, its usefulness to
cases of this sort. This is a great mistake or. misfortune. It
is scarcely less important as a remedy for diarrhoea. It has
been the specific in many epidemics, and at other times,
through whole seasons, it has been oftener called for and
successful than any other drug.




22


Ars., Gamboge, Jalap. and Senna in extremely painful
diarrhoeas. The characteristics of these remedies and their
distinctions, except Gamb. have been already noticed, and
it may be sufficient for this to say that it resembles Arsenic
more than either of the others, but with the evacuations of
Garmb. there is much disposition to tenesm8us, while with Ars.
there is less.
Ar., Lach., Merc. and Sulph. in purulent diarrhoeas.
Arn. has bloody and purulent discharges. Lach. has similar
evacuations, with gnawing, shooting, cutting pains, with hard
swelling of the abdomen, or with discharge of mucus and
scanty menses.   Sulph. a mixture of blood, mucus and pus.
Nux mos., Sec. corn., Verat, in cases, with comatose.lep. These three remedies are each characterized by profound and constant sleep. The kind of sleep is very similar
in the three, 'very quiet and undisturbed, but the conditions
out of which it grows are very different and not difficult of
distinction. With Nux mos. the symptom arises from exhaulntion of the brain power especially.  There is still sufficient to admit of the patient being aroused without great
difficulty, but not to sustain a continued attention to external
objects, the patient falls asleep again immediately, and continues to sleep till aroused by the attendants. The affection
is less profound than that of the other two remedies, and
generally less dangerous. Sec. corin. is opposed to Nux mos.
in this, that its coma seems to rest on a general exhausted
vital force, in which that of the brain participates, orof which.
its exhaustion is a part, all the organs being similarly
affected, the tendency being to a rapid extinction of life,
unless the downward progress be speedily arrested.   The
patient is roused with difficulty, and then immediately falls
off again, being wholly unable to give attention to external
objects for the shortest time. Verat is related to a condition
quite different from both, viz.: that which just precedes the
effusion of serum  into the* cavities of the brain  or the
early stage of effusion. In such cases Verat is often very
efficacious. If the patient be aroused he shows that he is




23
disturbed and complains.    Any interference is painful to
him, till he passes the point in insensibility at which he
ceases to regard the presence or acts of his attendants, and
beyond which all remedies are too likely to fail to relieve.
Aloes, Pod. and Rheum, as related to the class of feculent
diarrheas, have been already sufficiently treated of, though
it may be said of Aloes, in addition, that its evacuations are
often preceded by much rumbling and movement of flatus in
the bowels, flatulent distension and colic. Not unfrequently
these rumblings and movements are, after a night's sleep, first
manifested on the patients first stepping out of bed, in the
morning.    Or they are especially, at evening, and if the
flatus escapes, it is of the most offensive'odor.
It does not come within the plan of the present paper to
consider the diarrhceas which are at times concqmitants of
other more important affections, as    of Typhus, Fever,
Phthsis, &c., further than to reinark that an intelligent treatment of them involves, in addition to the,analysis of their
elements here inculcated, a careful study offthe characteristics
of the malady, in the elements of whlulh, alone, it often
happens, the clue can be found to th~ remedy for this as
well as the other symptoms. of the case.  This should never
be forgotten. It is a necessity in every case, perfectly apparent in the principle stated, that we treat patients, and not
diseases. Least of all can we isolate an element of a case,
and treat, that, and claim in such practice, the consideration
of scientific and able physicians.




DYSENTERY.
It is scarcely too much to say, that through the centuries
before the discovery of the homceopathic law, that which
passed for science, in the great business of curing the sick,
was little better than the imaginings of prominent men, who
by force, of their genius or circumstances, succeeded in
impressing their theories on the practice of their cotemporaries, to a controlling extent.  Each fancy in its turn,
giving place tb subsequent theories, after disappointment
and scrutiny had established the fallacy of its predecessors
This process wa continued through many centuries, no
one appearing ever to have suspected that imaginations,
however brilliant, could never become the foundations of a
true science. When Hahnemann suspected the existence of
a law of cure, he made an immense advance from the standpoint of his scientific professional cotemporaries, but when
he proved its existence, and stated it in explicit terms, he
was so tar beyond them on the pathway of scientific truth,
that, though before honored for learning, honesty, intelligence
and industry, he was to them henceforth only "as one who
dreamed."   That there should be such a law, was almost incredible; that it should be so simple, was incomprehensible;
that such simplicity should, in so few words and at once, displace forever the long  and labored series of ingenious
theories, which habit had accustomed them to respect and
trust, was impossible. Then there were a few, since increased to a multitude, who accepted the law with confidence,
practiced successfully on the principle it declares, and by




25
daily experiences lemonstrated to themselves its truth over
and over, till it remained with their most cherished convictions, and its discoverer was enshrined with those most
honored.   " Like cures like " became to them unquestioned law, has been so received by their successors, and as
such is presented to day by the whole homceopathic school,
to the confidence of the world, as the magic formula which
has opened up the way to possible cure to a multitude of
hitherto incurable chronic diseases, and deprived nearly the
whole train of acute of their tenors. We accept this formula, and having accepted it, propose to enquire what are
its precise teachings and requiremnents?
What* does it teach? That that which in the effects of
drugs on the living organism, is like to the phenomena of
natural diseases, enables these drugs to cure these diseases
by virtue of this similarity.  This is the principle contained
in the formula "like cures like."  What does this mean?
Twenty years ago, on the occasion of the first introduction of
the writer to that. friend who has done nmore by his teachings
and writings to advance the science of Homceopathy than
any other man in this country, the master put the question,
" What is like?"  This was evidently to his mind, then, the
-strongest argument against the truth of Homoeopathy, or at
least,. a question the most difficult for its friends to answer,
and he expressed the opinion that any successful opposition to
the homceopathic law must begin at this point. What is the
like which cures?   It was quite evident, at the time, that
even Hering had no answer to his own question. It was not
forgotten by the writer.  At first it seemed easy of answer,
but after years of unsuccessful puzzle, the difficulty was
confessed, and it was not till a hint from the same master, in
the introduction to his proving of Allium cepa threw light
upon the difficulty, that an answer became possible. He there
repeats his question, and replies " that which is characteristic." Here is the whole truth, plain enough. But it forces
another question, the answer to which lies at the foundation
of all intelligent success in practice.  What is charac



26


teristic?  This we propose now to attempt to answer and
to show that it is this which cures.
Hahnemann, in his Organon, third American edition, p.
102, says "the totality of the symptoms is the sole indication
in the choice of the remedies."  With this we have no difficulty, if by it be understood that the elements controling tle
choice are found among these symptoms, and no where else.
But this expression, " totality of the symptoms," has been,
taken in connection with the direction to seek in the pathogenesis of drugs their simillimium, a great hindrance to
many, and the cause of much useless labor on the part of
those who would conscientiously follow the directions of the
master.. These they have understood to require in the ascertained effects of the drug, a simillimum to the totality of
the symptoms of the disease. And in most cases, after long
search, they find, that for this they have sought in vain. It
was not to be found. If, perchance, they did succeed, the
cure certainly followed because the whole must have contained those elements which effect that result.  But this is
not the direction of Hahnemann, as is evident after reading
~ 153, p. 173 of Orgagno, where he gives instruction as to
those symptoms which are of controlling importance in the
choice of a remedy, and those which may be safely passed
with slight notice. We are not quite satisfied with the lines
of discrimination he here lays down.  Those to which we
are to attend " particularly and almost exclusively " are the
" striking, extraordinary and peculiar."  To these, except
the last, we cannot but somewhat object, as will be seen as
we proceed, and to illustrate these objections, we propose to.avail ourselves of the subject of Dysentery.
In Dysentery, what is the "like " which cures, and how.are we to find it? In other words, what are the characteristics, i. e., of the drug and the disease? It is obvious, at
the first glance, that there are two classes of these.  One,
ithe generic, which determines the case you have to treat as
belonging to the genus dysentery, belongs alike,to all the
members of the genus, and without which no case is dysen



27
tery. The other, the specific, that which distinguishes individual members of the genus from all other members.   It is
also obvious these two classes must play a very different
part in the discovery of the remedy for the cure.  Now in
relation to dysentery, what- are the generic characteristics?
Frequent, for the most part small discharges from the rectum,
of blood, or mucus, or of both, with colic pains, tenesmus and
fever.  These belong to every case and are essential to it as
dysentery. Is it for the simillimum of these we are to seek,
to find the prompt and safe cure, a compliance with the law
insures? If so, we are met at the outset with a singular difficulty in the wealth of material before us. There are in the
Materia Medica a large number of remedies, which present
equally these generic characteristics, and so like are they in
each, that the prescriber, if limiting his search to, these, will
be left, of necessity, to the bungling method of giving one
after another of these remedies, beginning with that which he
thinks likeliest to be the right, and proceeding to follow it
with others, if not, till the right is tiumbled on, if the
patient be not dead before he finds it.' Is this a compliance
with the requirements of the great law, and this the best
result it has to promise, to challenge our confidence, and
excite our hopes? If so, its importance is far less than some
have supposed, and the results of its observance are no great
advance on those realized before its discovery.
If the declaration that "like cures like " means to assure
us that the drug which produces symptoms like these generic
ones, will be found to cure the members of the class they
define, then I do not hesitate to say that the experience of
every homoeopathic practitioner is adequate to the conviction
of the declaration of falsehood. It is a lie and not a law. I
say the experience of every practitioner-for all have tried it,
and have been disappointed, again and again, by the failure,
which a right understanding of the law would have led
them to expect. But are not these the "striking" symptoms
of the case?  Certainly they are the most striking.   They
stand on the very surface, and are the first to arrest the




28


attention of the prescriber.  They are plain, discovered
without difficulty, unmistakable.  And because they are so,
are continually before his eyes, as the great facts with which
he has to do, making it not a little difficult to get beyond
them, to those which are the safer guides to successful practice.  They have led, and do still lead, multitudes through
the routine of remedies and disappointments which beginners
never escape, and into which it is only too easy for those who
are no longer beginners to fall. And hence the objection to
the word "striking " in the direction of the organon, as a
distinctive feature of the symptoms to which we are to be
"CC particularly and almost exclusively attentive." Can any
man tell by the examination of the blood, mucus, pain, tenesmus and fever, resulting from the taking of a drug, whether
that drug were Aloes, Arm., Caps., Nux vom. or Sulph.? If
not, how can he tell, when these result from natural disease,
whether they are more like the similar results of this or that
drug, of which each is so like all the others that they fail
of distinctions.  All attempts to do this, if serious, can
hardly be better than- a serious absurdity. Is there then a
law of cure in cases like these? If so whence did it originate, and for what purpose? If there be such a law, it must
have been instituted by the Creator of our race, when he
first called it into being, and the intention of it must have
been that it should serve as an instrument for the relief of
human suffering and danger. Would such a Being, in instituting such a law, have coupled with it the necessity of
perpetual blundering, which dependence on these generic
symptoms necessarily involves.
It is worthy of remark that there are in the pathogenesis
of all drugs a class of symptoms which in their relation to
the law of cure are very analogous to the generic symptoms of
disease. The allusion is to that class which is common to all
or a large class of drugs, and which rather indicate that the
organism revolts against drug assault, than point out the particular active agent in the assault. For the same reason that
generic symptoms of disease can rarely be availed of as




29


guides to the selection of a curative, these are of comparatively little value to the prescriber. The vomiting produced
by one irritant poison is so like that of every other, that from
this alone it cannot be told what that irritant is. So of the
diarrhoea, nausea, thirst, loss of appetite, headache, etc.
These of themselves can never be guides to a prescription,
though the elements associated with them may be. It is not
then to the generic symptoms of either drug or disease that
we are to direct our attention chiefly, in our search for the
"1 like " which cures. We have seen that their very nature
excludes them from the circle of curative relationship.
Where then are we to look for this?  Evidently in the list
of those symptoms which individzbalize both the disease and
the drug.  That which distinguishes the individual case of
disease to be treated, from other members of its class, is to,
find its resemblance among those effects of the drug which
distinguish it from other drugs. This is what we mean when
we talk of " characteristics" as the great reliance of intelligent practice, and assert that with these the law of cure has
chiefly to do. It is precisely in this relationship that the law
exists.  When we say " like cures like," this is the " like "
we mean. Thus understood, the phrase declares a law established at the creation of man, which will endure as long as.
his pains require relief.
With a case before us, declared by its generic symptoms
to be dysentery, how shall we proceed to this application?
After this ascertained fact, the uses of these symptoms to
the prescriber are nearly fulfilled.  He has now to pass
beyond these, and carefully examine and bring clearly out
those less obtrusive ones, which are often too likely to be
more or less masked by the violence of the group which presents itself to the first view, and seems to insist on his undivided attention.  He has to shut his ears and his eyes to the
outcries of his ~patient, the agitation of friends, and the frent
rank facts which pronounce his case a dysentery, and pass to
the discovery and consideration of those of the second rank,
often neglected, or judged of as insignificant, which declare




30


what kind of a dysentery it is with which he has to do. This
is his all-important work, for which there is no substitute, the
neglect of which can only plead as excuse, ignorance or indolence. If he will do his duty, he must do this. Having
brought these facts clearly to light, and in them exposed
the true character of his case, let him next seek their simillimum in the pathogenesis of whatever drug in which it may
be found, whether it has ever been prescribed for dystentery
before or not.  This is not of the slightest consequence. If
this simillimum be found, as very likely it will be, among
those facts which individualize the drug, which are characteristic of it, he need not be over solicitous to find in the same
drug, a repetition of the generic symptoms of his case, in all
their severity, for this is comparatively of little importance
to his cure.
If, with the generic symptoms of dysentery, there are
aggravation of the symptoms by acids; shooting and boring
pains in the region of the navel increased by pressure. The
lower part of the abdomen swollen and sensitive to pressure,
the distension and movements in the abdomen are more in
the left side and along the track of the colon, increased after
food; fainting whilst at stool; frequent stools of bloody
water; the tenesmus very violent; great repugnance to free
air, which notwithstanding ameliorates the sufferings; hunger during the stool; cutting and pinching pains in the
rectum and loins; heaviness, weariness and numbness in the
thighs, there need be no hesitation as to the remedy.  It is
Aloes.
With constant sense of fullness and satiety in the stomach,
with nausea; hard swelling in the right side of the abdomen,
with pain as if cutting into a wound, when touched, relieved
by escape of flatus; putrid and slimy taste and eructations; taste and eructations as of spoiled eggs; bitter and
sour eructations; loud rumbling in the bowels as if empty;
stools of blood and feces; bruised pain in the back; painfully
increased sensibility of the whole surface of the-body, perspiration smells sour; offensive flatulence, like bad eggs;




31


swallowing hindered by a sensation of nausea; repugnance
to animal food and broths; wishes to drink constantly, but
does not know what, all drinks are alike offensive; tenesmus
of the neck of the bladder; fruitless urgency to urinate;
putrid smell of the breath'; chill of the back and front of
thighs. It is Arnica.
If there be great thirst while the patient drinks but little
at a time; blueish tongue; stools smelling like old foul
ulcers; greenish urine; perspiration sticky; great restlessness, and tossing about the bed; pains relieved by external
heat; despair of life; sensation as if the abdomen would
burst, before the stool; sensation of contraction just above
the anus, at the stool; burning in the rectum and trembling
in all the limbs after the stool; heart beating and distension
of the abdomen, after the stool; tenesmus with burning in the
rectum and anus; face sunken, pale, and features distorted;
great exhaustion after each stool; petechial, milliary, and
nettle rash eruptions; cold dry skin alternates with cold
sweat; pain relieved after the evacuation, we can hardly fail
to recognize in each symptom the elements of distinction for
Arsenicum. These are some of its characteristics, which
may be found in any case of dysentery, none of which are
found so clear and strongly expressed in the pathogenesis of
any other drug.   Where these symptoms are present Ars.
will rarely fail to cure.
Belladonna is appropriate, especially in the early stage,
of those cases where the inflammation extends to the serous
tissues of the intestines, which is known by sensibility of the
abdomen to external pressure, the sense of soreness being
deep in the abdomen, while with Hyos. (Hyos. has both the
superficial and deep-seated soreness). Puls. and Sulph., it is
superficial. Bell. in this accords with Nux vom. and Yerat.
It is the morei certainly indicated where there is constant
pressing to the anus and genitals; the pains are more in the
left side, and are aggravated by bending the body to that
side; violent delirium; pains of a constricting character,
relieved by bending forward; painless inability to swallow;
sensation of dryness of the mouth while the tongue is moist.




32


Burning like fire in the anus, after the stool; dryness of
the lips and thirst during the pain; loss of epithelium on the
lips, tongue and palate; vesicles and canker in mouth and
throat, are significant of Cantharis.
Capsicum has thirst after every evacuation, and shuddering after drinking; stool after drinking; taste like putrid
water; tenesmus of the bladder; pains aggravated by currents of air, though warm; coldness of the body without
shuddering; drawing pains in the back which with the tenesmus are continued after the stool. It is a further indication
for Caps., if there be thin adhesive slime, mixed with black
blood, with twisting pains about the navel.  It is one of the
important remedies in dysentery, being in its relation to this
disease nearly allied to Nux v. and Mere.  The distinctions
between them will appear when we come to treat of those
remedies.
Colchicuzm has cramps in the calves of the legs; prolapsus
ani; constriction of the (Esaphagus; great swelling of lower
part of the abdomen; frequent shudderings down the back.
It is said to be curative when the stools are more mucus than
blood, and after sublimate has failed in such cases.
Colocynth may be examined where there are fruitless
efforts to vomit; weakness, paleness, and prostration after
the stool; burning pain along the sacral region; the pains
are cutting and squeezing and extremely severe, often accompanied by retching, and bending the body forward, and
are somewhat relieved by pressure; with the severe pain
there are shudderings on the cheeks, which seem to come
from the abdomen, with relief of the pain; the pains are
such as characterize neuralgic rather than inflammatory
affections, are relieved by Coffea, and the relief is followed
by immediate disposition to stool; cramps and cramp-like
contractions of the muscles of the body; cold hands with
warm feet. It will be found oftener called for in the first
stage of the attack.
Ourum~ metallicum may be considered if there be severe
retching with the stool; cramps in the fingers,and toes;




33


sweet, stringy saliva; paralytic sensation in arms and feet;
slimy mouth; sweet taste in the mouth; all food tastes like
clear water; hiccough; retching, with cramp-like pains in
the abdomen; downward pressure in the hypogastrium, like
a stone; distension of the lower part of the abdomen; hardness of the abdomen, with great sensibility to pressure;
severe cramps in the abdomen, and upper and lower extremities; comatose sleep after vomiting.
ALercurius has the following symptoms, which are not
unfrequently met in practical examinations of dysentery.
Excoriating discharges; cuttings in the lower part of the
abdomen, at night; the abdomen is externally cold to touch;
cutting stitch in the lower abdomen, from right to left and
aggravated by walking; fecal taste in the mouth; putrid
taste in the throat; salt saliva; nausea, with vertigo, obscured vision, and flashes of heat; offensive perspiration; the
pains are increased before the stool, and diaring the stool,
with violent tenesmus; the pains are rather increased than
diminished after the stool, and sometimes then extend to the
back; during the stool hot sweat on the forehead, which
soon becomes cold and sticky; dry cracked lips; drawing
pains in the lower extremities which impel to frequent
change of position.
MJercur. corr.-This very imperfectly proved remedy has
been much used by Homoeopathists in the treatment of
dysentery, and by many with a success which has been quite
satisfactory.  With others its use has been followed by frequent disappointment, and some have even failed of success
in every case in which it has been given. This last has been
the experience of the writei'. He has in no instance seen
relief to the pain, frequent discharges, or tenesmus, from its
administration, though he has given preparations of the drug
from different specimens and sources, in high, medium, and
low potencies, and in all stages of the disease.  This is
stated, notfto discredit the testimony of those whose experience is different, but as showing that its true use is not
known, and that something more than a similiarity to the




34


generic symptoms of the disease, which only are given in
the pathogenesis of the drug, is necessary to point this out.
In this pathogenesis, as found in our Materia Medica, specific
symptoms are almost entirely wanting; and wanting a
knowledge of these, its use must be uncertain. The following
symptoms derived from reported cases of poisoning by the
drug (Frank's 8Magazine, Vols. I, II, III) are given to supply'
this deficiency, as far as they go.
Cold face and hands, with small and feeble pulse; lips
dark red, and swollen; all the pains, but especially those of
the rectum, are aggravated by motion; pulse small, hard
and frequent; coma; cramps in arms, hands and fingers,
legs, feet and toes; faintings; weakness and shuddering in
the limbs; the limbs as if bruised and trembling; great
anxiety and palpitation of the heart; wandering shiverings;
sensation of coldness, pale face and slight nausea; coldness
of lower part of the abdomen; abdomen tense, hard, and
sensitive to pressure, especially about the navel; obstinate
sleeplessness; dysphagia; astringent, metallic taste in the
mouth; great prostration; great prostration after the vomiting of food; hiccough; frequent eructations; painful pinchings in the stomach; spasmodic, watery vomiting, without
previous nausea; severe shooting pains in the stomach and
liver, with vomiting of bile; drinks are immediately vomited,
with great effort, mixed with tenacious, stringy mucus; severe
pains ia the rectum, which continue alter the discharges;
the fruitless urgency to stool increases the pains; pain
extends from the navel to the back; distension of the abdomen with borborygmus; evacuations very offensive; suppression of the secretion of urine; retention Qf urine.
The following from the practice of my friend and colleague,
Dr. Carroll Dunham, is valuable as illustrative of the importance of Merc. corr. in cases with urinary complication, and
seems to throw light on the question of the classof cases to
which it specifically belongs.
SDuring a practice of several years in which dysentery
was not unfrequletly met withx, and often in severe forms, I




35


never prescribed Mercurius corr. in a single case, nor do I
Srecollect a single case in which I think it could have been
given with advantage or with the result of expediting the
cure at all. With Mere. sol., Nux vom., Colocynth, Capsicum, Sulphur, and Lachesis I have always succeeded, as it
appeared to me, in curing as rapidly as was possible. And
observations of cases under the treatment of my colleagues,
some of whom gave Mere. corr. and Coloc. as a standard prescription for Dysentery, satisfied me that the rapidity and
ratio of my cures were at the very least as satisfactory
as theirs.
During the summer of 1861, however, two cases came
under my treatment which presented certain features heretofore unobserved by me, and in which none of the remedies
above named was clearly indicated and none did any good,
but which both yielded most promptly to Mere. corr.
The first was a widow of 25 years, who had just lost her
only child of Typhoid fever. When I wascalled to her, she
lay in bed, with constant heat of skinr`quick, rather small
pulse, tongue dry with a yellow coat, thirst not excessive,
abdomen sore on pressure, somewhat distended; constant
uninterrupted pressure to stool felt in the sacral and the
hypogastric regions.  This pressure though very distressing
to the patient seemed utterly ineffectual, so far as the eeacutions of the bowels was concerned -it was not worse before a
stool and no better after a stool-the stool consisted of
bloody slime in small masses. There was great tenesmus
vesicae, and the urine was scanty, hot and bloody. The disposition was quiet, slightly desponding-little disposition to
sleep--on the whole the suffering which was evidently severe
was endured with much patience, and this was a decided
contra-indicatibn for Arsenic, between which and Mere. sol.
my choice was at first divided. The general symptoms certainly did not correspond with the characteristics of Arsenicum. The character of the thirst, the absence of great restlessness, of nocturnal aggravation, of a paroxysmal character,
of prostration greatly out of proportion to the severity of the




36


symptoms, all contra-indicated Arsenicum. Mercurius sol.
has pains of a paroxysmal character.  It lacks the constant
tenesmus and the tenesmus vesicae. I gave it however and
in various potencies, but it exercised no influence on the
disease. Belladonna, Colocynth, and finally Arsenic, were of
no avail. Indeed I had given them without confidence of a
favorable result, for it was evident they were not indicated.
Remembering now Hahnemann's remarks in the introduction to the proving of Mere. sol.*': " I have found a very
small part of a drop of the quintillionth, or still better of the
decillionth potency of Mere, corr. given alone in a single dose,
almost a specific cure in the ordinary Autumnal Dysen tery."
I turned to the few symptoms of Mercurius corrosive, which
I-Iahnemann gives in the same volume of the Materia Medica
Pura, and found among others which corresponded to the case
in hand, the following symptoms:
24. With almost constant cutting pains in the abdomen
and intolerable, painful, almost ineffectual, pressing, straining and tenesmus, frequent scanty discharge of bloody slime,
day and night.
17. Immediately after stool, pressing downwards in the
front of the abdomen, below the umbilicus.
28. Tenesmus vesicae.
I concluded to give Mere. corr. and remembering Hahnemann's injunction that those who follow his directions in the
hope of gaining results like his, should follow them accutrately
(" Machen sie nach, machen sie aber, richtig nach "-I gave
one single dose, namely, two small globules,) of the thirtieth
potency of Mere. corr. at eight, p.m., and awaited the result.
This was in every way so satisfactory that I gave the patient
no more medicine at all.  She was clearly convalescent on
the following day having no more of the characteristic pains
and stools of dysentery, no more fever and being able to
begin to take nourishing food.  After two days of pure
expectant observation I was able to dismiss her cured.


* Materia Medica Pura, Vol. I, p. 355, German edition.




37


The second case which presented itself to me within the
same month was similar in all respects, though much less
severe as regards intensity. I gave Merc. corr.'" as before in
a single dose, and the patient was convalescent the next day.
Since this period 1 have treated about twenty-eight cases
of well marked Dysentery, but have had no difficulty in
curing them with Nux vom., Mere. sol. or Coloc., and have
seen no similarity in them to those in which Mere. corr. had
been so very successful."
Since the above was written an exception to the stated
want of success with this remedy in the treatment of Dysentery has occurred in the practice of the writer, in which suppression of urine with tenesmnus of the bladder were prominent symptoms. The case was promptly relieved.
Nux om., evacuations small, frequent, with violent tenesmus; pressing pains in the loins and upper part of the sacral
region, with sensation as if broken; great heat and thirst,
with redness of the face. The importance of this remedy
in the treatment, of dysentery is hardly second to that of
any other.   In this latitude the proportion of occurring
cases to which it is appropriate is very great, and in these
it is all but absolutely specific, though utterly powerless
for good in others.  It is not because it is dysentery, let it
never be forgotten, that it cures, but because of that "like"
to the individualizing symptoms of the case, by virtue of
which it and all other drugs cure. The great resemblance of
some of the most prominent of these to those of one or two
other of the most important remedies in the treatment of this
disease, may render a word or two on the distinctions of
them not altogether useless. The allusion is especially to the
symptoms of Caps. and Merc.    These with Nux vom. constitute a group of the first importance, but the symptoms of
each are very like to those of the others; so like that without careful attention thers will always be a liability to the
mistake which results in giving the members of a group successively, the hope being that the right will be hit upon at
last.  If care on the part of the practitioner can avoid this,




38


he should be held responsible for its exercise, by the protracted torture of the patient which is necessarily its attendant, and by his increased danger, consequent on the administration of wrong drugs in the early stage of the case, which
must always embarrass the subsequent treatment, and render
a cure more difficult even by the administration of those
which are right.
These drugs are alike in the character of their discharges,
the quantity being small at each evacuation.     Mere., at
times, making the only exception.   The discharges of each
are preceded by similar severe pains, which are continued
through the period of the evacuation.     In all they are
attended by severe tenesmus. In all they recur at short
intervals, with pains extending to the back. The distinctions
are these: with Nux vom. the pains and tenesmus cease with
the evacuation; while those of Caps. and Mere. are continued after.  The pains of Nux vom. in the back are pressing, as if broken, and like a bruise; of Caps., drawing;
Mere., like a bruise. With a recollection of these facts, and
careful attention to the symptoms given under the separate
heads of each of these remedies, there need be no confusion
or mistake in prescribing them, on account of their resemblances.
Plumbum    has great violence of tenesmus; frequent and
almost fruitless efforts to stool; cutting pains, with violent
outcries; retraction of the abdomen; constriction and retraction of the anus.
S Phosphorus may be appropriate if there be paralytic relaxation of sphincter ani; and relief of pain from taking food.
Pulsatilla belongs rather to dysenteric diarrhoeas than to
real dysentery but may be appropriate with slimy evacuations, slight tenesmus, and nocturnal aggravations.
Rhus tox. This remedy is rarely called for in the early
stage of the disease, but is often valuable in the later, especially when there are nocturnal exacerbations; and also in the
diarrhoeas which sometimes follow dysentery.   The case is
marked for Rhus if there be constant tenesmus and urging to




39
stool, with nausea, and the passing of but little bloody water.
It is appropriate also in the last stage of dysentery with nocturnal exacerbation.
Sulphur.-Spasmodic, constricting pains, extending to the
chest, groins and genitals; cutting pains while urging at
stool, from pressure on the abdomen, or bending the body
backwards; prolapsus ani at stool; cuttings in the abdomen,
lower part of the loins and upper part of the sacrum, after
midnight; pains relieved by the application of dry heat to
the abdomen; the blood in the stool is in streaks. Sulph.
is especially appropriate in attacks attended with difficult
breathing at the outset, and also. in those of hnemorrhoidal
subjects.  It is seldom in place at the commencement of an
attack, but in the later stages is often of great value, and
some times indispensable; especially in such cases as are
threatening ulceration of the mucous membrane of the intestines. Where this great evil has actually occurred, Sulph. is
still one of our chief reliances for a cure, and in this is related
to Am., Ars., Lach. and Merc. A right selection from these
for a given case is only certain after a careful consideration
of their individualizing symptoms, and a like careful comparison of them with those of the case.
We have endeavored to present in the foregoing groups of
symptoms, those in connection with each medicine, which
individ-ialize that medicine in its relation to our subject, and
are, consequently, those which decide the choice of the
remedy in the treatment of cases which present similar
symptoms. We have presented this group of medicines not
as the entire series of those from which the prescriber may
have to seek the required simillimum, but as a group by
which the proper method of proceeding in this search might
be the most readily illustrated.  We state this method to
require, first, a proper distinction between those symptoms of
the disease which are generic, and those which are specific;
and also to make the same distinction in the recorded symptoms of the drug; and, second, to find in the specific symptoms of each, that similarity on which the law of cure is




40


based; and we add to this, that till these distinctions and
this comparison are made, no man can tell what is remedy
is to be in any ease, and further, that these distinctions and
this comparison are a necessary part of every intelligent
homoeopathic prescription, whether for dysentery, or for
whatever other disease. They underlie the whole of Homceopathy as a system of practical medicine. That knowledge of
diseases and of the Materia Medica which enables the physician to make these clearly, is indispensable to his best
success, and is just that' acquisition which raises the physician above the level of the blunderer.
If this exposition of the law of cure be a truth, it lays
bare the whole doctrine of specifics, and exposes clearly the
absurdity of the idea of a specific remedy for a generic disease. It demonstrates the fact that specifics can only exist
for individual cases, and that the true object of each intelligent prescription is to find the specific for the individual
case, according to this law.  That Quinine can never be a
specific for ague, or sublimate for dysentery, but are only
specifics for those cases, in each class, to which their similar
specific symptoms render them appropriate remedies.
It may not be amiss to note- the complete individuality of
the groups of symptoms, here presented, in connection with
the different drugs. There is, with many of them, no resemblance to the others, and where there is an apparent similarity, it is immediately resolved into distinctive elements by
the searching analysis a true prescription requires..;.
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